Trimarmeeya Chikitsa – Charaka Chikitsa 26th Chapter

26th chapter of Charaka Samhita Chikitsa Sthana, called Trimarmeeya Chikitsa deals with the treatment of diseases afflicting urinary system, heart and brain. Treatment of Afflictions of Three Vital Organ
We shall now explore the chapter on the treatment of the Afflictions of the 3 Vital Organs Marmas. Thus, said Lord Atreya. [1-2]

Prologue

While enumerating different organs and their parts in the body in chapter- 7 (Sharira Sthana), Vital organs are described to be 107 in number (vide Charaka Shareeera Sthana 7/14) of these, according to the experts in the field, 3 vital organs, viz, –
Basti – Urinary bladder
Hrudaya – Heart and
Shira – Head
These three are the most important because they are the seats of Prana (elan vitae / vital force.)
Their afflication by Vata, etc., endangers life thus, the methods of protecting these vital organs from the attacks of diseases, and treatment of the diseases already manifested in them will be described. Listen. [3-4]

Udavarta – Bloating

Etiology and pathogenesis of Udavarta:
Because of the intake of
Kashaya (Astringent), Tikta (bitter), Ushna (pungent) and Ruksha (ununctuous food), and
Sandharana – suppression of natural urges,
Abhojana – skipping food, excessive fasting,
Maithuna – excess sexual intercourse, The Apana Vata gets aggravated in the colon. It obstructs the downward moving channels [like anus and urinary passage] as a result of which the movement of stool, urine and flatus gets gradually obstructed, giving rise to Udavarta (upward movement of the wind in the abdomen) which is a serious ailment. [5- 2/4 6]

Signs and symptoms

The signs and symptoms of Udavarta are as follows:
Vit Maruta Mutra Sangha – obstruction to gas, feces (constipation) and Urine (dysurea)
Basti,Hrut, kukshi Udara ruk- Frequent pain in the region of urinary bladder, heart, pelvis and abdomen
Prushta, Parshveshu atidaruna – Excruciating pain in the back side of the chest
Aadhmana (Flatulence), Hrullasa (nausea),
Vikartika (griping pain, cutting type of pain),
Toda (Pricking pain), Vipaka (indigestion) and
Basthi shotha (inflammation of the urinary bladder)
Movement of flatus upwards because of obstruction in the anus
Ejaculation of semen with difficulty and after a long time and
Dryness and coldness of the body
As a result of Udavarta, the serious diseases manifested are
Jwara – fever
Mutrakruchra – difficulty in passing urine
Pravahika – dysentery
Hrud roga – cardiac ailments
Grahani – sprue syndrome
Chardi – vomiting
Aandhya – blindness
Badhirya – deafness
Shiro abhitapa – burning sensation in the head
Vatodara – affliction of abdomen by Vata
Asthila – Tumours
Mano vikara – Psychic version
Trshna – morbid thirst
Rakta pitta – an ailment characterized by bleeding from different parts of the body
Aruchi – anorexia
Gulma – phantom tumor
Kasa – cough
Shwasa – Asthma
Pratishyaya – chronic cold
Ardita – facial paralysis
Parshva diseases in the sides of the chest, and
Anya roga – such other serious diseases caused by the aggravation of Vata.
Agnivesha! You may listen to the treatment of these ailments which will be described hereafter [6 2/4 – 10]

Line of treatment

Udavarta Chikitsa Sutra: Line of treatment of Udavarta:
The Patient suffering from Udavarta is given massage with oil described for the treatment of Sheeta Jwara (fever with coldness in the exterior of the body).
Thereafter, Swedana – sweating therapy is administered for the detachment of the adhered Doshas in the tissue cells. This is followed by the administration of Varti suppository, Niruha type of medicated enema, and unctuous type of purgative. The patient is given food which in the downward movement of Vata [11]

Varti – Suppository

A suppository having the thickness of the thumb is prepared with the following recipes:
1 part of
Syama Trivrt – Operculina turpethum,
Magadhika – Piper longum and
Danti – Baliospermum montanum all taken together, 10 parts of Masha made to a paste by Triturating cow’s urine, 1 part of Neelika, and 2 parts of salt by adding jaggery in sufficient quantity
Pinyaka, Sauvarcala, Hingu, Sarshapa – Mustard, Sunthi – Ginger, Pippali – Piper longum, Maricha – Black pepper fruit – piper nigrum and Yava Ksara by adding jaggery.
Krimighna – Vidanga,
Kampillaka, Shankini – Canscora decussata, latex of Sudha (snuhi) and Arka – Calotropis gigantea by adding Jaggery and
Pippali – Long pepper fruit – Piper longum, Sarshapa – mustard, Radha, Madana- phala – Randia dumetorum and house soot by adding cow’s urine and jaggery
The above mentioned types of suppository are inserted into the oleated anus of the patient for the downward movement of wind and cure of the retention of stool, flatus and urine [caused by Udavarta or upward movement of wind in the abdomen. [12 – ½ 14]

Pradhamana (Insufflation)

Anal orifice is applied with ghee or oil. A tube is inserted into it, and through this, the powder of the following recipes is used for Pradhamana (insufflation):
Syama phala (Madana-phala – Randia dumetorum), Alabu and pippali – Piper longum or
Raksoghna (sarsaa), Tumbi – Curcurbita lagrenaria, karahata – Gardenia turgida,Madana- Phala – Randia dumetorum, krsna pippali – Piper longum, jimutaka – Luffa echinata and rock- salt.
These insufflations cause downward movement or voiding of the obstructed stool, flatus and urine. [14 ½ – 15]

Niruha Basti

If the above mentioned suppositories and Pradhamana therapies fail to produce the desired result, then the patient is given Snehana, Swedana followed by Basti. For the preparation of this enema,
sour herbs and salt along with oil is used if Vata is aggravated in excess;
milk is used if Pitta is aggravated; and
cow’s urine is used if Kapha is aggravated.
This Niruha Basti immediately relieves the retention of urine, stool and flatus and promotes the normal functioning of the rectum as well as connected vessels. [16- 17]

Diet

Diet for Udavarta – bloating with constipation
The patient suffering from Udavarta should take barley, as food along with the following:
Vegetable preparations made out of the aquatic animals, and Snuhi – Euphorbia neriifolia, Tila – Sesame etc.
Soup of the meat of domesticated and aquatic animals, and animals inhabiting marshy land
Such other ingredients which induce voiding of flatus, urine and stool and
Prasanna (clear top portion of alcohol) and Sidhu (type of line prepared of Jaggery) [18]

Purgation and Anuvasana Basti

If Udavarta continues to exist despite Niruha Basti, then the patient is given Virechana along with cow’s urine, Prasanna (clear to portion of alcohol), DadhiManda (upper liquid portion of curd) and Sukta (vinegar).
If even after relief from Udavarta, the retention of flatus and stool continues because of dryness, then the patient is given Anuvasana Basti (oil / fat enema) [19]

Dviruttara Hingvadi Churna

The recipe in order contains
1 part Hingu – Asa foetida
2 Parts Vacha – Acorus calamus Linn.
4 parts Agni or Chitraka – Leadword – Plumbago zeylanica,
8 parts Kushta – Saussurea lappa
16 parts Sauvarchala or Svarjika – Ksara and
32 parts Vidanga – Embelia ribes is given along with Luke warm water.
Cures
Anaha – tymphanitis
Visucika – Choloric diarrhea
Hrid roga – heart diseases
Gulma – Phantom tumor and
Urdhva Samirana or Udavarta – upward movement of wind [20]

Vachadi Churna

The recipe containing
Vacha – Acorus calamus Linn.
Abhaya – Terminalia chebula
Chitraka – Plumbago zeylanica
Yava Kshara
Pippali – Piper longum
Ativisa – Aconitum heterophyllum and
Kushta – Saussurea lappa is taken with hot water which instantaneously
Cures
Anaha – Constipation and
Vimudha- Vata (arrest of the movement of Vata Dosha in the abdomen)
The patient, while using this recipe should take along with meat- soup. [21]

Hingvadi Churna

Intake of recipe containing
1 part Hingu – Asa foetida
2 parts Ugra- gandha or Ajamoda – Ajowan fruit – Trachyspermum roxburghianum,
3 parts Bida type of salt
4 parts Sunthi – Ginger
5 parts Ajaji – Nigella sativa
7 parts Pushkara mula – Inula racemosa and
8 parts Kushta – Saussurea lappa
Cures
Plihodara – Splenomegaly
Vipaka – indigestion and
Visucika – Choloric diarrhea [22]

Sthiradi Ghrita

1 Prastha of ghee is cooked by adding the decoction of 2 Palas each of
Shalaparni
Prishnaparni – Uraria picta
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum
Gokshura – Tribulus terrestris
Punarnava – Boerhavia diffusa
Samaka (aragvadha) – Cassia fistula and
Puti-karanja – Holoptelea integrifolia
Intake of this medicated ghee cures
Pratiruddha- vata obstruction of the movement of flatus [23]

Medicine for Virechana

Fruits and Roots described in the group of purgative drugs [in Sutra 1: 77-85]
Hingu – Asa foetida,
Root of Arka – Calotropis gigantea,
Bilva – Aegle marmelos
Syonaka – Orchis mascula
Gambhari – Gmelina arborea
Patali – Ficus microcarpa
Ganikarika
Shala Parni
Prishniparni
Brhati – Solanum indicum
Kantakari – Solanum xanthocarpum
Goksura – Tribulus terrestris
Snuhi – Euphobia neerifolia
Chitraka – Leadword – Plumbago zeylanica and
Punarnava – Boerhavia diffusa is taken in equal quantities.
To this, equal quantity of Pancha lavana (5 types of salt) is added, and made to a coarse powder.
This powder is further triturated by adding fat and Go mutra (cow’s urine), and kept inside to earthen saucers having their joints sealed properly [with mud-smeared cloth]. This is then placed over fire. After it is cooked properly, the powder is removed from inside the earthen saucers, and triturated further.
This saline powder is taken along with food and drinks, this cures Anaha (constipation) and pain in the abdomen. [24-25]

Vamana, Virechana

Vamana – Emetic Therapy for Anaha:
Anaha (constipation with bloating) caused by Ama (product of improper digestion), and associated with Hrut stambha (stiffness in the chest), Shiro roga (diseases of the head) Gaurava (heaviness) is treated with Chardana (emesis), Langhana (fasting therapy) and pachana (carminatives) [26]

Use of Castrol Oil for Virechana
If the course of Vata Dosha is obstructed by fat, Kapha, Pitta or Rakta (vitiated blood) in the diseases like
Gulma – phantom tumor
Udara – obstinate abdominal diseases including ascites
Bradhna – Inguinal swelling
Arsha – piles
Pliha – splenic enlargement
Udavarta – upward movement of wind in the abdomen
Yoni Roga – diseases of the female genital tract
Shukra gada – Seminal disorders
Affliction of fat by the vitiated Kapha
Gambhira vata rakta – Deep seated Vata- Rakta (gout)
Gridhrasi – Sciatica
Pakshavadha – Hemiplegia, etc., and in such other Vatika diseases which are curable by Virechana (purgation therapy), castor oil is an excellent remedy.
It is added with such other ingredients that are conducive to the treatment of the aggravated Vata Dosha, and administered along with milk, meat soup, Triphala Kashaya, vegetable soup, cow’s urine, alcoholic drink, etc.
Because of its Vata Dosha- alleviating nature, because of the addition of other appropriate drugs, and because of its purgative effects, it cures Vatika diseases associated with the vitiated fat, blood, Pitta and Kapha.
Dosage of castor oil: Up to 5 Palas depending upon the Bala (strength of the patient), the condition of Kostha (thoracic and abdominal viscera), and the nature of the disease, castor oil is administered in the dose
If the patient is of Mrdu- Kostha (laxed bowel) and is weak, then castor oil is given to him along with food.
Thus, ends the treatment of Udavarta (upward movement of wind). [27-31]
Read more about castor oil benefits and usage

Mutra Kricchra – dysuria

Causes

Causes of Mutra-Krcchra (Dysuria):
Mutrakricchra or dysuria in human beings is of 7 types and these are caused by the following:
Vyayama – Exercise in excess of one’s on capacity
Intake of medicaments having Tikshna (sharp) attributes, and Ruksha (ununctuous) ingredients in excess.
Madya sevana – Habitual intake of alcohol
Prushta yanat – Regularly riding over the back of the fast moving animals
Intake of the meat of animals inhabiting marsh land (Anupa mamsa) and Matsya (fish) in excess.
Adhyashana – Intake of food before the previous meal is digested and
Ajirnat -Indigestion (chronic) [32]
Dysuria: Causes, Remedies, Tips, Diet, Ayurvedic Treatment

Samprapti

Samprapti or pathogenesis of Dysuria:
When, being provoked by their vitiating factors, the 3 Doshas and Malas either individually or jointly get aggravated in the urinary passage, then this gives rise to Mutrakrichra (dysuria). [33]

Signs and symptoms

Signs and Symptoms of Mutrakrichra – Dysuria Caused by Vata Dosha etc:
If dysuria is caused by the aggravated Vata, then the signs and symptoms manifested are as follows:
Teevra ruja in Vankshana, Basti, medhra – Excruciating pain in the groins, region of the urinary badder and genitals and
Muhur muhu mutra visarjana – The patient passes urine very frequently in small quantities
If dysuria is caused by the aggravated Pitta, then the signs and symptoms manifested are as follows:
Pitam mutram – The color of the urine is yellow
Sa rakta mutram – Blood comes out along with urine
Sa rujam sa daham – Micturation is associated with pain and burning sensation and
Krcchram muhur mutram – The patient passes urine very frequently with difficulty.
If dysuria is caused by the aggravated Kapha, then the signs and symptoms manifested are as follows:
Basthi Sa linga gurutva sotha – Heaviness and oedema in the urinary bladder and phallus; and
Sa piccham kapha mutram – The urine is associated with slimy material.
If all the Doshas are aggravated to cause Sannipatika type of Dysuria, then all the signs and symptoms described above in respect of all the Doshas are manifested. This Sannipatika type of Dysuria is very difficult of cure. [34-35]

Pathogenesis

Dysuria Caused by Urinary Calculus Ashmari
Pathogenesis:
When the aggravated Vata dries up the semen, urine, Pitta and Kapha located in the urinary bladder, gradually the stones are formed out of this as Gorochana (gall stone) in bile inside the Gall- Bladder of cattle. [36]

Signs and Symptoms of Urinary Calculus:
The Vataja Ashmari – calculus appears like the flowers of Kadamba – Anthocephalus indicus, and is Triputi (having 3 layers);
Paittika type of calculus is like a stone and smooth; and
Kaphaja as well as Shukraja type of calulus is soft.
If these calculi come into the urinary passage, they cause obstruction of the urine as a result of which there is Basthi shoola (pain in the urinary bladder), Perineum (Sevani [suture] below the pudendum and between to testicles), Phallus and hypogastric region over the urinary bladder.
The stream of the urine flow gets split. Because of pain, the patient squeezes the phallus and frequently voids stool and urine. If, in this process, the urinary passage or bladder gets injured by the calculus, then he passes urine mixed with blood when the calculus passes out, the urine comes out easily. [37- ½ 39]
Read related: Kidney Stones- Urinary Calculi- Ayurveda Remedies, Treatment In Detail

Dysuria Caused by Sharkara (Greaveluria – urinary gravels):
If the above mentioned calculus gets broken into small particles because of aggravated Vayu, then these sand particles come out through the urinary tract along with the urine. [39 2/4]

Dysuria Caused by Semen:
If dysuria occurs in a person because of the affliction by the obstruction of semen, then the patient suffers from
Vankshana basti medhre ati shoolam – pain in the groin, urinary bladder and phallus
Vrshana ativrtte – his testicles become enlarged and painful
Since the urinary flow is obstructed by semen, he passes urine with difficulty. This condition is called Anda-stambha or the stiffness of the testicles. The dysuria, thus, manifested is considered to be caused by the seminal obstruction. [41-42]

Dysuria caused by Vitiated Semen:
Malas aggravated Vayu, Pitta and Kapha individually or all taken together located in the urinary bladder obstruct the passage of semen.
Because of this seminal obstruction, there is pain in the phallus and urinary bladder along with obstruction to the voiding of urine and ejaculation of semen.
Subsequently this leads to
Stabdha – stiffness,
Shuna – swelling,
Bhrsha vedana – excessive pain and
Toda – pricking pain in the region of urinary bladder and testicles. [42- ½ 43]

Dysuria caused by Kshata (Vitiated Blood):
If the blood located in the urinary bladder get vitiated by Ksata (trauma) or by Kshaya (emaciation caused by excessive seminal discharge), it causes obstruction and excruciating pain in the urinary bladder, in association with urine, leads to the formation of calculus which causes abdominal distension and heaviness in the region of the urinary bladder. Thus, ends the diagnosis of dysuria [43 2/4 – 44]

Vataja mutrakrichra

Treatment of Vatika Mutrakrichra:
To the patient suffering from Vatika type of Mootrakrichra, Massage, oleation, Niruha type of medicated enema, Anuvasana type of medicated enema, Upanaha application of hot ointment). Uttara- Basti (urethra and vaginal douche), affusion and soup prepared of drugs like those belonging to Sthiradi or Ksudra-panca- Mula group (viz, Shala- parni, Prishnaparni, Brihati – Solanum indicum, Kantakari – Solanum xanthocarpum and Goksura – Tribulus terrestris) is administered.
Oil, fat of bear, and ghee is cooked by adding the decoction and paste of
Punarnava – Boerhavia diffusa,
Eranda – Ricinus communis,
Shatavari – Asparagus racemosus,
Pattura
Vrushceera
Bala – Sida cordifolia,
Pashanabheda – Cyclea peltata
Dashamoola (bilva, Syonaka, Gambhari,, Patala, ganikarika, ShalaParni, Prsniparni, Brihati, Kantakari and Goksura),
Kulattha – horse gram
Kola – Zizyphus jujuba and
Yava – Barley along with
5 types of Salt.
Intake of these medicated oil, etc., in appropriate dose, subdues the Vatika type of Dysuria associated with pain, instantaneously. The above mentioned drugs and such others having similar properties may also be used in the form of Upanaha (hot poultice) which is very useful in Vatika type of Dysuria.
Intake of oil-seeds like Tila – Sesame (Sesamum indicum), Uma – Linum usitatissimum and Asphota – Jasminum angustifolium along with fat and sour thing in luke-warm form is also useful in this condition Vatika type of Dysuria. [42-48]

Pittaja mutrakrichra

Treatment of Paittika Mutrakrichra:
To the patient suffering from Paittika type of dysuria,
Seka – cold affusion,
Avagaha – cold bath,
Shishira Pradeha – application of cooling unguentum, regimens prescribed for summer season, medicated enema, medicated milk and purgation therapy prepared of the juice of Draksha – Vitis vinfera,Vidari (Ipomoea paniculata / Pueraria tuberosa), and Sugar-cane solution, and ghee is administered.
The cold decoction of Shatavari –Asparagus racemosus, Kasa – Saccharum spontaneum, Kusha (Desmostachya bipinnata), Svadamstra – Tribulus terrestris, Vidari – Pueraria tuberosa, Shali – rice, Ikshu—Sugarcane and Kaseruka (Scripus grossus), mixed with honey and sugar is administered to the patient suffering from Paittika type of dysuria.
The decoctions of Kamala and Utpala (Nymphaea alba) or Srngataka – Tectona grandis or Vidari (Ipomoea paniculata / Pueraria tuberosa) or the root of Dandairaka (Hogaa) along with hone and sugar are useful in Paittika type of dysuria. Simple cold water mixed with honey and sugar is also useful in this type of dysuria. [49- 51]

Medicines for Paittika Mutrakrichra:
The patient should drink the potion prepared of the seeds of Ervaru – Cucumis melo, Trapusa – Cucumis sativus and Kusumbha – Carthamus tinctorius mixed with the Kunkuma and Vasa along with Grape juice it is exceedingly beneficial for Ashmari (urinary Calculus), Sarkara (Graveluria) and all types of dysuria.
In Paittika dysuria, the patient should take the potion prepared of the seeds of Ervaru – Cucumis melo, Madhuka– Licorice and Devadaru (Cedrus deodara) along with Tandulodaka (water used for washing rice).
Similarly, Daruharidra along with the juice of Amalaki – Phyllanthus emblica mixed with honey is useful in curing Paittika type of Dysuria. [52-53]

Kaphaja mutrakrichra

Treatment of Kaphaja Mutrakrichra:
For Kaphaja type of Dysuria, following types of therapies are useful:
Medicines, food and drinks containing Alkalis, hot and Sharp (Tikshna) ingredients
Fomentation therapies
Barley
Vamana – Emetic therapy
Niruha Basti (decoction enema)
Butter-milk
Massage with medicated oil prepared by cooking with bitter drugs and
Pana (oral intake) of the above mentioned medicated oil
The following recipes are useful in Kaphaja type of dysuria
One Kola (6 grams) of each of Sunthi – Ginger, Pipalli – Piper longum, Maricha – Black pepper, Svadamstra – Tribulus terrestris, Truti (cardamom) and bone of Sarasa to be taken along with honey and cow’s urine.
Truti (ela) mixed with honey along with the juice of Kadali or Kaidarya Maha- Nimba – Neem Azadirachta indica) or Parvata- Nimba – Neem Azadirachta indica))
Seeds of Sitivaraka (Salinca) along with buttermilk
Powder of Pravala (coral) along with Tandulodaka (water used for rice washing)
The decoction of Saptacchada, Aragvadha, Kebuka, Ela – cardamom), Dhava – Anogeissus latifolia, Karanja – Pongamia pinnata, Kutaja – Connessi Holarrhena antidysenterica Wall.) and guduchi – Tinospora cordifolia along with honey and
Yavagu (gruel) prepared of the above mentioned decoction. [54-57]

Sannipataja mutrakrichra

Treatment of Sannipatika Dysuria
If the dysuria is caused by Sannipata all the 3 Doshas simultaneously aggravated in equal proportion), then the physician, after proper examination, should, first of all, administer therapies for correcting the location of the aggravated Vayu [and thereafter, of the remaining Doshas].
In this Sannipatika type of Dysuria, the treatment is as follows:
Kapha aggravation – Vamana
Pitta aggravation – Virechana
Vata Aggravation – Basti

Mutrakrichra due to ashmari, sharkara treatment

Treatment of Dysuria Caused by Calculus (Ashmari) and Gravels (Sharkara)
If dysuria (MutraKrichra) is caused by Calculus (Ashmari) or gravels (Sarkara), then the therapies suggested for Kaphaja and Vatika types of Dysuria are beneficial.
Now, listen to the effective therapies to be administered specifically for the Bhedana (breaking or dissolution) and Patana (expulsion) of Ashmari are being described hereafter:
Pashanabhedadi –Kvatha: Intake of the powder of
Pashana- Bheda – Cyclea peltata,
Vasa – Adhathoda vasica,
Svadamstra – Tribulus terrestris,
Patha – Cissampelos parrieira,
Abhaya – Terminalia chebula,
Sunthi – Ginger,
Pippali – Long pepper fruit
Maricha – Black pepper fruit,
Shati – Hedychium spicatum,
Nikumbha – Danti – Baliospermum montanum
seeds of Himsra – Nardostachys jatamamsi,
Kharasva – Apium graveolens,
Ajamoda – Ajowan fruit) – Trachyspermum roxburghianum),
Sitivaraka (Salinca),
Ervaruka – Cucumis melo and
Trapusa – Cucumis sativus,
Utkuncika (Krsna- Jiraka – Carum carvi),
Hingu – Asa foetida,
Amla-Vetasa – Garcinia pedunculata,
Brihati – Solanum indicum,
Kantakari – Solanum xanthocarpum,
Hapusa – Juniperus communis and
Vacha -Acorus calamus Linn.) Helps in the breaking dissolution of calculus in the urinary tract.

Pasanabhedadi Ghrita

Ghee 4 parts cooked with the paste of the above mentioned drugs (1 part) and 4 parts cow’s urine also helps in the breaking dissolution of calculus in the urinary tract.
Roots of Svadamstra –Tribulus terrestris,
Ikshuraka,
Kokilaksa – Asteracantha longifolia,
Urubuka (eranda – Ricinus communis),
Brihati – Solanum indicum and
Kantakari – Solanum xanthocarpum is mixed by adding sweet curd. Intake of this potion for 7 days helps in the breaking dissolution of calculus in the urinary tract.
Recipes are taken by the patient suffering from Ashmari (Calculus) and Sarkara (graveluria):
Punarnava – Boerhavia diffusa,
Lauha- Bhasma,
Rajani – turmeric,
Svadamstra – Tribulus terrestris,
Pravala (adventitious root) of Phalgu (Kasthodumbara) and
flowers of Darbha – Desmostachya bipinnata is ground and made to a paste by adding milk, water, alcohol or sugar-cane juice.
Trutyadi Churna: 1 part of each of
Truti (lesser cardamom),
Surahva (Deva- Daru – Cedrus deodara),
5 types of salt,
Yavakshara,
Kunduru – Boswellia serrata,
Pashana- Bheda – Cyclea peltata,
Kampillaka – Mallotus philippinensis,
Seeds of Goksura – Tribulus terrestris,
Ervaru – Cucumis utilissimus and
Trapusa – Cucumis sativus,
Chitraka – Leadword – Plumbago zeylanica,
Hingu – Asa foetida,
Mamsi – Nordastachys jatamamsi and
Yavani – Trachyspermum amami and
2 parts of each of Haritaki – Terminalia chebula, Vibhitaka – Terminalia bellerica and Amalaki – Phyllanthus emblica is made to a powder.
Intake of this along with sour drinks excluding Sukta and Vinegar, meat soup, alcohol and vegetable soup helps in the cure of Gulma (phantom tumor) and breaking dissolution) of calculus in the urinary tract.
Root of Shigru – Moringa oliefera is made to a paste. The soup of the measurement of one Bilva of this paste is sizzled with ghee and oil, and cooled intake of this cold soup along with Dadhimanda (whey) and adequate quantity of salt helps in the breaking dissolution of the calculus in the urinary tract.
Intake of the root of Sobhanjana along with cold water is useful curing Ashmari (calculus) and Sarkara (Gravels) in the urinary tract.
Sitopala (Sugar of big crystals) mixed with equal quantity of Yavakshara is the remedy for all types of Dysuria.
After taking wholesome alcohol [in large quantity], the patient should ride over a chariot or horse running very fast which causes expulsion of gravels and stones from the urinary tract. If this expulsion does not take place then these stones and gravels is removed surgically by an expert surgeon. [59- 68]

Treatment of Dysuria Caused by Vitiated Semen

If obstruction by vitiated semen is the cause of dysuria, then the patient is treated with remedies appropriate to the aggravated Doshas responsible for such vitiation.
Meat soup prepared with the decoction of
Karpasa – Gossypium herbaceum,
Vasaka – Adhathoda vasaka,
Pashana- Bheda – Cyclea peltata,
Bala – Country mallow,
Shalaparni
Brihati – Solanum indicum,
Kantakari – Solanum xanthocarpum,
Goksura – Tribulus terrestris,
Gavedhuka – Grewia populifolia
Vruscheera (Sveta or white variety of punarnava – Boerhavia diffusa
Aindri – Colocynth – Citrullus colocynthis – indra-Varuni),
Red variety of Punarnava –Boerhavia diffusa
Satavari – Asparagus racemosus,
Madhu-Parni (Guduchi – Tinospora cordifolia) and
Asana-Parni (aparajita – Clitoria ternatea) is useful in dysuria caused by the seminal vitiation of Vatika type.
Milk or help prepared with the above mentioned decoction is useful in dysuria caused by the seminal vitiation of Kaphaja type
If the semen is vitiated by the aggravation of combined Doshas to or all 3 to cause dysuria, then therapies appropriate to each of these Doshas in a combined form is administered.
If the dysuria caused by the vitiation of semen is not relieved by the above mentioned therapeutic measures, then the patient is given old Sura alcohol or Madhukasava to drink. His body is nourished by the meat of birds, and he is given Uttara Basti (urethral douche) for cleansing the Sukrasaya (seminal vesicle). When he is cleansed, and he is refreshed with aphrodisiac recipes, he is made to stay with lovable ladies and desirable women having erotic disposition [69-72]

Raktaja mutrakrichra treatment

Treatment of Raktaja Mutrakrichra Dysuria caused by Vitiated Blood:
If dysuria is caused by the vitiation of blood, the following recipes are useful:
The patient should drink the juice of the stalk of Utpala, Tala – Borassus flabellifera, Kasa – Saccharum spontaneum, Ikshu – sugarcane, Baleksu and Kaseruka – Scripus grossus along with sugar and honey
He should eat Ikshu – Saccharum officinarum, Vidari (Ipomoea paniculata / Pueraria tuberosa) and Trapusa –Cucumis sativus in uncooked form
The medicated ghee prepared by cooking with juice of Svadamstra – Tribulus terrestris (equal in quantity of ghee) and milk (8 times of the quantity of ghee) is useful in this ailment;
Shalaparni, Prisniparni, Brihati – Solanum indicum, Kantakari – Solanum xanthocarpum, Goksura – Tribulus terrestris and Drugs belonging to the group beginning with Kataka (Kanaka) taken either individually or all together is made to a decoction. Recipes of medicated ghee prepared by cooking with this decoction are useful in this ailment.
Medicated milk prepared by cooking with the drugs having sweet taste may be used as urethra douche in this aliment
Medicated oil prepared b cooking with sweet fruits like Madhuka– Licorice – Glycyrrhiza glabra and Aksota – Juglans regia may also be used as urethral douche in this ailment and
Therapeutic measures described for the treatment of Pattika type of dysuria are also useful in this ailment. [73-75]

Prohibitions in Dysuria

The patient suffering from different type of Mutrakruchra (Dysuria) should avoid
Vyayama – exercise,
Vega sandharana – suppression of the manifested natural urges,
Sushka ruksha anna – dry and ununctuous articles of food,
Pistanna – Pastries,
Vata kara – exposure to strong wind,
Aatapa – strong rays of the sun,
Maithuna – sexual intercourse,
Kharjura – dates, Shaluka, Kapittha – Feronia limonia, Jambu – Sygyzium cumini, Bisa – Nelumbium speciosum and articles having astringent taste.
Thus, ends the description of the treatment of dysuria (Mutrakruchra).

Hrudroga – heart diseases

Causes of Heart Diseases:
Hrudroga (heart-disease) is caused by the following factors
Ati vyayama – Excessive Exercise
Excessive use of articles having Teekshna (sharp) attributes
Administration of Virechana (purgation) and Vamana (emetic) therapies, and Basti (enema) in excess
Ati chinta,bhaya, trasa – Excessive worry, fear and stress
Agada atichara – Improper treatment of diseases
Chardi – Emesis,
Ama – product of improper digestion and metabolism
Vega sandharana – suppression of the manifested natural urges
Karshya – Emaciation and
Abhighata – Trauma (physical and mental)

Associated diseases

Ailments Associated with Heart disease:
Ailments manifested in a patient suffering from heart disease:
Vaivarnya – Discoloration of the skin,
Murccha – fainting,
Jwara – fever,
Kasa – cough,
Hikka – hiccup,
Shvasa – Asthma,
Aasya vairasya – bad taste in the mouth,
Trshna – morbid thirst,
Pramoha – unconsciousness,
Chardi – vomiting,
Kapha utklesha – Nausea,
Ruja – pain,
Aruchi – anorexia [78]

Types of hridroga

Specific features of Different Types of Hridroga:
Hrut shunya bhava – Feeling of emptiness in the heart region,
Hrut drava – tachycardia,
Sosha – atrophy of the cardiac muscles,
Bheda – pricking pain,
Hrut Stambha – heart- block and
Sammoha – unconsciousness
The specific features manifested in Pittaja Hrud roga –
Stabdham – Bradycardia
Guru syat stimitam – heaviness and timidity of the heart,
Praseka – excessive salivation,
Jwara – fever,
Kasa – cough and
Santrasa – drowsiness
In the heart –disease caused by the Sannipata (aggravation of all the 3 Doshas), all the signs and symptoms described above are manifested together.
In the heart-disease caused by krimija (parasitic infestation), the patient gets acute pain, pricking pain and itching. [79- 80]

Vataja hridroga

Treatment of Vatika Hrudroga:
Treatment of heart ailment due to Vata imbalance:
Intake of this potion, in luke-warm water cures Vatika type of heart disease:
Oil, Sauviraka, Mastu (whey) and
butter milk, taken in equal quantities, is added with salt.
Intake of the medicated oil prepared by cooking with cow’s urine, water and salt cures flatulence, Gulma (phantom tumor), abdominal pain and heart disease [of Vatika type].
Decoction useful for Abhyanga (massage) and Pana (taking orally) in the Vatika type of heart disease: It may be prepared of
Punarnava – Boerhavia diffusa,
Devadaru (Cedrus deodara),
Bilva –Aegle marmelos (root),
Syonaka – Orchis mascula,
Gambhari – Gmelina arborea,
Patala – Ficus microcarpa,
Ganikarika,
Rasna (Vanda roxburghi / Pluchea lanceolata),
Yava – Barley Hordeum vulgare
Kulattha – horse gramand
Kola – Zizyphus jujube by boiling with water.
Medicated oil prepared by cooking with the paste of
Haritaki – Terminalia chebula,
Nagara – Ginger,
Puskara- Mula – Inula racemosa,
Juice of Vayastha (Guduci – Tinospora cordifolia),
Juice of Kayastha (Amalaki – Phyllanthus emblica) and salt, and
Hingu – Asa foetida is immensely effective for curing Gulma (phantom tumor), heart –disease and pain in the chest caused by the aggravated vayu.
Cures Vatika type of heart disease and Vikartika (angina pain): Intake of the paste of
Puskara-Mula – Inula racemosa,
root of Phala- pura(Bija-Puraka – Citrus medica),
Mahausadha – Ginger,
Sati – Hedychium spicatum and
Haritaki – Terminalia chebula mixed with
Alkali- water,
ghee and salt
This potion is given in luke-warm form to the patient suffering from Vatika type of heart-disease: The decoction of
Puskara-mula – Inula racemosa,
Matulunga – Lemon variety – Citrus decumana / Citrus limon,
Palasa – Butea monosperma
Bhutika,
Sati – Hedychium spicatum and
Devadaru – Cedrus deodara is added as praksepa with the powders of
Nagara – Ginger,
Ajaji – Cuminum cyminum,
Vacha- Acorus calamus,
Yavani – Trachispermum ammi,
Yava Kshara and Salt
Intake of this potion along with jaggery, Prasanna (scum of alcohol) and salt cures pain in the chest, sides of the chest, back abdomen and female genital tract: The paste of
Patha – Cisampelos parriera,
Shati – Hedychium spicatum,
Puskaramoola – Inula racemosa,
Pippali – Long pepper fruit – Piper longum,
Pippali mula – long pepper root
Chavya – Piper retrofractum,
Chitraka – Leadword – Plumbago zeylanica,
Shunthi – Ginger, and
Matulunga – Lemon variety – Citrus decumana / Citrus lemon is sizzled by adding oil and ghee.
This medicated ghee is administered in the dose of 1 Pala or 1 pichu by adding honey for curing cough, Asthma, Anaemia, Halimaka (a serious type of Jaundice), heart disease and sprue syndrome: 1 Aksa of each of
Sunthi – Ginger,
Pippali – Long pepper fruit,
Maricha – Black pepper fruit,
Haritaki – Terminalia chebula,
Vibhitaka – Terminalia bellerica,
Amalaki – Phyllanthus emblica,
Draksha – Raisin – Vitis vinifera,
Kasmarya – Gmelina arborea,
Parusaka – Grewia asiatica,
Patha – Cisaampelos parriera,
Nidigdhika,
Goksura – Tribulus terrestris,
Bala – Sida cordifolia,
Mahameda – Polygonatum verticillatum,
Rddhi,
Truti (Suksma-ela),
Shatavari – Asparagus racemosus,
Jivaka – Malaxis acuminata and
Prsniparni is made to a paste.
1 Prastha of ghee is cooked by adding this paste and curd prepared of buffalo- milk [81-89]\

Pittaja hridroga

Treatment of Paittika Hrudroga:
Treatment for Pittaja Type of Heart Disease:
If the heart disease is caused by aggravated Pitta, then the patient is given cooling Pradeha (application of ointment), affusion and purgation therapy.
After the body is anointed by the administration of purgative therapy, the patient is given food and drinks added with grapes, sugar, honey and parusaka.
The patient may also take the paste of Yastimadhu – Indian licorice and Katukarohini – Picrorhiza kurroa along with sugar mixed water.
If there is ulcer in the chest, then the patient is given medicated ghee and the recipes of Sarpir Guda (Vide Chikitsa 11: 50-77) after proper examination.
In Paittika type of heart disease, the patient is given the soup of the animals inhabiting arid zone, and food prepared of cow’s milk. By this, all types of diseases caused by the aggravation of Pitta, and those located in the blood get cured.
Medicated ghee useful in curing Paittika type of heart disease are prepared by cooking buffalo-ghee with milk and the paste of either
Draksha – Raisin – Vitis vinifera,
Bala – Country mallow root) – Sida cordifolia,
Sreyasi (rasna – Vanda roxburghii) and
Sarkara – sugarcandy, or
Kharjura—Phoenix slyvestris,
Veera
Rishabhaka – Manilkara hexandra and
Utpala Nymphaea alba,
Kakoli – Fritillaria roylei,
Meda – Polygonatum cirrhifolium,
Maha-Meda – Polygonatum cirrhifolium and
Jivaka – Malaxis acuminata
Intake of this medicated ghee cures heart disease: It is prepared by cooking with the paste of
Kaseruka – Scripus grossus
Saivala – Vallisneria spiralis
Shringavera – Ginger,
Prapaundarika,
Madhuka– Licorice – Glycyrrhiza glabra and
tuber of lotus, and
milk
Honey (1/4th in quantity of ghee) is added after cooking is over.
Ghee useful in paittika type of cardiac disease is cooked with the paste of
Shalaparni
Prisniparni
Brihati – Solanum indicum,
Kantakari – Solanum xanthocarpum and
Goksura – Tribulus terrestris, and
milk or
Grape- juice or
sugar-cane-juice
Cooling juice of sweet fruits and sugar-cane is useful in paittika type of heart-disease. [90-95]

Kaphaja hridroga

Treatment of Kaphaja Hridroga:
In Kaphaja type of heart-disease, remedies are given after the administration of
Swedana – fomentation,
Vamana – emetic and
Langhana (fasting) therapies.
Intake of barley as food along with the juice soup of Kulattha – horsegram and Dhanyaka – Coriandrum sativum, and drinks having sharp (tiksna) attribute is useful for Kaphaja type of heart disease.
Urine boiled with
Katphala –Sida rhombifolia,
Shringavera – Ginger,
Pitadru (Daruharidra – Berberis aristata),
Pathya and
Ativisha – Aconitum heterophyllum is useful in this condition
The powder of Krishna Pippali – Long pepper fruit – Piper longum), Shati – Hedychium spicatum, Pushkara- Mula – Inula racemosa, Rasna – Vanda roxburghi / Pluchea lanceolata), Vacha – Acorus calamus Linn.), Abhaya – Terminalia chebula and Nagara – Ginger is useful for this ailment.
Intake of this linctus along with warm water cures Kaphaja type of heart disease: To the decoction (3 parts) of
Udumbara –Ficus racemosa
Ashvattha – Ficus religiosa
Vata – Ficus bengalensis
Arjuna – terminalia arjuna
Palasha – Butea monosperma
Rohitaka – Tecomela undulata and
Khadira – Acacia catechu, the powder (1 part) of
Trivrt – Operculina turpethum
Sunthi – Ginger
Pippali – Long pepper fruit – Piper longum and
Maricha – Black pepper fruit – piper nigrum is added and made to a linctus
For curing Kaphaja type of cardiac disorder, an expert physician should administer Shilajatu according to the prescribed procedure to get its rejuvenating effect (kalpa—vide Chikitsa 1:3:55-65)
Similarly, ChyavanaPrasa (vide Chikitsa 1:1: 62- 74), Agastya Haritaki or Agastya Rasayana (vide Chikitsa 18: 57- 62), Brahma Rasayana (vide Chikitsa 1:1:75) are useful for the patient suffering from Kaphaja type of heart disease. [96-99]

Sannipataja hridroga

Treatment of Sannipatika Heart Disease
If the heart disease is caused by the simultaneous aggravation of all the 3 Doshas (Sannipata), then the beginning, langhana (fasting therapy) is administered, and the patient is given such food as are conductive to the alleviation of all the 3 Doshas.
After ascertaining the nature of these aggravated Doshas, i.e their mid aggravation, moderate aggravation or excessive aggravation, appropriate therapeutic measures is adopted for their alleviation [100]

Treatment of angina

Treatment of Angina in Sannipatika Heart- disease
If in the Sannipatika type of heart-disease, excruciating pain appears [in the cardiac region] immediately after taking food, is of moderate intensity during the process of digestion, and gets alleviation after the food is digested this happens because of excessive aggravation of kapha, then the patient is given to drink the powder of
Devadaru – Cedrus deodara,
Kushta – Saussurea lappa,
Tilvaka
Saindhava Lavana – rock salt
Sauvarchala Lavana
Vidanga – Embelia ribes and
Ativisa – Aconitum heterophyllum mixed with warm water.
If [in Sannipatika type of heart-disease], excruciating pain [in the cardiac region] appears after the digestion of food this happens because of excessive aggravation of Pitta, then the patient is given Virechana (purgation) therapy containing fruits like
Draksha – Raisin – Vitis vinifera and
Kasmarya – Gmelina arborea
If [in Sannipatika type of heart disease], excruciating pain [in the cardiac region] appears in all the 3 periods, viz, before, during and after digestion this happens because of excessive aggravation of all the 3 Doshas, then the patient is given strong (tiksna) purgation therapy containing roots of Trivrt –Operculina turpethum etc).
Vayu generally gets aggravated because of the obstruction to its movements in the Amasaya stomach including small intestine. Therefore, it is necessary to give Virechana (purgation therapy), Langhana (fasting therapy) and Pachana (carminative therapy) to the patient. [101- ¾ 103]

Krimija hridroga

Treatment of Krumija Heart Disease:
For the treatment of heart disease caused by Krmi (micro- organisms), therapeutic measures for the distribution of these micro –organisms is administered.
Thus, ends the description of the treatment of heart-diseases. [103 ¼]

Pratishyaya – Coryza, rhinitis

Etiology and Pathogenesis of Pratishyaya (Rhinitis)
Pratishyaya or Rhinitis is caused by the following:
Vega sandharana – Suppression of the manifested natural urges
Ajirnat – Indigestion
Excessive exposure to the dust
Ati bhashya – Excessive speech
Krodha – Anger
Vaishamya – Seasonal vagaries
Shiro abhitapa – Excessive exposure of the head to heat
Prajagarana – Remaining awake at night and
Diwa swapna – excessive sleep during day time
Exposure to cold water and forest
Maithuna – Sexual intercourse and
Ati bhaspa – weeping in excess and
Dhuma – Exposure to smoky atmosphere.
The above mentioned factors make the Dosha (mucus) in the head thick, and aggravated Vayu, giving rise to Rhinitis. [104- 1/ 105]

Vataja pratishyaya

Signs and symptoms of Vatika Pratishyaya:
Pratisyaya or Rhinitis is of 4 types, viz,
Vatika caused by the aggravation of Vayu
Paittika caused by the aggravation of Pitta
Kaphaja caused by the aggravation of Kapha
Sannipatika which are caused by the aggravation of simultaneous aggravation of all the 3 Doshas
The signs and symptoms of rhinitis caused by the aggravation of Vayu:
Excessive pain and pricking sensation in the nose
Srava ghana praseka – sneezing watery discharge,
Swara bheda – hoarseness of voice and
Shiro ruk – headache [105 2/4]

Pittaja pratishyaya

Signs and Symptoms of Paittika Pratishyaya
Nasa agra paka – Inflammation of the tip of the nose
Jwara – fever
Vaktra sosha – dryness of the mouth
Trushna – morbid thirst
Pita sravanani pittat – discharge of the hot as well as yellow liquid [2/4 106]

Kaphaja pratishyaya

Signs and Symptoms of Kaphaja Rhinitis
Kasa – Cough
Aruchi – anorexia
Ghana srava – thick discharge
Praseka – Salivation and
Guru – heaviness as well as
Srotasi kandu – itching sensation in the nasal passage [106 2/4]

Sannipataja pratishyaya

Signs and symptoms of Sannipatika Rhinitis:
All the above mentioned signs and symptoms along with excruciating pain and discomfort are manifested in Rhinits caused by Sannipata (simultaneous aggravation of a the 3 doshas) [2/4 107]

Dushta pratishyaya

Dusta Pratishyaya (Pernicious Rhinitis)
If all the above mentioned types of Pratisyaya get excessively aggravated due to neglect of appropriate treatment or due to the intake of unwholesome food, then this leads to Dusta Pratisyaya (pernicious Rhinitis) as a result of this, diseases like
Kshavatu – Sneezing,
Nasa sosha – dryness or atrophy of Nasal mucous membrane,
Pratinaha (nasal obstruction),
Prarisrava (excessive discharge from the nose),
Putighrana (ozena),
Apinasa (chornic Rhinitis),
Nasa-Paka (suppurative Rhinitis),
Nasa-Sotha (Oedematous Rhinitis),
Nasarbuda (Nasal Tumor),
Nasa –Puya-Rakta (Purulent and sanuinous Rhinitis),
Arumsi (furunculosis),
Sirsha sravana akshi roga – diseases of the head, ears and eyes,
Khalitya – alopecia,
Kasa – cough,
Jwara – fever,
Rakthapitta – an ailment characterized by bleeding from different parts of the body,
Vaisvarya – hoarseness of voice and
Sosa (Consumption) are caused. [107 2/4 – 109]

Signs and symptoms of Dusta-pratishyaya (Rhinitis with infection):
Dusta Pratisyaya is characterized by the following signs and symptoms
Rodha abhighata – Nasal obstruction,
Srava -discharge
Sosha – dryness
Paka – suppression
Na ghrana – Loss of sensation of smell
Durgandhim aasya – Foul smell of the mouth and
Bahushah prakopa – Frequent attack of the ailment [110]

Pathogenesis

Pathogenesis of Kshavathu (Sneezing):
Vayu afflicting the vital organs, after pervading all the channels in the head gives rise to sneezing. [2/4- 111]
Pathogenesis of Nasa- Sosa (dryness of Nasal Mucous Membrane):
The aggravated Vayu dries up the Kapha in the nose and the vital organ (marman) called Srngataka which result in the loss of the sense of smell and dryness of the nasal mucous membranes. [111 2/4]

Pathogenesis of Pratinaha (Nasal Obstruction):
Obstruction of the channel of Expiration by the aggravated Kapha and Vayu is called Pratinaha. [2/4 112]

Pathogenesis of Parisrava (Nasal Discharge):

The discharge of thick, yellow and ripe matured Kapha (Mucus) from the brain [Through the nose] is called parisrava.

Pathogenesis of Puti- Nasya (Ozena):
If appropriate treatment of Rhinitis is neglected, then this leads to
Vaivarnya (discoloration),
Daurgandhya (foul smell),
Shavyathu (oedema) and
Bhrama (giddiness) which are called Puti-Nasya. [2/4 113]

Signs and Symptoms of Apeenasa (chronic Rhinitis)
The signs and symptoms of Apeenasa (chronic Rhinitis):
Anahyate – Obstruction
Visoshana – dryness
Pkalidyate – stickiness
Dhupayati – fuming sensation in the nose and
Gandha rasam cha nasha – inability to recognize taste as well as smell
Caused by: Vayu and Kapha aggravation
It shares the signs and symptoms of Pratisyaya (ordinary Rhinitis). [113 2/4 – 114]

Nasapaka (suppurative Rhinitis):
Caused by: Vitiation of Rakta (Blood) and Pitta
It is characterized by the signs and symptoms like
Daha – burning sensation
Raga – redness
Shvyathu – oedema and
Sa paka ghrana – suppuration of the nose. [2/4 115]

Nasa-Sotha (Oedematous Rhinitis):
The aggravated Doshas Vitiate blood, etc, located in the nose giving rise to Nasa- Sotha (oedematous rhinitis) [115 2/4]

Nasa Arbuda (nasal polyp / tumour):
Nasarbuda (Nasal tumor) is caused by the Vitiation of mamsa and rakta located in the nose, thereby obstructing the course of respiration. [2/4 116]

Puyarakta (Purulent and Sanguinous Rhinitis):
In PuyaRakta (purulent and Sanguinous rhinitis), there is discharge of blood mixed with Pitta from the nose, ear or mouth. [116 2/4]

Arumsi (Furuculosis):
Aggravated vayu and Pitta vitiate skin, etc., in the nose to cause Arumshi (furunculosis) which gets suppurated [2/4 117].

Nasa Deepta (Burnt Nose):
If the nose looks as if burnt, then the ailment is called Nasa Deepta.
Thus, ends the description of the diagnosis of Nasal ailments. [117 2/4]

Shiro Roga (Diseases of Head)

Diagnosis of Shiro Roga (Diseases of Head):
In the Vatika type of Shiro-roga (head diseases) there is
Bhrshaarti – excruciating pain,
Shula – ache and
Spruhati – throbbing sensation.

Paittika type of Shiroroga (headache) is associated with
Daha – burning sensation and
Arti – pain.

Kaphaja type of headache is associated with heaviness.
In Sannipatika type of Shiro Roga (headache), which is caused by the simultaneous aggravation of all the 3 Doshas, all the above mentioned signs and symptoms are manifested.

Krimija Shiroroga caused by parasitic infestation gives rise to
Kandu – itching
Daurgandhya – foul smell
Toda – pricking sensation and
Shira ruk – pain in the head.
Thus ends, the description of the diagnosis of Shiroroga (diseases of the head). [118]

Mukharoga – mouth diseases

Diagnosis of oral disorders:
Mouth –diseases are of 4 types, viz,
Vatika
Paittika
Kaphaja and
Sannipatika

Vatika type of mouth – disease is characterized by:
Krishna aruna pita – dryness and pink coloration
Praseka – excessive salivation
Sa shita – coldness
Nishpatanam – loosening of teeth
Prasamsrana – throbbing sensation and
Toda bheda ruk – pricking as well as breaking pain

Pittaja Mukharoga is characterized by –
Trushna – dry mouth
Jwara – fever,
Sphotaka – boils
Taludaha – burning sensation in palate
Dhumayana – feeling of smoke
Avadeernata – cracks, degeneration
Murcha – fainting

Kaphaja type of mouth disease is characterized by
White discoloration
Kandu – itching
Guru – heaviness
pallor, Sliminess, dryness
Aruchi – anorexia
Jadya – stiffness
Praseka – excessive salivation
Utklesha – Nausea
Manda analata – suppression of the powder of digestion,
Tandra – drowsiness and
Manda ruja – Pull pain.
If all the signs and symptoms are manifested, then the ailment is to be diagnosed as Sannipatika, i.e caused by the simultaneous aggravation of all the 3 Doshas.
These oral diseases are described to be of 64 varieties depending upon the varieties in their locations, tissue elements which are vitiated, signs and symptoms, and names. These varieties are described in detail in Shalakya- Tantra specialized branch of Ayurveda, dealing with the diseases of the head and neck with reference to their etiology, signs and symptoms, characteristic features and treatment.
In the present text, however, the treatment of the 4 types of mouth- diseases will be described later.
Thus, ends the description of the diagnosis of mouth- diseases. [199- 123]

Arochaka (Anorexia)

Etiology, Signs and symptoms of anorexia:
Arochaka or anorexia is caused by aggravated Vayu, etc. by mental factors like grief, fear, excessive greed and anger, and boy resorting to unpleasant food, smell and sights.
It is of five types, Viz,
Vatika
Paittika
Kaphaja
Manobhighataja and
Sannipatika

The symptoms of Vatika type of Arocaka (anorexia):
Parihrusta danta – Setting teeth on edge and
Kashaya vakra – astringent taste in the mouth

The symptoms of Paittika type of arocaka (anorexia):
Katu amla virasa – Pungent and sour tastes in the mouth,
Ushna – hot sensation,
Virasam – bad taste in the mouth,
Puti vakra – foul smell and
Lavana vakra – Saline taste in the mouth

The symptoms of Kaphaja type of Arocaka (anorexia):
Madhurya – Sweet taste
Paichilya – sliminess
Gurutva – heaviness and
Shaitya – coldness in the mouth and
Vibaddha – knotty mucus
In anorexia caused by mental factor like excessive grief, fear, excessive greed for food), anger and unpleasant food as well as smell, there is dislike for food, even though the condition of the mouth is otherwise normal.
In anorexia caused by Sannipata (when all the 3 Doshas are simultaneously aggravated), different types of taste will appear in the mouth.
Thus, ends the description of the diagnosis of Arochaka (anorexia). [124- 126]

Ear Diseases – Karnaroga

Signs and Symptoms of Ear- Diseases:
Ear diseases are 4 types, viz.,
Vatika
Paittika
Kaphaja and
Sannipatika (which is caused by the Simultaneous aggravation of all the 3 Doshas)

The signs and symptoms of Vatika type of ear- disease:
Karna nada – Tinnitus
Ruk – excessive pain
Karna mala sosha – drying of ear-wax
Srava – thin discharge and
Ashravanam – inability to hear

The symptoms of Paittika type of ear-disease:
Sopha – Oedema
Raga – Redness
Daranam – ulceration
Vidaha – burning sensation and
Pita puti srava – yellow as well as putrid discharge

The signs and symptoms of Kaphaja type of ear- disease:
Vaisrutya – Defective hearing
Kandu – itching
Sthira – stiffness
Sopha – oedema
Shukla snigdha srava – white and unctuous discharge and
Alpa ruk – dull pain
If the ear disease is caused by Sannipata (simultaneous aggravation of all the 3 Doshas), then all the signs and symptoms described above in respect of each of the three Doshas are manifested. In this case, the discharge from the ear is extremely putrid containing many colors.
Thus ends the description of the diagnosis of ear- diseases. [127- 128]

Eye diseases – Netra Roga

Signs and symptoms of Netra Roga (Eye diseases):
Eye diseases are of 4 types, viz,
Vatika
Paittika
Kaphaja and
Sannipatika (caused by the simultaneous aggravation of all the 3 Doshas)

Vatika type of eye disorder is characterized by:
Alpa raga – slight redness
Anupa dehamscha – absences of sticky discharge, and
Toda bheda – pricking as well as cutting pain.

Paittika type of eye disease is characterized by:
Sa daho – burning sensation
Ati ruja – excessive pain
Sa raga – redness
Pitopadeha – discharge of sticky material of yellow color, and
Bhrushoshna vahi – extremely hot lachrymation.

Kaphaja type of eye-disease is characterized by
Shukla upadeham – discharge of sticky material of white color,
Bahu picchila ashru – excessive lachrymation which is slimy, Guru (heaviness) and
Kandu – itching.
In the Sannipatika type of eye disorder (which is caused by the simultaneous aggravation of all the three Doshas), all the signs and symptoms described in respect of each of the Doshas are manifested.
Eye-diseases are of 96 varieties. Their signs and symptoms and treatment are described in the Shalakya- Tantra specialized branch of Ayurveda dealing with the description of the diseases of the head and neck).
It is not desirable to delve deep into the field of another specialized branch. Therefore, description of such details is not attempted here.
Thus ends the description of the diagnosis of eye diseases. [129- 131]

Hair Diseases

Pathogenesis of Baldness and premature greying of hair:

The Tejas (heat) of the body in association with Vayu and other Doshas, Scorches up the hair- root (scalp) giving instantaneous rise to alopecia in men.
If there is partial scorching, then this given rise to premature greying of hair and tawny hair. [132]
Thus, ends the description of the diagnosis of the disease alopecia.
Only some of the ailments affecting the organs in the head and neck are described above in order to abviate the allegation of absolute omission of these ailments in this text.
Hereafter, the therapeutic measures for the treatment of these diseases will be described in brief which you may understand properly. [133]

Peenasa treatment

Vataja peenasa treatment

Treatment of Vatika Rhinitis
If Vatika type of Rhinitis is associated with cough and hoarseness of voice, then the patient is given to drink ghee mixed with Kshara (Alkali reparation). He may also be given meat-soup or warm milk to drink. Inhalation of unctuous type of smoke is also useful for its ailment.
A Varti (cigarette) is prepared of
Satahva
Tvak – cinnamon
root of Bala – Sida cordifolia,
Bark of Syonaka – Orchis mascula
Root of Castor
Bark of Bilva – Aegle marmelos and
Aragvadha (Cassia fistula) by adding bee’s wax, fat and ghee.
The patient is given this Varti (cigarette) to smoke.
Alternatively, the physician should keep Saktu (roasted flour of Barley) in an earthen saucer, and cover it with another saucer having a hole in the middle. After sealing the joint of these to earthen saucer, it is kept over the fire. To the hole in the upper saucer, a reed is fixed. The smoke coming out of this reed is fixed is inhaled by the patient suffering from freshly occurring rhinitis.
If there is a pain in the temples, head or forehead, then the patient is given fomentation with hot palm or hot poultice (Upanaha).
If there is sneezing, Nasal discharge or nasal obstruction, the patient is given Sankara (Vide Sutra 14: 41) and such other types of fomentation after adequate oleation.

In the above mentioned conditions, the powder of
Rohisa – Cymbopogon martinii
Ajaji – Cuminum cyminum
Swetha Jiraka – Carum carvi
Vacha – Acorus calamus Linn.
Tarkari and
Choraka – Angelica glauca or the order of
Tvak – cinnamon
Patra – Cinnamonum tamala
Maricha – Black pepper fruit – piper nigrum,
Ela – cardamom and
Prakunchika (black cumin) is inhaled.
If there is dryness or atrophy of the channels, Srngataka name of a vital sot representing the confluence of vessels supplying nourishment to the nose, ears and eyes), nose and eyes, then oil is given for inhalation.

Anu Taila

Sesame seeds is impregnated with Goat’s milk, and made to a paste by triturating with goat’s milk an earthen pot containing goat’s milk is tied to the brim of the earthen pot over this cloth. The sesame paste is kept and covered with another earthen pot.
Heat is applied below, and with the steam of the boiling goat’s milk the steam-cooked sesame paste is added with the powder of YastiMadhu – Glycyrrhiza glabra (1/4th in quantity of sesame paste), and squeezed through a cloth by sprinkling with goat’s milk the oil which comes out is added with the decoction of
Dashamoola and the paste of
Rasa
Madhuka – Madhuca longifolia and Rock-salt and cooked repeatedly for 10 times.
The oil processed in this manner is called Anu-Taila. This is so named because of its ability to permeate through the Anu-srotas or fine channels. This oil is useful for Snehana (oleation therapy).
After oleation therapy with the above mentioned medicated oil, the patient is given Asthapana type of medicated enema for the elimination of Doshas.
To the patient suffering from Vatika Type of Rhinitis, unctuous, sour hot and light food is given along with the soup of the meat of domesticated animals. He is given warm water for bath and drinking. He should stay in a place which is warm and free from strong wind.
He should avoid worry, physical exercise, excessive talk and sexual intercourse, if he wants his on well being. [134-143]

Pittaja peenasa treatment

Treatment of Paittika Rhinitis:
For Paittika type of Rhinitis, the patient is given ghee cooked with Shringavera – Ginger, or milk boiled by adding Shringavera – Ginger for the Pachana (ripening) of the morbid matter, and thereafter, he is given Errhines.
Inhalation of medicated oil prepared by cooking with
Patha – Cissampelos pareira
Haridra – turmeric – Curcuma longa
Daruharidra – Berberis aristata
Murva – Marsdenia tenacissima,
Pippali – Long pepper fruit – Piper longum
leaves of Jati – Jasminum grandiflorum and
Danti – Baliospermum montanum is useful for the ripened (Pakva) type of Rhinitis.
If there is discharge of pus and blood from the nose, then the patient is given decoctions and inhalation therapies prescribed for treatment of Rakta-Pitta (an ailment characterized by bleeding from different parts of the body) [vide Chapter 4 of this section].
If there is suppuration and burning sensation in excess, and dryness, then cooling ointments and afflictions is applied.
Inhalation therapy and other regimes for Paittika type of Rhinits are astringent and sweet in taste and cooling. If Rhinitis is caused by less aggravated Pitta, then purgation therapy with unctuous ingredients is administered.
For the patient suffering from Paittika type Rhinitis,
ghee, milk, barley, rice, wheat, Soup of the meat of animals inhabiting arid zone,
vegetables which are cooling, sour and bitter, and Soup of Mudga etc are useful. [144-148]

Kaphaja peenasa treatment

Treatment of Kaphaja Peenasa:
For Kaphaja type of Rhinitis associated with heaviness and anorexia, Langhana (fasting therapy) is administered. For the Paka (ripening of the morbid matter), the head is smeared with ghee, and thereafter, fomentation as well as affusion therapies is administered.
Garlic mixed with the powder of
Mudga – Phaseolus trilobus
Sunthi – Ginger
Pippali – Long pepper fruit
Maricha – Black pepper fruit
Yava Kshara and Ghee is given to the patient, and when Kapha gets dissolved, he is given emetic therapy containing Kapha- alleviating ingredients.
In Kaphaja Rhinitis, chronic Rhinits, ozena and excessive discharge from the nose associated with itching, Dhuma (smoke inhalation therapy) and Avapida pouring of medicated oil with pressure) containing
Sunthi – Ginger,
Pippali – Long pepper fruit and
Maricha – Black pepper fruit – piper nigrum,
Vidanga – Embelia ribes
Hingu – Asa foetida and
Guggulu [In the above mentioned conditions.]
The powder of pungent fruits like
Maricha – Black pepper fruit – piper nigrum and
Pippali – Long pepper fruit – Piper longum) is used for insufflation (Pradhamana) by the patient [in the above mentioned conditions.]
Cow’s urine is boiled with
Bhargi – Clerodendrum serratum,
Madana – Randia dumetorum,
Tarkari
Surasa (Tulasi) etc,
Mustard oil is cooked by adding the paste of
Laksa
Vasa – Adhatoda vasica
Jambu – Syzygium cumini,
Katu- Katukarohini – Picrorhiza kurroa),
Vidanga – Embelia ribes,
kustha –Sausserea lappa,
Pippali – Long pepper fruit – Piper longum and
Karanja – Pongamia pinnata
Inhalation therapy with this medicated oil is useful when the Rhinitis has ripened (Pakva) and when there is discharge of thick and fat-like mucus from the nose.
After the Kaphaja type of Rhinitis has become milder, the patient is given oleation therapy followed by emetic therapy. Gruel prepared of Taila and Masa by adding milk boiled with emetic drugs is used in this emetic therapy.
Soup of-
Vartaka
Kulaka (a type of Patola—Trichosanthes dioica),
Sunthi – ginger,
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper nigrum,
Kulattha – horse gram,
Adhaki – Cajanus cajan and
Mudga – Phaseolus trilobus and
Kapha- alleviating food ingredients and affusion with warm water are useful in Kaphaja type of Rhinitis. [149- 156]

Dushta peenasa treatment

Treatment of Dushta Peenasa:
For Dusta Pratisyaya (Pernicious Rhinitis), Therapeutic measures described above for all the 3 type of Rhinitis is administered.
For edematous Rhinitis, therapeutic measures for the relief of oedema are administered.
If there is tumor of fleshy growth (Adhi- Mamsa) in the nose, then caustic alkalies is applied.
For the remaining types of nasal ailments, appropriate therapies are administered after proper investigation.
Thus, ends the description of the treatment of nasal aliments including Rhinitis. [157]

Shiroroga Chikitsa

Vataja headache

For Vatika type of headache, oleation, fomentation and inhalation therapies, and Vayu- alleviating drinks, food and hot poultices is administered. [158]

Upanaha (Hot Poultices):
Luke- warm poultices prepared of the paste of Aguru – Aquallaria agallocha, etc, or of Jivaniya group of drugs or of Sumanas (Jasminum officinale) flowers of Jati or of fish or of meat, all sizzled with oil are useful in Vatika type of headache. [159]

Rasnadi Taila:
Medicated oil prepared by cooking with the paste of
Rasna – Vanda roxburghi / Pluchea lanceolata),
Sala- Parni
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum and
Goksura – Tribulus terrestris is used for Nasya (inhalation therapy) which cures headache. [160]

Baladya Taila:
Ingredients:
1 Prastha (768 ml) of Oil is cooked with
1 Prastha of milk
½ tula of the soup of the meat of animals inhabiting arid zone, and
The paste ( ¼ Prastha in total) of
Bala – Country mallow root – Sida cordifolia,
Madhuka – Madhuca longifolia
Madhu-Yasti – Glycyrrhiza glabra
Vidari Ipomoea paniculata / Pueraria tuberosa),
Chandana Sandalwood – Santalum album),
Utpala Nymphaea alba),
Jivaka – Malaxis acuminata,
Rishabhaka – Manilkara hexandra,
Draksha – Raisin – Vitis vinifer and
Sugar
Inhalation therapy with this medicated oil cures all the Vatika and Paittika diseases manifested in the head and neck supra- clavicular region) [161-162]

Mayura Ghrita:
Ingredients:
Bilva – Aegle marmelos
Syonaka – Orchis mascula
Gambhari – Gmelina arborea
Patala – Ficus microcarpa
Ganikarika
Salaparni
Prisniparni
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum
Gokshura – Tribulus terrestris
Bala – Country mallow root) – Sida cordifolia,
Rasna Vanda roxburghi / Pluchea lanceolata),
Haritaki – Terminalia chebula
Vibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica and
Madhuka– Licorice – Glycyrrhiza glabra is taken in the quantities of 3 Palas each
Peacock with its feather, Bile, intestines, fecal matter, beak and feet removed, is taken in quantity equal to all the above mentioned drugs [i.e 48 Tolas in total].
All these ingredients is boiled by adding 1 Drona of after and reduced to 1/4th.
Along with this decoction, 1 prastha of Ghee and 1 Karsha of each of drugs belonging to Madhuradi- Gana or the Group of drugs havin sweet taste viz,
Jivaka – Malaxis acuminata,
Rishabhaka – Manilkara hexandra,
Meda – Polygonatum cirrhifolium,
Mahameda
Kakoli – Fritillaria roylei,
Mudgaparni – Phaseolus trilobus
Masha-parni – Teramnus labialis
Jivanti – Leptadenia reticulata and
Madhuka– Licorice – Glycyrrhiza glabra
This medicated ghee cures
head diseases, facial paralysis,
Diseases of the ears, eyes, nose, tongue, palates, mouth and throat.
This recipe is well known as Mayura ghrta which cures the diseases of the head and neck.
Thus, ends the description of Mayura-Ghrta [163-165]

Mahamayura Ghrita:
To the decoction of Bilva – Aegle marmelos, etc., described above, 1 Prastha of ghee and 4 Prasthas of water is added.
This is cooked by adding the paste of one Karsha of each of
Jivanti – Leptadenia reticulata,
Haritaki – Terminalia chebula
Vibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Meda – Polygonatum verticillatum
Mrdvika – Vitis vinfera
Rddhi – Vigna cylindrica
Parusaka – Grewia asiatica
Samana
Cavika – Piper chaba
Bhargi – Clerodendrum serratum
Kasari – Inula helenium
Sura-daru – Cedrus deodara
Atmagupta – Mucuna pruriens
Maha-meda – Polygonatum verticillatum
Tala – Borassus flabellifera
Kharjura- Mastaka (top part),
Mrinala – lotus stalk
Bisa – Nelumbium speciosum
Saluka – Myrstica fragrans
Srngi – Calligonum polygonoides
Jivaka – Malaxis acuminata,
Padmaka – Prunus cerasoides,
Shatavari – Asparagus racemosus
Vidari – Ipomoea paniculata / Pueraria tuberosa),
Ikshu – sugarcane
Brihati – Solanum indicum,
Sveta- Sariva – Indian Sarsaparilla – Hemidesmus indicus,
Krsna- Sariva – Indian Sarsaparilla – Hemidesmus indicus,
Murva – Marsedenia tenacissima
Svadamstra – Tribulus terrestris
Rishabhaka – Manilkara hexandra,
Srngataka – Tectona grandis
Kaseruka – Scripus grossus
Rasna – Vanda roxburghi / Pluchea lanceolata),
Sthira – Desmodium gangeticum,
Tamalaki – Phyllanthus niruri
Suksma-ela – Elattaria cardamum
Sati – Hedychium spicatum
Puskara- Mula – Inula racemosa
Punarnava – Boerhavia diffusa
Tuga-Ksiri
Kakoli – Fritillaria roylei
Dhanvayasaka – Alhagi pseudalhagi
Kharjura fruits – Phoenix sylvestris
Aksota – Aleurites moluccana
Vatama
Mujata and
Abhisuka or as many of these drugs as are available cooking is done according to the above mentioned procedure.
This medicated ghee is used for Nasya (inhalation therapy), pana (drinking), enema and massage, It is very useful for all types of head- diseases, serious types of cough and asthma, torticollis, stiffness, of the back, consumption, hoarseness of voice, facial paralysis, diseases of the female genital tract, menstrual disorders and seminal vitiation it helps in the procreation of offerings even by a barren woman. Drinking this ghee, after the bath at the end of the menstrual period, will help in the procreation of a male offspring
This medicated ghee is called MahaMayura Ghruta, and is held in high esteem by Lord Atreya.
Thus, ends the description of MahaMayura Ghrita. [166-174]

Ghee prepared of Rat etc.
With the above mentioned ingredients and following the same procedure, a wise physician may also prepare medicated ghee by replacing pea-cook with a rat, cock, swan and rabbit which also cure the diseases of the head and neck. [175]

Pittaja headache

Treatment of Paittika Headache:
In Paittika type of headache, ghee, milk, affusion, cold poultice, inhalation therapy prepared of cooing drugs, medicated ghee prepared with drugs belonging to Jivaniya group vide Sutra 4:9), and Pitta- alleviating food and drinks are useful.
Recipe –
Chandana – Sandalwood
Ushira – Vetiveria zizanioides,
YastiMadhu – Glycyrrhiza glabra
Bala – Country mallow root) – Sida cordifolia,
Vyaghra-Nakha – Capparis zeylanica and
Utpala – Nymphaea alba is made to a paste by triturating with milk which is applied over the head the decoction of the above mentioned drugs may also be used for effusion in Paittika type of headache.
Tvak, Patra – Cinnamomum tamala Nees and Eberum. And sugar is made to a paste by adding Tandulambu (rice-wash). This paste is kept inside a cloth, and the liquid is squeezed into the nostrils (avapida) thereafter, ghee is given for inhalation to alleviate Paittika type of headache.
Medicated ghee prepared by boiling with
Yastimadhu – Glycyrrhiza glabra
Chandana – Sandalwood – Santalum album),
Ananta and milk is useful for inhalation.
Similarly, inhalation of the medicated ghee prepared by boiling with
Sugar,
Draksha – Raisin – Vitis vinifera and
Madhuka – Glycyrrhiza glabra is useful in Paittika type of Headache. [176- 179]

Kaphaja headache

Treatment of Kaphaja Headache
In Kaphaja type of headache, fomentation therapy, smoking therapy, inhalation therapy, Prdhamana (Insufflations of powders into the nostrils) Etc, is administered for cleaning the morbid matter from the head thereafter, Kapha-alleviating pralepa (application of drugs in a paste form), drinks and food is given to the patient he is given old ghee to drink to such patients, medicated enema prepared of drugs having Tiksna (sharp) attributes is administered.
In Kaphaja and Vatika types of headache, Daha cauterization in the fore-head and temples (vide Susruta: Sutra 12: 9) is useful in the remaining types of headache, Blood-letting therapy is administered.
Dhuma varti (cigar) prepared of
Eranda – Ricinus communis
Nalanda
Kshauma
Guggulu – Commifora mukul Engl.
Aguru – Aquallaria agallocha
Chandana Sandalwood – Santalum album) and
Other aromatic drugs, except Kushta – Saussurea lappa and Tagara – Valerian walichii , is used for smoking in Kaphaja type of headache [180- 182]

Sannipataja headache

Treatment of Sannipatika Headache
In Sannipatika type of headache which is caused by the simultaneous aggravation of all the 3 Doshas), therapeutic measures prescribed above for all the 3 types of headache measures prescribed above for all the 3 types of headache caused by Vayu, Pitta and Kapha) is administered together. [1/2 – 183]

Krimija headache

Treatment of Krimija Headache:
For the headache by Krimi (parasitic infestation), strong errhines having sharp (Tiksna) ingredients is administered.
Medicated oil prepared by cooking with
4 times of sheep’s urine, and the paste of
Tvak – Cinnamonum zeylanica
Danti – Baliospermum montanum
Vyaghra Nakhi – Capparis zeylanica
Vidanga – Embelia ribes
Nava-Mallika
Fruits seeds of Apamarga – Achyranthes aspera
Seeds of Nakta-Mala – Pongamia glabra and
Phanijjhaka [in total 1/4th in quantity of oil] is useful for the headache (head disease) caused by Krimi (Parasitic infestation).
Insufflations of the nostrils with the powder of the drugs mentioned above beginning with Tvak – Cinnamonum zeylanica and ending with Phanijjhaka is also useful in Krimija type of headache.
The paste of the fruits of Sigru – Moringa oliefera and Karanja – Pongamia glabra added with Sunthi – Ginger, Pippali – Long pepper fruit – Piper longum and Maricha – Black pepper fruit – piper nigrum is [tied in a piece of cloth and] squeezed into the Nostrils (Avapida) the decoction, juice alkali preparation, powder including paste of these drugs may also be used for Avapida.
Thus, ends the description of the treatment of headache. [183 ½- 186]

Mukharoga Chikitsa

Line of Treatment:
Kavala- Graha (holding the paste of drugs in the mouth) containing vinegar, paste of bitter and pungent drugs, honey and decoction of bitter and pungent drugs is useful for mouth- diseases.
Similarly, smoking pradhamana (insufflations), purgation, emetic and fasting therapies, and food containing ingredients which alleviate the aggravated Doshas useful in mouth – diseases [187- ½ 188]

Pipalyadi Churna:
Ingredients: All taken equal quantities is made to a powder
Pippali – Piper longum
Aguru – Aquallaria agallocha
bark of Daruharidra – Berberis aristata
Yava Kshara,
Rasanjana (Aqueous extract of Berberis aristata),
Patha – Cissampelos parriera
Tejovati – Zanthoxylum alatum and
Pathya – Terminalia Chebula
This is mixed with honey, and kept in the mouth which is useful in all types of mouth- diseases.
Adding Sidhu (a type of wine prepared of sugar-cane juice), Madhava (a type of wine prepared of honey) and Madhvika (a type of wine prepared of Madhuka– Licorice – Glycyrrhiza glabra) to the above mentioned powder, and holding it in the mouth (Kavala – Graha) is immensely useful for curing all types of mouth –diseases. [188 ½ – ½ 190]

Tejovatyadi Tooth powder:
Ingredients:
Tejohva (tejabala) – Zanthoxylum alatum
Abhaya – Terminalia chebula,
Ela (Elettaria cardamomum) ,
Samanga – Rubia cordifolia,
Katuka – Myrica carifera
Ghana
Patha – Cissampelos parriera
Jyotismati – Celastrus paniculatus
Lodhra – Symplocos racemosa
Darvi – Berberis aristata and
Kushta – Saussurea lappa is made to a powder
Brushing teeth with this powder cures bleeding, itching and pain in the teeth [190 ½ – 191]

Kshara Gutika:
Ingredients: The powder of [1 part of each of]
Pippali – Long pepper fruit – Piper longum,
Pippali Mula
Chavya – Piper retrofractum,
Chitraka – Leadword,
Nagara – Ginger
Talisa-patra – Abies webbiana
Ela – Elattaria cardamum
Maricha – Black pepper fruit – piper nigrum,
Tvak – Cinnamonum zeylanica
Palasa – Butea monosperma
Muskaka- Ksara and is cooked by adding double the quantity of old jaggery 24 parts in syrup form), and pills of the size of Karkandhu (bear fruit) is made out of this paste these pills is kept inside a heap of ash or Kshara(alkali preparation) of gradually sucking the part of this pill dissolved in the mouth [and gradually sucking the art of this pills dissolved in saliva] is useful like ambrosia in all types of throat- diseases [192 – ½ 194]

Kalaka Curna:
Ingredients:
Grha-Dhuma (Kitchen- Soot or carbon deposited in the chimney in the house)
Yava Kshara
Patha – Cissampelos parriera
Ela – Elattaria cardamum
Maricha – Black pepper fruit – piper nigrum,
Tvak – Cinnamon
Palasa – Butea monosperma
Muskaka- Kshara is cooked by adding double the quantity of old jaggery (24 parts in syrup form), and pills of the size of Karkandhu (bear fruit) is made out of this paste these pills is kept inside a heap of ash or Kshara (alkali preparation) of Muskaka for 7 days.
Keeping this pill in the mouth [and gradually sucking the part of this pill dissolved in Saliva] is useful like ambrosia in all types of throat diseases. [192- ½ 194]
Thus, ends the description of Kalaka-Churna [194 ½- ½ 196]

Peetaka Churna:
Manah –Sila, Yava Kshara, Haritala, Saindhava and bark of Daru Haridra – Berberis aristata is may be to a powder mixed with honey and Ghrta-Manda (upper part of ghee), this powder is kept in the mouth for the cure of mouth-diseases known as Pitaka- Curna, this is an excellent remedy for mouth – diseases.
Thus, ends the description of Peetaka Churna [192 ½ – ½ 198]

Mrudvikadi Churna
The powder of
Mrdvika – Vitis vinfera
Katuka – Myrica carifera
katu- Katukarohini – Picrorhiza kurroa),
Sunthi – Ginger
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper nigrum,
Bark of Daru- Haridra – Berberis aristata
Haritaki – Terminalia chebula
Vibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Ghana
Patha – Cissampelos parriera
Rasanjana (Aqueous extract of Berberis aristata),
Murva – Marsedenia tenacissima and
Tejohva is mixed with honey, and kept in the mouth for the treatment of throat-diseases
These 3 recipes Viz,
Kalaka Churna – Vatika types of Throat disease
Pitaka Churna – Paittika types of Throat disease and
Mrdvikadi Churna – Kaphaja types of Throat disease [190 ½ – 200]

Katukadi Kvatha:
Cow’s urine is boiled by adding
Katuka – Myrica carifera,
Ativisa – Aconitum heterophyllum
Patha – Cissampelos parriera
Daru- Haridra – Berberis aristata
Musta – Cyperus rotundus and
Kalinaka
Intake of this decoction cures Throat- diseases. [201]

Darvi Rasakriya:
The juice of decoction of Daru- Haridra (berberis aristata) is boiled in order to make it thick which is called Rasa-Kriya. Use of this with honey cures mouth- diseases, diseases caused by the vitiation of blood and Nadi- Vrana (sinus). [202]

Administration of Ghee:
If there is dryness of the palate in a patient who is not suffering from morbid thirst (Atrsna), then he is given ghee to drink after the intake of food (Uttara- Bhakitka) he is given inhalation therapy, and meat- soup which is sweet, unctuous and cooling. [203]

Venesection (Sirakarma) etc in Stomatitis:
If there is stomatitis, the patient is given venesection (Rakta- Moksana) therapy, errhines and purgatives. Kavala-Graha therapy (keeping in mouth drugs in paste form) prepared of cow’s urine, oil, ghee, honey and milk is administered to him mouth- wash (Mukha- Dhavana) with cold decoction of drugs having astringent and bitter tastes is useful in this condition. [204- 205]

Khadiradi Gutika and Khadiradi Taila
1 Tula of the heart wood of Khadira (Acacia catechu) and two Tulas of Arimeda – Acacia leucophloea is washed well, and made to a coarse powder which is boiled by adding 4 Dronas of water till 1 Drona remains. The decoction after filtering the wood – powder which is boiled by adding 4 Dronas of water till 1 Drona remains the decoction after filtering the wood-powder) is boiled again till it becomes thick.
To this paste, the powder of the Aksa of each of
Chandana – Sandalwood – Santalum album),
Padmaka – Prunus cerasoides,
Ushira – Vetiver – Vetiveria zizanioides,
Manjistha – Rubia cordifolia
Dhataki – Woodfordia fruticosa,
Ghana –
Prapaundarika Nymphaea lotus) – red variety,
Yastimadhu – Glycyrrhiza glabra
Tvak – Cinnamonum zeylanica
Ela – Elettaria cardamomum Maton) ,
Padmakesara,
Laksa
Rasanjana (Aqueous extract of Berberis aristata),
Mamsi – Nordostachys jatamamsi
Haritaki – Terminalia chebula
Vibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Lodhra – Symplocos racemosa
Balaka – Coleus vettiveroides
Haridra – turmeric – Curcuma longa),
Daru Haridra – Berberis aristata
Phalini (Priyangu Callicarpa macrophylla),
Ela – Elettaria cardamomum Maton) ,
Samanga – Mimosa pudica
Katphala – Myrica nagi,
Vacha – Acorus calamus Linn.
Yavasa – Alhagi pseudalhagi
Aguru – Aquallaria agallocha
Pattanga – Caesalpinia sappan
Gairika and
Anjana is added after the cooking is over; the pan is removed from the oven and allowed to become cool.
Thereafter, the powder of 1 Pala of each of
Lavanga – Syzygium aromaticum
Nakha, Kakoli and
Jatipatra along with 1 Kudava of
Karpura – Cinnamonum camphora is added [and mixed well] from out of this paste, pills is prepared and got dried this pills is kept in the mouth and sucked.
With the above mentioned decoction and paste of drugs Chandana Sandalwood – Santalum album), etc, which are mention above to be used in the form of powder), oil is cooked
Use of these pills and medicated oil cures
Chalana – looseness,
Bhramsha – displacement and
Saushirya – porosity of teeth,
Caries (teeth parasitic infestation of teeth),
Mukha paka – stomatitis,
Daurgandhya – foul odour emanating from the mouth,
Jadya – stiffness of the mouth,
Aruchi – anorexia
ptyalism,
Srava upalepa – stickiness and sliminess of the mouth,
Vaisvarya – hoarseness of the voice and
Gala sosha – Dryness of the throat.
This pill is an excellent remedy for all the diseases of teeth, mouth and throat. The pill described above is called Khadiradi- gutika, and the medicated oil is called Khadiradi – Taila.
Thus ends the description of Khadiradi – Gutika and Khadiradi – Taila. Here ends description of the treatment of mouth- diseases [206-214]

Aruchi Chikitsa

Line of Treatment of Anorexia
In Aruchi, Kavalagraha (keeping thin paste of drugs in the mouth), Dhuma (Smoking therapy), Mukha Dhavana (mouth wash), leasing food and drinks, and cheering as well as consulting measures are useful. [215]

Kavala Graha for Different Types of Anorexia
For the cure of Vatika Aruchi –
Kushta – Saussurea lappa
Sauvarcala
Ajaji – Cuminum cyminum
Sugar
Maricha – Black pepper fruit – piper nigrum and
Vida along with oil and honey is given as Kavala- graham (to keep the thin paste of drugs in the mouth).

For the cure of Pittaja Aruchi:
Dhatri – Emblica officinalis
Ela – Cardamom
Padmaka – Prunus cerasoides,
Ushira – Vetiver – Vetiveria zizanioides
Pippali – Long pepper fruit – Piper longum
Utpala – Nymphaea alba and
Chandana – Sandalwood – Santalum album along with oil and honey are given as Kavala- Graha.
For the cure of Kaphaja Aruchi:
Lodhra – Symplocos racemosa
Tejovati – Zanthoxylum alatum
Pathya – Terminalia chebula
Sunthi – Ginger
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper nigrum and
Yava Kshara along with oil and honey is given as Kavala-Graha (to keep the thin paste of drugs in the mouth).

For the cure of Paittika Aruchi –
Dhatri – Emblica officinalis
Ela – Elettaria cardamomum Maton
Tejovati – Zanthoxylum alatum
Pathya – Terminalia chebula
Sunthi – Ginger
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper nigrum and
YavaKshara along with oil and honey is given as Kavala-Graha.

For Sannipataja Aruchi:
Juice of green Dadima – Pomegranate – Punica granatum,
Ajaji – Cuminum cyminum, and
Sugar along with honey is given as Kavala Graha. [216- 218]

Karavyadi Yoga:
Use of the recipes containing
Karavi – Carum roxburghianum,
Maricha – Black pepper fruit – piper nigrum,
Ajaji – Cuminum cyminum,
Draksha – Raisin – Vitis vinifera,
Vrksamla – Rhus parviflora
Dadima – Pomegranate – Punica granatum,
Sauvarcala
Jaggery and
Honey cures all the types of anorexia. [219]

PanchaKarma Therapy, etc:
In Vatika type of anorexia – Basti (medicated enema) is useful;
In Paittika Type of anorexia – Virekam (purgation) therapy is useful; and
In Kaphaja type of anorexia – Vamana (emetic) therapy is useful.
In anorexia caused by mental afflictions, measures for easing the heart and cheering the mind of the patient are adopted.
Thus, ends the description of the treatment of Arocaka (anorexia). [220]

Karnaroga Chikitsa

Line of treatment:
In Karna Shoola (earache), Vayu-alleviating treatment on the lines suggested for [Vatika type of] rhinitis is administered application of ointment; ear- drops and inhalation therapy [containing Vayu- alleviating ingredients] are beneficial for this ailment.
If there is KarnaPaka (otitis) and Karna-Srava (Otorrhea), then the line of treatment prescribed for ulcers is adopted.
Depending upon the Doshas involved, suitable food and ear- drops is used. [221- ½ 222]

Hingvadi-Taila:
Mustard oil is cooked by adding Hingu – Asa foetida, Tumburu – Zanthoxylum alatum and Sunthi – Ginger, use of this medicated oil as ear-drop is immensely useful for curing earache. [222 ½ – ½ 223]

Devadarvadi Taila:
Oil cooked with
Deva- Daru – Cedrs deodara,
Vacha (Acorus calamus Linn.),
Sunthi – Ginger,
Satahva – Saccharum munja
Kushta – Saussurea lappa and
Saindhava along with Goat’s urine cures earache. [223 ½- ½ 224]

Gandha Taila:
In a new earthen pot, corie- shells is kept [with a cover], and burnt over fire. The Bhasman (ash), thus, obtained, is decanted by adding water with this alkaline water and the paste of Rasanjana (Aqueous extract of Berberis aristata) and Sunthi – Ginger, Gandha Taila (aromatic oil) is cooked. Ear- drop with this medicated oil cures earache. [224 ½ – 225]

Kshara Taila:
Ingredients and method:
Dry radish is cut into pieces and burnt to prepare ash.
Oil is cooked by adding the paste of this alkali preparation.
Hingu – Asa foetida,
Mahausadha – Ginger
Satapuspa – Anethum sowa
Vacha (Acorus calamus Linn.),
Kushta – Saussurea lappa,
Deva- daru – Cedrus deodara
Sigru – Moringa oleifera,
Rasanjana (Aqueous extract of Berberis aristata),
Sauvarcala
Yava Kshara
Svarji- Kshara
Audbhida-Lavana
Saindhava
Knots of Bhurja Betula utilis D. Don
Bida and
Mustra [all taken in equal quantities: in total 1/4th of the quantity of oil]
Madhu- Sukta (4 times of the quantity of oil),
Juice of Matulunga – Lemon variety – Citrus decumana / Citrus limon (equal to the quantity of oil).
This Kshara-Taila is dropped into the ears, which cures
Badhirya – Deafness
Tinitus
Serious type of Pus- discharge from ears,
Parasitic infestation of the ears and Ear ache. [226- 229]

Treatment of Diseases of Mouth, etc in General:
In the case of the diseases of the mouth, ears and eyes, the physician should first of all, ascertain the strength or weakness of the aggravated Doshas and the nature of the season, and thereafter administer therapies as described for different types of Pinasa (Rhinitis).
Thus, ends the description of the treatment of ear-diseases. [230]

Akshiroga Chikitsa

Line of Treatment:
In the critical stage of the freshly occurring eye disorder, Bidalaka (application of drugs in paste from over the closed eye-lids excluding eye lashes) is applied to relieve
Daha (burning sensation),
stickiness (Mucous discharge),
Ashru (lachrymation),
Sopha (swelling) and
Raga (redness) [231]

Bidalaka for Vatika Eye Diseases:
Nagara, Saindhava and Supernatant part of ghee is triturated and made to a paste (Rasa-kriya). This paste is used as Bidalaka (application of drugs in Paste form over the closed eyelids excluding eye-lashes) for the cure of Vatika type of eye-disease. Similarly, the paste of honey, Saindhava and Gairika can be in this condition.
The paste of Savara- Lodhra Symplocos racemosa) or Haritaki – Terminalia chebula may be sizzled with ghee, and used as Bidalaka for the cure of pain in the eyes. [232-233]

Bidalaka for paittika Eye-Diseases:
The paste of Chandana (Sandalwood – Santalum album), Ananta – Cynodon dactylon and Manjistha – Rubia cordifolia or the paste of Padmaka – Prunus puddum,Yastimadhu – Glycyrrhiza glabra, Jata- Mamsi – Nordostachys jatamamsi and Kaliyaka is used as Bidalaka in Paittika type of eye diseases. [234]

Bidalaka for Kaphaja Eye Diseases [Gairikadya Bidalaka]:
The Rasa- Kriya (sticky paste) of Gairika, Saindhava, Musta (Cyperus rotundus) and Gorocana, or the Paste of Priyangu (Callicarpa macrophylla), Manah- shila, and honey is used as Bidalaka in Kaphaja type of eye disorders. [235]

Bidalaka for Sannipatika Eye Diseases:
For eye diseases caused by Sannipata (Simultaneous aggravation of all the 3 Doshas), the paste of all the above mentioned ingredients described in verse nos. 232- 235) may be used by used by Bidalaka while applying the paste over the [closed] eyelids, the eye- lashes is not be touched. After 3 days when the eye—disease is matured (sampakva), collyrium (anjana) may be applied. [236]

Aschyotana for Vatika eye diseases:
In Vatika type of eye-disease, Ascyotana (sprinkling therapy or eye-douche) with the Luke-warm decoction of
Bilva – Aegle marmelos
Syonaka – Orchis mascula
Gambhari – Gmelina arborea
Patala – Ficus microcarpa and
Ganikarika along with
Eranda – Ricinus communis
Tarkari
Brihati – Solanum indicum and sweet varieties [237]

Eye Drop for Paittika Eye Diseases:
In Paittika type of eye disorder, the cold decoction of Prthvika, Daru-Haridra – Berberis aristata, Manjistha – Rubia cordifolia, Laksha, both the types of Yasti-Madhu – Glycyrrhiza glabra and Utpala along with sugar is used as eye- drop. [238]

Aschotana for Kaphaja and Sannipatika types of Eye Diseases:
Use of Lukewarm decoction or juice of
Nagara – Ginger,
Haritaki – Terminalia chebula,
Vibhitaka – Terminalia bellerica,
Amalaki – Phyllanthus emblica,
Musta (Cyperus rotundus),
Nimba – Neem Azadirachta indica), and
Vasaka – Adhatoda vasaka
Used as – Ascyotana (eye- douche) is useful in Kaphaja type of eye diseases.
In eye-diseases caused by Sannipata (Simultaneous aggravation of all the three Doshas), all the above mentioned drugs (vide verse nos 237- 239) is used as Ascyotana eye douche). [239]

Varti (wick – bogie) for Vatika Type of Eye diseases [Brihatadi Varti]:
Brihati – Solanum indicum, root-bark of eranda- Ricinus communis, flower of Sigru – Moringa oliefera and Saindhava is triturated by adding goat’s milk, and made to a paste Varti (bogie) is made out of this paste application of this Varti cures Vatika type of eye-diseases. [240]

Varti for Paittika Type of Eye-diseases [Sumana koradi Varti]:
Buds of sumanas (Jati-Puspa), Sankha, Haritaka – Terminalia chebula, Vibhitaka – Terminalia bellerica, Amalaki – Phyllanthus emblica, Madhuka– Licorice – Glycyrrhiza glabra and Bala – Country mallow root – Sida cordifolia is triturated by adding clean rain- water, and varti (bogie) is made out of this paste application of this Varti (bogie) cures eye diseases caused by the vitiation of Pitta and Raktha (blood). [241]

Varti for Kaphaja Type of Eye diseases [Saindhavadi Varti]:
Application of the Varti (bougie) containing
Saindhava – rock salt
Haritaki – Terminalia chebula
Vibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Sunthi – Zingiber officinale
Pippali – Long pepper fruit – Piper longum,
Maricha – Black pepper fruit – piper nigrum,
Sankha,
Samudra- Phena,
Saireyaka and
Sarja (Vateria indica) cures Kaphaja type of eye diseases. [242]

Varti for Sannipatika Eye diseases [Amrtahvadi Varti]:
8 palas of each of
Amrtahva – Guduci – Tinospora cordifloia
Bisa – Nelumbium speciosum
Bilva – Aegle marmelos
Patola – Trichosanthes dioica
Stool of goat,
Prapaundarika – Nymphaea lotus) – red variety,
Yasti-Madhu – Glychriza glabra
Daru-Haridra – Berberis aristata and
Kalanusariva is washed well and made to a coarse powder, and cooked by adding water.
This decoction is further boiled till it becomes thick. To this paste, 1 Karsa of
Sveta- Maricha – Black pepper fruit – piper nigrum
seeds of Sobhanjana and
1 Pala fresh Jatipuspa (dried) is added in powder form.
Varti (bougie) is made out of this paste.
Application of this Varti cures eye diseases caused by Sannipata (simultaneous aggravation of all the 3 Doshas). It also promotes eye- sight [243-245]

Recipes of other Eye Diseases:
Shankhadi Varti:
Varti (bougie) prepared of Sankha bhasma, Pravala Bhasma, Vaidurya Pisti, Lauha Bhasma, Tamra Bhasma, Bhasma of the bone of Plava, Srotonjana and Sveta- Maricha – Black pepper fruit – piper nigrum cures all types of eye diseases.

Churnanjana:
Half Sana of Maricha – Black pepper fruit – piper nigrum, 2 Sanas of Pipali – Piper longum, 2 Sanas of Samudra-Phena, ½ Sana of Saindhava and 9 Sanas of Sauviranjana shoud be triturated and made to a fine powder during the constellation of Chitra.
This powder is used as colyrium which is useful in itching, Kaca (cataract) and eye disorders caused by Kapha. It cleanses the eyes of its purulent discharge.
Seeds of Ela – Elattaria cardamum is well impregnated with goat’s urine and made to a powder. Application of this powder in the form of collyrium cures Timira (a type of cataract), Krimi (parasitic infestation), Patala (another type of cataract) and discharge of mucoid matter from the eyes.
Sauviranjana, Tuttha, Tapya-dhatu(maksika), Manah- Sila, Caksusya (variety of Kulattha), Madhuka– Licorice – Glycyrrhiza glabra, Loha Bhasma(iron), precious stones, uspanjana, Saindhava, Tusk of boar, and Kataka – Strychnos potatorum may be used in the form of either powder or Varti (bougie) as collyrium which are unsurpassable remedies for Timira Cataract) and such other eye-diseases. [246- 251]

Sukhavati- Varti:
Varti (Bougie) prepared of the
fruit of Kataka – Strychnos potatorum
Sankha
Saindhava – rock salt
Sunthi – Ginger
Pippali – Long pepper fruit,
Maricha – Black pepper fruit,
Sugar
Samudraphena
Rasanjana (Aqueous extract of Berberis aristata),
honey
Vidanga – Embelia ribes
Manah- Sila and
shell of hen’s egg
Instantaneously cures
Timira (cataract)
Patala
Kaca (another type of cataract) and
putrid discharge from the eyes
This is called Sukhavati- Varti
Thus, ends the description of Sukhavati- Varti [252-253]

Drushtiprada Varti:
Ingredients and Method:
Haritaki – Terminalia chebula,
Vibhitaka – Terminalia bellerica,
Amalaki – Phyllanthus emblica,
shell of hen’s egg,
Kasisa,
Lauha bhasma – Iron calx
Nilotpala,
Vidanga – Embelia ribes, and
Samudra-phena is made to a paste by triturating them with goat’s milk], and smeared over a cover pot this is kept for 7 nights.
This paste is scraped out the copper plate, triturated with goat’s milk again, and rolled into the form of Varti (bougie) this is called Dristi Prada-Varti.
Benefit: Application of this bougie besots eye-sight even to a blind person, provided the pupils of his eyes have not undergone any physical change or been damaged.
Thus, ends the description of Drshti- Prasada- Varti [254 -1/4 256]

Collyrium for Timira:
A wise physician should keep Anjana inside the buccal cavity of a dead black snake cobra for one month. Thereafter, this is removed, added with half the quantity of each of the dry buds of Sumanas (Jasminum officinale – jati- Puspa and Saindhva, and made to a fine powder this is an unsurpassable recipe for the cure of Timira (cataract). [256 ½ – ½ 258]

Pippalyadi Rasakriya:
Rasa-Kriya (thin paste) prepared of pippali – Piper longum, Juice of Kimsuka – Butea monosperma, fat of snake, Saindhva and old ghee cures all types of eye-diseases. [258 ½ – ½ 259]

Krishna sarpa Vasadi –Rasakriya:
RasaKriya (thin paste) prepared of the fat of black snake cobra, honey and the juice of Amalaki – Phyllanthus emblica is useful in curing all eye-diseases like Kaca (Cataract), Arbuda (Tumour in the eyes) and discharge of excreta from the eyes. [259 ½- ½ 260]

Other recipes for eye diseases:
The Rasa-Kriya (thin paste) prepared of Dhatri, Rasanjana (Aqueous extract of Berberis aristata), honey and ghee cures eye-diseases caused by the vitiation of Pitta and Raktha (blood), Timira (cataract) and Patala (another type of Cataract).
Thus, ends the description of the treatment of eye diseases. [260 ½ – ½ 262]

Kesha roga Chikitsa

Line of Treatment:
In Khalitya (alopecia), Palitya (Graying of the hair), Vali (appearance of wrinkles over the face) and Hari- Loman (Tawny hair), the patient should, in the beginning, be given elimination therapies, emetic, Purgation etc and thereafter, be given Nasya (inhalation therapy) with medicated oil, and application of paste of drugs over the head and face. [262 1/- ½ 263]

Medicated Oil and other medicines:
Recipe 1: Medicated oil is prepared by cooking with
Vidari- Gandha—Pueraria tuberosa
Shala- parni
Prishnaparni
Brhati – Solanum indicum
Kantakari – Garcinia Morella and
Goksura – Tribulus terrestris
Or with Jivaniya group of drugs, viz, Jivaka – Malaxiz acuminata,Rsabhaka – Manilkara hexandra, Meda – Polygonatum cirrhifolium, Maha-meda – Polygonatum verticillatum , Kakoli – Fritillaria roylei , Mudga – Green gram- Parni and Masa-Parni – Teramnus labialis.
Inhalation therapy with these medicated oils or with Anu Taila cures alopecia and greying of the hair.

Recipe 2:
1 Prastha – 768 ml of each of milk and
juice of Sahacara – Barleria prionitis,
Bhrnga-Raja – Eclipta alba and
Surasa –Cinnamonum zeylanica,
1 Kudava – 192 g of oil and
The paste of 1 Pala of
Yasti –Madhu – Glychrizza glabra is cooked, and kept inside a pot of stone or
the horn of sheep.
Appropriately administered by the physician for inhalation therapy, this medicated oil cures graying of hair.
Recipe 3: Dugdhika – Euphorbia hirta and Karavira – Nerium indicum are made to a paste by triturating them with milk. After pulling out Gray hairs, the physician should apply this paste over the head of the patient for curing greying of hair.
Recipe 4: 1 Kudava – 192 g of oil is cooked by adding 1 Prastha – 768 ml of the Juice of markava (Bhrnga- Raja – Eclipta alba) and milk and 1 Pala of Yasti-Madhu – Glychriza glabra.
Administration of this medicated oil for inhalation therapy cures graying of hair. [263 ½- ½ 268)

Mahaneela taila:
Ingredients:
1 Adhaka of oil extracted from the seeds of Vibhitaka – Terminalia bellerica
4 Adhakas of juice of Amalaki – Phyllanthus emblica is added with the
Paste of 10 palas of each of the
Root of Adityavalli and
Black variety of Saireyaka – Barleria prionitis,
leaves of Surasa – Cinnamonum zeylanica and
Black variety of Sana – Brassica alba,
Markava (Bhrnga-Raja – Eclipta alba),
Kakamaci – Solanum nigrum,
Yastimadhu –Glycrrhiza glabra and
Devadaru – Cedrus deodara
5 Palas of each of
Pippali – Piper longum
Haritaki – Terminalia chebula
Vibhitaka – Terminalia bellerica
Amalaki – Phyllanthus emblica
Anjana
Prapaundarika
Manjistha – Rubia cordifolia
Lodhra – Symplocos racemosa
black variety of Aguru – Aquallaria agallocha
Utpala – Nymphaea alba
Amrasthi (seeds of Mango –Mangifera indica),
Krishna – Kardama (black mud),
Mrinala – Lotus stalk
Rakta Chandana – red sandalwood
Nili – Indigofera tinctoria
Seeds of Bhallataka – Semecarpus anacardium Linn.
Kasisa
Madayantika – Lawsonia alba,
Somaraji – Psorelea corylifolia,
Asana – Terminalia crenulata,
Sastra Bhasma of Tiksna (type of iron),
black variety of Pinditaka (Madana –Randia dumetorum) and
Chitraka – Leadword – Plumbago zeylanica
Puskara – Inula racemosa
Arjuna – Terminalia arjuna
Kasmarya – Gmelina arborea and
fruits of Amra – mango – Mangifera indica as well as
Jambu – Syzmium cumini, and
Cooked in an iron pot by solar heat till the water is evaporated
This medicated oil is given to a patient whose body is cleansed by purgation therapy, etc], in the form of inhalation therapy or massage over the head.
Promotes: eye-sight and longevity
Cures: All the diseases of the head
This is called MahaNila Ghrta which is unsurasses as a cure for gray hair.
Thus, ends the description of Mahaneela taila. [268 ½ – ½ 276]

Prapaundarikadya Taila
Ingredients:
1 Kudava of oil and
2 Kudavas of the juice of Amalaki – Phyllanthus emblica is cooked by adding
Paste of 1 Karsha of each
Prapaundarika,
Yasti- Madhu – Glycrrhiza glabra
Pippali – Long pepper fruit – Piper longum,
Chandana – Sandalwood – Santalum album and
Utpala – Nymphaea alba
Administration: Pratimarsa Nasya (a type of inhalation therapy)
Cures: All the diseases of the head
According to Krsnatreya, this therapy is especially useful for curing graying of hair. [276 ½- ½ 278]

Ointment for Tawny hair:
Application of the paste prepared of
Milk
Priyala (Buchanania lanzan),
Yasti- Madhu – Glycrrchiza glabra
Jivaka – Malaxis acuminata,
Rishabhaka – Manilkara hexandra,
Meda – Polygonatum cirrhifolium,
Maha- Meda – Polygonatum cirrhifolium,
Kakoli – Fritillaria roylei, Ksira-Kakoli,
Mudga-Parni – Phaseolus trilobus,
Masa-Parni – Teramnus labialis,
Jivanti – Leptadenia reticulata,
Madhuka– Licorice – Glycyrrhiza glabra,
Honey,
Tila – Sesame Sesamum indicum) and
Pippali – Piper longum over the face cures Tawny hair. [278 ½- ½ 279]

Recipe for restoration of hair:
Application of the paste of Tila – Sesame Sesamum indicum), Amalaki – Phyllanthus emblica, Kinjalka, Madhuka– Licorice – Glycyrrhiza glabra and honey over the head restores the color of hair, and promotes hair growth. [279 ½- ½ 280]

Recipes for dyeing and softening hair:
Lauha powder (bhasma) is cooked with Saindhava, Suktama (sour vinegar) and rice [all taken in equal quantities]. After washing the head well to make it free from oily matter, this paste is applied over the scalp, and kept overnight.
In the morning, the head is washed with the decoction of Haritaki – Terminalia chebula, Vibhitaka – Terminalia bellerica and Amalaki – Phyllanthus emblica with this therapy, the hair becomes black and soft.
Lauha powder (bhasma) triturated with sour articles and Haritaki – Terminalia cheula, Vibhitaka – Terminalia bellerica and Amalaki – Phyllanthus emblica and Amalaki is an excellent hair-dye. [280 ½- 1/3 282]

Treatment of remaining Shiroroga – head diseases:
For the remaining ailments which appear as complications of the diseases described above, the treatment suitable for these ailments is given for the diseases of the three vital sorts not described here, the lines of treatment have been described earlier in this chapter, and some others are going to be described in Siddhi section [which are to be followed keeping in view the Doshas involved in the manifestation of these diseases]. Thus, ends the treatment of alopecia etc. [282 2/3]

Svarabheda Chikitsa

Treatment of Vatika Svara-Bheda
In Vatika type of Svarabheda (hoarseness of voice):
Dosage: medicated ghee is given after the intake of food
Recipes:
Medicated oil prepared by cooking with
Bala – Country mallow root – Sida cordifolia, etc),
Rasna (Vanda roxburghi / Pluchea lanceolata) etc), and
Guduci – Tinospora cordifolia etc., is administered in 4 ways viz,
Pana or drinking,
Abhyanga – massage,
Gargle and
Basti – enema
Meat-soup of pea-cock, partridge and cock prepared by cooking with Bilva- Aegle marmelos, Syonaka – Orchis mascula, Gambhari – Gmelina arborea, Patala – Ficus microcarpa and Ganikarika
Or medicated milk and
Medicated ghee prepared by boiling with the meat of pea-cock or Tryusana (Sunthi – Ginger, Pippali – Long pepper fruit and Maricha – Black pepper) are beneficial in this condition. [283- 284]

Treatment of Paittika SvaraBheda:
For Paittika type of Svara-Bheda (hoarseness of voice), purgation therapy is useful. In addition, following recipes are useful in this condition:
Milk boiled with drugs having sweet taste (vide Vimana 8 : 139)
Sarpirguda vide Chikitsa (11:50-69)
Tiktaka ghrita vide Chikitsa (7:140- 150)
Jivaniya Ghrta vide Chikitsa (29: 61-70) and
Vrusha Ghrita vide Chikitsa (5:126-127) [285]

Treatment of Kaphaja Svarabheda:
In Kaphaja type of Svarabheda (hoarseness of voice), the patient is given strong errhine, purgation, emetic and smoking therapies.
He should eat barley diet added with pungent ingredients.
He should take the linctus prepared of Chavya – Piper retrofractum, Bharngi – Clerodendrum serratum, Abhaya, Sunthi – Ginger, Pippali – Long pepper, Maricha – Black pepper fruit – piper nigrum, Yava Ksara, and Chitraka – Plumbago zeylanica, or the linctus prepared of Pippali – Long pepper fruit – Piper longum and Pathya (Haritaki – Terminalia chebula)
He should drink strong wine. [286- 287]

Treatment of Raktaja Svara Bheda:
If Svara Bheda (hoarseness of voice) is caused by the vitiated blood (Raktaja), then the patient is given
The soup of the meat of animals living in arid zone sizzled with ghee.
The juice of Draksha – Raisin – Vitis vinifera, Vidari (Ipomoea paniculata / Pueraria tuberosa) and sugar- cane added with ghee and sugar are beautiful for such patients.
All the therapeutic measures prescribed for the treatment of Kshayaja type of Kasa are useful in this condition similarly , the therapeutic measures prescribed in this chapter of treatment of Paittika type of Svara Bheda, and venesection therapy are useful for the treatment of Raktaja type of svara-Bheda (hoarseness of voice). [288-289]

Treatment of Sannipatika Svara-Bheda:
Svara Bheda (hoarseness of voice) caused by Sannipata (simultaneous vitiation of all the 3 Doshas) is treated with all the therapeutic measures prescribed above for the Vatika, Paittika and Kaphaja type of Svara Bheda, except vensection therapy (siravyadha).
Thus, in brief, the treatment of Svara-Bheda is described.
Thus, ends the description of the treatment of Svara-Bheda (hoarseness of voice) [290]
In human beings, Vata, Pitta and Kapha are located in the basti region of the urinary bladder, i.e Pelvic region, Hrt (cardiac region) and Murdhan (head) respectively therefore, the morbid matter located in these places is eliminated from the nearby region appropriately by emetic therapy etc [291]
Micro- cosm and macro- cosm:
As the Loka (macro- cosm) is afflicted or maintained respectively by the morbidity and normal settle of the mind, sun and moon, so also the Adhyatma-loka (sentiment world or micro-cosm) is either afflicted or maintained respectively by the morbidity and normal state of Vayu, Pitta and Kapha. [292]

Dosha balance:
The Doshas Viz, Vayu, Pitta and Kapha never destroy each other. They coexist in a harmonious state, even though they are of mutually contradictory attributes. This happens because of their Sahaja- Satmya (natural wholesome disposition of coexistence), on the analogy of the virulent poison not causing any harm to the snake hose body contains it. [293]

To sum up:
In this chapter on “the Treatment of diseases of the Three Vital Organs”, the etiology, signs and symptoms, and treatment of the body of the individual diseases afflicting the three vital organs of the body are described in detail.
Thus, ends the 26th chapter of Chikitsa sthana section dealing with the treatment of diseases of the three vital organs in Agnivesha’s work as redacted by Charaka, and supplemented by Drudhabala.