Sushruta Samhita Chapter 39 Samshodhana Samshamaniya Adhyaya

This article explains Sushruta Samhita Sutrasthana Chapter 39 “Samshodhana Samshamaniya Adhyaya” – Purificatory and Palliative Drugs.

Samshodhana Samshamaniya Adhyaya – Purificatory and Palliative Drugs

अथातः संशोधनसंशमनीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound the chapter by name Samshodhana Samshamaniya Purificatory and Palliative drugs; as revealed by the venerable Dhanvantari.
Read – Lord Dhanwantari ‘The God of Ayurveda’

Table of Contents

1. Samshodhana – Purificatory drugs.

1. Vamana dravya – Emetics

मदनकुटजजीमूतकेक्ष्वाकुधामार्गवकृतवेधनसर्षपविडङ्गपिप्पलीकरञ्जप्रपुन्नाड कोविदारकर्बुदारारिष्टाश्वगन्धाविदुलबन्धुजीवकश्वेताशणपुष्पीबिम्बीवचामृगेर्वारवश्चित्रा चेत्यूर्ध्वभागहराणि |
तत्र, कोविदारपूर्वाणां फलानि, कोविदारादीनां मूलानि ||३||
Urdhwa Bhaga Hara Dravya / Vamaka Dravya – Below mentioned drugs are said to be urdhva bhaga hara in action i.e., they remove the doshas from upper part of the body. To put it in other words, these drugs produce vomiting. Therefore, these can be considered as emetic drugs. They are –

Madana,
Kutaja,
Jimutaka,
Ikshvaku,
Dhamargava,
Kritavedhana,
Sarshapa,
Vidanga,
Pippali,
Karanja,
Prapunnada,
Kovidara,
Karbudara,
Arista,
Ashwagandha,
Vidula,
Bandhu Jivaka,
Sveta,
Shanapuspi,
Bimbi,
Vaca,
Mrigervaru and
Chitra

Among these drugs mentioned prior to Kovidara, their fruits only are to be used and from Kovidara onwards their roots only should be used.
Read – Vamana Therapy – Right Method, Side Effects, Management

2. Virechana Dravya – Purgatives

विवृताश्यामादन्तीद्रवन्तीसप्तलाशङ्खिनीविषाणिकागवाक्षीच्छगलान्त्रीस्नुक्सु वर्णक्षीरीचित्रककिणिहीकुशकाशतिल्वककम्पिल्लकरम्यकपाटलापूगहरीतक्या मलकबिभीतकनीलिनीचतुरङ्गुलैरण्डपूतीकमहावृक्षसप्तच्छदार्का ज्योतिष्मती चेत्यधोभागहराणि |
तत्र तिल्वकपूर्वाणां मूलानि, तिल्वकादीनां पाटलान्तानां त्वचः, कम्पिल्लकफलरजः, पूगादीनामेरण्डान्तानां फलानि, पूतीकारग्वधयोः पत्राणि, शेषाणां क्षीराणीति ||४||
Adho Bhaga Hara Dravya / Virechaka Dravya – Below mentioned drugs are said to be adho bhaga hara in action i.e., they remove the doshas from the lower parts of the body. To put it in other words, these drugs produce purgation. Therefore, these can be considered as purgatory drugs. They are –

Vivrita,
Shyama,
Danti,
Dravanti,
Saptala,
Shankhaini,
Vishanika,
Gavakshi,
Chagalantri,
Snuk,
Suvarnakshiri,
Chitraka,
Kinihi,
Kusha,
Kasha,
Tilvaka,
Kampillaka,
Ramyaka,
Patola,
Puga,
Haritaki,
Amalaki,
Vibhitaka,
Nilini,
Chaturangula,
Eranda,
Putika,
Mahavriksha,
Saptacchadi,
Arka and
Jyothishmati

Among these drugs mentioned earlier to Tilvaka, their roots only are to be used. Only bark should be used on the drugs starting with Tilvaka and ending with Patala.
Kampillaka – its dust (on the fruits) only is to be used. Only fruits should be used of the drugs commencing with Puga and ending with Eranda.
Only leaves of Putika and aragvadha are to be used, and of the remaining their milky sap only should be used.
Read – Virechana Therapy – Right Method, Side Effects, Management

Vamana Virechana dravya

कोशातकी सप्तला शङ्खिनी देवदाली कारवेल्लिका चेत्युभयतोभागहराणि |
एषां स्वरसा इति ||५||
Ubhaya Bhagahara Dravyas – The below mentioned drugs are called as ubhaya bhagahara which means that they can expel the doshas from both parts i.e., upper and lower parts. Therefore, they are useful in causing both vomiting and purgation –

Koshataki,
Saptala,
Shankhini,
Devadali,
Karavella

It is their fresh juice only that is to be used.
Read – Benefits of Vamana and Virechana Treatment – Charaka Sutrasthana 16

3. Shiro Virechana – Purgatives to the head

पिप्पलीविडङ्गापामार्गशिग्रुसिद्धार्थकशिरीषमरिचकरवीरबिम्बीगिरिकर्णिकाकिणिहीवचाज्योतिष्मती- करञ्जार्कालर्कलशुनातिविषाशृङ्गवेरतालीशतमालसुरसार्जकेङ्गुदीमेषशृङ्गीमातुलुङ्गीमुरङ्गीपीलु- जातीशालतालमधूकलाक्षाहिङ्गुलवणमद्यगोशकृद्रसमूत्राणीति शिरोविरेचनानि |
तत्र करवीरपूर्वाणां फलानि, करवीरादीनामर्कान्तानां मूलानि, तालीशपूर्वाणां कन्दाः, तालीशादीनामर्जकान्तानां पत्राणि, इङ्गुदीमेषशृङ्ग्योस्त्वचः, मातुलुङ्गीमुरङ्गीपीलुजातीनां पुष्पाणि, शालतालमधूकानां साराः, हिङ्गुलाक्षे निर्यासौ, लवणानि पार्थिवविशेषाः; मद्यान्यासुतसंयोगाः, शकृद्रसमूत्रे मलाविति ||६||
Shirovirechana – Below mentioned drugs are said to cause shirovirechana i.e., head purging –

Pippali,
Vidanga,
Apamarga,
Shigru,
Siddhartha,
Shirisha,
Maricha,
Karavira,
Bimbi,
Girukarnika,
Kinihi,
Vacha,
Jyothishmati,
Karanja,
Arka,
Alarka,
Lashuna,
Ativisha,
Shringavera,
Talisa,
Tamala,
Surasa,
Arjaka,
Ingudi,
Meshashringi,
Matulungi,
Murangi,
Pilu,
Jati,
Shala,
Tala,
Madhuka,
Laksha,
Hingu,
Lavana (Salts),
Madya (wines)
Goshakrit rasa (juice of fresh cow dung) and
Mutra (urines)

Among these,

drugs mentioned earlier to Karavira, their fruits only are to be used;
those from Karavira and ending with Arka their roots only are to be used;
those earlier to Talisa, their rhizomes only to be used;
those from Talisa and ending with Arjaka, their leaves only to be used;
the barks only of Ingudi and Meshashringi should be used
flowers only one of Matulungin, Murangi, Pilu and Jati to be used;
pith only of Shala, Tala and Madhuka is to be used;
gum only of Hingu and Laksha is to be used;
salts are products of the earth (ores); wines are products of fermentation , juice of cow dung and urines are waste products (of animals)

Notes: These drugs are administered through the nose in the form of fine powder, fresh juice, infusion, decoction, medicated oil or ghee producing purgation to the head.
Read – Shirovirechanopaga Gana – Herbs useful in Nasya treatment (nasal drops)

II. Samshamana – Palliative drugs

1. Vata Samshamana – Palliative of vata

संशमनान्यत ऊर्ध्वं वक्ष्यामः- तत्र भद्रदारुकुष्ठहरिद्रावरुणमेषशृङ्गीबलातिबलार्तगलकच्छुराशल्लकीकुबेराक्षीवीरतरुसहचराग्निमन्थ- वत्सादन्येरण्डाश्मभेदकालर्कार्कशतावरीपुनर्नवावसुकवशिरकाञ्चनकभार्गीकार्पासीवृश्चिकालीपत्तूरबदरयवकोलकुलत्थप्रभृतीनि विदारिगन्धादिश्च द्वे चाद्ये पञ्चमूल्यौ समासेन वातसंशमनो वर्गः ||७||
We will now enumerate palliative drugs; such as –

Below mentioned are the herbs belonging to the ‘vata mitigating’ group –

Bhadradaru
Kustha,
Haridra,
Varuna,
Meshashringi,
Bala,
Atibala,
Artagala,
Kacchura,
Shallaki,
Kuberakshi,
Virataru,
Sahachara,
Agnimantha,
Vatsadani,
Eranda,
Ashmabheda,
Kalaka,
Arka,
Shatavari,
Punarnava,
Vasuka,
Vashira,
Kanchanaka,
Bharngi,
Karpasi,
Vracikali,
Pattura,
Badara,
Yava,
Kola,
Kulattha,
Drugs of Vidarigandhadi gana,
the first two Panchamula drugs

This in brief is the group mitigating vata.
Read – Sahacharadi Kashayam Uses, Ingredients, Side Effects, Dose

2. Pitta Samshamana – Palliatives of Pitta

चन्दनकुचन्दनह्रीबेरोशीरमञ्जिष्ठापयस्याविदारीशतावरीगुन्द्राशैवलकह्लारकुमुदोत्पलकन्द(द)लीदूर्वामूर्वाप्रभृतीनि काकोल्यादिः सारिवादिरञ्जनादिरुत्पलादिर्न्यग्रोधादिस्तृणपञ्चमूलमिति समासेन पित्तसंशमनो वर्गः ||८||
Below mentioned are the herbs belonging to the ‘pitta mitigating’ group –

Chandana,
Kuchandana,
Hribera,
Ushira,
Manjistha,
Payasya,
Vidari,
Shatavari,
Gundra,
Shaivala,
Kalhara,
Kumuda,
Utpala,
Durva,
Murva etc.
drugs of Kakolyadi, Sarivadi, Anjanadi, Utpaladi, Nyagrodhadi gana and Trina Pancamula

This in brief is the group mitigating Pitta.

3. Kapha samshamana – Palliatives of Kapha

कालेयकागुरुतिलपर्णीकुष्ठहरिद्राशीतशिवशतपुष्पासरलारास्नाप्रकीर्योदकीर्येङ्गुदीसुमना- काकादनीलाङ्गलकीहस्तिकर्णमुञ्जातकलामज्जकप्रभृतीनि वल्लीकण्टकपञ्चमूल्यौ पिप्पल्यादिर्बृहत्यादिर्मुष्ककादिर्वचादिः सुरसादिरारग्वधादिरिति समासेन श्लेष्मसंशमनो वर्गः ||९||
Below mentioned are the herbs belonging to the ‘kapha mitigating’ group –

Kaleeka,
Aguru,
Tilaparni,
Kustha,
Haridra,
Shitashiva,
Shatapushpa
Sarala,
Rasna,
Prakriya,
Udakirya,
Ingudi,
Sumana,
Kakadani,
Langalaki,
Hastikarna,
Munjataka,
Lamajjaka, etc.
drugs of Valli Panchamula, Kantaka Panchamula; Pippalyadi, Brihatyadi, Mushkakadi, Vachadi, Surasadi and Aragvadhadi gana

This in brief, is Sleshma samshamana varga – group of drugs mitigating Kapha.

Samapramana upayoga – Use in appropriate dose

तत्र सर्वाण्येवौषधानि व्याध्यग्निपुरुषबलान्यभिसमीक्ष्य विदध्यात् |
तत्र, व्याधिबलादधिकमौषधमुपयुक्तं तमुपशम्य व्याधिं व्याधिमन्यमावहति; अग्निबलादधिकमजीर्णं विष्टभ्य वा पच्यते; पुरुषबलादधिकं ग्लानिमूर्च्छामदानावहति संशमनम्; एवं संशोधनमतिपातयति |
हीनमेभ्यो दत्तमकिञ्चित्करं भवति |
तस्मात् सममेव विदध्यात् ||१०||

All these drugs should be administered after considering the strength of the disease, digestive fire and strength of the body of the patient.
Palliative drugs (medicines), if used in excess (dosage) of the strength of the disease, after relieving that disease the medicines will give rise to another disease.
Medicine if used in excess of digestion power (agni) will cause vistabdha i.e., painful conditions in the abdomen and get digested after a long time.
Medicine, if used in excess of the strength of the person, gives rise to exhaustion, fainting and intoxication (toxicity).
Similarly, purificatory drugs also give troubles to the patient if administered in excess of the strength of the disease, digestive fire (power) and patient.
Medicines given in insufficient quantities of the strength of the disease, digestive fire and patient will become futile (do not produce any effect).

Hence, these should be used in suitable quantities as appropriate to the strength of disease, digestion capacity (agni) and the patient.
Read – Charaka Siddhisthana Chapter 6 – Vamana Virechana Vyapat Siddhi

भवन्ति चात्र-
रोगे शोधनसाध्ये तु यो भवेद्दोषदुर्बलः |
तस्मै दद्याद्भिषक् प्राज्ञो दोषप्रच्यावानं मृदु ||११||
चले दोषे मृदौ कोष्ठे नेक्षेतात्र बलं नृणाम् |
अव्याधिदुर्बलस्यापि शोधनं हि तदा भवेत् ||१२||
स्वयं प्रवृत्तदोषस्य मृदुकोष्ठस्य शोधनम् |
भवेदल्पबलस्यापि प्रयुक्तं व्याधिनाशनम् ||१३||
In diseases to be treated with purificatory therapies, in patients who have become weak due to the impact of strong and morbid doshas, the wise physician should administer purificatory drugs in mild doses to eliminate the mild dosa (slightly increased Dosa) smoothly.
When the doshas are unsteady (circulating) and the bowel movement is soft, then the strength of the person need not be considered; since purification is beneficial even in persons who are not debilitated by diseases. Purifactory drugs administered will cure the diseases; when the Doshas are going out of the body on their own, in the person who has soft bowel movements and even when the person is of poor strength, purgatives will cure the disease.

Aushada matra – Dose of medicine

व्याध्यादिषु तु मध्येषु क्वाथस्याञ्जलिरिष्यते |
बिडालपदकं चूर्णं देयः कल्कोऽक्षसम्मितः ||१४||
When diseases etc. (strength of digestive fire and of the patient) are moderate, the dose of decoction should be one anjali (160 gm / ml), that of powders should be Bidalapadaka (aksa – 910gms) and the dose of paste should be one aksa (10 gms)

इति श्रीसुश्रुतसंहितायां सूत्रस्थाने संशोधनसंशमनीयोनामैकोनचत्वारिंशोऽध्यायः ॥३९॥
Thus ends the chapter by name Samshodhana – Samshamaniya in Sutra Sthana Samhita.