Sushruta Samhita Sutrasthana Chapter 43 Vamanadravya Vikalpa Vijnaniya Adhyaya (Knowledge of Preparing Emetic Recipes)

The 43rd chapter of Sutrasthana of Sushruta Samhita is named as Vamanadravya Vikalpa Vijnaniya Adhyaya. This chapter deals with Knowledge of Preparing Emetic Recipes.

अथातो वमनद्रव्यविकल्पविज्ञानीयमध्यायं व्याख्यास्यामः ॥१॥
यथोवाच भगवान् धन्वन्तरिः॥२॥

 We will now expound the chapter by name Vamanadravya  vikalpa vijnaniya- knowledge of preparing recipes from emetic drugs; as revealed by the venerable dhanvantari.

 Madana Phaladi Kalpa: Emetic recipes from Madanaphala etc.

वमनद्रव्याणां फलदीनां मदनफलानि श्रेष्ठतमानि भवन्ति। अथ मदनपुष्पाणा मातपपरिशुष्काणां चूर्णप्रकुञ्चं प्रत्यक्पुष्पासदापुश्पीनिम्बकषायाणामन्यतमेनालोड्च मधुसैन्धवयुक्तां पुष्पचूर्णमात्रां पाययित्वा वामयेत्।मदनशलाटुचूर्णान्येवं  वा बकुलरम्यकोपयुक्तानि मधुलवणयुक्तान्यभिप्रतप्तानि;  मदनशलाटुचूर्नसिद्धां वातिलतण्डुलयवागूम् । निर्वृत्तानां वा नातिहरितपाण्डूना  कुश्मूढावबद्धमृद्रोमय्प्रलिप्तानां यवबु(तु) षमुद्रमाषशाल्यादिधिन्यराशावष्टरात्रोषितक्लिन्नभिन्नानां फलानां फलपिप्पलीरुद्धत्यातपे  शोषयेत्, तासां दधिमधुपललविमृदितपरिशुष्काणां सुभाजनस्थानामन्त  र्नखमुष्टिमुष्णे यष्टीमधुककषायेकोविदारादीनामन्यतमे वा कषाये प्रमृद्य रात्रिपर्युषितं मधुसैन्धवयुक्तामाशीर्भिरभिमन्त्रितमुदङ्मुखः प्राङ्मुखमातुरं पाययेदनेन मन्त्रेणाभिमन्त्र्य-

“ब्रह्यदक्षाश्विरुद्रेन्द्रभूचद्रार्कानलनिलाः ।
ऋषयः सौषधिग्रामा भूतसंघाश्च पान्तुते ॥१॥
रसायनमिवर्षीणां देवानाममृतं यथा।
सुधेवोत्तमनागानां भैषज्यमिदमस्तु ते ॥२॥

विशेषेण श्लेष्मज्वरप्रतिश्यायान्तार्विद्रधिषु अप्रवर्तमाने वा दोषे  पिप्पलीवचा गौरसर्षपकल्कोन्मिश्रैः सलवणैरुष्णान्मुभिः पुनः पुनः प्रवर्तयेदासम्यग्वान्तलक्षणादिति।

मदनफलमज्जाचूर्णं वा तत्क्वाथपरिभावितं

मदनफलकषायेण; मदनफलमज्जसिद्धस्ये  वा  पयसः सन्तानिकां क्षौद्रयुक्तां मदनफल,मज्जसिद्धं यापयः मदनफलमज्जसिद्धेन वा पयसा यवागूम्,अधोभागासृक्पित्तहृद्दाहयोहयोः;

मदनफलमज्जासिद्धस्य वा पयसे दधिभावमुपगतस्य दध्युत्तरं दधिवा कप्रप्रसेकच्छर्दिमूर्च्छातमकेषु; मदनफलमज्जरसं स्नेहं वा भल्लातकस्नेहवदादाय फाणितीभूतं लेहयेत्, आतपपरिशुष्कं वा तमेव जीवन्ती कषायेवा, पित्ते कफस्थानगने; मदनफलमज्जक्वाथं वा  पिप्पल्यादिप्रतीवापं, तच्चूर्णं वा निम्बरुपिकाकषाययोरन्यतरेण संतर्पणकफजव्याधिहरं, मदनफलमज्जचूर्णं वा  मधुककाश्मर्यद्राक्षाकषायेण । मदनफलविधानमुक्तम् ॥३॥

Madana phala (Randia dumetorum Lam) is the best among all vamana dravyas – emetic medicines and vamana phalas – fruits used for producing emesis.

Emetic formulation of Madana flowers

–        Flowers (fruit according to Dalhana) of Madana, should be dried well in sunlight and powdered.
–        One prakunca (40 gms) of this powder should be mixed with the decoction of either Patyakpuspa (apamarga), Sadapuspi (arka), Nimba or any other drug, added with Madhu (honey) and Saindhava.
–        This combination should be given to the patient to drink and made to vomit.

Emetic formulation of Madana Salatu

–        Similarly, the powder of unripe fruit of Madanaphala may be used. It needs to be used with Kashaya – decoction of Bakula or Ramyaka after having added honey and rock salt. The recipe should be made warm and given to drink to produce effective emesis.
–        Yavagu – thick gruel should be prepared with Tila – sesame and Tandula – rice. To this, powder of unripe fruit of Madanaphala should be added, mixed thoroughly and given to drink so as to cause effective emesis.

Selection, collection and method of use of Madanaphala

What type of Madanaphala is ideal for collection?

Those fruits of madanaphala which are neither very green nor very yellow in color should be collected. They should be in a stage of ripening.

How to preserve Madanaphala?

–        After collecting the mentioned type of Madanaphala fruits, they should be placed inside a pouch / bag of kusa grass and later tied with threads and made into a bundle.
–        This bundle consisting of Madanaphala fruits should be smeared with mud or cow dung and slightly dried.
–        This bolus should now be kept hidden in a heap of Yava busa – braley husk, Masa – black gram, Sali – rice (paddy) and such other corn for eight days.
–        After eight days, the bolus is removed from the heaps of Yava busa etc. in which they have been buried and the layers removed.
–        Now, the fruits which have become moist and have opened should be selected and slightly squeezed. Their seeds should be collected separately and dried in sunlight.

How to prepare the vamana recipe?

–        Next, the dried seeds of Madanaphala should be grinded with curd, honey and paste of sesame seeds and dried.
–        From this, one fistful quantity of the above said (1 pala – 40 grams approximately) is taken and put in a good and clean vessel containing hot decoction of Yashtimadhu, Kovidara or any such drug and kept soaked for one whole night.
–        Next morning, the decoction is separated and the paste of madanaphala etc. should be added with honey and rock salt and thoroughly mixed.
–        The madanaphala recipe to be administered for vamana – emesis is now ready.

How should the Madana Phala emetic recipe be administered to the patient?

The physician should make the patient sit facing east. The physician himself should sit facing north.

The vamana recipe of Madana Phala which was prepared as said above shall be sanctified by the below mentioned mantras – benedictory hymns –

‘May Lord Brahma, Daksa, Asvini, Rudra, Indra, Bhu, Candra, Arka, Anala, Anila, Rsis, groups of aushadhi grama – groups of medicinal herbs and Bhuta samghatas – all living beings protect you. May this medicine have a similar impact on you just like Rasayana to the sages, Amrta to the Gods and Sudha to the noble Nagas.’

The recipe sanctified with the above mantra shall now be given to the patient for drinking.

The Madana Phala recipe explained above should be administered mixed with paste of pippali, vaca and gaura sarsapa, lavana – salt and warm water in the below mentioned conditions –

–        in diseases such as fevers caused by aggravated kapha, nasal catarrh and internal abscess mainly, or
–        when the doshas are not moving out (expelled from the body)

The formulation should be administered repeatedly and vomiting induced until the samyak vanta lakshanas – symptoms of satisfactory vomiting appear.

Powder of marrow of Madana Phala should be soaked in its own decoction (Madana Phala Kashaya) may also be administered.

In adhoga raktapitta i.e. bleeding disease of downward route and hrd daha – burning sensation in the region of the heart, the below mentioned recipes of Madana Phala should be given –

–        marrow of Madana Phala boiled with cream of milk, mixed with honey
–        milk cooked and prepared with marrow of Madana Phala or
–        yavagu – thick gruel prepared with marrow of Madana Phala

In Kapha praseka – more secretion of kapha, chardi – vomiting, murcha – fainting and tamaka – asthma, dyspnea, the below mentioned recipe of Madanaphala should be administered –

–        milk is boiled with marrow of Madana Phala. This milk is curdled. The fluid of that curd or the curd itself shall be used for administering emesis.

When pitta has localized in the seats of Kapha, the below mentioned recipes of Madana Phala shall be used –

–        juice or oil of marrow of Madana Phala should be obtained in a similar way as the oil of Bhallataka is obtained. It is allowed to become thick and given to the patient for licking or
–        it is dried well in sunlight and later consumed with decoction of Jivanti.

In diseases caused by over-nutrition and in conditions caused by aggravation of kapha, the below mentioned recipes of Madana Phala should be administered –
–        decoction of marrow of madanaphala should be given after adding with powder of Pippalyadi Gana group of herbs or
–        powder of marrow of madanaphala should be given mixed with decoction of Nimba, Rupika or any other drug administered in diseases caused by over-nutrition or kapha aggravation or
–        powder of marrow of Madana Phala mixed with decoction of Madhuka, Kasmarya and Draksa

Thus, the recipes of Madana Phala have been described till here.

 Jimutaka Kalpa: Recipes of Madanaphala

जीमूतककुसुमचूर्णं पूर्ववदेव क्षीरेण, निर्वृत्तेषुक्षीरयवागूं, रोमशेषु सन्तानिकां अरोमशेषु दध्युत्तरं, हरितपाण्डुषु दधि, तत्कषायसंसृष्टां वा सुरां कफारोचककासश्वासपाण्डुरोगयक्ष्मसु; पर्यागतेषु मदनफलमज्जवदुपयोगः ॥४॥

Powder of Jimutaka flowers should be used for emesis therapy. It should be administered in a similar manner, with milk, as explained in Madana Phala recipes.

Ksira Yavagu – thick milk gruel is prepared with fresh Jimutaka fruits and used.

Very young (fresh) Jimutaka fruit having minute hairs on it may be used mixed with cream of milk.

More developed (matured) Jimutaka fruit without hairs on it may be used with cream of curds.

Greenish-white (ripening) Jimutaka fruits may be used with curds.

In case of kapha aggravation, loss of taste, cough, dyspnea, anemia and consumption – decoction or sura (beer) of the fruit may be used.

Ripe Jimutaka fruit may be used in a similar way as the usage of marrow of Madana Phala fruit was described.

Anya Dravya Kalpa: Recipes of other drugs

Kutaja Phala and Kritavedhana

तद्वदेव कुटजफविधानम् ॥५॥
कृतवेधनानामप्येष एव कल्पः ॥६॥

The recipes of Kutaja Phala – fruits of Holarrhena antidysenterica and Krtavedhana – Luffa acutangular should be prepared and used similar to those of Jimutaka.

Ikshvaku

 इक्ष्वाकुकुसुमचूर्णं वा पूर्ववत्, एवं क्षीरेण, कासश्वासच्छर्दिकफरोगेषूपयोगः ॥७॥

Similarly, recipes of flowers of Iksvaku – Laganeria vulgaris should be prepared with milk and administered to cure cough, dyspnea, vomiting and kapha disorders.

Dhamargava

धामार्गवस्यापि मदफलमज्जवदुपयोगः ; विशेषतस्तु गरगुल्मोदरकासश्वासश्लेष्मामयेषु वायौ च  कफस्थानगते ॥८॥

Dhamargava (Krtavedana) should be used in a similar way as the marrow of Madana Phala.

Benefits – Dhamargava recipes are used mainly to treat the below mentioned conditions –

–        artificial poisons and their effects,
–        abdominal tumor,
–        abdominal enlargement,
–        cough
–        dyspnea and
–        kapha and vata disorders localized in the seats of kapha

कृतवेधनफलपिप्पलीनां वमनद्रव्यकषायपरिपीतानां बहुशश्चूर्णमुत्पलादिषु दन्तमाघ्रातं वामयति, तत्त्वनवबद्धदोषेषु यवागूमाकण्ठात्पीतवत्सु च विदध्यात् । वमनविरेचनशिरोविरेचनद्रव्याण्येवं वा  प्रधानतमानि भवन्ति ॥९॥

Powder of Phala Pippali (seeds) of Krtavedhana is prepared. This powder is well soaked in the decoction of emetic drugs. This powder is sprinkled on the Utpala etc. flowers. These flowers are given to the patient to inhale. Inhalation of these flowers sprinkled with powder of Krtavedana seeds dipped in emetic decoctions will produce vomiting. When the doshas are not adhering inside the seat of kapha, this method shall be adopted after making the patient drink Yavagu – thick gruel to his full capacity. When used in this method the drugs / herbs used for vamana – emesis and shiro virechana – head purging becomes more efficient.

Different forms of using emetic drugs

वमनद्रव्ययोगाणां दिगियं संप्रकीर्तिता॥
तान् विभज्य यथाव्याधि कालशक्तिविनिश्चयात् ॥१०॥
कषायैः स्वरसैः कल्कैश्चूर्णैरपि च बुद्धिमान् ॥
पेयलेह्याद्यभोज्येषु वमनान्युपकल्पयेत् ॥११॥

Some verses here:-

The description of vamana dravyas – emetic drugs and recipes given so far are just pointers of clues. Based on these guidelines, an intelligent physician may administer these recipes after considering the kala – time or season and shakti – strength of the patient and as suitable to each disease.

They can be used in any of the below mentioned forms to produce vomiting –

–        decoction
–        fresh juice
–        paste
–        powder
–        thin gruel
–        confection or
–        mixed with food

इति श्रीसुश्रुतसंहितायां सूत्रस्थाने वमनद्रव्यविकल्पविज्ञानीयो नाम  त्रिचत्वारिंशत्तमोऽध्यायः ॥४३॥
Thus ends the forty third chapter by name Vamana dravya Vikalpa in Sutra Sthana of Susrutha Samhita.