Ashtanga Hridayam Cikitsasthanam Chapter 21: Vatavyadhi Chikitsitam (Treatment of diseases of vata origin)

21^st chapter of Cikitsasthanam of Ashtanga Hridayam is named as Vata Vyadhi Cikitsitam Adhyayah. This chapter deals with the explanation of ‘treatment of diseases of vata origin’.

The topics covered in this chapter include –

• Treatment of Kevala Vata, Snehana, Svedana
• Importance of snehana and svedana explained with help of simily
• Benefits of snehana
• Shodhana using medicated fats
• Elimination of dosas by administering purgative ghee and oil
• Vata anulomana
• Logical administration of niruha, dipana, pacana, snehana and svedana as per situation
• Amasayagata Vata Cikitsa
• Nabhigata Vata Cikitsa
• Adhonabhigata Vata Cikitsa
• Koshtagata Vata Cikitsa
• Hrt-Shiro-Srotradi-gata Vata Cikitsa
• Dhatugata Vata Cikitsa
• Shukragata Vata Cikitsa
• Garbhashayagata Vata Cikitsa
• Apatanaka Cikitsa
• Apatanaka Cikitsa – Mahasneha
• Apatanaka Cikitsa – Shirovirecana
• Treating increased vata
• Tilvakadi Ghrta
• Ramyaka-Asoka Ghrta
• Tumburvadi and Hingvadi Curna
• Treatment of ayamas on the lines of ardita
• Dhanuskhambha
• Hanusramsa Cikitsa
• Jihva Stambha Cikitsa
• Ardita Cikitsa
• Paksaghata Avabahu Cikitsa
• Urusthambha Cikitsa
• Vyosadi Curna
• Panchatikta Guggulu Ghrta
• Baladi Ghrta Nasya
• Siddha Vasa
• Pinyakadi Siddha Tailam
• Prasarinyadi tailam
• Sahacaradi Taila
• Bala Taila
• Different types of using Bala Taila
• Administering of enema to eliminate liquefied pitta and kapha from colon

Pledge by the author (s)

अथातो वातव्याधिचिकित्सितं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘treatment of diseases of vata origin’. Thus say (pledge) Atreya and other sages.

Treatment of Kevala Vata, Snehana, Svedana

केवलं निरुपस्तम्भमादौ स्नेहैरुपाचरेत् ।
वायुं सर्पिर्वसामज्जतैलपानैर्नरं ततः ॥ १ ॥
स्नेहक्लान्तं समाश्वास्य पयोभिः स्नेहयेत्पुनः ।
यूषैर्ग्राम्यौदकानूपरसैर्वा स्नेहसंयुतैः ॥ २ ॥
पायसैः कृशरैः साम्ललवणैः सानुवासनैः ।
नावनैस्तर्पणैश्चान्नैः सुस्निग्धैः स्वेदयेत्ततः ॥ ३ ॥
स्वभ्यक्तं स्नेहसंयुक्तैः शङ्कराद्यैः पुनः पुनः ।
Vata which is alone (not associated with other doshas) and not supported by others (secondary affections) should be first treated with sneha (lubricating treatments, oleation), mainly drinking of either ghee, muscle fat, marrow or oil.  The person who has become weak by drinking of fats should be reassured and administered oleation therapy again by the use of milks, soups (of grains), juice (soup) of meat of domesticated animals, aquatic and of marshy lands with payasa (milk pudding), rice boiled with green gram, mixed with fats, with sours and salt; by oil enema, nasal medication nourishing foods added with fats. Next the patient should be anointed with oil and given sudation therapy by sankara sveda etc. (chapter 17 of sutrasthana) again and again.

Importance of snehana and svedana explained with help of simily

स्नेहाक्तं स्विन्नमङ्गं तु वक्रं स्तब्धं सवेदनम् ॥ ४ ॥
यथेष्टमानामयितुं सुखमेव हि शक्यते ।
शुष्काण्यपि हि काष्ठानि स्नेहस्वेदोपपादनैः ॥ ५ ॥
शक्यं कर्मण्यतां नेतुं किमु गात्राणि जीवताम् ।
The body parts which have become curved, rigid, and painful, if smeared with oil and given sudation therapy, is easily possible to bend as desired after being anointed, and given sudation therapy. When even dried log of wood can be brought into functional stage (used by treating it with fats and heat), then what to say of the living body?

Benefits of snehana

हर्षतोदरुगायामशोफस्तम्भग्रहादयः ॥ ६ ॥
स्विन्नस्याशु प्रशाम्यन्ति मार्दवं चोपजायते ।
Tingling sensation (pins and needles), pricking pain, constant pain, dilatation, swelling, stiffness (loss of movement), catching (muscle catch) etc. subside.  (Body parts)attainquick softness in him who has been given sudation (fomentation).

Benefits of snehana

स्नेहश्चधातून्संशुष्कान्पुष्णात्याशूपयोजितः ॥ ७ ॥
बलमग्निबलं पुष्टिं प्राणांश्चास्याभिवर्धयेत्।
असकृत्तं पुनः स्नेहैः स्वेदैश्चप्रतिपादयेत् ॥ ८ ॥
तथास्नेहमृदौकोष्ठेनतिष्ठन्त्यनिलामयाः।
Fats, if consumed, nourishes the dry tissues quickly and increases the strength, digestive fire, growth of the body parts and life span. Often the patient should be administered with oleation and sudation therapies since diseases of vata origin cannot remain in the alimentary tract and in the body has become soft by oleation.

Shodhana using medicated fats

यद्येतेन सदोषत्वात्कर्मणा न प्रशाम्यति ॥ ९ ॥
मृदुभिः स्नेहसंयुक्तैर्भेषजैस्तं विशोधयेत् ।
If, by these methods of treatment, the diseases do not subside, because of great increase of doshas, then sodhana (purificatory therapy) should be administered using mild herbs mixed with fats. Elimination of dosas by administering purgative ghee and oil

घृतं तिल्वकसिद्धं वा सातलासिद्धमेव वा ॥ १० ॥
पयसैरण्डतैलं वा पिबेद्दोषहरं शिवम् ।
Ghee boiled with either Symplocos racemosa or processed with Acacia concinna; or eranda taila (castor oil) mixed with payas (milk) should be consumed for the elimination of the doshas and to obtain comfort.

Vata anulomana

स्निग्धाम्ललवणोष्णाद्यैराहारैर्हि मलश्चितः ॥ ११ ॥
स्रोतो बद्ध्वाऽनिलं रुन्ध्यात्तस्मात्तमनुलोमयेत् ।
By indulgence in foods which are unctuous (fatty), sour, salty, hot (heat producing) etc. only the malas (doshas) get increased, obstruct the passage of Vata and hinder the activities of vata, hence it (vata) should be

Logical administration of niruha, dipana, pacana, snehana and svedana as per situation

दुर्बलो योऽविरेच्यः स्यात्तं निरूहैरुपाचरेत् ॥ १२ ॥
दीपनैः पाचनीयैर्वा भोज्यैर्वा तद्युतैर्नरम् ।
संशुद्धस्योत्थिते चाग्नौ स्नेहस्वेदौ पुनर्हितौ ॥ १३ ॥
He who is weak and he who is unfit for purgative therapy should be treated with decoction enema or with dipana (herbs which increase hunger) and pacana (digestives) or with foods possessing these properties. The digestive fire gets augmented after proper purificatory therapies.  Administration of sneha (oleation) and sveda (sudation) therapies again is beneficial.

Amasayagata Vata Chikitsa

आमाशयगते वायौ वमितप्रतिभोजिते ।
सुखाम्बुना षड्धरणं वचादिं वा प्रयोजयेत् ॥ १४ ॥
सन्धुक्षितेऽग्नौ परतो विधिः केवलवातिकः ।
When the Vata is localized in the stomach, after giving vamana (emesis) and he is advised to take regimen of diets either saddharana curna (vide chapter 21 of cikitsasthana of astangasangraha) or (powder of) herbs of vacadi gana (vide chapter 1 of sutrasthana).  They should be administered with lukewarm water.  After the digestive fire becomes augmented (by these powders), adopt treatments meant for Vata alone.

Nabhigata Vata Chikitsa

मत्स्यान् नाभिप्रदेशस्थे सिद्धान् बिल्वशलाटुभिः ॥ १५ ॥
When it (Vata) is localized in the region of the umbilicus, fish processed with tender fruits of Aegle marmelos should be given (as food).

Adhonabhigata Vata Chikitsa

बस्तिकर्म त्वधो नाभेः शस्यते चावपीडकः ।
When it (Vata) is localized below the umbilicus, enema therapy and avapidaka (drinking ghee in the maximum dose of oleation therapy both before and after food – vide sutrasthana chapter 4/6-7) is beneficial.

Koshtagata Vata Chikitsa

कोष्ठगे क्षारचूर्णाद्या हिताः पाचनदीपनाः ॥ १६ ॥  
When it is located in the abdomen,  alkali and powders which are digestive and which kindle digestive fire are beneficial.

Hrit-Shiro-Srotradi-gata Vata Chikitsa

हृत्स्थे पयः स्थिरासिद्धं शिरोवस्तिः शिरोगते ।
स्नैहिकं नावनं धूमः श्रोत्रादीनां च तर्पणम् ॥ १७ ॥
When it is localized in the heart, milk boiled with Desmodium gangeticum, when localized in the head, bathing the head with oil snaihika navana (nasal medication with fats) and snaihika dhuma (inhalation of smoke of untuous herbs) and nourishing to the eye etc. (filling the eyes, ears etc. with oil which is nourishing to them).

Dhatugata Vata Chikitsa

स्वेदाभ्यङ्गनिवातानि हृद्यं चान्नं त्वगाश्रिते ।
शीताः प्रदेहा रक्तस्थे विरेको रक्तमोक्षणम् ॥ १८ ॥
विरेको मांसमेदःस्थे निरूहः शमनानि च ।
बाह्याभ्यन्तरतः स्नेहैरस्थिमज्जगतं जयेत् ॥ १९ ॥
Sudation, oil massage, avoidance of breeze, foods which are good to the heart (mind) are ideal when it (Vata) is localized in the skin.  Applying cold pastes on the skin, purgation and bloodletting are ideal when localized in blood.  When localized in muscles and fat tissues, – purgation, decoction enema and palliative measures are ideal.  When localized in bone and marrow tissue, both external and internal will win it.

Shukragata Vata Chikitsa

प्रहर्षोऽन्नं च शुक्रस्थे बलशुक्रकरं हितम् ।
विबद्धमार्गं दृष्ट्वा तु शुक्रं दद्याद्विरेचनम् ॥ २० ॥
विरिक्तं प्रतिभुक्तं च पूर्वोक्तां कारयेत्क्रियाम् ।
When localized in the semen, praharsa (great pleasure related to sexual intercourse) and food which increase strength and semen are beneficial. If it is observedthat the passage of semen is obstructed, purgation should be given first.  After purgation, regimen of diet is given.  After these the treatments mentioned earlier (above) should be administered.

Garbhashayagata Vata Chikitsa

गर्भे शुष्के तु वातेन बालानां च विशुष्यताम् ॥ २१ ॥
सिताकाश्मर्यमधुकैः सिद्धमुत्थापने पयः ।
When the foetus becomes dry because of (increase of) Vata in the uterus which is also dry, milk boiled with sugar, Gmelina arborea and Glycyrrhiza glabra is good for restoring (the foetus).

Garbhashayagata Vata Chikitsa

स्नावसन्धिसिराप्राप्ते स्नेहदाहोपनाहनम् ॥ २२ ॥
तैलं सङ्कुचितेऽभ्यङ्गो माषसैन्धवसाधितम् ।
आगारधूमलवणतैलैर्लेपः स्रुतेऽसृजि ॥ २३ ॥
सुप्तेऽङ्गे वेष्टयुक्ते तु कर्तव्यमुपनाहनम् ।
अथापतानकेनार्तमस्रस्ताक्षमवेपनम् ॥ २४ ॥
When it is localized in the tendons, joints and veins, oleation fire cautery and warm poultices are ideal. In case of contractures (of body parts) oil massage with oil processed with Vigna mungo and rock salt should be done. Blood-letting followed by application of oil processed with agaradhuma (soot) and lavana should be done – when there is loss of sensation (of body parts).  the body part should be wrapped in band of cloth and warm poultice should be applied.

Apatanaka Chikitsa

अथापतानकेनार्तमस्रस्ताक्षमवेपनम् ॥ २४ ॥
अस्तब्धमेढ्रमस्वेदं बहिरायामवर्जितम् ।
अखट्वाघातिनं चैनं त्वरितं समुपाचरेत् ॥ २५ ॥
The patient of tetanus whose sense organs are not weak, who is not having tremors, whose penis is not stiff, who is not sweating, who is not having his body bent exteriorly (outwards) and who is not thumping the cot with his legs should be treated quickly.

Apatanaka Chikitsa

तत्र प्रागेव सुस्निग्धस्विन्नाङ्गे तीक्ष्णनावनम् ।
स्रोतोविशुद्धये युञ्ज्यादच्छपानं ततो घृतम् ॥ २६ ॥
विदार्यादिगणक्वाथदधिक्षीररसैः शृतम् ।
नातिमात्रं तथा वायुर्व्याप्नोति सहसैव वा ॥ २७ ॥
In the beginning (of treatment) itself, to clear the channels, he should be given adequate oleation and sudation therapies to the whole body, followed by strong navana (nasal medication).  Acchapana (drinking of pure fat), then consuming of ghee should be suggested prepared with the decoction of herbs of vidaryadigana (vide chapter 15 of sutrasthana), dadhi (curds), ksira (milk) and rasa (meat soup), in such a way that vata does not spread quickly all over the body.

Apatanaka Chikitsa: Mahasneha

कुलत्थयवकोलानि भद्रदार्वादिकं गणम् ।
निःक्वाथ्यानूपमांसं च तेनाम्लैः पयसापि च ॥ २८ ॥
स्वादुस्कन्धप्रतीवापं महास्नेहं विपाचयेत् ।
सेकाभ्यङ्गावगाहान्नपाननस्यानुवासनैः ॥ २९ ॥
स हन्ति वातं ते ते च स्नेहस्वेदाः सुयोजिताः ।
Mahasneha (mixture of all the four fats, viz, ghee, oil, muscle fat and marrow) should be cooked (prepared) with Dolichos biflorus,  Hordeum vulgare,  kolāni – Ziziphus jujuba, Ziziphus mauritiana,  bhadradārvādikaṃ gaṇam – herbs of bhadradaru gana (vide chapter 15 of sutrasthana),  by processing meat of animals of marshy regions,  added with sours (sour liquids),  – and milk and paste of herbs of Svadu skandha (sweet group) (chapter 10 of sutrasthana). This mitigates vata, when used for pouring over the body, massage, immersing the body, mixed with foods and drink, for nasal medication and oil enema, along with oleation and sudation therapies described earlier.

Apatanaka Chikitsa: Shirovirecana

वेगान्तरेषु मूर्धानमसकृच्चास्य रेचयेत् ॥ ३० ॥
अवपीडैः प्रधमनैस्तीक्ष्णैः श्लेष्मनिबर्हणैः ।
श्वसनासु विमुक्तासु तथा सञ्ज्ञां स विन्दति ॥ ३१ ॥
In between the bouts (of convulsions) purgations to the head should be administered many times with strong avapida and pradhamana (nasal medications, vide chapter 20 of Sutrasthana) which eliminate Kapha.  By these when the respiratory passage gets released (becomes free of Kapha) the patient regains consciousness.

Treating increased Vata: Sauvarchaladi Ghrita

सौवर्चलाभयाव्योषसिद्धं सर्पिश्चलेऽधिके ॥ ३१ब् ॥
When there is great increase of Vata, use of ghee processed with black salt Terminalia chebula Black pepper – Piper nigrum, long pepper fruit – Piper longum and Ginger – Zingiber officinale (should be done).

Tilvakadi Ghrita

पलाष्टकं तिल्वकतो वरायाः प्रस्थं पलांशं गुरुपञ्चमूलम् ।
सैरण्डसिंहीत्रिवृतं घटेऽपां पक्त्वा पचेत्पादशृतेन तेन ॥ ३२ ॥
दध्नः पात्रे यावशूकात्त्रिबिल्वैः सर्पिःप्रस्थं हन्ति तत्सेव्यमानम् ।
दुष्टान् वातानेकसर्वाङ्गसंस्थान् योनिव्यापद्गुल्मवर्ध्मोदरं च ॥ ३३ ॥
Eight pala (384 grams) of Symplocos racemosa,  one prastha (768 grams) of vara (Haritaki – Terminalia chebula, Terminalia bellerica, Amalaki – Emblica officinalis),  one pala (48 grams) of guru (mahat) pancamula -Bilva – Aegle Marmelos Agnimantha – Premna mucronate Shyonaka – Oroxylum indicum Patala – Stereospermum Suaveolens Gambhari – Gmelina arborea ,eraṇḍa – Ricinus communis,  siṃhī – Adhathoda vasica ,trivṛtaṃ – and Operculina turpethum are boiled in one ghata (12.288 liters) of water and decoction is reduced to a quarter. To this are added one patra (adhaka – 3 litre 72 ml) of curds, three bilva (three pala – 144 grams) of alkali of Hordeum vulgare and one prastha (768 grams) of ghee and medicated ghee is cooked.  This recipe consumed (daily) cures diseases manifested due to vitiation of vata occurring either in one part of the body, or all the parts, and also diseases of the vaginal tract, abdominal tumor, scrotal enlargement and enlargement of the abdomen.

Ramyaka: Ashoka Ghrita

विधिस्तिल्वकवज्ज्ञेयो रम्यकाशोकयोरपि ॥ ३४अब् ॥
Same procedure similar to that of tilvaka ghrta is even suitable to prepare medicated ghee from Cassia fistula and Saraca indica also.

Tumburvadi and Hingvadi Churna

चिकित्सितमिदं कुर्याच्छुद्धवातापतानके ।
संसृष्टदोषे संसृष्टं चूर्णयित्वा कफान्विते ॥ ३५ ॥
तुम्बुरूण्यभया हिङ्गु पौष्करं लवणत्रयम् ।
यवक्वाथाम्बुना पेयं हृत्पार्श्वार्त्यपतन्त्रके ॥ ३६ ॥
हिङ्गु सौवर्चलं शुण्ठी दाडिमं साम्लवेतसम् ।
पिबेद्वा श्लेष्मपवनहृद्रोगोक्तं च शस्यते ॥ ३७ ॥
This is the line of treatment in Apatanaka produced by suddhavata (Vata not associated with other dosha).  When there is association of other doshas, when associated with Kapha, tumburūṇi – Zanthoxylum alatum, abhayā – Terminalia chebula, hiṅgu – Ferula asafoetida, pauṣkaraṃ – pauskarabija – seeds of Inula racemosa, lavanatrayam (Saindhava – rock salt, Souvarchala – black salt and Bida salt), should be powdered and consumed with decoction of Hordeum vulgare.  When there is pain in the region of the heart and flanks and in apatantraka hiṅgu – powder of Ferula asafoetida, sauvarcalaṃ – black salt, śuṇṭhī – Zingiber officinale, dāḍimaṃ – Punica granatum and amlavetasam – Garcinia pedunculata (may be consumed with decoction of yava) should be consumed so also those mentioned in the treatment of heart diseases caused by kapha and vata together (chapter of cikitsa sthana) are suitable.

Treatment of ayamas on the lines of ardita

आयामयोरर्दितवद्बाह्याभ्यन्तरयोः क्रिया ।
तैलद्रोण्यां च शयनमान्तरोऽत्र सुदुस्तरः ॥ ३८ ॥
In both the ayama (bending of the body exteriorly and interiorly) treatments both external and internal should be done,  similar to that of facial palsy and also lying down (remaining) in a taila droni (tub filled with medicated oil).  The interior bending of the body is very difficult to cure.

Dhanuskhambha

विवर्णदन्तवदनः स्रस्ताङ्गो नष्टचेतनः ।
प्रस्विद्यंश्च धनुष्कम्भी दशरात्रं न जीवति ॥ ३९ ॥
वेगेष्वतो अन्यथा जीवेन् मन्देषु विनतो जडः ।
खञ्जः कुणिः पक्षहतः पङ्गुलो विकलोऽथवा ॥ ४० ॥
The patient of dhanuskambha (tetanus) whose teeth and face have become discolored, body parts dropping down, who has lost consciousness, who perspires heavily, does not survive for ten days. Otherwise, he can survive, when the bouts (of convulsions) are mild, the patient lives on the stiff, immobile body with loss of movement in both legs, or distorted body parts, hemiplegia, lame or disability.

Hanusramsa Chikitsa

हनुस्रंसे हनू स्निग्धस्विन्नौ स्वस्थानमानयेत् ।
उन्नामयेच्च कुशलश्चिबुकं विवृत्ते मुखे ॥ ४१ ॥
नामयेत्संवृते शेषमेकायामवदाचरेत्
In locked jaw, the lower jaw should be placed in its normal place after giving oleation and sudation. The skilled physician should elevate the chin when the mouth is open and pull it down when the mouth is closed.  Afterwards the treatments prescribed for ekayama (ardita- facial palsy) should be adopted.

Jihva Stambha Chikitsa

जिह्वास्तम्भे यथावस्थं कार्यं वातचिकित्सितम् ॥ ४२ ॥
Loss of movement of the tongueshould be treated with such kind of treatment which are enumerated (in chapter 13 of sutrasthana) for vata diseases as are appropriate to the condition.

Ardita Chikitsa

अर्दिते नावनं मूर्ध्नि तैलं श्रोत्राक्षितर्पणम् ।
सशोफे वमनं दाहरागयुक्ते सिराव्यधः ॥ ४३ ॥
For facial palsy, nasal medication, anointing oil on the head, filling oil to the ears and eyes, emesis, if there is swelling; and venescetion if there is burning sensation and redness – are the treatments.

Paksaghata Avabahu Chikitsa

स्नेहनं स्नेहसंयुक्तं पक्षाघाते विरेचनम् ।
अवबाहौ हितं नस्यं स्नेहश्चोत्तरभक्तिकः ॥ ४४ ॥
Oleation and purgative therapy accompanied with oleation are the treatment for hemiplegia for loss of movement of the arm, nasal medication is beneficial and also oleation after meals.

Urusthambha Chikitsa

ऊरुस्तम्भे तु न स्नेहो न च संशोधनं हितम् ।
श्लेष्माममेदोबाहुल्याद्युक्त्या तत्क्षपणान्यतः ॥ ४५ ॥
कुर्याद्रूक्षोपचारश्च यवश्यामाककोद्रवाः ।
शाकैरलवणैः शस्ताः किञ्चित्तैलैर्जलैः शृतैः ॥ ४६ ॥
जाङ्गलैरघृतैर्मांसैर्मध्वम्भोऽरिष्टपायिनः ।
वत्सकादिर्हरिद्रादिर्वचादिर्वा ससैन्धवः ॥ ४७ ॥
आढ्यवाते सुखाम्भोभिः पेयः षड्धरणोऽथवा ।
For rigidity/loss of movement of the thighs neither oleation nor purifactory therapies are beneficial because of the predominance of Kapha,  undigested metobolities and medas.  Skilful treatments to reduce the same are administered.  Measures to produce dryness inside should be done using Hordeum vulgare, śyāmāka – Echinochloa esculenta and kodravāḥ – Paspalum scrobiculatum. Vegetables without salt (or very little of) and with very little of oil are beneficial which are boiled in water,  soup of meat of animals of desert–like regions without addition of ghee,  honey water and arista (fermented decoction) are suitable as food and drink; Decoction of herbs of vatsakadi,  haridradi or vacadi gana (chapter 15 of sutrasthana)  added with rock salt,  or saddharana curna (chapter 21 of cikitsa sthana of asthangasangraha) should be consumed,  along with warm water  in adhyavata (urusthambha).  

Urusthambha Chikitsa

लिह्यात्क्षौद्रेण वा श्रेष्ठाचव्यतिक्ताकणाघनात् ॥ ४८ ॥
चित्रकेन्द्रयवाः पाठा कटुकातिविषा निशा ।
वातव्याधिप्रशमनो योगः षड्धरणाह्वयः ॥ ४८१+१ ॥
कल्कं समधु वा चव्यपथ्याग्निसुरदारुजम्
मूत्रैर्वा शीलयेत्पथ्यां गुग्गुलुं गिरिसम्भवम् ॥ ४९ ॥
The paste of śreṣṭhā – Aquilaria agallocha,  cavya – Piper retrofractum,  tiktā – Swertia chirata,  kaṇā – Piper longum,  ghanāt – and Cyperus rotundus,  may be licked  ­with honey; citraka – or paste of Plumbago zeylanica,  indrayavāḥ – Holarrhena antidysenterica,  pāṭhā – Cissampelos pareira,  kaṭuka – Picrorhiza kurrooa,  ativiṣā – Aconitum heterophyllum, niśā – Curcuma longa – pacifies (cures) vatavyadi (diseases of vata origin)  and (similarly should be used) Shaddharana yoga cavya – or the paste of Piper retrofractum,  pathyā – Terminalia chebula,  agni – Plumbago zeylanica suradārujam – and Cedrus deodara sa madhu vā – with honey;  – or made use of paste of pathyāṃ – Terminalia chebula,  gugguluṃ – Commiphora mukul girisambhavam – and silajatu – Asphaltum mixed with cows urine.

Vyoshadi Churna / Vyoshadi Guggulu

व्योषाग्निमुस्तत्रिफलाविडङ्गैर्गुग्गुलुं समम् ।
खादन् सर्वाञ्जयेद्व्याधीन् मेदःश्लेष्मामवातजान् ॥ ५० ॥
Equal quantities ofvyosa (Black pepper – Piper nigrum
Long pepper fruit – Piper longum and Ginger – Zingiber officinale),  agni – Plumbago zeylanica,  musta – Cyperus rotundus,  triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellerica, Amalaki – Emblica officinalis),  viḍaṅgai: – and Embelia ribes – (together forming one part) mixed with equal quantity (of all the other herbs put together) of Commiphora mukul converted into a paste by cooking) and consumed sarvān jayet vyādhīn – cures all the diseases arising from medas (fat), shleshma (kapha) ama (undigested metabolites) and vata.

Urustambha Chikitsa

शाम्यत्येवं कफाक्रान्तः समेदस्कः प्रभञ्जनः ।
क्षारमूत्रान्वितान् स्वेदान् सेकान् उद्वर्तनानि च ॥ ५१ ॥
कुर्याद्दिह्याच्च मूत्राढ्यैः करञ्जफलसर्षपैः ।
मूलैर्वाऽप्यर्कतर्कारीनिम्बजैः ससुराह्वयैः ॥ ५२ ॥
सक्षौद्रसर्षपापक्वलोष्टवल्मीकमृत्तिकैः ।
कफक्षयार्थं व्यायामे सह्ये चैनं प्रवर्तयेत् ॥ ५३ ॥
स्थलान्युल्लङ्घयेन्नारीः शक्तितः परिशीलयेत् ।
स्थिरतोयं सरः क्षेमं प्रतिस्रोतो नदीं तरेत् ॥ ५४ ॥
Vata associated with meda (fat) and invaded by Kapha gets mitigated by  sudation,  pouring of liquids on the body,  dry massage etc. using alkalies, mixed with urine should be done; Paste of karanja (Pongamia pinnata) and Brassica nigra prepared by mixing them in large quantities of urine of cow should be smeared on the afflicted part.   – Similarly the powder / paste of roots of Calotropis gigantea,  Clerodendrum phlomidis,  Azadirachta indica and Cedrus deodara made by mixing them in honey and added with Brassica nigra by fomenting the thigh with heated stone or mud of ant-hill; – for decreasing the kapha,  he should resort to physical exercises,  should be performed to the tolerance extent,  jump  from place to place,  indulge in women (sexual intercourse) to the limit of his strength,  swim – in stagnant water or in safe rivers (free from whirls, crocodiles etc.)  in the opposite direction of the flow.

Urustambha Chikitsa

श्लेष्ममेदःक्षये चात्र स्नेहादीन् अवचारयेत् ।
स्थानदूष्यादि चालोच्य कार्या शेषेष्वपि क्रिया ॥ ५५ ॥
If Kapha and fat are found to be decreased, sneha etc. oleation therapy and others which increase these should be administered Even in other diseases (of vata origin) treatments considering suitable to the sthana (place affected) and according to tissues vitiated after considering these factors should be done.

Sahacharadi Kashayam

सहचरं सुरदारु सनागरं क्वथितमम्भसि तैलविमिश्रितम् ।
पवनपीडितदेहगतिः पिबन् द्रुतविलम्बितगो भवतीच्छया ॥ ५६ ॥
sahacaraṃ – Strobilanthus ciliatus, suradāru – Cedrus deodara nāgaraṃ – and Zingiber officinale made into decoction with water and consumed mixed with oil.  Gait of the body affected by Vata soon gets either quick pace or slow pace whichever he desires.

Rasnadi Ghritam

रास्नामहौषधद्वीपिपिप्पलीशठिपौष्करम् ।
पिष्ट्वा विपाचयेत्सर्पिर्वातरोगहरं परम् ॥ ५७ ॥
Ghee boiled with the paste of Rāsnā – Pluchea lanceolata,  mahauṣadha – Zingiber officinale,  dvīpi – Plumbago zeylanica,  pippalī – Piper longum,  śaṭhi – Hedychium spicatum pauṣkaram – Inula racemosa,  is best to cure all the diseases caused by vata.

Panchatikta Guggulu Ghrita

निम्बामृतावृषपटोलनिदिग्धिकानां भागान् पृथक् दश पलान् विपचेद्घटेऽपाम् ।
अष्टांशशेषितरसेन पुनश्च तेन प्रस्थं घृतस्य विपचेत्पिचुभागकल्कैः ॥ ५८ ॥
पाठाविडङ्गसुरदारुगजोपकुल्याद्विक्षारनागरनिशामिशिचव्यकुष्ठैः ।
तेजोवतीमरिचवत्सकदीप्यकाग्निरोहिण्यरुष्करवचाकणमूलयुक्तैः ॥ ५९ ॥
मञ्जिष्ठयाऽतिविषया विषया यवान्या संशुद्धगुग्गुलुपलैरपि पञ्चसङ्ख्यैः ।
तत्सेवितं विधमति प्रबलं समीरं सन्ध्यस्थिमज्जगतमप्यथ कुष्ठमीदृक् ॥ ६० ॥
नाडीव्रणार्बुदभगन्दरगण्डमालाजत्रूर्ध्वसर्वगदगुल्मगुदोत्थमेहान् ।
यक्ष्मारुचिश्वसनपीनसकासशोफहृत्पाण्डुरोगमदविद्रधिवातरक्तम् ॥ ६१ ॥
Ten pala (480 grams) each separately of nimba – Azadirachta indica,  amṛtā – Tinospora cordifolia,  vṛṣa – Adhatoda vasica,  paṭola – Trichosanthes dioica,  and Solanum surattense are boiled  in one ghata (one drona – 12 Kg 228 grams) of water and decoction reduced to one-eight quantity.  punaśca – Again to this, one prastha (768 grams) of ghee is cooked with of paste of pāṭhā – Cissampelos pareira,  viḍaṅga – Embelia ribes,  suradāru – Cedrus deodara,  gaja upakulyā – Piper chaba,  dvikṣāra – the two ksara – alkali prepared of Hordeum vulgare and Swarjika kshara nāgara – Zingiber officinale,  niśā – Foeniculum vulgare,  miśi – Curcuma longa,  cavya – Piper retrofractum,  kuṣṭhaiḥ – Saussurea lappa,  tejovatī – Zanthoxylum alatum,  marica – Piper nigrum,  vatsaka – Holarrhena antidysenterica,  dīpyaka – Apium graveolens,  agni – Plumbago zeylanica,  rohiṇi – Picrorhiza kurroa,  aruṣkara – Semecarpus anacardium,  vacā – Acorus calamus,  kaṇa mūla – Piper longum,  yuktaiḥ – Pluchea lanceolata,  mañjiṣṭhayā – Rubia cordifolia,  ativiṣayā – Aconitum heterophyllum,  viṣayā – Roscoea purpurea Roscoea purpurea – and Trachyspermum ammi each 24 g in quantity,  and five pala (240 grams) of saṃśuddha guggulu – purified Commiphora mukul.  It is advised for consumption in severe diseases of vata even though localized in the joints, bone and bone marrow, so also the skin disease of similar nature, sinus ulcers, tumor, – fistula, swellings in the neck (glandular), all diseases above the level of shoulders, abdominal tumors, hemorrhoids, diabetes, consumption, loss of the taste / appetite, dyspnea, rhinitis, cough, oedema, disease of the heart, anaemia, intoxication, abscesses, and gout.  

Baladi Ghrita Nasya

बलाबिल्वशृते क्षीरे घृतमण्डं विपाचयेत् ।
तस्य शुक्तिः प्रकुञ्चो वा नस्यं वाते शिरोगते ॥ ६२ ॥
balā – Sida cordifolia bilva – and Aegle marmelos are boiled in milk and the scum of ghee is added to it and cooked again.  This ghee used as nasal medication – in doses of either one sukti (24 grams) or 48 grams is ideal for diseases of Vata affecting (localized in) the head.

Siddha Vasa

तद्वत्सिद्धा वसा नक्रमत्स्यकूर्मचुलूकजा ।
विशेषेण प्रयोक्तव्या केवले मातरिश्वनि ॥ ६३ ॥
Muscle fat of crocodile, fish, tortoise, porpoise prepared in the same manner (as above) should be administered especially in aggravated Vata without association of other doshas.

Pinyakadi Siddha Tailam

जीर्णं पिण्याकं पञ्चमूलं पृथक् च क्वाथ्यं क्वाथाभ्यामेकतस्तैलमाभ्याम् ।
क्षीरादष्टांशं पाचयेत्तेन पानाद्वाता नश्येयुः श्लेष्मयुक्ता विशेषात् ॥ ६४ ॥
Old oil cake and brihat panchamoola (Bilva – Aegle Marmelos, Agnimantha – Premna mucronata, Shyonaka – Oroxylum indicum, Patala – Stereospermum suaveolens & Gambhari – Gmelina arborea) are made into decoction separately, one among them is cooked along with sesame oil and 8 parts of milk. By consuming this, especially Vata associated with Kapha gets cured.

Prasarinyadi tailam

प्रसारिणीतुलाक्वाथे तैलप्रस्थं पयःसमम् ।
द्विमेदामिशिमञ्जिष्ठाकुष्ठरास्नाकुचन्दनैः ॥ ६५ ॥
जीवकर्षभकाकोलीयुगलामरदारुभिः ।
कल्कितैर्विपचेत्सर्वमारुतामयनाशनम् ॥ ६६ ॥
To the decoction prepared from one tula (4.8 Kg) of Paederia foetida  one prastha (768 ml) of oil,  equal quantity of milk and paste of the two meda (Meda- Polygonatum verticillatum, Maha meda– Polygonatum cirrhifolium),  Foeniculum vulgare,  Rubia cordifolia,  Saussurea lappa,  Pluchea lanceolata,  Caesalpinia sappan,  Malaxis acuminata,  Manilkara hexandra,  the two kakoli (Kakoli – Fritillaria roylei, Kshira Kakoli – Roscoea purpurea),  and Cedrus deodara are added and medicated oil cooked.  This destroys (cures) all the diseases of Vata.

Sahacharadi Taila

समूलशाखस्य सहाचरस्य तुलां समेतां दशमूलतश्च ।
पलानि पञ्चाशदभीरुतश्च पादावशेषं विपचेद्वहेऽपाम् ॥ ६७ ॥
तत्र सेव्यनखकुष्ठहिमैलास्पृक्प्रियङ्गुनलिकाम्बुशिलाजैः ।
लोहितानलदलोहसुराह्वैः कोपनामिशितुरुष्कनतैश्च ॥ ६८ ॥
तुल्यक्षीरं पालिकैस्तैलपात्रं सिद्धं कृच्छ्राञ्छीलितं हन्ति वातान् ।
कम्पाक्षेपस्तम्भशोषादियुक्तान् गुल्मोन्मादौ पीनसं योनिरोगान् ॥ ६९ ॥
One tula (4.8 Kg) of roots and branches of Casearia esculanta  equal quantity of  dasamula – Bilva – Aegle Marmelos Agnimantha – Premna mucronate Shyonaka – Oroxylum indicum Patala – Stereospermum Suaveolens Gambhari – Gmelina arborea Shalaparni – Desomodium gangeticum Prishniparni – Uraria picta Brihati – Solanum indicum Kantakari – Solanum xanthocarpum Gokshura – Tribulus terrestris – fifteen pala (720 grams) of abhīru – Asparagus racemosus,  are boiled in one vaha (four drona – 48 litre 912 ml) and decoction reduced to one-forth the quantity. to this are added the paste of one pala (48 grams) each of  sevya – Vetiveria zizanioides,  nakha – Capparis sepiaria,  kuṣṭha – Saussurea lappa,  hima – Cinnamomum camphora,  elā – Elettaria cardamomum,  spṛk – Anisomeles malabarica,  priyaṅgu – Callicarpa macrophylla,  nalika – Commiphora myrrha ambu – Cyperus rotundus,  śilājaiḥ – Asphaltum,  lohitā – Boerhavia diffusa / Aphanamixis polystachya,  nalada – Nardostachys jatamansi,  loha – iron calx,  surāhvaiḥ – Cedrus deodara kopanā – Angelica glauca,  miśi – Foeniculum vulgare,  turuṣka – Altingia excelsa  nataiśca – and Valeriana wallicii; one patra (one adhaka – 3 litres 72 ml) of oil and equal (same) quantity of milk  are all added and medicated oil cooked,  consumed (internally daily).  This oil cures diseases of Vata which are difficult to cure associated with tremors, convulsions, rigidity, emaciation, abdominal tumors, insanity, rhinitis and diseases of the vagina.

Sahacharadi Taila 2

सहचरतुलायास्तु रसे तैलाढकं पचेत् ।
मूलकल्काद्दशपलं पयो दत्त्वा चतुर्गुणम् ॥ ७० ॥
अथवा नतषड्ग्रन्थास्थिराकुष्ठसुराह्वयात् ।
सैलानलदशैलेयशताह्वारक्तचन्दनात् ॥ ७१ ॥
सिद्धेऽस्मिञ्छर्कराचूर्णादष्टादशपलं क्षिपेत् ।
भेडस्य सम्मतं तैलं तत्कृच्छ्रान् अनिलामयान् ॥ ७२ ॥
वातकुण्डलिकोन्मादगुल्मवर्ध्मादिकाञ्जयेत् ।
In the decoction of one tula (4.8 Kg) of sahacara – Strobilanthus ciliatus,  one adhaka (3 litre 72 ml) of oil and ten pala (480 grams) of stem of roots of Strobilanthus ciliates  and four parts of milk  are added and medicated oil cooked. or the paste of Valeriana wallicii, ṣaḍgranthā – Acorus calamus, sthirā – Desomodium gangeticum, kuṣṭha – Saussurea lappa, surāhvayāt – Cedrus deodara, elā – Elettaria cardamomum, nalada – Nardostachys jatamamsi, śaileya – Parmelia perlata, śatāhvā – Anethum sowa raktacandanāt – and Pterocapus santalinus and eighteen pala (864 grams) of powdered sugar are added to the decoction of Strobilanthus ciliatus and taila (medicated oil) prepared. This oil, approved by sage bheda, wins (cures) diseases of Vata which are difficult to cure, and also vatakundalika (pain around the bladder), insanity, abdominal tumor, scrotal enlargement etc.

Bala Taila

बलाशतं छिन्नरुहापादं रास्नाष्टभागिकम् ॥ ७३ ॥
जलाढकशते पक्त्वा शतभागस्थिते रसे ।
दधिमस्त्विक्षुनिर्यासशुक्तैस्तैलाढकं समैः ॥ ७४ ॥
पचेत्साजपयोऽर्धांशं कल्कैरेभिः पलोन्मितैः ।
शठीसरलदार्वेलामञ्जिष्ठागुरुचन्दनैः ॥ ७५ ॥
पद्मकातिबलामुस्ताशूर्पपर्णीहरेणुभिः ।
यष्ट्याह्वसुरसव्याघ्रनखर्षभकजीवकैः ॥ ७६ ॥
पलाशरसकस्तूरीनलिकाजातिकोशकैः ।
स्पृक्काकुङ्कुमशैलेयजातीकटुफलाम्बुभिः ॥ ७७ ॥
त्वक्कुन्दुरुककर्पूरतुरुष्कश्रीनिवासकैः ।
लवङ्गनखकङ्कोलकुष्ठमांसीप्रियङ्गुभिः ॥ ७८ ॥
स्थौणेयतगरध्यामवचामदनकप्लवैः ।
सनागकेसरैः सिद्धे दद्याच्चात्रावतारिते ॥ ७९ ॥
पत्रकल्कं ततः पूतं विधिना तत्प्रयोजितम् ।
कासं श्वासं ज्वरं छर्दिं मूर्छां गुल्मक्षतक्षयान् ॥ ८० ॥
प्लीहशोषावपस्मारमलक्ष्मीं च प्रणाशयेत् ।
बलातैलमिदं श्रेष्ठं वातव्याधिविनाशनम् ॥ ८१ ॥
One hundred pala – 4.8 Kg of balā – Sida cordifolia,  quarter of that quantity (twenty-five pala – 1.2 Kg) of chinnaruhā – Tinospora cordifolia,  one- eight quantity (twelve and half pala – 600 grams) rāsnā – of Pluchea lanceolata are boiled in one hundred adhaka (307.2 litres) of water and decoction  reduced to one hundred pala (4.8 litres).  To this are added equal quantities of water portion of curds sugarcane juice fermented rice-wash and oil each one adhaka (3 litres 72 ml), should be preapared. Half quantity (half adhaka – 1536.5 ml) of goats milk,  paste of one pala (48 grams) each of these herbs śaṭhī – Curcuma zedoaria,  sarala – Pinus roxburghii,  dāru – Berberis aristata,  elā – Elettaria cardamomum,  mañjiṣṭhā – Rubia cordifolia,  aguru – Aquilaria agallocha,  candanaiḥ – Santalum album,  padmaka – Prunus cerasoides,  atibalā – Abutilon indicum,  mustā – Cyperus rotundus,  śūrpaparṇī – Desmodium gangeticum,  hareṇubhiḥ – Pisum sativum,  yaṣṭyāhva – Glycyrrhiza glabra,  surasa – Ocimum sanctum,  vyāghranakha – Capparis sepiaria,  ṛṣabhaka – Manilkara hexandra,  jīvakaiḥ – Malaxis acuminata / Microstylis wallichii,  palāśa – Butea monosperma,  rasa – bala – Sida cordifolia kastūrī – Abelmoschus moschatus (musk) nalikā – Commiphora myrrha,  jātikośakaiḥ – Myristica fragrens,  spṛkkā – Anisomeles malabarica,  kuṅkuma – Crocus sativus,  śaileya – Parmelia perlata,  jātī – Jasminum grandiflorum,  kaṭuphala – Myrica nagi,  ambubhiḥ – Plectranthus vettiveroides,  twak Cinnamomum zeylanicum,  kunduruka – Coccinia grandis,  karpūra – Cinnamomum camphora,  turuṣka – Altingia excels śrīnivāsakaiḥ – Pinus roxburghii, lavaṅga – Syzygium aromaticum,  nakha – Martynia annua,  kaṅkola – Piper cubeba,  kuṣṭha – Saussurea lappa,  māṃsī – Nardostachys jatamansi priyaṅgubhiḥ – Callicarpa macrophylla, sthauṇeya – Taxus baccata,  tagara – Valeriana wallichii dhyāma – Cymbopogon martinii, vacā – Acorus calamus,  madanaka – Randia dumetorum,  plavaiḥ – Ficus lacor sanāgakesaraiḥ – and Messua ferrea siddhe – and medicated oil prepared dadyāt cā – and administered atrā avatārite – after it cools. after filtering it, paste of Cinnamomum tamala is added, this oil knows as Bala taila, administered (both internally and externally) as prescribed (in proper method) cures cough, dysponea, fever, vomiting, fainting, abdominal tumors, tears of the lungs, consumption, diseases of the spleen, emaciation, epilepsy, alakshmi (disease caused by sorcery) and is best to cure diseases of vata origin.

Different types of administration of oils

पाने नस्येऽन्वासनेऽभ्यञ्जने च स्नेहाः काले सम्यगेते प्रयुक्ताः ।
दुष्टान् वातान् आशु शान्तिं नयेयुर्वन्ध्या नारीः पुत्रभाजश्च कुर्युः ॥ ८२ ॥
Medicated oils enumerated above used for drinking, nasal medication, oil enema, and anointing (and massage) at the proper time, brings down the aggravated vata (cures diseases of vata) and make the barren lady fit to have sons.

Administering of enema to eliminate liquefied pitta and kapha from colon

स्नेहस्वेदैर्द्रुतः श्लेष्मा यदा पक्वाशये स्थितः ।
पित्तं वा दर्शयेद्रूपं वस्तिभिस्तं विनिर्जयेत् ॥ ८३ ॥
When either kapha or pitta getting liquefied by oleation and sudation therapies exhibit their symptoms in the large intestine then they should be vanquished (mitigated or eliminated) by enema therapies.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने वातव्याधिचिकित्सितं नाम एकविंशोऽध्याय: ॥ २१ ॥
Thus, ends the chapter vataroga cikitsita twenty-first in cikitsita sthana of asthanag hrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.