Ashtanga Hridayam Uttara Sthanam Chapter 32: Kshudra Roga Pratishedham (Treatment of Minor Diseases)

The 32nd chapter of Uttara Sthanam of Ashtanga Hridayam is named as ‘Kshudra Roga Pratishedham’. This chapter deals with the explanation of ‘Treatment of minor diseases.

The topics covered in this chapter include –

• Ajagallika Cikitsa
• Treatments of all conditions like Pashanagardabha
• Mukha Dushika Cikitsa
• Padmakantaka Cikitsa
• Vivartadi Cikitsa
• Jalagardabha Cikitsa
• Vidarika Cikitsa
• Sharkararbuda Cikitsa
• Valmika Cikitsa
• Treatment of Kadara
• Treatment of Ruddhaguda
• Treatment of Chipya, Kunakha
• Treatment of Alasa
• Treatment of Tilakalaka, Masha, Charmakila, Jatumani
• Treatment of Tilakalaka, Masha, Charmakila, Jatumani
• Treatment of Lanchana, Vyanga, Nilika
• Treatment of Vyanga
• Treatment of Vyanga
• Treatment of Nilika, Patila, Vyanga, Vali, Tila and Mukhadushika;
• Treatment of Prasupti
• Treatment of Utkotha and Kotha

Pledge by the author(s)

अथात: क्षुद्ररोगप्रतिषेधं 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 minor diseases. Thus, say (pledge) Atreya and other sages.

Ajagallika Chikitsa

विस्रावयेज्जलौकोभिरपक्वामजगल्लिकाम् ।
स्वेदयित्वा यवप्रख्यां विलयाय प्रलेपयेत् ॥ १ ॥
दारुकुष्ठमनोह्वालै:
Ajagallika which is unripe should be treated with bloodletting using leeches. Yavaprakhya should be given fomentation and to liquefy it, apply the paste of dāru – Cedrus deodara, kuṣṭha – Saussurea lappa, realgar and purified arsenic trisulphide.

Treatments of all conditions like Pashanagardabha

इत्यापाषाणगर्दभात् ।
विधिस्तांश्चाचरेत्पक्वान् व्रणवत्साजगल्लिकान् ॥ २ ॥
This is the treatment which should be practiced for all diseases up to Pasanagardabha (Alaji, Kachapa, Panasika) in their unripe stage, the ripened conditions should be treated like Vrana (ulcer) including Ajagallika.

Mukha Dushika Chikitsa

लोध्रकुस्तुम्बुरुवचाः प्रलेपो मुखदूषिके ।
वटपल्लवयुक्ता वा नारिकेलोत्थशुक्तयः ॥ ३ ॥
अशान्तौ वमनं नस्यं ललाटे च सिराव्यधः ।
A paste of lodhra – Symplocos racemosa, kustumburu – Coriandrum sativum and vacāḥ – Acorus calamus is useful for Mukhadushika, or a paste of tender leaves of Ficus benghalensis and Narikela Shukti (coconut shells); when the diseases do not subside, emesis, nasal medication and cutting the vein in the forehead should be resorted.

Padmakantaka Chikitsa

निम्बाम्बुवान्तो निम्बाम्बुसाधितं पद्मकण्टके ॥ ४ ॥
पिबेत्क्षौद्रान्वितं सर्पिर्निम्बारग्वधलेपनम् |
In Padmakantaka, the patient should be made to vomit using decoction of nimbāmbu – ­Azadirachta indica, then consume ghee prepared with decoction of nimbāmbu – Azadirachta indica added with honey, paste of nimba – Azadirachta indica and āragvadha – Cassia fistula should be applied.

Vivritadi Chikitsa

विवृतादींस्तु जालान्तांश्चिकित्सेत्सेरिवेल्लिकान् |
पित्तविसर्पवत्तद्वत्प्रत्याख्यायाग्निरोहिणीम् ॥ ५ ॥ Diseases commencing with Vivrita and ending with Jala (gardabha), (Masurika, Visphota, Viddha, Gardhabhi, Kaksa, Gandhanama and Rajika), along with Irivellika should be treated just like treating Pittaja Visarpa (chapter 18 of Chikitsa sthana), similarly, Agnirohini should be treated after intimating its incurability.

Jalagardabha Chikitsa

विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च ।
धात्रीप्रयोगाञ्छिशिरप्रदेहान् कुर्यात्सदा जालकगर्दभस्य ॥ ६ ॥
Fasting, bloodletting, therapy causing dryness, body purificatory therapies, recipes of dhātrī – Emblica officinalis; cold application on the body should be done always in Jalagardabha.

Vidarika Chikitsa

विदारिकां हृते रक्ते श्लेष्मग्रन्थिवदाचरेत् ।|
In Vidarika, blood should be removed and then treated similarly to Kapha granthi (chapter 30) should be adopted.

Sharkararbuda Chikitsa

मेदोऽर्बुदक्रियां कुर्यात्सुतरां शर्करार्बुदे ॥ ७ ॥
In Sharkararbuda, the treatments prescribed for Medo arbuda (chapter 30) should be adopted.

Valmika Chikitsa

प्रवृद्धं सुबहुच्छिद्रं सशोफं मर्मणि स्थितम् ।
वल्मीकं हस्तपादे च वर्जयेदितरत्पुनः ॥ ८ ॥
शुद्धस्यास्रे हृते लिम्पेत्सपट्वारेवतामृतैः ।
श्यामाकुलत्थिकामूलदन्तीपललसक्तुभिः ॥ ९ ॥
पक्वे तु दुष्टमांसानि गतीः सर्वाश्च शोधयेत् ।
शस्त्रेण सम्यगनु च क्षारेण ज्वलनेन वा ॥ १० ॥
Valmika which has grown to a big size, which has multiple openings, accompanied with swelling, situated on vital spots, hands and feet; should be refused treatment. The others should be treated, the person given purificatory therapies, bloodletting and then paste of ārevata – Cassia fistula, amṛtaiḥ – Tinospora cordifolia, śyāmā – Operculina turpethum, root of Dolichos biflorus, dantī – Baliospermum montanum, paste of Sesamum indicum, and roasted corn flour added with – should be applied. When it has become ripe, the putrefied muscle and all the sinuses should be cleared, later by the proper use of either the knife, alkali or fire.

Treatment of Kadara

शस्त्रेणोत्कृत्य निःशेषं स्नेहेन कदरं दहेत् ।
Kadara should be removed with a knife without leaving any residue and then the site is burnt with hot fat.

Treatment of Ruddhaguda

निरुद्धमणिवत्कार्यं रुद्धपायोश्चिकित्सितम् ॥ ११ ॥ Ruddhaguda should be treated in the same manner as treating Niruddamani (chapter 34).

Treatment of Chipya, Kunakha

चिप्यं शुद्ध्या जितोष्माणं साधयेच्छस्त्रकर्मणा ।
दुष्टं कुनखमप्येवं
Chipya is treated by winning over Pitta through purificatory therapies and then by surgery. Even the dosha afflicted Kunakha should be treated in the same manner.

Treatment of Alasa

चरणावलसे पुनः ॥ १२ ॥
धान्याम्लसिक्तौ कासीसपटोलीरोचनातिलैः ।
सनिम्बपत्रैरालिम्पेत्
In Alasa, the foot should be washed with fermented rice wash and applied with the paste of kāsīsa – ferrous sulphate, paṭolī – Trichosanthes dioica, rocanā – bezoar, tilaiḥ – Sesamum indicum and leaves of Azadirachta indica.

Treatment of Tilakalaka, Masha, Charmakila, Jatumani

दहेत्तु तिलकालकान् ॥ १३ ॥
मषांश्च सूर्यकान्तेन क्षारेण यदि वाऽग्निना ।
Tilkalaka and Mashaka should be burnt either by Suryakanta (convex lens), caustic alkali or fire.

Treatment of Tilakalaka, Masha, Charmakila, Jatumani

तद्वदुत्कृत्य शस्त्रेण चर्मकीलजतूमणी ॥ १४ ॥
Charmakila and Jatumani should be pulled up with instruments and treated in the same way (cauterized).

Treatment of Lanchana, Vyanga, Nilika

लाञ्छनादित्रये कुर्याद्यथासन्नं सिराव्यधम् ।
लेपयेत्क्षीरपिष्टैश्च क्षीरिवृक्षत्वगङ्कुरैः ॥ १५ ॥
In the three diseases commencing with Lanchana (Lanchana, Vyanga, Nilika), the nearest vein should be cut, the bark and sprouts of trees having milky- sap made paste with milk should be applied.

Treatment of Lanchana, Vyanga, Nilika

व्यङ्गेषु चार्जुनत्वग्वा मञ्जिष्ठा वा समाक्षिका ।
लेपः सनवनीता वा श्वेताश्वखुरजा मषी ॥ १६ ॥
For Vyanga, application of paste of either the bark of arjuna – Terminalia arjuna, mañjiṣṭhā – Rubia cordifolia mixed with honey or Shveta – Brassica juncea and ash of horse hoof mixed with butter is beneficial.

Treatment of Vyanga

रक्तचन्दनमञ्जिष्ठाकुष्ठलोध्रप्रियङ्गवः ।
वटाङ्कुरा मसूराश्च व्यङ्गघ्ना मुखकान्तिदाः ॥ १७ ॥
(Paste of) Pterocarpus santalinus, mañjiṣṭhā – Rubia cordifolia, kuṣṭha – Saussurea lappa, lodhra – Symplocos racemosa, priyaṅgavaḥ – Callicarpa macrophylla, vaṭāṅkurā – Ficus benghalensis and masūrāśca – Masura-Lens culinaris (individually or together) cure Vyanga and bestow complexion to the face.

Treatment of Vyanga

द्वे जीरके कृष्णतिलाः सर्षपाः पयसा सह ।
पिष्टाः कुर्वन्ति वक्त्रेन्दुमपास्तव्यङ्गलाञ्छनम् ॥१८॥
क्षीरपिष्टा घृतक्षौद्रयुक्ता वा भृष्टनिस्तुषाः ।
मसूराः क्षीरपिष्टा वा तीक्ष्णाः शाल्मलिकण्टकाः ॥१९॥
सगुडः कोलमज्जा वा शशासृक्क्षौद्रकल्कितः ।
सप्ताहं मातुलुङ्गस्थं कुष्ठं वा मधुनाऽन्वितम् ॥२०॥
पिष्टा वा छागपयसा सक्षौद्रा मौसली जटा ।
गोरस्थि मुसलीमूलयुक्तं वा साज्यमाक्षिकम् ॥२१॥
The two Jiraka-Cuminum cyminum and Carum carvi, seeds of black Sesamum indicum and sarṣapāḥ – Brassica juncea made into a paste with milk and applied, makes the face like the moon and cures Vyanga and Lanchana. masūrāḥ – Lens culinaris macerated with milk mixed with ghee and honey, fried, nistuṣāḥ – de-husked and macerated with milk, or sharp thorns śālmali – Salmalia malabarica added with jaggery or kolamajjā – Ziziphus mauritiana mixed with rabbit blood and honey, kuṣṭhaṃ – Saussurea lappa, kept inside the fruit of mātuluṅgasthaṃ – Citrus medica for seven days, added with honey, roots of Salmalia malabarica macerated with goat milk and mixed with honey, (ash of) bones of a cow together with the roots of musalī – Asparagus adscendens or with ghee and honey (these cure Vyanga, Lanchana and Nilika).

Treatment of Vyanga

जम्ब्वाम्रपल्लवा मस्तु हरिद्रे द्वे नवो गुडः ।
लेपः सवर्णकृत्पिष्टं स्वरसेन च तिन्दुकम् ॥ २२ ॥
Paste of tender leaves of Jambu – Syzygium cumini, āmra – and Mangifera indica, the two harida-Haridra – Curcuma longa, Daruharidra – Berberis aristate along with fresh jaggery and macerated with water of curds imparts natural color to the discolored area; so also, the paste of tindukam – Diospyros peregrine macerated with its own juice.

Treatment of Vyanga

उत्पलमुत्पलकुष्ठं प्रियङ्गुकालीयकं बदरमज्जा ।
इदमुद्वर्तनमास्यं करोति शतपत्रसङ्काशम् ॥ २३ ॥
Rubbing the paste of utpala – Nymphaea alba, kuṣṭhaṃ – Saussurea lappa, priyaṅgu – Callicarpa macrophylla, kālīyakaṃ – Santalum album and marrow of Ziziphus jujuba over the face cures Utpalakustha (a variety of skin disease) and makes the face resemble a lotus flower.

Treatment of Vyanga

एभिरेवौषधैः पिष्टैर्मुखाभ्यङ्गाय साधयेत् ।
यथादोषर्तुकान् स्नेहान् मधुकक्वाथसंयुतैः ॥ २४ ॥
Medicated oils should be prepared with the paste of herbs mentioned above and with the decoction of madhuka – Glycyrrhiza glabra, suitable to the aggravated dosha and suitable to the season and used for anointing/massaging the face.

Treatment of Vyanga, Nilika, Dushika

यवान् सर्जरसं लोध्रमुशीरं मदनं मधु ।
घृतं गुडं च गोमूत्रे पचेदादर्विलेपनात् ॥ २५ ॥
तदभ्यङ्गान्निहन्त्याशु नीलिकाव्यङ्गदूषिकान् ।
मुखं करोति पद्माभं पादौ पद्मदलोपमौ ॥ २६ ॥
Yavān – Hordeum vulgare, sarjarasaṃ – resin of Vateria indica, lodhraṃ – Symplocos racemosa, uśīraṃ – Vetiveria zizanioides, madanaṃ – Randia dumetorum, honey, ghee and jaggery all these should be cooked in cow urine till the liquid begins to adhere to the ladle. By anointing this on the face, it cures quickly Nilika, Vyanga, Dushika etc. makes the face and feet (beautiful and red) like lotus and like the petals of a lotus.

Treatment of Nilika, Patila, Vyanga, Vali, Tila and Mukhadushka

कुङ्कुमोशीरकालीयलाक्षायष्ट्याह्वचन्दनम् ।
न्यग्रोधपादांस्तरुणान् पद्मकं पद्मकेसरम् ॥ २७ ॥
सनीलोत्पलमञ्जिष्ठं पालिकं सलिलाढके ।
पक्त्वा पादावशेषेण तेन पिष्टैश्च कार्षिकैः ॥ २८ ॥
लाक्षापत्तङ्गमञ्जिष्ठायष्टीमधुककुङ्कुमैः ।
अजाक्षीरं द्विगुणितं तैलस्य कुडवं पचेत् ॥ २९ ॥
नीलिकापलितव्यङ्गवलीतिलकदूषिकान् ।
हन्ति तन्नस्यमभ्यस्तं मुखोपचयवर्णकृत् ॥ ३०
Kuṅkuma – Crocus sativus, uśīra – Vetiveria zizanioides, kālīya – Santalum album, lākṣā – Laccifer lacca, yaṣṭyāhva – Glycyrrhiza glabra, candanam – Santalum album, tender aerial roots of Ficus benghalensis, padmakaṃ – Prunus cerasoides, stamen of lotus Nelumbo nucifera, sanīlotpala – Nymphaea stellata and mañjiṣṭhaṃ – Rubia cordifolia each one pala (48 grams) are boiled in one adhaka (3.072 litres) of water and decoction reduced to one fourth; to it are added the paste of one karsha (12 grams) each of lākṣā – Laccifer lacca, pattaṅga – Caesalpinia sappan, mañjiṣṭhā – Rubia cordifolia, yaṣṭīmadhuka – Glycyrrhiza glabra and kuṅkumaiḥ – Crocus sativus; goat milk double the quantity of oil one kudava (3.072 litres) in quantity and medicated oil cooked. This oil habitually used as nasal drops cures Nilika, Patila, Vyanga, Vali, Tila and Mukhadushaka; develops the face and improves the color.

Treatment of Vyanga & Nila

मञ्जिष्ठा शबरोद्भवस्तुवरिका लाक्षा हरिद्राद्वयं
नेपाली हरितालकुङ्कुमगदा गोरोचना गैरिकम् |
पत्रं पाण्डु वटस्य चन्दनयुगं कालीयकं पारदं
पत्तङ्गं कनकत्वचं कमलजं बीजं तथा केसरम् ॥३१॥
सिक्थं तुत्थं पद्मकाद्यो वसाऽऽज्यं मज्जा क्षीरं क्षीरिवृक्षाम्बु चाग्नौ ।
सिद्धं सिद्धं व्यङ्गनील्यादिनाशे वक्त्रे छायामैन्दवीं चाशु धत्ते ॥ ३२ ॥
Mañjiṣṭhā – Rubia cordifolia, śabarodbhava: -Symplocos racemosa, tuvarikā – Hydnocarpus laurifolia, lākṣā – Laccifer lacca, the two Haridra-Haridra – Curcuma longa, Daruharidra – Berberis aristata, nepālī – arsenic bi sulphide, haritāla – arsenic trisulphidum, kuṅkuma – Crocus sativus, gadā – Saussurea lappa, gorocanā – bezoar, gairikam – red ochre, Ficus benghalensis – leaves, the two Chandana Red Sandalwood– Pterocarpus santalinus –
Sandalwood – Chandana Santalum album, kālīyakaṃ – Berberis aristata, purified mercury, pattaṅgaṃ – Caesalpinia sappan, bark of Datura metel, seeds of Nelumbo nucifera, stamens of- Nelumbo nucifera, bee wax, purified copper sulphate, herbs of Padmakadigana (chapter 15 of sutrasthana), muscle fat, ghee, bone marrow, milk and decoction of bark of trees having milky-sap all these are cooked over fire and medicated fat prepared. This quickly cures Vyanga, Nila etc. and to the face. impart moonlike radiances.

Treatment of Vyanga

मार्कवस्वरसक्षीरतोयानीष्टानि नावने ।
Fresh juice, mixed with milk or with water of mārkava – Eclipta alba is ideal for Nasal medication.

Treatment of Prasupti

प्रसुप्तौ वातकुष्ठोक्तं कुर्याद्दाहं च वह्निना ॥३३॥
For Prasupti, the treatments advocated for Vatajakustha (vide chapter 19 of Chikitsasathana) should be done and then cauterised by fire.

Treatment of Utkotha and Kotha

उत्कोठे कफपित्तोक्तं कोठे सर्वं च कौष्ठिकम् ॥ ३३+ ॥
All treatment mitigating Kapha and Pitta should be done in Utkotha and in Kotha and all treatments prescribed for skin disease.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने क्षुद्ररोगप्रतिषेधो नाम द्वात्रिंशोऽध्याय: ॥ ३२ ॥
Thus, ends the Chapter – Kshusdrarogapratishedha – the thirty second in Uttarasthana of Astanga Hridaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.