Ashtanga Hridayam UttaraSthanam Chapter 24: Shiroroga Pratishedha (Treatment of Diseases of the Head)

The 24th chapter of Uttara Sthanam of Ashtanga Hridayam is named as Shiroroga Pratishedha. This chapter deals with the explanation of ‘Treatment of diseases of the head’.

The topics covered in this chapter include –

•   Vataja Shirashula Chikitsa
•   Vataja Shirashula Chikitsa
•   Ardhavabhedaka Chikitsa
•    Suryavarta Chikitsa
•   Pittaja Shirashula Chikitsa
•   Raktaja Shirashulaand Sankhaka Chikitsa
•   Kaphaja Shirashula Chikitsa
•   Sarvaja Shirashula Chikitsa
•   Krimija Shirashula Chikitsa
•       Sirahkampa Chikitsa
•       Upasirsaka Chikitsa
•       Vidradi, Pitaka and Arbuda Chikitsa
•       Arumsika Chikitsa
•   Kusta Churna for Arumshika
•   Malatyadi Taila for coca and Arumshika
•       Purification of head
•       Darunaka Chikitsa
•       Indralupta Chikitsa
•       Khalita – Palita Chikitsa
•       Indralupta Chikitsa
•       Priyalvadi pralepa
•   Tiladi lepa for kesharanjana
•       Mamsyadi Lepa
•       Ayorajadi Lepam
•   Kesharanjana
•       Prapaundarikadi Taila
•       Mayura Ghrta
•   Mahamayura Ghrita
•       Other medicated ghee prepared form meats
•       Number of diseases affecting the region above shoulder
•       Importance of treating the head

Pledge by the author(s)

अथात: शिरोरोगप्रतिषेधं 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 the diseases of the head’. Thus, say (pledge) Atreya and other sages.

Vataja Shirashula Chikitsa

शिरोऽभितापेऽनिलजे वातव्याधिविधिं चरेत् ।
घृतमक्तशिरा रात्रौ पिबेदुष्णपयोऽनुपः ॥ १ ॥
माषान् कुलत्थान् मुद्गान् वा तद्वत्खादेद्घृतान्वितान् ।
तैलं तिलानां कल्कं वा क्षीरेण सह पाययेत् ॥ २
पिण्डोपनाहस्वेदाश्च मांसधान्यकृता हिताः ।
वातघ्नदशमूलादिसिद्धक्षीरेण सेचनम् ॥ ३ ॥
स्निग्धं नस्यं तथा धूमः शिरःश्रवणतर्पणम् ।
In Shiro’bhitapa caused by Vata, treatment advocated for Vatavyadhi (diseases caused by aggravated Vata) should be adopted. The heads should be anointed and ghee should be consumed at night followed by drinking warm milk. Vigna mungo, kulatthān – Dolichos biflorus or mudgān vā – Vigna radiata may be similarly consumed, added with ghee; or oil or paste of Sesamum indicum may be consumed with milk, application of poultice or fomentation with balls of meat and corns (well cooked) are beneficial if done; pouring warm milk boiled with Dashamula –
Bilva – Aegle marmelos
Agnimantha – Premnamucronata
Shyonaka – Oroxylum indicum
Patala – Stereospermum suaveolens
Gambhari – Gmelina arborea
Shalaparni – Desmodium gangeticum
Prishniparni – Urariapicta
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum
Gokshura – Tribulus terrestris
and other herbs mitigating Vata should be done; lubricating nasal drops and inhalation recipes are also to be done to nourish the head and ears.

Vataja Shirashula Chikitsa

वरणादौ गणे क्षुण्णे क्षीरमर्धोदकं पचेत् ॥ ४ ॥
क्षीरावशिष्टं तच्छीतं मथित्वा सारमाहरेत् ।
ततो मधुरकैः सिद्धं नस्यं तत्पूजितं हविः ॥ ५ ॥
Herbs of Varanadi Gana (chapter 15 of Sutrasthana), are crushed and boiled in milk with half its quantity of water, till only milk remains. After it gets cooled its essence (butter) is taken out by churning and that butter is cooked with herbs of sweet taste. This ghee is ideal to be used for nasal medication.

Vataja Shirashula Chikitsa

वर्गेऽत्र पक्वं क्षीरे च पेयं सर्पिः सशर्करम् ।
Medicated ghee prepared with herbs of this group itself (Varandigana), added with milk and consumed along with sugar is beneficial.

Vataja Shirashula Chikitsa

कार्पासमज्जा त्वङ्मुस्ता सुमनःकोरकाणि च ॥ ६ ॥
नस्यमुष्णाम्बुपिष्टानि सर्वमूर्धरुजापहम् ।
kārpāsamajjā – Gossypium herbaceum, tvak – Cinnamomum zeylanica, mustā – Cyperus rotundus and buds of Jasminum grandiflorum, macerated in hot water and instilled to the nose cures headaches of all types.

Chikitsa of Shirashula caused by Pitta and Rakta

शर्कराकुङ्कुमशृतं घृतं पित्तासृगन्वये ॥ ७ ॥
प्रलेपैः सघृतैः कुष्ठकुटिलोत्पलचन्दनैः ।
वातोद्रेकभयाद्रक्तं न चास्मिन्नवसेचयेत् ॥ ८ ॥
इत्यशान्तौ चले दाहः कफे चेष्टो यथोदितः ।
In Shirashula (caused by Vata) associated with Pitta and blood, ghee boiled with sugar and kuṅkuma – Crocus sativus is beneficial. Application of paste of kuṣṭha – Saussurea lappa, kuṭila – Valeriana wallichii, utpala – Nymphaea alba and candanaiḥ – Santalum album added with ghee is suitable. Bloodletting should not be done in these kinds for the fear of aggravation of Vata. If the disease does not subside by these, then burning by fire (thermal cautery) as prescribed for Vata and Kapha are desirable.

Ardhavabhedaka Chikitsa

अर्धावभेदकेऽप्येषा तथा दोषान्वयात्क्रिया ॥ ९ ॥
शिरीषबीजापामार्गमूलं नस्यं विडान्वितम् ।
स्थिरारसो वा लेपे तु प्रपुन्नाटोऽम्लकल्कितः ॥ १० ॥
Even for Ardhavabhedaka, the same treatment together with those relevant to the increased dosha should be done. Seeds of Albizia lebbeck­, root of Achyranthes aspera added with Bida salt, should be used for nasal medication or the juice (or decoction) of sthirā – Desmodium gangeticum may be used; prapunnāṭo – Cassia tora macerated with any sour liquid should be applied over the head.

Suryavarta Chikitsa

सूर्यावर्तेऽपि तस्मिंस्तु सिरयाऽपहरेदसृक् ।
Even in Suryavarta, the same treatments should be done and blood should be let out from the veins.

Pittaja Shirashula Chikitsa

शिरोऽभितापे पित्तोत्थे स्निग्धस्य व्यधयेत्सिराम् ॥ ११ ॥
शीताः शिरोमुखालेपसेकशोधनवस्तयः ।
जीवनीयशृते क्षीरसर्पिषी पाननस्ययोः ॥ १२ ॥
In Shirobhitapa caused by Pitta, oleation should be done and then venesection; cold applications on the head and face; bathing the head and purificatory enema therapies should be resorted to; milk and ghee boiled with herbs of Jivaniya gana (chapter 15 of Sutrasthana) are suitable for internal consumption and nasal medication.

Raktaja Shirashula and Shankhaka Chikitsa

कर्तव्यं रक्तजेऽप्येतत्प्रत्याख्याय च शङ्खके ।
Even in Shirashula caused by Rakta (blood), should be done the same treatment so also in Shankhaka, its incurability being intimated before commencing treatment.

Kaphaja Shirashula Chikitsa

श्लेष्माभितापे जीर्णाज्यस्नेहितैः कटुकैर्वमेत् ॥ १३ ॥
स्वेदप्रलेपनस्याद्या रूक्षतीक्ष्णोष्णभेषजैः ।
शस्यन्तेचोपवासो
In Shiro’bhitapa due to Kapha, the patient should be given oleation therapy by drinking of old ghee and then administered emesis therapy using herbs of pungent taste; fomentation, external application of paste, nasal medication etc. by herbs having properties such as dry, penetrating and hot, and avoidance of food are ideal.

Sarvaja Shirashula Chikitsa

अत्र निचये मिश्रमाचरेत् ॥ १४ ॥
In that caused by all the doshas, combined treatment should be done.

Krimija Shirashula Chikitsa

कृमिजे शोणितं नस्यं तेन मूर्छन्ति जन्तवः ।
मत्ताः शोणितगन्धेन निर्यान्ति घ्राणवक्त्रयोः ॥ १५ ॥ सुतीक्ष्णनस्यधूमाभ्यां कुर्यान्निर्हरणं ततः ।
In Shirashula caused by Krimi (worm, bacteria), blood (of animals) should be put into the nose, with this the worms become unconscious intoxicated by the smell of the blood, come out of the nose and mouth, then they should be removed by strong nasal medication and inhalation of smoke.

Krimija Shirashula Chikitsa

विडङ्गस्वर्जिकादन्तीहिङ्गुगोमूत्रसाधितम् ॥ १६ ॥
कटुनिम्बेङ्गुदीपीलुतैलं नस्यं पृथक् पृथक् ।
Oil of Brassica nigra, Oil of Azadirachta indica, Oil of Balanites aegyptiaca or oil of Salvadora persica each separately boiled with viḍaṅga – Embelia ribes, svarjikā – svarjika Kshara, dantī – Baliospermum montanum, hiṅgu – Ferula asafoetida, and gomutra (cow urine) should be used for nasal medication.

Krimija Shirashula Chikitsa

अजामूत्रद्रुतं नस्यं कृमिजित्कृमिजित्परम् ॥ १७ ॥
kṛmijit – Embelia ribes boiled in ajamutra (goat’s urine) and used as nasal drops is best to remove worms.

Krimija Shirashula Chikitsa

पूतिमत्स्ययुतैः कुर्याद्धूमं नावनभेषजैः ।
कृमिभिः पीतरक्तत्वाद्रक्तमत्र न निर्हरेत् ॥ १८ ॥
Smoke of bad smelling fish and herbs meant for nasal medication should be inhaled. In this variety, blood should not be taken out since the worms will have consumed the blood.

Shirahkampa Chikitsa

वाताभितापविहितः कम्पे दाहाद्विना क्रमः ।
For Shirahkampa, all treatments except burning by fire (thermal cautery) prescribed for Shirobhitapa caused by Vata should be adopted.

Upashirshaka Chikitsa

नवे जन्मोत्तरं जाते योजयेदुपशीर्षके ॥ १९ ॥
वातव्याधिक्रियां पक्वे कर्म विद्रधिचोदितम् ।
In Upashirshaka, which is new and developed after birth, treatments prescribed for Vatavyadhi should be administered. After ripening, the treatments prescribed for Vidradi should be done.

Vidradi, Pitaka and Arbuda Chikitsa

आमपक्वे यथायोग्यं विद्रधिपिटिकार्बुदे ॥ २० ॥
In Vidradhi, Pitaka and Arbuda appropriate treatments should be done determining whether they are Ama (unripe) or Pakva (ripe) stages.

Arumshika Chikitsa

अरूंषिका जलौकोभिर्हृतास्रा निम्बवारिणा ।
सिक्ता प्रभूतलवणैर्लिम्पेदश्वशकृद्रसैः ॥ २१ ॥
पटोलनिम्बपत्रैर्वा सहरिद्रैः सुकल्कितैः ।
गोमूत्रजीर्णपिण्याककृकवाकुमलैरपि ॥ २२ ॥
In Arumshika, blood should be removed by using the leech, then washed with the decoction of nimbavāriṇā – Azadirachta indica and covered with plenty of salt macerated in juice of fresh horse dung or with the paste of paṭola -­ Trichosanthes dioica, leaves of Azadirachta indica and saharidraiḥ – Curcuma longa with cow urine or old pinyaka (oil cake of Tila – Sesamum indicum) excreta of Krikavaku (cock) made with cow urine.

Kusta Churna for Arumshika

कपालभृष्टं कुष्ठं वा चूर्णितं तैलसंयुतम् ।
रूंषिकालेपनं कण्डूक्लेददाहार्तिनाशनम् ॥ २३ ॥
Powder of kuṣṭhaṃ – Saussurea lappa fried on a pan, mixed with oil and applied to Arumshika cures itching, exudation, burning sensation and pain.

Malatyadi Taila for Chacha and Arumshika

मालतीचित्रकाश्वघ्ननक्तमालप्रसाधितम् ।
चाचारूंषिकयोस्तैलमभ्यङ्गः क्षुरघृष्टयोः ॥ २४ ॥
Oil medicated with mālatī – Jasminum grandiflorum, citraka – Plumbago zeylanica, aśvaghna – Nerium indicum and naktamāla – Pongamia pinnata is beneficial for anointing the head in Chacha (Indralupta) and Arumshika, which have been scraped with a razor.

Purification of head

अशान्तौ शिरसः शुद्ध्यै यतेत वमनादिभिः ।
If the disease does not subside, then attempts should be made to purify the head by emesis and other therapies.

Darunaka Chikitsa

विध्येत्सिरां दारुणके लालाट्यां शीलयेन्मृजाम् ॥ २५ ॥
नावनं मूर्धवस्तिं च लेपयेच्च समाक्षिकैः ।
प्रियालबीजमधुककुष्ठमाषैः ससर्षपैः ॥ २६ ॥
लाक्षाशम्याकपत्रैडगजधात्रीफलैस्तथा ।
कोरदूषतृणक्षारवारिप्रक्षालनं हितम् ॥ २७ ॥
In Darunaka, the vein in the forehead should be cut, observe cleanliness, adopt nasal therapy and shirobasti (making oil to stand on the head for some time) and apply the paste of seeds of Buchanania lanzan, madhuka – Glycyrrhiza glabra, kuṣṭha – Saussurea lappa, māṣaiḥ – Vigna mungo and sasarṣapaiḥ – Brassica nigra, lākṣā – Laccifer lacca leaves of Cassia fistula eḍagaja – Cassia tora and Emblica officinalis added with honey; washing the head with water in which ash of reeds of koradūṣa tṛṇa – Paspalum scorbiculatum is dissolved will be beneficial.

Indralupta Chikitsa

इन्द्रलुप्ते यथासन्नं सिरां विद्ध्वा प्रलेपयेत् ।
प्रच्छाय गाढं कासीसमनोह्वातुत्थकोषणैः ॥ २८ ॥
वन्यामरतरुभ्यां वा गुञ्जामूलफलैस्तथा ।
तथा लाङ्गलिकामूलैः करवीररसेन वा ॥ २९ ॥
सक्षौद्रक्षुद्रवार्ताकस्वरसेन रसेन वा ।
धत्तूरकस्य पत्राणां भल्लातकरसेन वा ॥ ३० ॥
अथवा माक्षिकहविस्तिलपुष्पत्रिकण्टकैः ।
In Indralupta, the vein nearest to the site should be cut, the patch should be scratched well and then covered with thick paste of kāsīsa – ferrous sulphate, manohvā – realgar, tutthaka – copper sulphate, ūṣaṇaiḥ – Piper nigrum or of vanyā – Cyperus tenuiflorus, amaratarubhyāṃ vā – Cedrus deodara, or root or fruits of guñjā – Abrus precatorius or root of lāṅgalikā – Gloriosa superba or juice of karavīra – Nerium indicum added with honey; or with juice of Variant of Solanum melongena or with juice of leaves of Datura metal or juice of bhallātaka – Semecarpus anacardium or added with honey; or ghee, flowers of tila – Sesamum indicum and trikaṇṭakaiḥ -­ Tribulus terrestris.

Indralupta Chikitsa

तैलाक्ता हस्तिदन्तस्य मषी चाचौषधं परम् ॥ ३१ ॥
शुक्लरोमोद्गमे तद्वन्मषी मेषविषाणजा ।
वर्जयेद्वारिणा सेकं यावद्रोमसमुद्भवः ॥ ३२ ॥
Ash of tooth of an elephant mixed with oil and applied is the best medicine for Indralupta. In the case of white hair emerging, the ash of horn of a ram, used similarly is beneficial, similarly pouring (warm) water on the head should be avoided till the hairs grow.

Khalita: Palita Chikitsa 

खलतौ पलिते वल्यां हरिद्रोम्नि च शोधितम् ।
नस्यवक्त्रशिरोऽभ्यङ्गप्रदेहैः समुपाचरेत् ॥ ३३ ॥
In Khalita, Palita, Vali (wrinkles on the scalp) and haritaloma (brown hair), purifactory therapies followed by nasal medication, anointing the face and head and application of paste of herbs should be resorted to.

Indralupta, Palita Chikitsa

सिद्धं तैलं बृहत्याद्यैर्जीवनीयैश्च नावनम् ।
मासं वा निम्बजं तैलं भुङ्नावयेद्यतिः ॥ ३४ ॥
नीलीशिरीषकोरण्टभृङ्गस्वरसभावितम् ।
शेल्वक्षतिलरामाणां बीजं काकाण्डकीसमम् ॥ ३५ ॥
पिष्ट्वाऽऽजपयसा लोहाल्लिप्तादर्कांशुतापितात् ।
तैलं स्रुतं क्षीरभुजो नावनात्पलितान्तकृत् ॥ ३६ ॥
Medicated oil prepared with herbs brihatyadi (hrsva pancamula) and jivaniya gana (Chapter 15 of Sutrasthana) should be used for nasal medication; or for one month, Oil of Azadirachta indica should be used for Navana Nasya by the person who consumes milk. nīlī – Indigofera tinctoria, śirīṣa – Albizia lebbeck, koraṇṭa – Barleria prionitis, bhṛṅga svarasa – Eclipta alba – juice extract of above four herbs, should be used for grinding seeds of Cordia dichotoma, seed of Terminalia bellerica, seed of Sesamum indicum, Seed of Annona reticulata, Seed of Celastrus paniculatus, all seeds taken in equal quantities; it is ground with goat milk and made into paste, the paste is applied to an iron vessel oil of Sesamum indicum is taken in that Iron vessel, heated in sunlight, filtered. The patient, consuming milk should undergo Navana Nasya with such an oil, will get rid of Palita.

Indralupta, Palita Chikitsa

क्षीरात्साहचराद्भृङ्गरजसः सौरसाद्रसात् ।
प्रस्थैस्तैलस्य कुडवः सिद्धो यष्टीपलान्वितः ॥ ३७ ॥
नस्यं शैलासने भाण्डे शृङ्गे मेषस्य वा स्थितः ।
768 ml of cow milk, 768 ml of Juice of Barleria prionitis, 768 ml of juice of Eclipta alba, 768 ml of juice of Ocimum sanctum, 768 ml of each of above is added to 192 ml of oil of Sesamum indicum, 48 g of Glycyrrhiza glabra is added, oil is prepared. The oil is used for Nasya. In the vessel made of stone or Pterocarpus marsupium, Gymnema sylvestre is taken, oil is prepared and used for Nasya.

Indralupta Chikitsa

क्षीरेण श्लक्ष्णपिष्टौ वा दुग्धिकाकरवीरकौ ॥ ३८ ॥
उत्पाट्य पलितं देयावाशये पलितापहौ ।
Fine paste of dugdhikā – Euphorbia hirta or karavīrakau – Nerium indicum made with milk, applied to the scalp after plucking the grey hair palitāpahau – cures Palita.

Priyaladi pralepa

क्षीरं प्रियालं यष्ट्याह्वं जीवनीयो गणस्तिलाः ॥ ३९ ॥
कृष्णाः प्रलेपो वक्त्रस्य हरिद्रोमवलीहितः ।
Paste of Buchanania lanzan, yaṣṭyāhvaṃ -­ Glycyrrhiza glabra, herbs of jivaniya gana (chapter 15 of sutrasthana) and kṛṣṇāḥ tilāḥ – Black Sesamum indicum made into a paste with milk and applied on the face / mouth cures brown hair and wrinkles.

Tiladi lepa for kesharanjana

तिलाः सामलकाः पद्मकिञ्जल्को मधुकं मधु ॥ ४० ॥
बृंहयेद्रञ्जयेच्चैतत्केशान् मूर्धप्रलेपनात् ।
Paste made from Sesamum indicum, āmalakāḥ – Emblica officinalis, padmakiñjalko –­ Nelumbo nucifera androecium, madhukaṃ – Glycyrrhiza glabra and honey, this applied on the head nourishes the hair and gives them color.

Mamsyadi Lepa

मांसी कुष्ठं तिलाः कृष्णाः सारिवा नीलमुत्पलम् ॥ ४१ ॥
क्षौद्रं च क्षीरपिष्टानि केशसंवर्धनं परम् ।
māṃsī – Nardostachys jatamansi, kuṣṭhaṃ – Saussurea lappa, kṛṣṇāḥ tilāḥ – black Sesamum indicum, sārivā – Hemidesmus indicus and nīlaṃ utpalam – Nymphaea stellata, made into a paste with milk added with honey and applied to the head is best to promote growth of hair.

Ayorajadi Lepam

अयोरजो भृङ्गरजस्त्रिफला कृष्णमृत्तिका ॥ ४२ ॥
स्थितमिक्षुरसे मासं समूलं पलितं रजेत् ।
Iron filings, bhṛṅgaraja: – powder of Eclipta alba, triphala –

• Haritaki – Terminalia chebula
• Vibhitaki – Terminalia bellerica
• Amalaki – Emblica officinalis
  kṛṣṇamṛttikā – and black mud kept soaked in sugarcane juice for one month, applied to the head completely cures Palita (imparts black color to the hair).

Kesharanjana

माषकोद्रवधान्याम्लैर्यवागूंस्त्रिदिनोषिता ॥ ४३ ॥
लोहशुक्लोत्कटा पिष्टा बलाकामपि रञ्जयेत् ।
Yavagu (thick gruel) fermented for three days with the addition of māṣa – Vigna mungo, kodrava – Paspalum scrobiculatum and fermented liquid and made predominant with paste of iron imparts color even to the crane (which is white).

Prapaundarikadi Taila

प्रपौण्डरीकमधुकपिप्पलीचन्दनोत्पलैः ॥ ४४ ॥
सिद्धं धात्रीरसे तैलं नस्येनाभ्यञ्जनेन च ।
सर्वान् मूर्धगदान् हन्ति पलितानि च शीलितम् ॥ ४५ ॥
Medicated oil prepared with prapauṇḍarīka -­ Nymphaea lotus, madhuka – Glycyrrhiza glabra, pippalī – Piper longum, candana – Santalum album, utpalaiḥ – Nymphaea alba and dhātrīrase – juice of Emblica officinalis, used for nasal medication and anointing daily cures all the diseases of the head and also cures Palita, if administered.

Nasya

वरीजीवन्तिनिर्यासपयोभिर्यमकं पचेत् ।
जीवनीयैश्च तन्नस्यं सर्वजत्रूर्ध्वरोगजित् ॥ ४६ ॥
Yamaka sneha (two fats – oil and ghee) are cooked with vari, decoction of jīvanti -Leptadenia­ reticulata, milk and herbs of Jivaniya gana (chapter 15 of Sutrasthana); this, used for nasal medication cures all the diseases arising above the shoulders.

Mayura Ghrita

मयूरं पक्षपित्तान्त्रपादविट्तुण्डवर्जितम् ।
दशमूलबलारास्नामधुकैस्त्रिपलैर्युतम् ॥ ४७ ॥
जले पक्त्वा घृतप्रस्थं तस्मिन् क्षीरसमं पचेत् ।
कल्कितैर्मधुरद्रव्यैः सर्वजत्रूर्ध्वरोगजित् ॥ ४८ ॥
तदभ्यासीकृतं पानबस्त्यभ्यञ्जननावनैः ।
Peacock devoid of feather, bile, intestines, legs, excreta and beak (only the flesh) is cooked along with three pala (1454 grams) each of
Dasamula –

• Bilva – Aegle marmelos
• Agnimantha – Premnamucronata
• Shyonaka – Oroxylum indicum
• Patala – Stereospermumsuaveolens
• Gambhari – Gmelina arborea
• Shalaparni – Desmodiumgangeticum
• Prishniparni – Urariapicta
• Brihati – Solanum indicum
• Kantakari – Solanum xanthocarpum
• Gokshura – Tribulus terrestris,
• balā -­ Sida cordifolia, rāsnā – Pluchea lanceolata and madhukai: – Glycyrrhiza glabra cooked in water, one prastha (768 grams) of ghee and equal quantity of milk and paste of herbs of sweet taste are added and medicated ghee prepared. Consumed habitually in the form of internal potion, enema, anointing the body and nasal medication, it cures all the diseases of the parts above the shoulders.

Mahamayura Ghrita

एतेनैव कषायेण घृतप्रस्थं विपाचयेत् ॥ ४९ ॥
चतुर्गुणेन पयसा कल्कैरेभिश्च कार्षिकैः ।
जीवन्तीत्रिफलामेदामृद्वीकर्द्धिपरूषकैः ॥ ५० ॥
समङ्गाचविकाभार्गीकाश्मरीकर्कटाह्वयैः ।
आत्मगुप्तामहामेदातालखर्जूरमस्तकैः ॥ ५१ ॥
मृणालबिसखर्जूरयष्टीमधुकजीवकैः ।
शतावरीविदारीक्षुबृहतीसारिवायुगैः ॥ ५२ ॥
मूर्वाश्वदंष्ट्रर्षभकशृङ्गाटककसेरुकैः ।
रास्नास्थिरातामलकीसूक्ष्मैलाशठिपौष्करैः ॥ ५३ ॥
पुनर्नवातवक्षीरीकाकोलीधन्वयासकैः ।
मधूकाक्षोटवाताममुञ्जाताभिषुकैरपि ॥ ५४ ॥
महामायूरमित्येतन्मायूरादधिकं गुणैः ।
धात्विन्द्रियस्वरभ्रंशश्वासकासार्दितापहम् ॥ ५५ ॥
योन्यसृक्शुक्रदोषेषु शस्तं वन्ध्यासुतप्रदम् ।
From this decoction itself (of peacock’s flesh etc.), one prastha (768 grams) of ghee should be cooked adding four times of milk and paste of one karsa (12 grams) each of jīvantī – Leptadenia reticulata, Triphala –

• Haritaki – Terminalia chebula
• Vibhitaki – Terminalia bellerica
• Amalaki – Emblica officinalis,
  medā – Polygonatum cirrhifolium, mṛdvīka – Vitis vinfera­, rddhi – Habenaria intermedia, Parusaka- Grewia asiatica, samaṅgā – Rubia cordifolia, cavikā – Piper chaba, bhārgī – Clerodendrum serratum, kāśmarī – Gmelina arborea, karkaṭāhvayaiḥ – Karkatahvaya, ātmaguptā – Mucuna pruriens, mahāmedā – Polygonatum cirrhifolium, tāla – Borassus flabellifer, kharjūra mastakaiḥ – Phoenix dactylifera, mṛṇāla – lotus stalk, bisa – Nelumbo nucifera, kharjūra – Pheonix dactylifera, yaṣṭīmadhuka – Glycyrrhiza glabra, jīvakaiḥ – ­Malaxis acuminata, śatāvarī – Asparagus racemosus, vidārī – Pueraria tuberosa, ikṣu -­ Saccharum officinarum, bṛhatī – Solanum indicum,
  the two Sariva –
• Shveta Sariva – white variety – Hemidesmus indicus
• Krishna Sariva – Cryptolepis buchanani / Ichnocarpus frutescens,
  mūrvā – Marsdenia tenacissima, śvadaṃṣṭra – Tribulus terrestris, ṛṣabhaka – Manilkara hexandra, śṛṅgāṭaka -­ Tectona grandis, kaserukaiḥ – Scripus grossus, rāsnā – Pluchea lanceolata, sthirā – Desmodium gangeticum, tāmalakī – Phyllanthus niruri­, sūkṣmailā – Elettaria cardamomum, śaṭhi – Hedychium spicatum, pauṣkaraiḥ – Inula racemosa, punarnavā – Boerhavia diffusa, tavakṣīrī – Curcuma angustifolia, kākolī – Fritillaria roylei, dhanvayāsakaiḥ – Fagonia cretica, madhūka – Madhuca longifolia, ākṣoṭa -­ Juglans regia, vātāma – Amygdalus commonis, muñjāta – Orchis latifolia and abhiṣukai: api -­ Pistacia vera. This known as Mahamayuraghrita, is more effective than Mayuraghrita, cures loss of tissues, sense organs and voice, dyspnoea, cough, facial palsy, best in diseases of the vaginal tract, menstrual blood, semen and bestows sons to the women who are childless.

Other medicated ghee prepared form meats

आखुभिः कुक्कुटैर्हंसैः शशैश्चेति प्रकल्पयेत् ॥ ५६ ॥
This kind of medicated ghee may be prepared from (meat of) the mouse, cock, swan or rabbit.

Number of diseases affecting the region above shoulder

जत्रूर्ध्वजानां व्याधीनामेकत्रिंशच्छतद्वयम् ।
परस्परमसङ्कीर्णं विस्तरेण प्रकाशितम् ॥ ५७ ॥
Thus, were described in detail two hundred and thirty-one diseases, not mixed with one another, affect the parts of the above the shoulders.

Importance of treating the head

ऊर्ध्वमूलमधःशाखमृषयः पुरुषं विदुः ।
मूलप्रहारिणस्तस्माद्रोगाञ्छीघ्रतरं जयेत् ॥ ५८ ॥
The sages described the human being as “having the root on the top and branches below”. So, by striking at the roots, the diseases can be very quickly defeated.

Importance of treating the head

सर्वेन्द्रियाणि येनास्मिन् प्राणा येन च संश्रिताः ।
तेन तस्योत्तमाङ्गस्य रक्षायामादृतो भवेत् ॥ ५९ ॥
That in which all the sense organs are located, that in which prana (life) resides, such a chief organ, the head should be protected with great effort.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने शिरोरोगप्रतिषेधो नाम चतुर्विंशोऽध्याय: ॥ २४ ॥
Thus, ends the chapter Shiro Roga Pratishedha the twenty fourth in Uttarasthana of Astanga Hridaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.

Thus, ends Urdhvanga Chikitsa (Shalakyatnantra- treatment of diseases above the shoulders), the fourth branch of Ayurveda.