Treatment of the major diseases, part one
महाव्याधिचिकित्सित · चिकित्साधिकार
Opening of the eleventh chapter, the section on the major diseases (mahamaya). It begins with an invocation, a statement of intent and the plan of the chapter, names the major diseases and then takes up prameha.
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Headings from the book in reading order. Open a topic for its summary and the knowledge it refers to.
Bowing to the Jina, lord of inner and outer glory and supreme lord, who teaches the nature of things through pramana, naya and nikshepa, the author undertakes to describe in order the…
No disorder can arise without the three doshas, vata, pitta and kapha; even so, the author will state the names, forms and signs of all diseases together with their treatment.
First the major diseases will be described in order with their signs, the signs foretelling death (rishta) and their treatment; after that the groups of minor diseases, together with the…
The omniscient ones call prameha, kushtha, udara (abdominal disease), vatavyadhi, mudhagarbha (obstructed foetus), haemorrhoids, urinary stone and fistula-in-ano the major diseases.
Opening of the eleventh chapter, the section on the major diseases (mahamaya). It begins with an invocation, a statement of intent and the plan of the chapter, names the major diseases and…
The complete treatment of the major diseases will be set out in order, together with their signs, the judgement of curable and incurable cases, the chief causes of their arising and the…
Eating too much heavy, liquid, unctuous and cold food, sleeping much by day, avoiding exertion and idleness are said to produce prameha; it is to be diagnosed once its signs appear.
Burning in the hands, feet and body, much thirst, a very unctuous and sticky body, great sweetness in the mouth and overeating are the prodromal signs of prameha.
Aggravated kapha, pitta and vata, together with fat (medas), reach the bladder and, ripening there, produce prameha; turbid urine then flows out in large amounts and often, which the…
Although prameha arises from the three doshas, it takes many forms through the differences of the doshas and which of them is primary or secondary, just as one actor plays many moods and…
When, with the prodromes present, a person begins to pass much urine, it is to be called prameha, and the patient is called pramidha. The commentary adds that if prameha is not treated…
Prameha patients get ten kinds of boils: sharavika, sarshapika, jalini, putrini, kacchapika, masurika, vidarika, vidradhika, alaji and vinata.
A boil of many colours, with discharge and severe pain, low in the middle with raised edges and shaped like a sharava (shallow earthen dish), is called sharavika by the learned.
Small boils that ripen quickly, are very painful and have the size and shape of a mustard seed are called sarshapika by the learned; the verse adds that it is of two kinds.
A large boil covered with a mesh of flesh and channels (nadi), with severe pain and pricking, unctuous, discharging, with fine openings and stiff, is called jalini.
A large boil accompanied by small boils is putrini; one that is large at the base, very painful, shaped like a tortoise's back, with severe pricking, smooth and very distressing is…
Vidarika is hard and round like the vidari tuber and painful; vidradhi, painful and arising from all the doshas, is of five kinds but is described here as two, savarnaka and shighravidahi;…
Sharavika and the other boils have names that match their form and qualities: the one resembling an abscess is called vidradhi, and alaji is the one covered with red blisters. The author…
Loss of appetite, indigestion, discharge of phlegm, pinasa (a nasal disease), lethargy, excessive sleep, flies settling on the patient and sliminess of the mouth are the complications of…
Sores on the penis and scrotum, colic with pain in the bladder (pitta colic), burning, thirst, a sour taste in the mouth, fever, fainting, mada (intoxication) and pandu are the…
A gripping feeling in the heart, craving for sense objects, sleeplessness, tremor, severe colic, retention of stool, cough, hiccup, breathlessness and dryness of the mouth are the…
Prameha patients whose turbid urine flows like fat, ghee or honey or like the rut fluid of an elephant, who have the complications described, boils on the anus, shoulders, heart region,…
The physician who knows everything should carefully determine the signs and form of the prameha arising from the three doshas according to which dosha is aggravated, and then treat all…
Prameha patients are of two kinds, by birth or from unwholesome diet: thin and stout. The thin are to be built up with nourishing medicines and the stout made lean with reducing (karshana)…
A prameha patient should give up alcohol, asava and arishta, milk, ghee, tamarind and other sour things, plenty of sweet food, curd, sugarcane and meat, and keep to dry (ruksha) food.
The prameha patient's body is first oiled with sesame, linseed and mustard oil; he is then made to vomit with neem juice and the decoction of madanaphala fruits, and purged with purgative…
Right after purgation the patient is given a niruha enema of niruhana drugs mixed with cow urine and sesame oil; once his body is cleansed he is treated with the foods described next.
The physician should feed the patient on priyangu, wild kodo millet, rice flour, foxtail millet, wheat and barley, with astringent, bitter and pungent things, and with pigeon pea, peas and…
Well-ground turmeric is mixed with amla juice or decoction, put into a pot prepared with fumigation and the like, sealed and kept in a pit filled with grain (for a month, says the…
A decoction carefully made of turmeric, nut grass, triphala and devadaru, given regularly to a patient who has mastered his senses by the path taught in the scriptures, is said to overcome…
A decoction of sandalwood, indra, asana, tinduka, the group of milky trees and the three fruits, mixed with a paste of nut grass and drunk, is said to remove pitta-type prameha; the…
A self-controlled patient who drinks a decoction of wood apple, bael, asana (vijayasara), prishniparni, turmeric, the three myrobalans and arjuna bark is said to overcome prameha together…
Eating flour of rice, wheat and the like mixed with the juice of the dung of the donkey, camel, cow, buffalo and horse, and using water strained through the ash of the same dung for…
A decoction of triphala with ghee and shilajit, given to drink, is said to overcome completely all pramehas, together with their many complications and the prameha boils.
To destroy prameha a person should constantly practise exertion: riding elephants and horses, practising all kinds of weapons such as the staff, running and similar activities that tire the…
- Special measure for a well-born patient to overcome pramehaकुलीन को प्रमेहजयार्थ क्रियाविशेषRegimenp. 165
A well-born but poor prameha patient whose disease is hard to cure should be told kindly to leave villages, towns and other settlements and go on pilgrimage on foot, so that he gets…
- Special measure for a patient of low birth to overcome pramehaप्रमेहजयार्थ नीचकुलोत्पन्न का क्रियाविशेषRegimenp. 166
A poor prameha patient of low birth should dig wells, tanks and step-wells and always tend cows and buffaloes; he should eat once a day the food he gets by begging and drink water of the…
If a prameha patient is not treated with the diet, conduct and medicines described, the various unbearable boils described earlier appear, especially in the lower part of his body.
First, bloodletting by applying leeches over the boils is beneficial, and after that strong purgation should be given; the madhumeha patient, however, is hard to purge.
Mustard with radish seed, rock salt, drumstick (shigru) and the three pungents, together with all hot drugs that ripen and dissolve ama, are used for pressing, plastering and bandaging the…
When, after pressing, plastering and bandaging, the boils have ripened by themselves, the physician should incise them, cleanse the wound with cleansing drugs and then heal it with drugs…
Karanja, cumin, turmeric, sariva, neem, patha, kutki, ingudi, amaltas, indrayava, indravaruni, wild patola and jasmine are named as beneficial for cleansing wounds (removing pus and the…
Sesame, lodhra, liquorice, arjuna bark, palasha, the young shoots of the milky trees, kadamba, jamun, mango, wood apple, tinduka and manjishtha are named as beneficial for healing (filling…
A wick made with the latex of snuhi, arka and kurantaka together with karanja, langali (glory lily), rock salt, ankola and manahshila, placed in the wound, is said to destroy foul wounds…
A fresh wound is washed well and its opening filled with ghee, with the healing paste described above or with a paste of well-ground liquorice to relieve the heat of the wound. A footnote…
After the paste has been filled into the wound, leaves are placed over it and it is wrapped carefully with fine cloth, that is, bandaged; paying attention to the dosha, body, wound, season…
On the second day the bandage is opened, the pus is pressed out, the wound is washed with astringent decoction water, medicines are applied again and it is bandaged as before.
Bandaged in this way, the wound is cleansed, heals, becomes soft and free of pain; therefore bandaging is always proper, and this is the right course in the treatment of all wounds.
The physician who knows what is curable and the means of cure should, after weighing the strength of the doshas, use as suitable the decoctions, pastes, ghees and oils prepared with the…
A wound that is stable, without discharge of pus, painless, pigeon-coloured inside and fleshy (filling in) is to be known as clean, and a clean wound surely heals; a wound level with the…
When the prameha patient passes urine that is clear, very bitter, dry, alkaline, slightly warm and free of turbidity, only now and then and in small amounts, he is to be considered free of…
Knowing all these kinds of wounds and their varieties, the skilled physician should cleanse them with cleansing measures and, once clean, heal them with healing decoctions, pastes and the…
Through wrong conduct (such as reviling gods, teachers and scriptures) or unwholesome diet, vitiated vata takes up aggravated pitta and kapha and, wherever it throws and lodges them,…
Excessive sweating or no sweating at all, horripilation, loss of touch sensation, blackening of the blood, great heaviness of the body, itching, roughness and tremor are the prodromal signs…
Aruna kushtha arises from vata, with painful reddish blisters; kapala, rishyajihva, audumbara and kakanaka arise from pitta; dadru and pundarika arise from kapha and are very itchy, white,…
Minor kushtha has thousands of varieties through kapha and blood; among them arush kushtha and sidhma are kapha-predominant, and sidhma is the one with intense itching in which the skin…
Many small pimples without discharge that arise on the body every day and vanish again, itchy, minute, of many kinds and unctuous, arising from kapha, are called rakasha.
Mahakushtha arises from vata and parisarpa and others from pitta, while the remaining kinds arise from all three doshas; in mahakushtha there are beating and splitting pains and contraction…
When the whole body turns dense black or reddish with pain and pricking, that too is a kushtha (eka); the one causing burning in the palms is vicharchi, and in both soles vipadika.
Burning, very severe pustules from pitta that discharge pus and blood make up parisarpa, which is hot and spreads over the whole body; the sharp form is called visarpana.
Kitibha is discharging, unctuous, very black and patchy; the kushtha of the palms with heat, drying and pricking pain is charmadala; very itchy, pus-discharging, hot pustules on both feet…
Kilasa, named as another kind set apart from the kushthas, kushtha produced by all three doshas, non-discharging pale kushtha seated in the skin, and congenital kushtha are all incurable.
In vata kushtha there are loss of skin sensation, drying, hoarseness, disturbed sleep and similar disorders; in pitta kushtha there are sores on the eyebrows, ears and nose, red eyes, and…
- Signs of kapha-dominant kushtha and of kushtha seated in the skinकफप्रधान व त्वक्स्थ कुष्ठ लक्षण / कुष्ठ में कफ का लक्षणConditionp. 172
Discharge, itching, heaviness of the body, coldness and swelling are the signs of kapha kushtha; kushtha seated in the skin shows a colour unlike the skin and dryness.
Excessive sweating, numbness of the limbs, deformity and swelling are the signs of kushtha seated in the blood; in strong kushtha that has reached the flesh, severe discharging blisters…
Kushtha that has reached the fat, vessels and sinews causes lameness of the hand, sores, spreading, damage to the body, difficulty in walking, lassitude and foul ulcers, among many other…
In dreadful kushtha that has reached the marrow and bone there are severe eye disease, the breeding of worms, splitting open, sores in the nose and loss of voice, and the signs of the…
Kushtha seated in the skin, blood and flesh is curable with the prescribed medicines; kushtha in the fat is manageable (yapya); the rest is to be left as incurable.
Pundarika that looks like a white lotus, kakanaka with pitta whose colour is like the bandhuka flower, gold or the bimba fruit, and kushtha present from birth are to be abandoned as…
A child born of parents with kushtha through vitiated menstrual blood and semen who is badly affected is incurable; severe eye disease, loss of voice and pus flowing from the sores are the…
A kushtha patient should not take milk, curd, sugar, jaggery and other sugarcane products, field beans, black gram, sesame, oil, horse gram, flour preparations, heavy foods, (sour) fruits,…
Sub-heading that opens the treatment of kushtha; wholesome vegetables and grains, purification by tissue stage, medicated ghee or oil and powders follow under their own headings.
In kushtha, vasa, guduchi, punarnava, arka flowers and all bitter and pungent vegetables, cooked in water of amaltas, bhallataka and neem, are to be used, with constant drinks of khadira…
The kushtha patient should eat dry grains such as shyamaka, foxtail millet and varaka (moth bean in the commentary) with soup of green gram and pigeon pea, cooked in decoction of amaltas…
- Emesis and purgation in kushtha, and treatment of kushtha in the skinकुष्ठ में वमन विरेचन व त्वक्स्थ कुष्ठ की चिकित्साMethodp. 174
When the prodromes of kushtha appear, the body should be purified by both routes, emesis and purgation; for kushtha seated in the skin, too, extra purification by emesis and purgation and…
In kushtha seated in the blood, all the measures for skin kushtha (emesis and purgation) and application are used, together with bloodletting and taking decoctions; in kushtha in the flesh,…
- Treatment of kushtha in the fat, bone and deeper tissuesमेद, अस्थि आदि गत कुष्ठ चिकित्साPrognosisp. 174
Kushtha in the fat is very troublesome and is only to be kept in check (yapana) with many kinds of medicine; the remaining kinds, in bone, marrow and semen, do not heal even with the five…
In kushtha from the three doshas the patient drinks ghee or good oil cooked with drugs that break the force of kushtha, to purify the body. After judging curability and letting blood from a…
A powder of neem seed kernel, vidanga, bhallataka seed and the two turmerics, combined with neem seed oil, is said to destroy every kind of kushtha.
In kushtha with markedly raised patches, the patches are rubbed down with a knife, samudraphena or a sharp brick and then smeared with a paste of punnaga seeds, rock salt, arka, black salt…
Palasha ash is stirred into water, filtered and boiled again; turmeric, house soot, kushtha, black salt and the three pungents are added and the mixture is applied, which the text says…
Two pastes ground in cow urine: one of rock salt, chakramarda, kushtha, chitraka and the three pungents; the other of bakuchi, rock salt, bhushirisha, kushtha, karavira, the three pungents…
A powdered paste of white and ordinary mustard, rock salt, vacha, kushtha, realgar, orpiment and a sharp poison, mixed with black mushkaka ash and arka latex, is applied in kushtha. Verse…
A colour-restoring paste: bhallataka seed, chitraka, bilva pulp, bhringaraja, arka latex, orpiment and realgar, or the hides of leopard, tiger, elephant or deer, burnt, powdered and mixed…
Bhallataka, bibhitaki, amalaki, haritaki, arka latex, sesame, the three pungents, vidanga, apamarga, kanjira, bitter ridge gourd, bitter gourd and neem seed are burnt, mixed with sesame oil…
Kushtha patients are to be thoroughly purified by emesis and purgation and bled freely, because if any dosha remains the kushtha returns; so the treatment must be carried through as…
- Schedule of emesis, purgation and bloodletting in kushthaकुष्ठ में वमन विरेचन रक्तमोक्षण का क्रमMethodp. 177
Emesis every fifteen days, strong purgation every month, bloodletting every six days and head purgation every three days are called the course for all kushtha. Without further headings the…
Khadira heartwood powder is impregnated with khadira juice, dried and drunk with khadira decoction; the text calls it an excellent medicine that removes kushtha.
Thin sheets of sharp iron are smeared with a paste of the five salts and sour substances, heated in a closed crucible on a cow-dung fire and quenched in khadira and triphala liquid, sixteen…
One who uses one tula of this sharp iron ash while eating food free of salt and sour things, as suited to the disease, is said to live a hundred years free of disease; the commentary…
Musta, vidanga, triphala, chitraka and the three pungents are powdered in equal parts and mixed with iron equal to the nine parts, then taken with sugar and ghee; the well-known navayasa is…
Ghee or sesame oil cooked with the paste and decoction of the various kushtha-destroying drugs, used daily for massage, drinking, affusion and head purgation, is said to remove kushtha…
A decoction of khadira heartwood alone, drunk continually and used for bathing, is said to make even a severely affected kushtha patient clean-bodied, with nails and hair restored, and soon…
Terrible mahodaras arise from the doshas singly or together, liver and spleen disorders, water, poisoning, and obstruction or foreign bodies; the commentary lists eight kinds, from vatodara…
Vata aggravated by unwholesome food and wrong conduct produces an abdominal enlargement with colic, distension, pricking pains and black abdominal veins.
Vitiated pitta produces a quickly spreading abdominal enlargement with burning, thirst, fever and wasting, and yellow stool, urine and abdominal veins.
Aggravated kapha makes the abdomen heavy, stable, unctuous, cold, large and white with white veins and swelling, growing slowly.
Food mixed with urine, faeces, semen or menstrual blood, poisoned water and other poisons aggravate the three doshas with the blood and cause dushyodara; a footnote says some women do this…
This udara flares up especially in the rainy season on heavily clouded days, when the patient faints and suffers thirst and burning throughout the body.
Fever, intense burning, much water and burning-type foods aggravate vitiated blood, so the liver on the right or the spleen on the left enlarges, giving yakridudara or plihodara.
Hair, small stones or grass in food lodge in the intestine, faeces accumulate and pass with difficulty, and a foul faecal smell results; this is baddhagudodara.
A thorn or sharp object swallowed unknowingly with food pierces the intestine; much watery fluid oozes and passes through the anus with pricking pain; this is called sravi udara.
One who has undergone emesis, purgation, an enema or oleation and then drinks a great deal of cold water develops jalodara.
The enlarged abdomen shakes and is agitated like a water-skin full of water; the patient grows thin, faints, is very thirsty and has little desire for food.
All mahodaras show burning, fainting, a full abdomen, weak digestion, retention of wind and faeces, swelling, emaciation and body pain.
In their final stage all udaras become jalodara and incurable (in old age, the commentary says), and baddhodara and sravi udara are added to those the physician should not treat.
The remaining mahodaras are very hard to cure and improve only with difficulty under daily, suitable treatment by a skilled physician.
Of the eight mahodaras, the first four (from vata, pitta, kapha and their combination) are curable by excellent medicines and the other four by surgery; after a long time all of them need…
A patient with marked loss of appetite, flanks that feel broken, swelling, and fluid that quickly refills even after purgation is to be abandoned as incurable.
Treatment begins with ghee cooked with a decoction and paste of vida salt, vacha and madhushigru, given to drink, followed by purgation with tilvaka ghee and a decoction enema with cow…
The abdomen is oiled and a poultice of shigru roots and both karanjas cooked in milk and curd is bound on it with vata-relieving leaves; sudation is given repeatedly, and food such as milk…
The pitta-type udara patient is given ghee well cooked with especially cooling drugs and is then purged with trivrit mixed with an equal amount of sugar.
Decoction enemas of lukewarm tree decoctions rich in sugar, milk and ghee are given; after the bowel is cleansed, the abdomen is smeared with ghee and a poultice cooked with milk is bound…
The kapha-type udara patient is oleated with ghee and oil cooked with bitter, astringent and drying drugs, the three pungents and alkalis, then purged with snuhi latex; decoction enemas of…
Dushyodara (combined-dosha udara) is treated quickly with drugs that pacify all three doshas, and the abdomen is smeared externally with a paste of karanja, langali and shirisha.
Ghee cooked with a decoction of nidigdhika, neem, karanja, patala, palasha, nili and kutaja and a paste of vidanga, patha and snuhi latex is given to drink to the patient with poison-caused…
Castor oil mixed with rock salt and dry ginger powder is licked and lukewarm cow milk is drunk; this is said to destroy all udaras.
Castor oil cooked a hundred times with milk, ginger juice and jati juice, or prepared with the juice of black shigru or of punarnava, is said to destroy mahodara.
Lukewarm milk with suvarchika (yavakshara in the commentary), asafoetida and dry ginger, or jaggery taken daily with haritaki, is said to relieve mahodara; so are a thousand pippalis…
Cow milk four times the amount of snuhi latex is boiled, set into curd with buttermilk and churned; the butter taken out is cooked again with snuhi latex. This naracha ghee, called the best…
Naracha ghee is cooked again with a decoction of trivrit, danti, triphala and shankhini and a paste of aragvadha pulp, snuhi latex, chitraka, vidanga, chavya, turmeric and the three…
Equal parts of all purifying drugs, pungent drugs and salts ground with cow urine and snuhi latex are made into a suppository (mutravartika), which placed in the anus is said to destroy…
A second suppository for mahodara is made of purifying drugs, mustard, rock salt, the alkalis (yavakshara, sarjikshara and others) and the three pungents ground with cow urine and sour…
The anus is smeared with sesame oil mixed with rock salt, the suppository is smeared too and inserted carefully; this is said to remove severe distension, worms in the abdomen and retention…
The dushyodara patient should be abandoned as incurable, or else given poison to take; with it, the text says, the disease sometimes ends quickly and sometimes death comes easily.
After the patient has eaten plenty of curd, the vein in the middle of the right arm (liver) or left arm (spleen) is pierced while the spleen is pressed; lukewarm cow milk with camphor is…
Black salt, asafoetida and dry ginger mixed in strained palasha-ash water, or sea salt cooked with the alkalis, are drunk and said to destroy plihodara.
Equal parts of pippali, rock salt, chitraka and yavakshara, finely powdered and mixed with shigru juice, are licked daily to relieve liver and spleen udara.
Ghee cooked with six pala of decoction and six pala of paste of pippali, dry ginger, gajapippali, shati, sea salt, chitraka and yavakshara and one prastha of cow-dung juice is the shatpala…
The abdomen is opened on the left four fingers below the navel, the intestine drawn out and inspected, the obstruction removed and the torn intestine joined with fine silver wire; the outer…
The jalodara patient is oiled, bathed with lukewarm water and has a cloth wrapped round the waist; the abdomen is then pierced at the stated place with an instrument that has no cutting…
A two-mouthed tube is set in the puncture and the fluid is let out a little at a time, never all at once for fear of severe thirst, fainting, fever and burning; the waist cloth is tightened…
For six months the jalodara patient eats only with lukewarm milk, and milk is used in every treatment of mahodara.
Milk combined with drugs suited to the disease is said to benefit mahodara and to destroy burning distress, wasting, thirst, raktapitta and vata disorders, and to be aphrodisiac,…
The closing verse, the same as at the end of other chapters, calls the work a drop from the ocean of scripture that issued from the Jina's mouth and the one benefactor of the world; the…