Treatment of minor diseases, part one
क्षुद्ररोगचिकित्सित · चिकित्साधिकार
Heading that opens the thirteenth chapter. Its first section, named after sharkara (urinary gravel), goes on to ashmari (urinary stone) and bhagandara (fistula-in-ano).
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Topics in this session
Headings from the book in reading order. Open a topic for its summary and the knowledge it refers to.
The author bows to Vira, the Jina endowed with all inner and outer riches and imperishable glory, and vows to describe with care the nature and treatment of sharkara, the extremely painful…
The bladder (basti) is described as lying amid the waist, the sacral bone (trika), the navel and the groin, shaped like a bottle gourd with its mouth facing down. Kapha enters it together…
As mud settles by itself at the bottom of a new pot filled with clear water, kapha that has gone into the bladder settles, is dried hard by heat and is broken by vata into sand-like grains;…
The dried kapha, struck by strong vata, breaks into two, three or many pieces; lodged in the urinary passage they cause intense pain in the waist, groin, bladder and penis. The verse also…
Heading that opens the thirteenth chapter. Its first section, named after sharkara (urinary gravel), goes on to ashmari (urinary stone) and bhagandara (fistula-in-ano).
The sand-like gravel in this way produces sharkara colic. When the best medicines that break up gravel are used, the gravel falls out again and again with the urine.
Kapha predominates in every stone, yet by primary and secondary factor four kinds are named: from kapha, pitta, vata and semen. Footnotes add that a stone is kapha hardened in the bladder,…
A stone arising from kapha alone is heavy, large and pale white. When it blocks the urinary outlet the bladder feels heavy and there is pain as if it were being split open.
A stone from kapha with excess pitta is red, black and yellow and shaped like the stone of the marking nut (bhallataka). It blocks the urine, so the bladder burns and seems to cook from…
A stone from kapha with excess vata is rough, dark, beset with thorn-like points and looks like a kadamba flower. Blocking the bladder mouth it stops the urine with great pain: the patient…
Stones of all the doshas are said to occur especially in children, because of much sleeping by day, a very narrow urinary passage, rich and pleasant sweet food and the natural increase of…
Because a child's body and bladder are small, its flesh is scant and an instrument can be applied easily, a stone arising in a child can be taken out very easily.
When the arising urge of semen is held back, the semen leaves its place and, finding no outlet, goes astray; driven by vata it enters between scrotum and penis at the mouth of the bladder,…
Pressed between scrotum and penis, this stone dissolves for a time but soon gathers and grows again. The text likens the suffering this misdirected semen brings even to a strong man to the…
When a stone causes terrible pain, urine mixed with blood comes out with great difficulty and ulcers have formed in the urinary passage, the commentary calls it incurable or hard to cure;…
A patient whose navel and scrotum are swollen, whose urine is blocked and who is tormented by extreme pain from gravel and stones is to be given up as incurable. Ashmari is likened to…
At the onset of a stone the patient is cleansed by emesis, purgation and the like, then given ghee cooked with the decoction and paste of pashanabheda, shilajit, shatavari, gokshura,…
For vata-type stone, gruels (yavagu, vilepi) and khala-yusha made with water boiled with the same drugs, and milk, snacks, meals and drinks prepared with them, are to be given. A footnote…
Decoctions of kasha, darbha, utkata, sugarcane root, pashanabheda, gokshura, sariva, sandalwood, shirisha, dhattura, kurantaka, shami, musta, patha, banana root, vidaraka, nagakesara, ash…
Oil, ghee, milk and food cooked with the paste and decoction of triphala, trikatu, shigru, chitraka root, vidanga, kushtha, varuna, large and small cardamom and bida, black and rock salts,…
A decoction of the roots of patala and kapichuta (ambada, or a kind of ashvattha) with shilajit and sugar added is said, when drunk, to remove gravel and stone.
A decoction of brahmi (kapotavanka), vishnukranta, the fruit of the teak tree, semal and hijjala (samudraphala), mixed with borax powder, sugar and camphor, is to be drunk by one with…
Giving up all food, the patient drinks quite hot goat's milk mixed with sugar and roasted borax powder for several days; this is said to remove gravel and stone.
A paste of nrityakanda seed (the commentator queries its identity), gokshura and patala, mixed well with milk, curd and sugar and drunk, is said quickly to break up gravel and stone.
Sesame, apamarga, gokshura, tala palm, mushkaka, aragvadha and kimshuka are burnt to ash, stirred in water and strained; this alkaline water with shilajit and bida salt added is said to…
Uttara basti is said to overcome all diseases located in the bladder, so the text now describes its nozzle (netra) and bag, the quantity of fluid and the order of the procedure.
For men the nozzle is eight finger-breadths long (a footnote: of the patient's own finger), round, smooth and well formed, made of silver or another metal, with a collar (karnika) at its…
For women the nozzle is half as long, four finger-breadths, with a large collar; for girls it is two finger-breadths long with a collar. All three kinds are fitted to a bag.
Whatever fluid is used, decoction, oil, ghee or the like, its largest amount is one prasrita, which the commentary glosses as sixty tola. Before the injection the urethral opening is…
Before uttara basti the parts are first rubbed, then the injection is given, and that day the patient is fed with milk in the evening (the verse says afternoon); the order of the procedure…
A man is seated in the cock posture (kukkutasana) on a firm seat as high as his knees; a woman lies on her back on such a seat with both legs raised and drawn up. When the syringe fluid has…
A wick smeared with the liquid (decoction or the like) of house soot, blue lotus, kushtha, pippali, rock salt and brihati fruit, when inserted, makes the injected fluid come out easily at…
Uttara basti is called the best means for urinary diseases, painful urination, gravel and even the fiercest stones, and for all diseases located in the bladder.
Having briefly described stone, the author promises to set out bhagandara with its signs, the judgement of curability, its fatal signs (rishta) and its treatment.
The vata type, shatayonaka, has pricking, splitting and intense pain; a footnote explains the name as a sieve, for its many openings. The pitta type has severe burning and fever and…
The kapha type is large and firm, itches, has mild pain and keeps discharging pus, so it is called parisravi. The type from all three doshas shows their separate signs together and is…
Bhagandara is of five kinds: from vata, pitta, kapha, all three doshas together, and from injury by a foreign body such as a thorn; it is called as dreadful as poison, fire and death. A…
When a thorn swallowed with food eaten carelessly pricks the anus, it causes a bhagandara with many tracts that run in wrong directions; it is called unmargi and is very dreadful.
- Meaning of the name and curability of bhagandaraभगंदर की व्युत्पत्ति व साध्यासाध्य-विचारPrognosisp. 231
It is called bhagandara because it tears open the region of the bhaga, bladder and anus (footnote: bhagam darayati iti bhagandarah). All kinds are very hard to cure; the all-dosha and…
A patient troubled by the bhagandara boil is to be treated promptly with fasting, emesis, purgation, bloodletting, sweating, plasters and bandaging.
If neglected, the bhagandara becomes involved with all three doshas and suppurates; semen, faeces, urine and wind start coming out through its openings, ulcers with many mouths form, and…
When faeces, urine, wind, semen and worms are seen coming from the bhagandara wound and severe complications have arisen, the physician should give the patient up as incurable.
- Examining whether the opening is internal or externalभगंदर की अन्तर्मुख-बहिर्मुख परीक्षाSurgeryp. 232
A bhagandara free of the incurable signs is examined, as with piles, by carefully inserting the instrument and passing a probe (eshani, an iron rod) to judge whether its opening is internal…
The instrument for bhagandara is like the one described earlier for piles, with one difference stated by the learned: its collar (karnika) is shaped like a half moon.
Following the track of the probe, the bhagandara and its base are cut open with the knife and burnt with fire, or a caustic alkali is applied; the wound is then treated with cleansing and…
When the tracts of the bhagandara join one another they are cut at one time; tracts that are separate are opened one after another, the next only after the previous has healed, so that the…
If the wound made in bhagandara becomes very large, faeces, urine and semen escape through it and the tract worsens; so the surgeon must never make it large, for it then tears the anus, and…
A pot filled with a decoction of vata-reducing drugs is closed and fitted with a bent tube, and the steam coming through it is applied to the anus of the patient lying down; or the body is…
Oil, milk, ghee, rock salt and vata-reducing drugs are cooked together until thick like rice pudding (payasa); this poultice is bound over the bhagandara wound with leaves and cloth, as is…
For the bhagandara caused by a swallowed thorn, the physician first informs the king that it is incurable and difficult, then opens it with great care and removes the thorn.
The bhagandara wound is cleansed by the same wound procedure given earlier for prameha ulcers, and cleansing and healing drugs are used on it in particular.
Oil or ghee, or both, cooked with the paste and decoction of sesame, danti, trivrit, indravaruni, shatavari (as glossed), kushtha, karavira, turmeric, kanjira, karanja, langali root, arka,…
The same oil and ghee are said to benefit malignant tumours, sinus ulcers, piles, breast injuries, boils, purulent ear, prameha, kushtha, kacchu, dadru, apachi and worms.
A fine powder of haritaki, katuki, rock salt, vacha and trikatu, mixed in a kanji of horse gram and buttermilk, or with any liquid, is drunk by the bhagandara patient, who is said to become…
Even after the bhagandara wound has healed, for two months the patient should avoid sexual intercourse, long journeys on foot, much riding, wrestling and other activities that cause injury,…
Having thus described in order the major diseases with their signs, curability and treatment, the author turns next to the minor diseases (kshudra roga).
Next, scrotal enlargement (vriddhi), upadamsha, shlipada, apachi, galaganda, arbuda and granthi are to be described in order with their signs and treatment.
Enlargement of the scrotum in men is of seven kinds, each named after its cause: the doshas vata, pitta and kapha, blood, fat, urine and the intestine.
Any one of the doshas, aggravated by its own causes, reaches the vessel that runs into the scrotum and, aided by vata, produces swelling in the scrotum; this is called andavriddhi.
A swelling that is full (of air), hard, beset with thorn-like points, dark and very painful is the vata type; the same swelling with fever and intense burning is to be known as the pitta or…
The kapha type is heavy and steady (it does not come and go), with little pain, severe itching and hardness; the fat type is large, soft, shaped like a palm fruit, with intense itching.
A soft swelling that sways as the patient walks, like a leather bag filled with water, with painful urination and much pain, is the urine type; it arises from holding back urine.
When vata inside presses the intestine, the intestine bends the skin, shakes the groin joint and enters the scrotum through it with great pain; the physician calls this the intestinal type…
In every kind of scrotal enlargement the patient should give up intercourse, holding back natural urges, riding, fighting and other things that injure the body, and then have the disease…
A patient with vata-type enlargement is purged with an unctuous purgative; castor oil mixed with milk is especially helpful, or niruha and anuvasana enemas are given.
A much enlarged swelling is always treated with sweating, plasters and bandaging using suitable drugs; one that is especially firm is burnt on its lower and upper parts with a rod heated in…
For enlargement from pitta and blood, purgation with pitta-reducing drugs is given, the vitiated blood of the scrotum is drawn out with leeches, and cooling drugs are applied as plasters.
For the kapha type, triphala and trikatu ground well with cow's urine containing alkali are applied as a plaster and the same is given to drink; poultices of hot drugs are always bound on.
In fat-type enlargement the scrotum is opened with great care, avoiding the sevani (the line running from below the penis to the anus); the fat is quickly removed, the wound is cleansed…
In urine-type enlargement, following the method given for draining fluid in jalodara, the scrotum (bound firmly, says the verse) is pierced with care using the vrihimukha instrument, a tube…
Intestinal enlargement is to be declared incurable from the start; then vata-reducing treatment is tried with great effort, and bala oil (described in the childbirth section, says a…
A paste of the roots of sukhahva, a particular thorny plant, kanjira, karanja, langali and apamarga is spread on leaves and bound over the swelling, which is said to subside.
A paste of the roots of patala (kuberakshi) and madana is taken with a sour liquid, buttermilk or kanji; or a paste of shigru root, trikatu and rock salt is drunk with a decoction of…
A powder of sarjika alkali, rock salt, asafoetida, cumin, both karanjas, shravani and trikatu taken with milk is said to make the scrotum firm like an elephant's.
Having given all the signs and treatment of scrotal enlargement, the author promises to describe next upadamsha and the shuka diseases that arise on the penis.
The work is called a drop drawn from the great ocean of scripture that issued from the mouth of the Jina, whose waves are all substances and principles and whose two shores are the means to…
- Colophon of chapter thirteenइत्युग्रादित्याचार्यकृत कल्याणकारके चिकित्साधिकारे क्षुद्ररोगचिकित्सितं नामादितस्त्रयोदशः परिच्छेदःEditorialp. 240
Colophon: thus ends the thirteenth chapter, named treatment of minor diseases (kshudraroga-chikitsita), in the treatment section of Ugradityacharya's Kalyanakaraka. The Hindi line adds that…