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|title=Kshatakshina Chikitsa
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|titlemode=append
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|keywords=Kshatakshina, adventures, occupational disease, pneumo-thorax, tuberculosis, nourishment therapy, Ayurveda, charak samhita, Indian system of medicine.
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|description=Chikitsa Sthana Chapter 11. Management of Kshata-kshina (Emaciation due to Trauma)
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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<big>'''[[Chikitsa Sthana]] Chapter 11. Management of Kshata-kshina (Emaciation due to Trauma)</big>'''
 
{{Infobox
 
{{Infobox
 
|title = Kshatakshina Chikitsa
 
|title = Kshatakshina Chikitsa
Line 7: Line 18:
  
 
|label3= Succeeding Chapter
 
|label3= Succeeding Chapter
|data3 = [[Svayatu Chikitsa]]
+
|data3 = [[Shvayathu Chikitsa]]
 
|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
+
|label6 = Translator and commentator
|header3 =  
+
|data6 = Tiwari S.K., [[Yogesh Deole|Deole Y. S.]]
 
+
|label7 = Reviewer
 +
|data7  = Singh G., Ghadi R.
 +
|label8 = Editors
 +
|data8  = Singh G. & Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.012 10.47468/CSNE.2020.e01.s06.012]
 
}}
 
}}
  
==([[Chikitsa Sthana]] Chapter 11, Chapter on the Management of Emaciation due to Trauma) ==
+
<big>'''Abstract </big>'''
 +
<p style="text-align:justify;">''Kshatakshina'' is a condition with ''kshaya'' (wasting, debility, emaciation) due to injury/trauma. Trauma is usually from external injury but in the present context this term signifies rupture of lung tissue due to exogenous as well as endogenous causes. The etiology includes significant exertion beyond one’s capacity. The disease shows close resemblance with ''rajayakshma'' in pathogenesis, as both involve ''anuloma kshaya'' (the depletion of ''[[dhatu]]s'' takes place in the direction of their nourishment i.e. ''[[rasa]]'' then ''[[rakta]]'' then ''[[mamsa]]'' and so on) and ''pratiloma kshaya'' (depletion of ''[[dhatu]]s'' in the direction opposite to their nourishment i.e. ''[[shukra]]'' then ''[[majja]]'' then ''[[asthi]]'' and so on). Nourishment therapy is the principle of management in ''kshatakshina''. Various formulations to regain strength and replenishment of depleted tissues are described in this chapter.  <br/>
  
=== Abstract ===
+
'''Keywords''': ''Kshatakshina,'' adventures, occupational disease, pneumo-thorax, tuberculosis, nourishment therapy. </div>
 +
</p>
  
''Kshatakshina'' is a condition with ''kshaya'' (wasting, debility, emaciation) due to injury/trauma. Trauma is usually from external injury but in the present context this term signifies rupture of lung tissue due to exogenous as well as endogenous causes. The etiology includes significant exertion beyond one’s capacity. The disease shows close resemblance with ''rajayakshma'' in pathogenesis, as both involve ''anuloma kshaya'' (the depletion of ''dhatus'' takes place in the direction of their nourishment i.e. ''rasa'' then ''rakta'' then ''mamsa'' and so on) and ''pratiloma kshaya'' (depletion of ''dhatus'' in the direction opposite to their nourishment i.e. ''shukra'' then ''majja'' then ''asthi'' and so on). Nourishment therapy is the principle of management in ''kshatakshina''. Various formulations to regain strength and replenishment of depleted tissues are described in this chapter.   
+
== Introduction ==
 +
<div style="text-align:justify;">
 +
In [[Ayurveda]], rather than disease, mainly the syndromes are described and ''kshatakshina'' is also a syndrome. ''Kshata'' means injury and ''kshina'' means depletion of tissue. The term literally means depletion of tissues due to injury. It includes various pathologies leading to depletion of tissues in the body as a result of external and internal injuries. It shows close resemblance with tuberculosis, however the cardinal cause in ''kshatakshina'' is injury. Hemoptysis (symptom of pulmonary tuberculosis), hematuria (symptom of renal tuberculosis) and diarrhea (symptom of intestinal tuberculosis) all have cardinal symptoms of tuberculosis which are described as the symptom of ''kshatakshina''. It refers to those dreaded complications of tuberculosis that  appear suddenly and require prompt treatment just as acute onset of chest-pain in patient of tuberculosis who suddenly develops pneumothorax due to rupture of subpleural blebs and massive painless hematuria in the patient of genitourinary tuberculosis. Similar to tuberculosis, there is impaired immunity in ''kshatakshina'' patients also. ''Kshatakshina'' refers to cluster of diseases like spontaneous pneumothorax and renal tuberculosis, whereas presence of hemoptysis and hematuria in a single disease suggests a pulmonary-renal syndrome (eg, Goodpasture's syndrome, Wegener's granulomatosis). The diseases due to excess exertion during work or occupational hazards can also be referred to ''kshatakshina''.
  
'''Keywords''': ''Kshatakshina,'' adventures, occupational disease, pneumo-thorax, tuberculosis, nourishment therapy.
+
== Sanskrit text, Transliteration and English Translation ==
 
+
<div class="mw-collapsible mw-collapsed">
=== Introduction ===
 
 
 
In Ayurveda, rather than disease, mainly the syndromes are described and ''kshatakshina'' is also a syndrome. ''Kshata'' means injury and ''kshina'' means depletion of tissue. The term literally means depletion of tissues due to injury. It includes various pathologies leading to depletion of tissues in the body as a result of external and internal injuries. It shows close resemblance with tuberculosis, however the cardinal cause in ''kshatakshina'' is injury. Hemoptysis (symptom of pulmonary tuberculosis), hematuria (symptom of renal tuberculosis) and diarrhea (symptom of intestinal tuberculosis) all have cardinal symptoms of tuberculosis which are described as the symptom of ''kshatakshina''. It refers to those dreaded complications of tuberculosis that  appear suddenly and require prompt treatment just as acute onset of chest-pain in patient of tuberculosis who suddenly develops pneumothorax due to rupture of subpleural blebs and massive painless hematuria in the patient of genitourinary tuberculosis. Similar to tuberculosis, there is impaired immunity in ''kshatakshina'' patients also. ''Kshatakshina'' refers to cluster of diseases like spontaneous pneumothorax and renal tuberculosis, whereas presence of hemoptysis and hematuria in a single disease suggests a pulmonary-renal syndrome (eg, Goodpasture's syndrome, Wegener's granulomatosis). The diseases due to excess exertion during work or occupational hazards can also be referred to ''kshatakshina''.
 
 
 
===Sanskrit text, Transliteration and English Translation===
 
  
 
अथातः क्षतक्षीणचिकित्सितं व्याख्यास्यामः||१||
 
अथातः क्षतक्षीणचिकित्सितं व्याख्यास्यामः||१||
  
 
इति ह स्माह भगवानात्रेयः||२||
 
इति ह स्माह भगवानात्रेयः||२||
 +
<div class="mw-collapsible-content">
  
 
athātaḥ kṣatakṣīṇacikitsitaṁ vyākhyāsyāmaḥ||1||  
 
athātaḥ kṣatakṣīṇacikitsitaṁ vyākhyāsyāmaḥ||1||  
Line 40: Line 60:
  
 
iti ha smAha bhagavAnAtreyaH||2||
 
iti ha smAha bhagavAnAtreyaH||2||
 +
</div></div>
  
We shall now expound the chapter on the treatment of ''Kshatakshina''.
+
Now we shall expound the chapter "Kshatakshina Chikitsa ( Management of emaciation due to trauma).Thus said Lord Atreya. [1-2]
  
Thus, said Lord Atreya. [1-2]
+
<div class="mw-collapsible mw-collapsed">
  
उदारकीर्तिर्ब्रह्मर्षिरात्रेयः परमार्थवित्|  
+
उदारकीर्तिर्ब्रह्मर्षिरात्रेयः परमार्थवित्| <br />
क्षतक्षीणचिकित्सार्थमिदमाह चिकित्सितम्||३||
+
क्षतक्षीणचिकित्सार्थमिदमाह चिकित्सितम्||३||<br />
 +
<div class="mw-collapsible-content">
  
udārakīrtirbrahmarṣirātrēyaḥ paramārthavit|  
+
udārakīrtirbrahmarṣirātrēyaḥ paramārthavit| <br />
kṣatakṣīṇacikitsārthamidamāha cikitsitam||3||
+
kṣatakṣīṇacikitsārthamidamāha cikitsitam||3||<br />
  
udArakIrtirbrahmarShirAtreyaH paramArthavit|
+
udArakIrtirbrahmarShirAtreyaH paramArthavit|<br />
kShatakShINacikitsArthamidamAha cikitsitam||3||
+
kShatakShINacikitsArthamidamAha cikitsitam||3||<br />
 +
</div></div>
  
 
Atreya, the illustrious sage, the brahmin-seer and the knower of ultimate truth, (thereafter) expounded therapeutics for the treatment of ''kshatakshina'', as given below. [3]
 
Atreya, the illustrious sage, the brahmin-seer and the knower of ultimate truth, (thereafter) expounded therapeutics for the treatment of ''kshatakshina'', as given below. [3]
  
==== ''Nidana'' (Etiology) of ''kshatakshina'' ====
+
=== ''Nidana'' (Etiology) of ''kshatakshina'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
धनुषाऽऽयस्यतोऽत्यर्थं भारमुद्वहतो गुरुम्|  
+
धनुषाऽऽयस्यतोऽत्यर्थं भारमुद्वहतो गुरुम्| <br />
पततो विषमोच्चेभ्यो बलिभिः सह युध्यतः||४||  
+
पततो विषमोच्चेभ्यो बलिभिः सह युध्यतः||४|| <br />
  
वृषं हयं वा धावन्तं दम्यं वाऽन्यं निगृह्णतः|  
+
वृषं हयं वा धावन्तं दम्यं वाऽन्यं निगृह्णतः| <br />
शिलाकाष्ठाश्मनिर्घातान्क्षिपतो निघ्नतः परान्||५||  
+
शिलाकाष्ठाश्मनिर्घातान्क्षिपतो निघ्नतः परान्||५|| <br />
  
अधीयानस्य वाऽत्युच्चैर्दूरं वा व्रजतो द्रुतम्|  
+
अधीयानस्य वाऽत्युच्चैर्दूरं वा व्रजतो द्रुतम्| <br />
महानदीं वा तरतो हयैर्वा सह धावतः||६||  
+
महानदीं वा तरतो हयैर्वा सह धावतः||६|| <br />
  
सहसोत्पततो दूरं[१] तूर्णं चातिप्रनृत्यतः|  
+
सहसोत्पततो दूरं[१] तूर्णं चातिप्रनृत्यतः| <br />
तथाऽन्यैः कर्मभिः क्रूरैर्भृशमभ्याहतस्य च||७||  
+
तथाऽन्यैः कर्मभिः क्रूरैर्भृशमभ्याहतस्य च||७|| <br />
  
विक्षते वक्षसि व्याधिर्बलवान् समुदीर्यते|  
+
विक्षते वक्षसि व्याधिर्बलवान् समुदीर्यते| <br />
स्त्रीषु चातिप्रसक्तस्य रूक्षाल्पप्रमिताशिनः||८||
+
स्त्रीषु चातिप्रसक्तस्य रूक्षाल्पप्रमिताशिनः||८||<br />
 +
<div class="mw-collapsible-content">
  
dhanuṣā''yasyatō'tyarthaṁ bhāramudvahatō gurum|  
+
dhanuṣā''yasyatō'tyarthaṁ bhāramudvahatō gurum| <br />
patatō viṣamōccēbhyō balibhiḥ saha yudhyataḥ||4||  
+
patatō viṣamōccēbhyō balibhiḥ saha yudhyataḥ||4|| <br />
  
vr̥ṣaṁ hayaṁ vā dhāvantaṁ damyaṁ vā'nyaṁ nigr̥hṇataḥ|  
+
vr̥ṣaṁ hayaṁ vā dhāvantaṁ damyaṁ vā'nyaṁ nigr̥hṇataḥ| <br />
śilākāṣṭhāśmanirghātān kṣipatō nighnataḥ parān||5||  
+
śilākāṣṭhāśmanirghātān kṣipatō nighnataḥ parān||5|| <br />
  
adhīyānasya vā'tyuccairdūraṁ vā vrajatō drutam|  
+
adhīyānasya vā'tyuccairdūraṁ vā vrajatō drutam| <br />
mahānadīṁ vā taratō hayairvā saha dhāvataḥ||6||  
+
mahānadīṁ vā taratō hayairvā saha dhāvataḥ||6|| <br />
  
sahasōtpatatō dūraṁ [1] tūrṇaṁ cātipranr̥tyataḥ|  
+
sahasōtpatatō dūraṁ [1] tūrṇaṁ cātipranr̥tyataḥ| <br />
tathā'nyaiḥ karmabhiḥ krūrairbhr̥śamabhyāhatasya ca||7||  
+
tathā'nyaiḥ karmabhiḥ krūrairbhr̥śamabhyāhatasya ca||7|| <br />
  
vikṣatē vakṣasi vyādhirbalavān samudīryatē|  
+
vikṣatē vakṣasi vyādhirbalavān samudīryatē| <br />
strīṣu cātiprasaktasya rūkṣālpapramitāśinaḥ||8||
+
strīṣu cātiprasaktasya rūkṣālpapramitāśinaḥ||8||<br />
  
dhanuShA~a~ayasyato~atyarthaM bhAramudvahato
+
dhanuShA~a~ayasyato~atyarthaM bhAramudvahato gurum| <br />
gurum| patato viShamoccebhyo balibhiH saha yudhyataH||4||
+
patato viShamoccebhyo balibhiH saha yudhyataH||4|| <br />
  
vRuShaM hayaM vA dhAvantaM damyaM vA~anyaM nigRuhNataH|  
+
vRuShaM hayaM vA dhAvantaM damyaM vA~anyaM nigRuhNataH| <br />
shilAkAShThAshmanirghAtAn kShipato nighnataH parAn||5||  
+
shilAkAShThAshmanirghAtAn kShipato nighnataH parAn||5|| <br />
  
adhIyAnasya vA~atyuccairdUraM vA vrajato drutam|  
+
adhIyAnasya vA~atyuccairdUraM vA vrajato drutam| <br />
mahAnadIM vA tarato hayairvA saha dhAvataH||6||  
+
mahAnadIM vA tarato hayairvA saha dhAvataH||6|| <br />
  
sahasotpatato dUraM tUrNaM cAtipranRutyataH|  
+
sahasotpatato dUraM tUrNaM cAtipranRutyataH| <br />
tathA~anyaiH karmabhiH krUrairbhRushamabhyAhatasya ca||7||  
+
tathA~anyaiH karmabhiH krUrairbhRushamabhyAhatasya ca||7|| <br />
  
vikShate vakShasi vyAdhirbalavAn samudIryate|  
+
vikShate vakShasi vyAdhirbalavAn samudIryate| <br />
strIShu cAtiprasaktasya rUkShAlpapramitAshinaH||8||
+
strIShu cAtiprasaktasya rUkShAlpapramitAshinaH||8||<br />
 +
</div></div>
  
 
The person who (beyond his own power) subjects himself to following activities:  
 
The person who (beyond his own power) subjects himself to following activities:  
Line 122: Line 148:
 
''Kshatakshina'', the formidable disease, gets manifested, as a result of the injury to the chest due to the above causative factors. [4-8]
 
''Kshatakshina'', the formidable disease, gets manifested, as a result of the injury to the chest due to the above causative factors. [4-8]
  
==== Pathogenesis and clinical features ====
+
=== Pathogenesis and clinical features ===
 +
<div class="mw-collapsible mw-collapsed">
  
उरो विरुज्यते तस्य भिद्यतेऽथ  विभज्यते|  
+
उरो विरुज्यते तस्य भिद्यतेऽथ  विभज्यते| <br />
प्रपीड्येते ततः पार्श्वे शुष्यत्यङ्गं प्रवेपते||९||  
+
प्रपीड्येते ततः पार्श्वे शुष्यत्यङ्गं प्रवेपते||९|| <br />
  
क्रमाद्वीर्यं बलं वर्णो रुचिरग्निश्च हीयते|  
+
क्रमाद्वीर्यं बलं वर्णो रुचिरग्निश्च हीयते| <br />
ज्वरो व्यथा मनोदैन्यं विड्भेदोऽग्निवधादपि||१०||  
+
ज्वरो व्यथा मनोदैन्यं विड्भेदोऽग्निवधादपि||१०|| <br />
  
दुष्टः श्यावः सुदुर्गन्धः पीतो विग्रथितो बहुः|  
+
दुष्टः श्यावः सुदुर्गन्धः पीतो विग्रथितो बहुः| <br />
कासमानस्य च[१] श्लेष्मा सरक्तः सम्प्रवर्तते||११||  
+
कासमानस्य च[१] श्लेष्मा सरक्तः सम्प्रवर्तते||११|| <br />
  
स क्षतः क्षीयतेऽत्यर्थं तथा शुक्रौजसोः क्षयात्|१२|
+
स क्षतः क्षीयतेऽत्यर्थं तथा शुक्रौजसोः क्षयात्|१२|<br />
 +
<div class="mw-collapsible-content">
  
urō virujyatē tasya bhidyatē'tha vibhajyatē|  
+
urō virujyatē tasya bhidyatē'tha vibhajyatē| <br />
prapīḍyētē tataḥ pārśvē śuṣyatyaṅgaṁ pravēpatē||9||  
+
prapīḍyētē tataḥ pārśvē śuṣyatyaṅgaṁ pravēpatē||9|| <br />
  
kramādvīryaṁ balaṁ varṇō ruciragniśca hīyatē|  
+
kramādvīryaṁ balaṁ varṇō ruciragniśca hīyatē| <br />
jvarō vyathā manōdainyaṁ viḍbhēdō'gnivadhādapi||10||  
+
jvarō vyathā manōdainyaṁ viḍbhēdō'gnivadhādapi||10||<br />
  
duṣṭaḥ śyāvaḥ sudurgandhaḥ pītō vigrathitō bahuḥ|  
+
duṣṭaḥ śyāvaḥ sudurgandhaḥ pītō vigrathitō bahuḥ| <br />
kāsamānasya ca [1] ślēṣmā saraktaḥ sampravartatē||11||  
+
kāsamānasya ca [1] ślēṣmā saraktaḥ sampravartatē||11|| <br />
  
sa kṣataḥ kṣīyatē'tyarthaṁ tathā śukraujasōḥ kṣayāt|
+
sa kṣataḥ kṣīyatē'tyarthaṁ tathā śukraujasōḥ kṣayāt| <br />
  
uro virujyate tasya bhidyate~atha vibhajyate|  
+
uro virujyate tasya bhidyate~atha vibhajyate| <br />
prapIDyete tataH pArshve shuShyatya~ggaM pravepate||9||  
+
prapIDyete tataH pArshve shuShyatya~ggaM pravepate||9|| <br />
  
kramAdvIryaM balaM varNo ruciragnishca hIyate|  
+
kramAdvIryaM balaM varNo ruciragnishca hIyate| <br />
jvaro vyathA manodainyaM viDbhedo~agnivadhAdapi||10||
+
jvaro vyathA manodainyaM viDbhedo~agnivadhAdapi||10||<br />
 
   
 
   
duShTaH shyAvaH sudurgandhaH pIto vigrathito bahuH|  
+
duShTaH shyAvaH sudurgandhaH pIto vigrathito bahuH| <br />
kAsamAnasya ca shleShmA saraktaH sampravartate||11||  
+
kAsamAnasya ca shleShmA saraktaH sampravartate||11|| <br />
  
sa kShataH kShIyate~atyarthaM tathA shukraujasoH kShayAt|12|
+
sa kShataH kShIyate~atyarthaM tathA shukraujasoH kShayAt|12|<br />
 +
</div></div>
  
 
Because of the above mentioned causative factors, the chest gets broken, punctured and cracked; sides of the chest get pressed and there is emaciation as well as tremor in the limbs. Gradually the potency, strength, complexion, appetite and agni (the power of digestion) of the patient get reduced. The patient suffers from fever, pain, mental depression and diarrhea even with the diminution of ''agni'' (decreased power of digestion).
 
Because of the above mentioned causative factors, the chest gets broken, punctured and cracked; sides of the chest get pressed and there is emaciation as well as tremor in the limbs. Gradually the potency, strength, complexion, appetite and agni (the power of digestion) of the patient get reduced. The patient suffers from fever, pain, mental depression and diarrhea even with the diminution of ''agni'' (decreased power of digestion).
  
While coughing, the patient spits out phlegm which is putrid, grayish in color, foul smelling, and yellow and knotty, in large quantities along with blood. The person suffering from ''kshatakshina'' becomes excessively emaciated due to further wastage of ''shukra'' and ''ojas''. [9-12]
+
While coughing, the patient spits out phlegm which is putrid, grayish in color, foul smelling, and yellow and knotty, in large quantities along with blood. The person suffering from ''kshatakshina'' becomes excessively emaciated due to further wastage of ''[[shukra]]'' and ''[[ojas]]''. [9-12]
  
==== Prodromal signs and symptoms ====
+
=== Prodromal signs and symptoms ===
 +
<div class="mw-collapsible mw-collapsed">
  
अव्यक्तं लक्षणं तस्य पूर्वरूपमिति स्मृतम्||१२||
+
अव्यक्तं लक्षणं तस्य पूर्वरूपमिति स्मृतम्||१२||<br />
  
उरोरुक्शोणितच्छर्दिः कासो वैशेषिकः  क्षते|  
+
उरोरुक्शोणितच्छर्दिः कासो वैशेषिकः  क्षते| <br />
क्षीणे सरक्तमूत्रत्वं पार्श्वपृष्ठकटिग्रहः||१३||
+
क्षीणे सरक्तमूत्रत्वं पार्श्वपृष्ठकटिग्रहः||१३||<br />
 +
<div class="mw-collapsible-content">
  
avyaktaṁ lakṣaṇaṁ tasya pūrvarūpamiti smr̥tam||12||  
+
avyaktaṁ lakṣaṇaṁ tasya pūrvarūpamiti smr̥tam||12|| <br />
  
urōrukśōṇitacchardiḥ kāsō vaiśēṣikaḥ kṣatē|  
+
urōrukśōṇitacchardiḥ kāsō vaiśēṣikaḥ kṣatē| <br />
kṣīṇē saraktamūtratvaṁ pārśvapr̥ṣṭhakaṭigrahaḥ||13||
+
kṣīṇē saraktamūtratvaṁ pārśvapr̥ṣṭhakaṭigrahaḥ||13||<br />
  
avyaktaM lakShaNaM tasya pUrvarUpamiti smRutam||12||
+
avyaktaM lakShaNaM tasya pUrvarUpamiti smRutam||12||<br />
  
urorukshoNitacchardiH kAso vaisheShikaH kShate|
+
urorukshoNitacchardiH kAso vaisheShikaH kShate|<br />
kShINe saraktamUtratvaM pArshvapRuShThakaTigrahaH||13||
+
kShINe saraktamUtratvaM pArshvapRuShThakaTigrahaH||13||<br />
 +
</div></div>
  
 
Signs and symptoms in unmanifested form (less manifested) constitute the premonitory signs and symptoms of this disease. (There is no appearance of premonitory sings).
 
Signs and symptoms in unmanifested form (less manifested) constitute the premonitory signs and symptoms of this disease. (There is no appearance of premonitory sings).
Line 182: Line 214:
 
However, if there is ''kshata'' (injury), pain in the chest, blood vomiting and cough are specially manifested, and if there is ''kshaya'' (diminution of tissue elements), then hematuria and stiffness of the sides of the chest, back and lumbar region are specially manifested [121/2-13]
 
However, if there is ''kshata'' (injury), pain in the chest, blood vomiting and cough are specially manifested, and if there is ''kshaya'' (diminution of tissue elements), then hematuria and stiffness of the sides of the chest, back and lumbar region are specially manifested [121/2-13]
  
==== Prognosis ====
+
=== Prognosis ===
 +
<div class="mw-collapsible mw-collapsed">
  
अल्पलिङ्गस्य दीप्ताग्नेः साध्यो बलवतो नवः|  
+
अल्पलिङ्गस्य दीप्ताग्नेः साध्यो बलवतो नवः| <br />
परिसंवत्सरो याप्यः सर्वलिङ्गं तु वर्जयेत्||१४||
+
परिसंवत्सरो याप्यः सर्वलिङ्गं तु वर्जयेत्||१४||<br />
 +
<div class="mw-collapsible-content">
  
alpaliṅgasya dīptāgnēḥ sādhyō balavatō navaḥ|  
+
alpaliṅgasya dīptāgnēḥ sādhyō balavatō navaḥ| <br />
parisaṁvatsarō yāpyaḥ sarvaliṅgaṁ tu varjayēt||14||
+
parisaṁvatsarō yāpyaḥ sarvaliṅgaṁ tu varjayēt||14||<br />
  
alpali~ggasya dIptAgneH sAdhyo balavato navaH|  
+
alpali~ggasya dIptAgneH sAdhyo balavato navaH| <br />
parisaMvatsaro yApyaH sarvali~ggaM tu varjayet||14||
+
parisaMvatsaro yApyaH sarvali~ggaM tu varjayet||14||<br />
 +
</div></div>
  
 
If the signs and symptoms are mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. If the disease is chronic i.e. more than one year, then it is ''yapya'' (palliable). If however, all the signs and symptoms of the disease are simultaneously manifested, then such a patient should not be treated, because the condition is incurable.[14]
 
If the signs and symptoms are mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. If the disease is chronic i.e. more than one year, then it is ''yapya'' (palliable). If however, all the signs and symptoms of the disease are simultaneously manifested, then such a patient should not be treated, because the condition is incurable.[14]
  
==== Management ====
+
=== Management ===
 +
<div class="mw-collapsible mw-collapsed">
  
उरो मत्वा क्षतं लाक्षां पयसा मधुसंयुताम्|
+
उरो मत्वा क्षतं लाक्षां पयसा मधुसंयुताम्|<br />
सद्य एव पिबेज्जीर्णे पयसाऽद्यात् सशर्करम्||१५||  
+
सद्य एव पिबेज्जीर्णे पयसाऽद्यात् सशर्करम्||१५|| <br />
  
पार्श्वबस्तिरुजी चाल्पपित्ताग्निस्तां सुरायुताम्|
+
पार्श्वबस्तिरुजी चाल्पपित्ताग्निस्तां सुरायुताम्|<br />
भिन्नविट्कः समुस्तातिविषापाठां सवत्सकाम्||१६||  
+
भिन्नविट्कः समुस्तातिविषापाठां सवत्सकाम्||१६|| <br />
  
लाक्षां सर्पिर्मधूच्छिष्टं जीवनीयगणं सिताम्|  
+
लाक्षां सर्पिर्मधूच्छिष्टं जीवनीयगणं सिताम्| <br />
त्वक्क्षीरीं समितां क्षीरे पक्त्वा दीप्तानलः पिबेत्||१७||  
+
त्वक्क्षीरीं समितां क्षीरे पक्त्वा दीप्तानलः पिबेत्||१७|| <br />
  
इक्ष्वालिकाबिसग्रन्थिपद्मकेशरचन्दनैः|  
+
इक्ष्वालिकाबिसग्रन्थिपद्मकेशरचन्दनैः| <br />
शृतं पयो मधुयुतं सन्धानार्थं पिबेत् क्षती||१८||  
+
शृतं पयो मधुयुतं सन्धानार्थं पिबेत् क्षती||१८|| <br />
  
यवानां चूर्णमादाय क्षीरसिद्धं घृतप्लुतम्|  
+
यवानां चूर्णमादाय क्षीरसिद्धं घृतप्लुतम्| <br />
ज्वरे दाहे सिताक्षौद्रसक्तून् वा पयसा पिबेत्||१९||  
+
ज्वरे दाहे सिताक्षौद्रसक्तून् वा पयसा पिबेत्||१९|| <br />
  
मधूकमधुकद्राक्षात्वक्क्षीरीपिप्पलीबलाः|  
+
मधूकमधुकद्राक्षात्वक्क्षीरीपिप्पलीबलाः| <br />
कासी पार्श्वास्थिशूली च लिह्यात्सघृतमाक्षिकाः||२०||
+
कासी पार्श्वास्थिशूली च लिह्यात्सघृतमाक्षिकाः||२०||<br />
 +
<div class="mw-collapsible-content">
  
urō matvā kṣataṁ lākṣāṁ payasā madhusaṁyutām|  
+
urō matvā kṣataṁ lākṣāṁ payasā madhusaṁyutām| <br />
sadya ēva pibējjīrṇē payasā'dyāt saśarkaram||15||  
+
sadya ēva pibējjīrṇē payasā'dyāt saśarkaram||15|| <br />
  
pārśvabastirujī cālpapittāgnistāṁ surāyutām|  
+
pārśvabastirujī cālpapittāgnistāṁ surāyutām| <br />
bhinnaviṭkaḥ samustātiviṣāpāṭhāṁ savatsakām||16||  
+
bhinnaviṭkaḥ samustātiviṣāpāṭhāṁ savatsakām||16|| <br />
  
lākṣāṁ sarpirmadhūcchiṣṭaṁ jīvanīyagaṇaṁ sitām|  
+
lākṣāṁ sarpirmadhūcchiṣṭaṁ jīvanīyagaṇaṁ sitām| <br />
tvakkṣīrīṁ samitāṁ kṣīrē paktvā dīptānalaḥ pibēt||17||  
+
tvakkṣīrīṁ samitāṁ kṣīrē paktvā dīptānalaḥ pibēt||17||<br />
  
ikṣvālikābisagranthipadmakēśaracandanaiḥ|  
+
ikṣvālikābisagranthipadmakēśaracandanaiḥ| <br />
śr̥taṁ payō madhuyutaṁ sandhānārthaṁ pibēt kṣatī||18||  
+
śr̥taṁ payō madhuyutaṁ sandhānārthaṁ pibēt kṣatī||18|| <br />
  
yavānāṁ cūrṇamādāya kṣīrasiddhaṁ ghr̥taplutam|  
+
yavānāṁ cūrṇamādāya kṣīrasiddhaṁ ghr̥taplutam| <br />
jvarē dāhē sitākṣaudrasaktūn vā payasā pibēt||19||  
+
jvarē dāhē sitākṣaudrasaktūn vā payasā pibēt||19|| <br />
  
madhūkamadhukadrākṣātvakkṣīrīpippalībalāḥ|  
+
madhūkamadhukadrākṣātvakkṣīrīpippalībalāḥ| <br />
kāsī pārśvāsthiśūlī ca lihyātsaghr̥tamākṣikāḥ||20||
+
kāsī pārśvāsthiśūlī ca lihyātsaghr̥tamākṣikāḥ||20||<br />
  
Uro matvA kShataM lAkShAM payasA madhusaMyutAm|  
+
Uro matvA kShataM lAkShAM payasA madhusaMyutAm| <br />
sadya eva pibejjIrNe payasA~adyAt sasharkaram||15||  
+
sadya eva pibejjIrNe payasA~adyAt sasharkaram||15|| <br />
  
pArshvabastirujI cAlpapittAgnistAM surAyutAm|  
+
pArshvabastirujI cAlpapittAgnistAM surAyutAm| <br />
bhinnaviTkaH samustAtiviShApAThAM savatsakAm||16||  
+
bhinnaviTkaH samustAtiviShApAThAM savatsakAm||16|| <br />
  
lAkShAM sarpirmadhUcchiShTaM jIvanIyagaNaM sitAm|  
+
lAkShAM sarpirmadhUcchiShTaM jIvanIyagaNaM sitAm| <br />
tvakkShIrIM samitAM kShIre paktvA  dIptAnalaH pibet||17||
+
tvakkShIrIM samitAM kShIre paktvA  dIptAnalaH pibet||17||<br />
  
ikShvAlikAbisagranthipadmakesharacandanaiH|
+
ikShvAlikAbisagranthipadmakesharacandanaiH|<br />
shRutaM payo madhuyutaM sandhAnArthaM pibet kShatI||18||  
+
shRutaM payo madhuyutaM sandhAnArthaM pibet kShatI||18|| <br />
  
yavAnAM cUrNamAdAya kShIrasiddhaM ghRutaplutam|  
+
yavAnAM cUrNamAdAya kShIrasiddhaM ghRutaplutam| <br />
jvare dAhe sitAkShaudrasaktUn vA payasA pibet||19||  
+
jvare dAhe sitAkShaudrasaktUn vA payasA pibet||19|| <br />
  
madhUkamadhukadrAkShAtvakkShIrIpippalIbalAH|
+
madhUkamadhukadrAkShAtvakkShIrIpippalIbalAH|<br />
kAsI pArshvAsthishUlI ca lihyAtsaghRutamAkShikAH||20||
+
kAsI pArshvAsthishUlI ca lihyAtsaghRutamAkShikAH||20||<br />
 +
</div></div>
  
 
If there is fresh injury to the chest, then the patient should be given ''laksha'' (lac) along with milk and honey. After the potion is digested, he should be given food along with milk and sugar.
 
If there is fresh injury to the chest, then the patient should be given ''laksha'' (lac) along with milk and honey. After the potion is digested, he should be given food along with milk and sugar.
  
If there is pain in the sides of the chest or in the region of the urinary bladder, and if there is less of ''pitta'' and ''agni'' (digestive power), then the patient should be given ''laksha'' (lac) along with ''sura'' (alcoholic drink).
+
If there is pain in the sides of the chest or in the region of the urinary bladder, and if there is less of ''[[pitta]]'' and ''agni'' (digestive power), then the patient should be given ''laksha'' (lac) along with ''sura'' (alcoholic drink).
  
 
If there is diarrhea, then the patient should be given ''laksha'' along with ''musta, ativisha, patha'' and ''vatsaka''.
 
If there is diarrhea, then the patient should be given ''laksha'' along with ''musta, ativisha, patha'' and ''vatsaka''.
Line 265: Line 303:
 
If the patient is suffering from cough and pain in the sides of the chest as well as bones, then he should take linctus prepared of the powder ''madhuka'' (flower), ''madhu, draksha, tvakshiri, pippali'' and ''bala'' mixed with ghee and honey. [15-20]
 
If the patient is suffering from cough and pain in the sides of the chest as well as bones, then he should take linctus prepared of the powder ''madhuka'' (flower), ''madhu, draksha, tvakshiri, pippali'' and ''bala'' mixed with ghee and honey. [15-20]
  
==== ''Eladi gutika'' ====
+
=== ''Eladi gutika'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
एलापत्रत्वचोऽर्धाक्षाः पिप्पल्यर्धपलं तथा|  
+
एलापत्रत्वचोऽर्धाक्षाः पिप्पल्यर्धपलं तथा| <br />
सितामधुकखर्जूरमृद्वीकाश्च पलोन्मिताः||२१||  
+
सितामधुकखर्जूरमृद्वीकाश्च पलोन्मिताः||२१|| <br />
  
सञ्चूर्ण्य मधुना युक्ता गुटिकाः सम्प्रकल्पयेत्|
+
सञ्चूर्ण्य मधुना युक्ता गुटिकाः सम्प्रकल्पयेत्|<br />
अक्षमात्रां ततश्चैकां भक्षयेन्ना दिने दिने||२२||  
+
अक्षमात्रां ततश्चैकां भक्षयेन्ना दिने दिने||२२|| <br />
  
कासं  श्वासं ज्वरं हिक्कां छर्दिं मूर्च्छां मदं भ्रमम्|  
+
कासं  श्वासं ज्वरं हिक्कां छर्दिं मूर्च्छां मदं भ्रमम्| <br />
रक्तनिष्ठीवनं  तृष्णां पार्श्वशूलमरोचकम्||२३||  
+
रक्तनिष्ठीवनं  तृष्णां पार्श्वशूलमरोचकम्||२३|| <br />
  
शोषप्लीहाढ्यवातांश्च  स्वरभेदं क्षतं क्षयम्|  
+
शोषप्लीहाढ्यवातांश्च  स्वरभेदं क्षतं क्षयम्| <br />
गुटिका तर्पणी वृष्या रक्तपित्तं च नाशयेत्||२४||  
+
गुटिका तर्पणी वृष्या रक्तपित्तं च नाशयेत्||२४|| <br />
  
इत्येलादिगुटिका|
+
इत्येलादिगुटिका| <br />
 +
<div class="mw-collapsible-content">
  
ēlāpatratvacō'rdhākṣāḥ pippalyardhapalaṁ tathā|  
+
ēlāpatratvacō'rdhākṣāḥ pippalyardhapalaṁ tathā|<br />
sitāmadhukakharjūramr̥dvīkāśca palōnmitāḥ||21||  
+
sitāmadhukakharjūramr̥dvīkāśca palōnmitāḥ||21|| <br />
  
sañcūrṇya madhunā yuktā guṭikāḥ samprakalpayēt|  
+
sañcūrṇya madhunā yuktā guṭikāḥ samprakalpayēt| <br />
akṣamātrāṁ tataścaikāṁ bhakṣayēnnā dinē dinē||22||  
+
akṣamātrāṁ tataścaikāṁ bhakṣayēnnā dinē dinē||22|| <br />
  
kāsaṁ śvāsaṁ jvaraṁ hikkāṁ chardiṁ mūrcchāṁ madaṁ bhramam|  
+
kāsaṁ śvāsaṁ jvaraṁ hikkāṁ chardiṁ mūrcchāṁ madaṁ bhramam| <br />
raktaniṣṭhīvanaṁ tr̥ṣṇāṁ pārśvaśūlamarōcakam||23||  
+
raktaniṣṭhīvanaṁ tr̥ṣṇāṁ pārśvaśūlamarōcakam||23|| <br />
  
śōṣaplīhāḍhyavātāṁśca svarabhēdaṁ kṣataṁ kṣayam|  
+
śōṣaplīhāḍhyavātāṁśca svarabhēdaṁ kṣataṁ kṣayam| <br />
guṭikā tarpaṇī vr̥ṣyā raktapittaṁ ca nāśayēt||24||  
+
guṭikā tarpaṇī vr̥ṣyā raktapittaṁ ca nāśayēt||24|| <br />
  
ityēlādiguṭikā  
+
ityēlādiguṭikā <br />
  
elApatratvaco~ardhAkShAH pippalyardhapalaM tathA|  
+
elApatratvaco~ardhAkShAH pippalyardhapalaM tathA|<br />
sitAmadhukakharjUramRudvIkAshca palonmitAH||21||  
+
sitAmadhukakharjUramRudvIkAshca palonmitAH||21|| <br />
  
sa~jcUrNya madhunA yuktA guTikAH samprakalpayet|  
+
sa~jcUrNya madhunA yuktA guTikAH samprakalpayet| <br />
akShamAtrAM tatashcaikAM bhakShayennA dine dine||22||  
+
akShamAtrAM tatashcaikAM bhakShayennA dine dine||22|| <br />
  
kAsaM shvAsaM jvaraM hikkAM chardiM mUrcchAM madaM bhramam|  
+
kAsaM shvAsaM jvaraM hikkAM chardiM mUrcchAM madaM bhramam| <br />
raktaniShThIvanaM tRuShNAM pArshvashUlamarocakam||23||  
+
raktaniShThIvanaM tRuShNAM pArshvashUlamarocakam||23|| <br />
  
shoShaplIhADhyavAtAMshca svarabhedaM kShataM kShayam|  
+
shoShaplIhADhyavAtAMshca svarabhedaM kShataM kShayam| <br />
guTikA tarpaNI vRuShyA raktapittaM ca nAshayet||24||  
+
guTikA tarpaNI vRuShyA raktapittaM ca nAshayet||24|| <br />
  
ityelAdiguTikA|
+
ityelAdiguTikA| <br />
 +
</div></div>
  
Half ''aksha'' (five grams) each of ''ela, patra'' and ''tvak'', half ''pala'' (twenty grams) of ''pippali'', one ''pala'' each of ''sita''(forty grams), ''madhuka, kharjura'' and ''mridvika'' should be made to a powder. Honey should be added to this powder to make a paste. From this paste, pills of one ''aksha'' each should be prepared. One such pill should be taken every day. It cures ''kasa'' (cough), ''shvasa'' (dyspnea), ''jwara'' (fever), hiccup, vomiting, fainting, hemoptysis, morbid thirst, pain in the sides of the chest, anorexia, consumption, splenic enlargement, ''adhyavata'' (rheumatoid arthritis), hoarseness of voice, ''kshata'' (injury to the chest), ''kshaya'' (diminution of tissues elements) and ''raktapitta'' (a condition charcterised by bleeding from different parts of the body). This pill is refreshing and aphrodisiac.  [21-24]
+
Half ''aksha'' (five grams) each of ''ela, patra'' and ''tvak'', half ''pala'' (twenty grams) of ''pippali'', one ''pala'' each of ''sita''(forty grams), ''madhuka, kharjura'' and ''mridvika'' should be made to a powder. Honey should be added to this powder to make a paste. From this paste, pills of one ''aksha'' each should be prepared. One such pill should be taken every day. It cures ''kasa'' (cough), ''shvasa'' (dyspnea), ''[[jwara]]'' (fever), hiccup, vomiting, fainting, hemoptysis, morbid thirst, pain in the sides of the chest, anorexia, consumption, splenic enlargement, ''adhyavata'' (rheumatoid arthritis), hoarseness of voice, ''kshata'' (injury to the chest), ''kshaya'' (diminution of tissues elements) and ''raktapitta'' (a condition charcterised by bleeding from different parts of the body). This pill is refreshing and aphrodisiac.  [21-24]
  
==== Treatment of excessive bleeding ====
+
=== Treatment of excessive bleeding ===
 +
<div class="mw-collapsible mw-collapsed">
  
रक्तेऽतिवृत्ते दक्षाण्डं यूषैस्तोयेन वा पिबेत्|  
+
रक्तेऽतिवृत्ते दक्षाण्डं यूषैस्तोयेन वा पिबेत्| <br />
चटकाण्डरसं वाऽपि रक्तं वा छागजाङ्गलम्||२५||  
+
चटकाण्डरसं वाऽपि रक्तं वा छागजाङ्गलम्||२५|| <br />
  
चूर्णं पौनर्नवं रक्तशालितण्डुलशर्करम्|  
+
चूर्णं पौनर्नवं रक्तशालितण्डुलशर्करम्| <br />
रक्तष्ठीवी पिबेत् सिद्धं द्राक्षारसपयोघृतैः||२६||
+
रक्तष्ठीवी पिबेत् सिद्धं द्राक्षारसपयोघृतैः||२६||<br />
 +
<div class="mw-collapsible-content">
  
raktē'tivr̥ttē dakṣāṇḍaṁ yūṣaistōyēna vā pibēt|  
+
raktē'tivr̥ttē dakṣāṇḍaṁ yūṣaistōyēna vā pibēt| <br />
caṭakāṇḍarasaṁ vā'pi raktaṁ vā chāgajāṅgalam||25||  
+
caṭakāṇḍarasaṁ vā'pi raktaṁ vā chāgajāṅgalam||25|| <br />
  
cūrṇaṁ paunarnavaṁ raktaśālitaṇḍulaśarkaram|  
+
cūrṇaṁ paunarnavaṁ raktaśālitaṇḍulaśarkaram| <br />
raktaṣṭhīvī pibēt siddhaṁ drākṣārasapayōghr̥taiḥ||26||
+
raktaṣṭhīvī pibēt siddhaṁ drākṣārasapayōghr̥taiḥ||26||<br />
  
rakte~ativRutte dakShANDaM yUShaistoyena vA pibet|  
+
rakte~ativRutte dakShANDaM yUShaistoyena vA pibet| <br />
caTakANDarasaM vA~api raktaM vA chAgajA~ggalam||25||  
+
caTakANDarasaM vA~api raktaM vA chAgajA~ggalam||25|| <br />
  
cUrNaM paunarnavaM raktashAlitaNDulasharkaram|  
+
cUrNaM paunarnavaM raktashAlitaNDulasharkaram| <br />
raktaShThIvI pibet siddhaM drAkShArasapayoghRutaiH||26||
+
raktaShThIvI pibet siddhaM drAkShArasapayoghRutaiH||26||<br />
 +
</div></div>
  
 
If there is excessive bleeding, then the patient should take eggs of ''daksha'' (wild hen) along with green gram soup or water. He may also take the soup of eggs of sparrow or (preparations) of the blood of goat or wild animals (like deer, etc).
 
If there is excessive bleeding, then the patient should take eggs of ''daksha'' (wild hen) along with green gram soup or water. He may also take the soup of eggs of sparrow or (preparations) of the blood of goat or wild animals (like deer, etc).
Line 335: Line 379:
 
The patient having hemoptysis should take the powder of ''punarnava,'' red variety of shali rice and sugar cooked along with grape juice, milk and ghee. [25-26]
 
The patient having hemoptysis should take the powder of ''punarnava,'' red variety of shali rice and sugar cooked along with grape juice, milk and ghee. [25-26]
  
==== Various formulations ====
+
=== Various formulations ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
मधूकमधुकक्षीरसिद्धं वा तण्डुलीयकम्| <br />
 +
मूढवातस्त्वजामेदः सुराभृष्टं ससैन्धवम्||२७|| <br />
 +
 
 +
क्षामः क्षीणः क्षतोरस्कस्त्वनिद्रः सबलेऽनिले| <br />
 +
शृतक्षीरसरेणाद्यात् सक्षौद्रघृतशर्करम्||२८|| <br />
 +
 
 +
शर्करां यवगोधूमौ जीवकर्षभकौ मधु| <br />
 +
शृतक्षीरानुपानं वा लिह्यात् क्षीणः क्षती कृशः||२९|| <br />
 +
 
 +
क्रव्यादमांसनिर्यूहं घृतभृष्टं पिबेच्च सः| <br />
 +
पिप्पलीक्षौद्रसंयुक्तं मांसशोणितवर्धनम्||३०|| <br />
 +
 
 +
न्यग्रोधोदुम्बराश्वत्थप्लक्षशालप्रियङ्गुभिः| <br />
 +
तालमस्तकजम्बूत्वक्प्रियालैश्च सपद्मकैः||३१|| <br />
 +
 
 +
साश्वकर्णैः शृतात् क्षीरादद्याज्जातेन सर्पिषा| <br />
 +
शाल्योदनं क्षतोरस्कः क्षीणशुक्रश्च मानवः||३२|| <br />
 +
 
 +
यष्ट्याह्वनागबलयोः क्वाथे क्षीरसमं घृतम्| <br />
 +
पयस्यापिप्पलीवांशीकल्कसिद्धं क्षते शुभम्||३३|| <br />
 +
 
 +
कोललाक्षारसे तद्वत् क्षीराष्टगुणसाधितम्| <br />
 +
कल्कैः कट्वङ्गदार्वीत्वग्वत्सकत्वक्फलैर्घृतम्||३४||<br />
 +
<div class="mw-collapsible-content">
 +
 
 +
madhūkamadhukakṣīrasiddhaṁ vā taṇḍulīyakam| <br />
 +
mūḍhavātastvajāmēdaḥ surābhr̥ṣṭaṁ sasaindhavam||27|| <br />
 +
 
 +
kṣāmaḥ kṣīṇaḥ kṣatōraskastvanidraḥ sabalē'nilē| <br />
 +
śr̥takṣīrasarēṇādyāt sakṣaudraghr̥taśarkaram||28|| <br />
 +
 
 +
śarkarāṁ yavagōdhūmau jīvakarṣabhakau madhu| <br />
 +
śr̥takṣīrānupānaṁ vā lihyāt kṣīṇaḥ kṣatī kr̥śaḥ||29|| <br />
 +
 
 +
kravyādamāṁsaniryūhaṁ ghr̥tabhr̥ṣṭaṁ pibēcca saḥ| <br />
 +
pippalīkṣaudrasaṁyuktaṁ māṁsaśōṇitavardhanam||30|| <br />
 +
 
 +
nyagrōdhōdumbarāśvatthaplakṣaśālapriyaṅgubhiḥ| <br />
 +
tālamastakajambūtvakpriyālaiśca sapadmakaiḥ||31|| <br />
 +
 
 +
sāśvakarṇaiḥ śr̥tāt kṣīrādadyājjātēna sarpiṣā| <br />
 +
śālyōdanaṁ kṣatōraskaḥ kṣīṇaśukraśca mānavaḥ||32|| <br />
 +
 
 +
yaṣṭyāhvanāgabalayōḥ kvāthē kṣīrasamaṁ ghr̥tam| <br />
 +
payasyāpippalīvāṁśīkalkasiddhaṁ kṣatē śubham||33|| <br />
 +
 
 +
kōlalākṣārasē tadvat kṣīrāṣṭaguṇasādhitam| <br />
 +
kalkaiḥ kaṭvaṅgadārvītvagvatsakatvakphalairghr̥tam||34||<br />
 +
 
 +
madhUkamadhukakShIrasiddhaM vA taNDulIyakam| <br />
 +
mUDhavAtastvajAmedaH surAbhRuShTaM sasaindhavam||27|| <br />
 +
 
 +
kShAmaH kShINaH kShatoraskastvanidraH sabale~anile|<br />
 +
shRutakShIrasareNAdyAt sakShaudraghRutasharkaram||28|| <br />
 +
 
 +
sharkarAM yavagodhUmau jIvakarShabhakau madhu| <br />
 +
shRutakShIrAnupAnaM vA lihyAt kShINaH kShatI kRushaH||29|| <br />
 +
 
 +
kravyAdamAMsaniryUhaM ghRutabhRuShTaM pibecca saH| <br />
 +
pippalIkShaudrasaMyuktaM mAMsashoNitavardhanam||30|| <br />
 +
 
 +
nyagrodhodumbarAshvatthaplakShashAlapriya~ggubhiH| <br />
 +
tAlamastakajambUtvakpriyAlaishca sapadmakaiH||31|| <br />
 +
 
 +
sAshvakarNaiH shRutAt kShIrAdadyAjjAtena sarpiShA| <br />
 +
shAlyodanaM kShatoraskaH kShINashukrashca mAnavaH||32|| <br />
 +
 
 +
yaShTyAhvanAgabalayoH kvAthe kShIrasamaM ghRutam| <br />
 +
payasyApippalIvAMshIkalkasiddhaM kShate shubham||33||<br />
 +
 +
kolalAkShArase tadvat kShIrAShTaguNasAdhitam|<br />
 +
kalkaiH kaTva~ggadArvItvagvatsakatvakphalairghRuta ||34||<br />
 +
</div></div>
 +
 
 +
Milk should be boiled with the paste of ''madhooka'' and ''madhuka''. With this milk, ''tanduliyaka'' should be cooked (which is useful for the patient suffering from the hemoptysis).
 +
 
 +
If there is ''mudhavata'' (claudication of ''[[vata]]''), the patient should take the fat of goat fried with ''sura'' (type of liquor) and mixed with rock salt.
 +
 
 +
If the patient is weak, emaciated and having injury in the chest, sleeplessness and excessive aggravation of ''[[vayu]]'', then he should take goat’s fat boiled with the cream of milk and added with honey, ghee and sugar.
 +
 
 +
If the patient is emaciated, having injury in the chest and cachectic, he may be given sugar, barley, wheat, ''jivaka, rushabhaka'' and honey in linctus form. Thereafter, he should take boiled milk.
 +
 
 +
The above mentioned patient should take the decoction of the meat of carnivorous animal sizzled with ghee and added with ''pippali'' and honey. This potion promotes muscles tissues and blood.
 +
 
 +
The  patient having injury to the chest and diminution of semen, should take ''sali'' rice mixed with ghee which latter is prepared of the milk boiled with ''nyagrodha, udumbara, ashvattha, plaksha, sala, priyangu,'' tuft of ''tala'', bark of ''jambu, priyala, padmaka'' and ''asvakarna''.
 +
 
 +
==== ''Yashtyavahadi ghrita'' ====
 +
 
 +
Ghee should be cooked with equal quantity of milk, the decoction of ''madhuyashti'' and ''nagabala'' (four times of ghee in total), and the paste of ''payasya, pippali'' and ''vamshi'' (one fourth in total of ghee). The medicated ghee is useful in the treatment of ''kshata'' (injury to chest).
 +
 
 +
==== ''Koladi ghrita'' ====
 +
 
 +
Similarly, ghee should be cooked with the decoction of ''kola'' and ''laksha'' (four times in total of ghee), eight times of milk, and the paste of the bark of ''kaivanga'', bark of ''darvi'', bark of ''kutaja'' and fruit of ''kutaja'' (one fourth in total of ghee). This medicated ghee is useful in the treatment of ''kshata''.[27-34]
 +
 
 +
=== ''Amritaprasha ghee'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
जीवकर्षभकौ वीरां जीवन्तीं नागरं शटीम्|<br />
 +
चतस्रः पर्णिनीर्मेदे काकोल्यौ द्वे निदिग्धिके||३५||<br />
 +
 
 +
पुनर्नवे द्वे मधुकमात्मगुप्तां शतावरीम्| <br />
 +
ऋद्धिं  परूषकं भार्गीं मृद्वीकां बृहतीं तथा||३६|| <br />
 +
 
 +
शृङ्गाटकं तामलकीं पयस्यां पिप्पलीं बलाम्| <br />
 +
बदराक्षोटखर्जूरवातामाभिषुकाण्यपि||३७||<br />
 +
 
 +
फलानि चैवमादीनि कल्कान् कुर्वीत कार्षिकान्| <br />
 +
धात्रीरसविदारीक्षुच्छागमांसरसं पयः||३८||<br />
 +
 
 +
कुर्यात् प्रस्थोन्मितं तेन घृतप्रस्थं विपाचयेत्| <br />
 +
प्रस्थार्धं मधुनः शीते शर्करार्धतुलां तथा||३९|| <br />
 +
 
 +
द्विकार्षिकाणि[१] पत्रैलाहेमत्वङ्मरिचानि च| <br />
 +
विनीय चूर्णितं तस्माल्लिह्यान्मात्रां सदा नरः||४०|| <br />
 +
 
 +
अमृतप्राशमित्येतन्नराणाममृतं घृतम्| <br />
 +
सुधामृतरसं प्राश्यं क्षीरमांसरसाशिना||४१|| <br />
 +
 
 +
नष्टशुक्रक्षतक्षीणदुर्बलव्याधिकर्शितान्| <br />
 +
स्त्रीप्रसक्तान् कृशान् वर्णस्वरहीनांश्च बृंहयेत्||४२|| <br />
 +
 
 +
कासहिक्काज्वरश्वासदाहतृष्णास्रपित्तनुत्| <br />
 +
पुत्रदं वमिमूर्च्छाहृद्योनिमूत्रामयापहम्||४३|| <br />
 +
 
 +
इत्यमृतप्राशघृतम्|<br />
 +
<div class="mw-collapsible-content">
 +
 
 +
jīvakarṣabhakau vīrāṁ jīvantīṁ nāgaraṁ śaṭīm| <br />
 +
catasraḥ parṇinīrmēdē kākōlyau dvē nidigdhikē||35|| <br />
 +
 
 +
punarnavē dvē madhukamātmaguptāṁ śatāvarīm| <br />
 +
r̥ddhiṁ parūṣakaṁ bhārgīṁ mr̥dvīkāṁ br̥hatīṁ tathā||36|| <br />
 +
 
 +
śr̥ṅgāṭakaṁ tāmalakīṁ payasyāṁ pippalīṁ balām| <br />
 +
badarākṣōṭakharjūravātāmābhiṣukāṇyapi||37|| <br />
 +
 
 +
phalāni caivamādīni kalkān kurvīta kārṣikān| <br />
 +
dhātrīrasavidārīkṣucchāgamāṁsarasaṁ payaḥ||38|| <br />
 +
 
 +
kuryāt prasthōnmitaṁ tēna ghr̥taprasthaṁ vipācayēt| <br />
 +
prasthārdhaṁ madhunaḥ śītē śarkarārdhatulāṁ tathā||39|| <br />
 +
 
 +
dvikārṣikāṇi [2] patrailāhēmatvaṅmaricāni ca| <br />
 +
vinīya cūrṇitaṁ tasmāllihyānmātrāṁ sadā naraḥ||40|| <br />
 +
 
 +
amr̥taprāśamityētannarāṇāmamr̥taṁ ghr̥tam| <br />
 +
sudhāmr̥tarasaṁ prāśyaṁ kṣīramāṁsarasāśinā||41|| <br />
 +
 
 +
naṣṭaśukrakṣatakṣīṇadurbalavyādhikarśitān| <br />
 +
strīprasaktān kr̥śān varṇasvarahīnāṁśca br̥ṁhayēt||42|| <br />
 +
 
 +
kāsahikkājvaraśvāsadāhatr̥ṣṇāsrapittanut| <br />
 +
putradaṁ vamimūrcchāhr̥dyōnimūtrāmayāpaham||43|| <br />
 +
 
 +
ityamr̥taprāśaghr̥tam <br />
 +
 
 +
jIvakarShabhakau vIrAM jIvantIM nAgaraM shaTIm|<br />
 +
catasraH parNinIrmede kAkolyau dve nidigdhike||35||<br />
 +
 
 +
punarnave dve madhukamAtmaguptAM shatAvarIm|<br />
 +
RuddhiM parUShakaM bhArgIM mRudvIkAM bRuhatIM tathA||36|| <br />
 +
 
 +
shRu~ggATakaM tAmalakIM payasyAM pippalIM balAm| <br />
 +
badarAkShoTakharjUravAtAmAbhiShukANyapi||37||<br />
 +
 
 +
phalAni caivamAdIni kalkAn kurvIta kArShikAn|<br />
 +
dhAtrIrasavidArIkShucchAgamAMsarasaM payaH||38|| <br />
 +
 
 +
kuryAt prasthonmitaM tena ghRutaprasthaM vipAcayet|<br />
 +
prasthArdhaM madhunaH shIte sharkarArdhatulAM tathA||39||<br />
 +
 
 +
dvikArShikANi patrailAhematva~gmaricAni ca|<br />
 +
vinIya cUrNitaM tasmAllihyAnmAtrAM sadA naraH||40||<br />
 +
 
 +
amRutaprAshamityetannarANAmamRutaM ghRutam| <br />
 +
sudhAmRutarasaM prAshyaM kShIramAMsarasAshinA||41|| <br />
 +
 
 +
naShTashukrakShatakShINadurbalavyAdhikarshitAn|<br />
 +
strIprasaktAn kRushAn varNasvarahInAMshca bRuMhayet||42|| <br />
 +
 
 +
kAsahikkAjvarashvAsadAhatRuShNAsrapittanut| <br />
 +
putradaM vamimUrcchAhRudyonimUtrAmayApaham||43||<br />
 +
 
 +
ityamRutaprAshaghRutam| <br />
 +
</div></div>
 +
 
 +
Two ''prasthas'' of ghee should be cooked with the juice ''dhatri'' (two ''prasthas''), juice of ''vidari'' (two ''prasthas''), sugarcane juice (two ''prasthas''), soup of the meat of goat (two ''prasthas''), milk (two ''prasthas''), and the paste (one ''karsha'' each) of ''jivaka, rsabhaka, vira, jivanti, nagara, shati, shalaparni, prushniparni, mashaparni, mudgaparni,meda, mahameda, kakoli, kshirakakoli, kantakari, bruhati, shveta punarnava, rakta punarnava,madhuka, atmagupta, shatavari, riddhi,parushaka, bharangi, mridvika, brihati, shringataka,tamalaki, payasya'' (''kshiravidari''), ''pippali, badara, akshota, kharjura, vatama, abhishuka'' (''pista'') and such other fruits  which alleviate ''[[vata]]'' and ''[[pitta]]''. After cooking when the the recipe is cooled, one ''prastha'' of honey, half ''tula'' of sugar, and the powder (two ''karshas'' each) of ''patra, ela, hema, tvak'' and ''maricha'' should be added to it. This medicated ghee should be taken by a person in appropriate dose regularly. This is called ''amrita prasa ghrita'' and it is like ''amrita'' (ambrosia) for human beings.  This linctus is like ''sudha'' (ambrosia worth the consumption of worldly creatures) and the ''amrita'' (ambrosia worth the consumption of the gods). It should be taken along with milk and meat soup. It promotes nourishment of persons who had depleted ''[[shukra]]'' ( as in azoospermia or oligospermia), who are suffering from ''kshatakshina'', who are weak, who are emaciated because of chronic diseases, who are cachectic and who have lost their complexion and voice. It cures cough, hiccup, fever, asthma, burning sensation, morbid thirst, ''rakta-pitta'', vomiting, fainting and diseases of the heart, female genital tract and urinary tract. It helps in the treatment of infertility. [35-43]
 +
 
 +
=== ''Shvadamshtradi ghee'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
श्वदंष्ट्रोशीरमञ्जिष्ठाबलाकाश्मर्यकत्तृणम्| <br />
 +
दर्भमूलं पृथक्पर्णीं पलाशर्षभकौ स्थिराम्||४४||<br />
 +
 
 +
पलिकं साधयेत्तेषां रसे क्षीरचतुर्गुणे| <br />
 +
कल्कः स्वगुप्ताजीवन्तीमेदर्षभकजीवकैः||४५||<br />
 +
 
 +
शतावर्यृद्धिमृद्वीकाशर्कराश्रावणीबिसैः| <br />
 +
प्रस्थः सिद्धो घृताद्वातपित्तहृद्द्र(द्भ)वशूलनुत्||४६|| <br />
 +
 
 +
मूत्रकृच्छ्रप्रमेहार्शःकासशोषक्षयापहः| <br />
 +
धनुःस्त्रीमद्यभाराध्वखिन्नानां बलमांसदः||४७|| <br />
 +
 
 +
इति श्वदंष्ट्रादिघृतम्| <br />
 +
<div class="mw-collapsible-content">
 +
 
 +
śvadaṁṣṭrōśīramañjiṣṭhābalākāśmaryakattr̥ṇam| <br />
 +
darbhamūlaṁ pr̥thakparṇīṁ palāśarṣabhakau sthirām||44|| <br />
 +
 
 +
palikaṁ sādhayēttēṣāṁ rasē kṣīracaturguṇē| <br />
 +
kalkaḥ svaguptājīvantīmēdarṣabhakajīvakaiḥ||45|| <br />
 +
 
 +
śatāvaryr̥ddhimr̥dvīkāśarkarāśrāvaṇībisaiḥ| <br />
 +
prasthaḥ siddhō ghr̥tādvātapittahr̥ddra(dbha)vaśūlanut||46|| <br />
 +
 
 +
mūtrakr̥cchrapramēhārśaḥkāsaśōṣakṣayāpahaḥ| <br />
 +
dhanuḥstrīmadyabhārādhvakhinnānāṁ balamāṁsadaḥ||47|| <br />
 +
 
 +
iti śvadaṁṣṭrādighr̥tam <br />
 +
 
 +
shvadaMShTroshIrama~jjiShThAbalAkAshmaryakattRuNam| <br />
 +
darbhamUlaM pRuthakparNIM palAsharShabhakau sthirAm||44|| <br />
 +
 
 +
palikaM sAdhayetteShAM rase kShIracaturguNe| <br />
 +
kalkaH svaguptAjIvantImedarShabhakajIvakaiH||45|| <br />
 +
 
 +
shatAvaryRuddhimRudvIkAsharkarAshrAvaNIbisaiH| <br />
 +
prasthaH siddho ghRutAdvAtapittahRuddra(dbha)vashUlanut||46|| <br />
 +
 
 +
mUtrakRucchrapramehArshaHkAsashoShakShayApahaH| <br />
 +
dhanuHstrImadyabhArAdhvakhinnAnAM balamAMsadaH||47|| <br />
 +
 
 +
iti shvadaMShTrAdighRutam| <br />
 +
</div></div>
 +
 
 +
One ''pala'' of each of ''shvadamshtra, ushira, manjishtha, bala, kashmarya, katrna'', the root of  ''darbha, prithak parni, palasha, rishabhaka,'' and ''sthira'' should be made to decoction. Two ''prasthas'' of ghee should be mixed with the above mentioned decoction, eight prasthas of milk, and the paste of ''svagupta, jivanti, meda, rishabhaka, jivaka, shatavari, riddhi, mridvika, sharkara, shravani'' and bias (lotus stalk), (half prastha in total) and cooked. This medicated ghee cures ''hridaya shula'' caused by ''[[vata]]'' and ''[[pitta]], mutrakrucchra'' (dysuria), ''prameha'' (diabetes mellitus), piles, bronchitis, and consumption and ''kshatakshina''. It promotes strength of muscles tissues of persons emaciated because of indulgence in archery, women, alcohol, carrying heavy weight and walking a long distance. [44-47]
 +
 
 +
=== ''Samasaktu ghee'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
मधुकाष्टपलद्राक्षाप्रस्थक्वाथे घृतं पचेत्| <br />
 +
पिप्पल्यष्टपले कल्के प्रस्थं सिद्धे च शीतले||४८||<br />
 +
 +
पृथगष्टपलं क्षौद्रशर्कराभ्यां विमिश्रयेत्| <br />
 +
समसक्तु क्षतक्षीणे रक्तगुल्मे च तद्धितम्||४९||<br />
 +
<div class="mw-collapsible-content">
 +
 
 +
madhukāṣṭapaladrākṣāprasthakvāthē ghr̥taṁ pacēt| <br />
 +
pippalyaṣṭapalē kalkē prasthaṁ siddhē ca śītalē||48|| <br />
 +
 
 +
pr̥thagaṣṭapalaṁ kṣaudraśarkarābhyāṁ vimiśrayēt| <br />
 +
samasaktu kṣatakṣīṇē raktagulmē ca taddhitam||49||<br />
 +
 
 +
madhukAShTapaladrAkShAprasthakv the ghRutaM pacet| <br />
 +
pippalyaShTapale kalke prasthaM siddhe ca shItale||48|| <br />
 +
 
 +
pRuthagaShTapalaM kShaudrasharkarAbhyAM vimishrayet| <br />
 +
samasaktu kShatakShINe raktagulme ca taddhitam||49|| <br />
 +
</div></div>
 +
 
 +
Two ''prasthas'' of ghee should be cooked by adding the decoction of ''madhuka'' (eight ''palas'') and ''draksha'' (one ''prastha''), and the paste of ''pippali'' (eight ''palas''). After it is cooked and cooled, eight ''palas'' of each of honey and sugar should be added and mixed well. This medicated ghee should be administered by adding ''saktu'' (roasted barley flour) in equal quantity. It is useful in the treatment of ''kshatakshina'' and ''rakta gulma''. [48-49]
 +
 
 +
=== ''Sarpi-gud'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
धात्रीफलविदारीक्षुजीवनीयरसैर्घृतम्| <br />
 +
अजागोपयसोश्चैव सप्त प्रस्थान् पचेद्भिषक्||५०|| <br />
 +
 
 +
सिद्धशीते सिताक्षौद्रद्विप्रस्थं  विनयेच्च तत्| <br />
 +
यक्ष्मापस्मारपित्तासृक्कासमेहक्षयापहम्||५१|| <br />
 +
 
 +
वयःस्थापनमायुष्यं मांसशुक्रबलप्रदम्| <br />
 +
घृतं तु पित्तेऽभ्यधिके लिह्याद्वातेऽधिके पिबेत्||५२|| <br />
 +
 
 +
लीढं निर्वापयेत् पित्तमल्पत्वाद्धन्ति नानलम्| <br />
 +
आक्रामत्यनिलं पीतमूष्माणं  निरुणद्धि च||५३|| <br />
 +
 
 +
क्षामक्षीणकृशाङ्गानामेतान्येव घृतानि तु| <br />
 +
त्वक्क्षीरीशर्करालाजचूर्णैः स्त्यानानि योजयेत्||५४|| <br />
 +
 
 +
सर्पिर्गुडान् समध्वंशाञ्जग्ध्वा चानु पयः पिबेत्| <br />
 +
रेतो वीर्यं बलं पुष्टिं तैराशुतरमाप्नुयात्||५५|| <br />
 +
 
 +
इति सर्पिर्गुडाः| <br />
 +
<div class="mw-collapsible-content">
 +
 
 +
dhātrīphalavidārīkṣujīvanīyarasairghr̥tam| <br />
 +
ajāgōpayasōścaiva sapta prasthān pacēdbhiṣak||50|| <br />
 +
 
 +
siddhaśītē sitākṣaudradviprasthaṁ vinayēcca tat| <br />
 +
yakṣmāpasmārapittāsr̥kkāsamēhakṣayāpaham||51|| <br />
 +
 
 +
vayaḥsthāpanamāyuṣyaṁ māṁsaśukrabalapradam| <br />
 +
ghr̥taṁ tu pittē'bhyadhikē lihyādvātē'dhikē pibēt||52|| <br />
 +
 
 +
līḍhaṁ nirvāpayēt pittamalpatvāddhanti nānalam| <br />
 +
ākrāmatyanilaṁ pītamūṣmāṇaṁ niruṇaddhi ca||53|| <br />
 +
 
 +
kṣāmakṣīṇakr̥śāṅgānāmētānyēva ghr̥tāni tu| <br />
 +
tvakkṣīrīśarkarālājacūrṇaiḥ [3] styānāni yōjayēt||54|| <br />
 +
 
 +
sarpirguḍān samadhvaṁśāñjagdhvā cānu payaḥ pibēt| <br />
 +
rētō vīryaṁ balaṁ puṣṭiṁ tairāśutaramāpnuyāt||55|| <br />
 +
 
 +
iti sarpirguḍāḥ <br />
 +
 
 +
dhAtrIphalavidArIkShujIvanIyarasairghRutam| <br />
 +
ajAgopayasoshcaiva sapta prasthAn pacedbhiShak||50||<br />
 +
 
 +
siddhashIte sitAkShaudradviprasthaM vinayecca tat|<br />
 +
yakShmApasmArapittAsRukkAsamehakShayApaham||51|| <br />
 +
 
 +
vayaHsthApanamAyuShyaM mAMsashukrabalapradam| <br />
 +
ghRutaM tu pitte~abhyadhike lihyAdvAte~adhike pibet||52|| <br />
 +
 
 +
lIDhaM nirvApayet pittamalpatvAddhanti nAnalam| <br />
 +
AkrAmatyanilaM pItamUShmANaM niruNaddhi ca||53|| <br />
 +
 
 +
kShAmakShINakRushA~ggAnAmetAnyeva ghRutAni tu| <br />
 +
tvakkShIrIsharkarAlAjacUrNaiH styAnAni yojayet||54|| <br />
 +
 
 +
sarpirguDAn samadhvaMshA~jjagdhvA cAnu payaH pibet| <br />
 +
reto vIryaM balaM puShTiM tairAshutaramApnuyAt||55|| <br />
 +
 
 +
iti sarpirguDAH| <br />
 +
</div></div>
 +
 
 +
Two ''prasthas'' of ghee should be added with the juice of ''amalaka'' (two ''prasthas''), ''vidari'' (two ''prasthas'') and ''ikshu'' (two ''prasthas'') decoction of drugs belonging to ''jivaniya'' group (two ''prasthas''), goat’s milk (two ''prasthas'') and cow’s milk (two ''prasthas'') and cooked. After the cooking is over and the recipe is cooled, sugar (one ''prastha'') and honey (two ''prasthas'') should be added and mixed well. This medicated ghee is useful in the treatment of ''rajayaskshma, apasmara, raktapitta, prameha,'' and ''kshaya''. It prevents aging, promotes longevity and endows the person with muscle tissues, semen as well as strength. If the disease is caused by excess of ''[[pitta]'', then this recipe should be used as linctus. If, however, the disease is caused by the excess of ''[[vata]]'', then it should be taken as a drink.
 +
 
 +
When this medicated ghee is used (licked) in the form of a linctus, it alleviates ''[[pitta]]''. Since it is in small quantity, it however, doesn’t suppress the ''agni'' (power of digestion).
 +
 
 +
When it is used in the form of a drink, it alleviates ''[[vata]]'' and obstructs ''[[pitta]] ushma''.
 +
 
 +
This and such other medicated ghee should be made to a thick paste by adding the powder of ''tvakkshiri,'' sugar and ''lajja'' (fried paddy), which should then be given to persons who are tired, weak and emaciated.
 +
 
 +
This and such other recipes of ''sarpigud'' [recipes of medicated ghee in which sugar, honey etc. are added] should be added with honey (which should be equal in quantity with the powder of ''tvak-kshiri'', etc.) and taken. Thereafter, the patient should drink milk. This instantaneously promotes semen, potency, strength and nourishment.  [50-55]
 +
 
 +
=== ''Sarpi gud'' (second recipe) ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
बला विदारी ह्रस्वा च पञ्चमूली पुनर्नवा| <br />
 +
पञ्चानां क्षीरिवृक्षाणां शुङ्गा मुष्ट्यंशका अपि||५६|| <br />
 +
 
 +
एषां कषाये द्विक्षीरे विदार्याजरसांशिके| <br />
 +
जीवनीयैः पचेत् कल्कैरक्षमात्रैर्घृताढकम्||५७|| <br />
 +
 
 +
सितापलानि पूते च शीते द्वात्रिंशतं क्षिपेत्| <br />
 +
गोधूमपिप्पलीवांशीचूर्णं शृङ्गाटकस्य च||५८|| <br />
 +
 
 +
समाक्षिकं कौडविकं तत् सर्वं खजमूर्च्छितम्| <br />
 +
स्त्यानं सर्पिर्गुडान् कृत्वा भूर्जपत्रेण वेष्टयेत्||५९|| <br />
 +
 
 +
ताञ्जग्ध्वा पलिकान् क्षीरं मद्यं वाऽनुपिबेत् कफे| <br />
 +
शोषे कासे क्षते क्षीणे श्रमस्त्रीभारकर्शिते||६०|| <br />
 +
 
 +
रक्तनिष्ठीवने तापे पीनसे चोरसि स्थिते| <br />
 +
शस्ताः पार्श्वशिरःशूले भेदे च स्वरवर्णयोः||६१|| <br />
 +
 
 +
इति द्वितीयसर्पिर्गुडाः| <br />
 +
<div class="mw-collapsible-content">
 +
 
 +
balā vidārī hrasvā ca pañcamūlī punarnavā| <br />
 +
pañcānāṁ kṣīrivr̥kṣāṇāṁ śuṅgā muṣṭyaṁśakā api||56|| <br />
 +
 
 +
ēṣāṁ kaṣāyē dvikṣīrē vidāryājarasāṁśikē| <br />
 +
jīvanīyaiḥ pacēt kalkairakṣamātrairghr̥tāḍhakam||57|| <br />
 +
 
 +
sitāpalāni pūtē ca śītē dvātriṁśataṁ kṣipēt| <br />
 +
gōdhūmapippalīvāṁśīcūrṇaṁ śr̥ṅgāṭakasya ca||58|| <br />
 +
 
 +
samākṣikaṁ kauḍavikaṁ tat sarvaṁ khajamūrcchitam| <br />
 +
styānaṁ sarpirguḍān kr̥tvā bhūrjapatrēṇa vēṣṭayēt||59|| <br />
  
मधूकमधुकक्षीरसिद्धं वा तण्डुलीयकम्|  
+
tāñjagdhvā palikān kṣīraṁ madyaṁ vā'nupibēt kaphē| <br />
मूढवातस्त्वजामेदः सुराभृष्टं ससैन्धवम्||२७||  
+
śōṣē kāsē kṣatē kṣīṇē śramastrībhārakarśitē||60|| <br />
  
क्षामः क्षीणः क्षतोरस्कस्त्वनिद्रः सबलेऽनिले|  
+
raktaniṣṭhīvanē tāpē pīnasē cōrasi sthitē| <br />
शृतक्षीरसरेणाद्यात् सक्षौद्रघृतशर्करम्||२८||  
+
śastāḥ pārśvaśiraḥśūlē bhēdē ca svaravarṇayōḥ||61|| <br />
  
शर्करां यवगोधूमौ जीवकर्षभकौ मधु|
+
iti dvitīyasarpirguḍāḥ <br />
शृतक्षीरानुपानं वा लिह्यात् क्षीणः क्षती कृशः||२९||
 
  
क्रव्यादमांसनिर्यूहं घृतभृष्टं पिबेच्च सः|  
+
balA vidArI hrasvA ca pa~jcamUlI punarnavA| <br />
पिप्पलीक्षौद्रसंयुक्तं मांसशोणितवर्धनम्||३०||  
+
pa~jcAnAM kShIrivRukShANAM shu~ggA muShTyaMshakA api||56|| <br />
  
न्यग्रोधोदुम्बराश्वत्थप्लक्षशालप्रियङ्गुभिः|  
+
eShAM kaShAye dvikShIre vidAryAjarasAMshike| <br />
तालमस्तकजम्बूत्वक्प्रियालैश्च सपद्मकैः||३१||  
+
jIvanIyaiH pacet kalkairakShamAtrairghRutADhakam||57|| <br />
  
साश्वकर्णैः शृतात् क्षीरादद्याज्जातेन सर्पिषा|  
+
sitApalAni pUte ca shIte dvAtriMshataM kShipet| <br />
शाल्योदनं क्षतोरस्कः क्षीणशुक्रश्च मानवः||३२||  
+
godhUmapippalIvAMshIcUrNaM shRu~ggATakasya ca||58|| <br />
  
यष्ट्याह्वनागबलयोः क्वाथे क्षीरसमं घृतम्|  
+
samAkShikaM kauDavikaM tat sarvaM khajamUrcchitam| <br />
पयस्यापिप्पलीवांशीकल्कसिद्धं क्षते शुभम्||३३||  
+
styAnaM sarpirguDAn kRutvA bhUrjapatreNa veShTayet||59|| <br />
  
कोललाक्षारसे तद्वत् क्षीराष्टगुणसाधितम्|  
+
tA~jjagdhvA palikAn kShIraM madyaM vA~anupibet kaphe| <br />
कल्कैः कट्वङ्गदार्वीत्वग्वत्सकत्वक्फलैर्घृतम्||३४||
+
shoShe kAse kShate kShINe shramastrIbhArakarshite||60|| <br />
  
madhūkamadhukakṣīrasiddhaṁ vā taṇḍulīyakam|  
+
raktaniShThIvane tApe pInase corasi sthite| <br />
mūḍhavātastvajāmēdaḥ surābhr̥ṣṭaṁ sasaindhavam||27||  
+
shastAH pArshvashiraHshUle bhede ca svaravarNayoH||61|| <br />
  
kṣāmaḥ kṣīṇaḥ kṣatōraskastvanidraḥ sabalē'nilē|  
+
iti dvitIyasarpirguDAH| <br />
śr̥takṣīrasarēṇādyāt sakṣaudraghr̥taśarkaram||28||
+
</div></div>
  
śarkarāṁ yavagōdhūmau jīvakarṣabhakau madhu|
+
''Bala, vidari, hrasva panchamula'' (''shalaparni, prsniparni, brihati, kantakari'' and ''gokshura''), ''punarnava'', and the ''sungas'' (terminal buds) of five ''kshirivrikshas'' (''nyagrodha, udumbara, asvattha, madhuka'' and ''plaksha'')- one ''pala'' of each of these drugs should be made to a decoction. To this, milk (two parts, i.e., double the quantity of the decoction), juice of ''vidari'' (one part), soup of goat meat (one part), ghee (two ''adhakas'') (in the text, actually one ''adhaka'' is mentioned. But in practice, it is to be taken double the quantity according to the general rule), and the paste of drugs belonging to the ''jivaniya'' group (one ''aksa'' each) should be added and cooked. When it is well cooked and cooled, thirty two ''palas'' of sugar should be added. Thereafter, one ''kudava'' of each of the powder of ''godhuma, pippali, vamsha lochana, shringataka'' and honey should be added. All of them should be stirred with the help of a stirrer. When it becomes dense, cakes (''sarpigud'') should be prepared and each of them should be wrapped with thin bark of ''bhurja'' tree. Having taken this cake one ''pala'' in weight, the patient should take milk or alcohol as post-prandial drink. These are useful in the treatment of disease caused by ''[[kapha]], sosha, kasa'' and ''kshatakshina''. These are also helpful for persons who are emaciated because of excessive exertion, overindulgence in sex and exhaustion by lifting excessive weight. These cakes are efficacious in the treatment of ''[[rakta]]-nishthivana'' (hemoptysis), burning sensation, chronic rhinitis (''pinasa''), having residual infection in the chest, pain in the sides of the chest, headache, hoarseness of voice and loss of complexion. [56-61]
śr̥takṣīrānupānaṁ vā lihyāt kṣīṇaḥ kṣatī kr̥śaḥ||29||
 
  
kravyādamāṁsaniryūhaṁ ghr̥tabhr̥ṣṭaṁ pibēcca saḥ|
+
=== ''Sarpi gud''(third recipe) ===
pippalīkṣaudrasaṁyuktaṁ māṁsaśōṇitavardhanam||30||
+
<div class="mw-collapsible mw-collapsed">
  
nyagrōdhōdumbarāśvatthaplakṣaśālapriyaṅgubhiḥ|  
+
त्वक्क्षीरीश्रावणीद्राक्षामूर्वर्षभकजीवकैः| <br />
tālamastakajambūtvakpriyālaiśca sapadmakaiḥ||31||  
+
वीरर्धिक्षीरकाकोलीबृहतीकपिकच्छुभिः||६२|| <br />
  
sāśvakarṇaiḥ śr̥tāt kṣīrādadyājjātēna sarpiṣā|  
+
खर्जूरफलमेदाभिः क्षीरपिष्टैः पलोन्मितैः| <br />
śālyōdanaṁ kṣatōraskaḥ kṣīṇaśukraśca mānavaḥ||32||  
+
धात्रीविदारीक्षुरसप्रस्थैः प्रस्थं घृतात् पचेत्||६३||<br />
 +
 +
शर्करार्धतुलां शीते क्षौद्रार्धप्रस्थमेव च| <br />
 +
दत्त्वा सर्पिर्गुडान् कुर्यात्कासहिक्काज्वरापहान्||६४|| <br />
  
yaṣṭyāhvanāgabalayōḥ kvāthē kṣīrasamaṁ ghr̥tam|  
+
यक्ष्माणं तमकं श्वासं रक्तपित्तं हलीमकम्| <br />
payasyāpippalīvāṁśīkalkasiddhaṁ kṣatē śubham||33||  
+
शुक्रनिद्राक्षयं तृष्णां हन्युः कार्श्यं सकामलम्||६५|| <br />
  
kōlalākṣārasē tadvat kṣīrāṣṭaguṇasādhitam|  
+
इति तृतीयाः सर्पिर्गुडाः|<br />
kalkaiḥ kaṭvaṅgadārvītvagvatsakatvakphalairghr̥tam||34||
+
<div class="mw-collapsible-content">
  
madhUkamadhukakShIrasiddhaM vA taNDulIyakam|  
+
tvakkṣīrīśrāvaṇīdrākṣāmūrvarṣabhakajīvakaiḥ| <br />
mUDhavAtastvajAmedaH surAbhRuShTaM sasaindhavam||27||  
+
vīrardhikṣīrakākōlībr̥hatīkapikacchubhiḥ||62|| <br />
  
kShAmaH kShINaH kShatoraskastvanidraH sabale~anile|
+
kharjūraphalamēdābhiḥ kṣīrapiṣṭaiḥ palōnmitaiḥ| <br />
shRutakShIrasareNAdyAt sakShaudraghRutasharkaram||28||  
+
dhātrīvidārīkṣurasaprasthaiḥ prasthaṁ ghr̥tāt pacēt||63|| <br />
  
sharkarAM yavagodhUmau jIvakarShabhakau madhu|  
+
śarkarārdhatulāṁ śītē kṣaudrārdhaprasthamēva ca| <br />
shRutakShIrAnupAnaM vA lihyAt kShINaH kShatI kRushaH||29||  
+
dattvā sarpirguḍān kuryātkāsahikkājvarāpahān||64|| <br />
  
kravyAdamAMsaniryUhaM ghRutabhRuShTaM pibecca saH|  
+
yakṣmāṇaṁ tamakaṁ śvāsaṁ raktapittaṁ halīmakam| <br />
pippalIkShaudrasaMyuktaM mAMsashoNitavardhanam||30||  
+
śukranidrākṣayaṁ tr̥ṣṇāṁ hanyuḥ kārśyaṁ sakāmalam||65||<br />
  
nyagrodhodumbarAshvatthaplakShashAlapriya~ggubhiH|
+
iti tr̥tīyāḥ sarpirguḍāḥ <br />
tAlamastakajambUtvakpriyAlaishca sapadmakaiH||31||
 
  
sAshvakarNaiH shRutAt kShIrAdadyAjjAtena sarpiShA|  
+
tvakkShIrIshrAvaNIdrAkShAmUrvarShabhakajIvakaiH|<br />
shAlyodanaM kShatoraskaH kShINashukrashca mAnavaH||32||  
+
vIrardhikShIrakAkolIbRuhatIkapikacchubhiH||62|| <br />
  
yaShTyAhvanAgabalayoH kvAthe kShIrasamaM ghRutam|  
+
kharjUraphalamedAbhiH kShIrapiShTaiH palonmitaiH| <br />
payasyApippalIvAMshIkalkasiddhaM kShate shubham||33||
+
dhAtrIvidArIkShurasaprasthaiH prasthaM ghRutAt pacet||63||<br />
 
   
 
   
kolalAkShArase tadvat kShIrAShTaguNasAdhitam|
+
sharkarArdhatulAM shIte kShaudrArdhaprasthameva ca|<br />
kalkaiH kaTva~ggadArvItvagvatsakatvakphalairghRuta ||34||
+
dattvA sarpirguDAn kuryAtkAsahikkAjvarApahAn||64|| <br />
 +
 
 +
yakShmANaM tamakaM shvAsaM raktapittaM halImakam| <br />
 +
shukranidrAkShayaM tRuShNAM hanyuH kArshyaM sakAmalam||65|| <br />
 +
 
 +
iti tRutIyAH sarpirguDAH| <br />
 +
</div></div>
 +
 
 +
One ''pala'' of each of ''tvak-kshiri, shravani'' (''munditika''), ''draksha, murva, rushabhaka, jivaka, vira'' (''vidarikanda''), ''riddhi, kshirakakoli, brihati, kapikacchu,'' fruit of ''kharjura'' and ''meda'' should be made into paste by triturating with milk. This paste, juice of ''dhatri'' (two ''prasthas''), juice of ''vidari'' (two ''prasthas''), sugarcane juice (two ''prasthas''), and ghee (two ''prasthas'') should be cooked together. After the ghee is well cooked and cooled, half ''tulas'' of sugar and one ''prastha'' of honey should be added, out of which cakes (''sarpi gud'') should be prepared. These cakes cures cough, hiccup, fever, ''rajayakshma, tamaka svasa, rakta-pitta, halimaka'' ( a serious type of jaundice), ''[[shukra]] kshaya'' (diminution of ''[[shukra]]''), insomnia, ''trishna'' (morbid thirst), ''karshya'' (emaciation) and ''kamala'' (jaundice). (In transalation liquids, ghee and honey are taken double the prescribed quantity according to the rule) [ 62-65]
 +
 
 +
=== ''Sarpi gud'' (fourth recipe) ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
नवमामलकं द्राक्षामात्मगुप्तां पुनर्नवाम्| <br />
 +
शतावरीं विदारीं च समङ्गां पिप्पलीं तथा||६६|| <br />
 +
 
 +
पृथग्दशपलान् भागान् पलान्यष्टौ  च नागरात्| <br />
 +
यष्ट्याह्वसौवर्चलयोर्द्विपलं मरिचस्य च||६७|| <br />
  
Milk should be boiled with the paste of madhooka and madhuka. With this milk, tanduliyaka should be cooked [which is useful for the patient suffering from the hemoptysis].
+
क्षीरतैलघृतानां च त्र्याढके शर्कराशते| <br />
If there is mudhavata [claudication of vata], the patient should take the fat of goat fried with sura (type of liquor) and mixed with rock salt.
+
क्वथिते तानि चूर्णानि दत्त्वा बिल्वसमान् गुडान्||६८|| <br />
If the patient is weak, emaciated and having injury in the chest, sleeplessness and excessive aggravation of vayu, then he should take goat’s fat boiled with the cream of milk and added with honey, ghee and sugar.
 
If the patient is emaciated, having injury in the chest and cachectic, he may be given sugar, barley, wheat, jivaka, rushabhaka and honey in linctus form. Therafter he should take boiled milk.
 
The above mentioned patient should take the decoction of the meat of carnivorous animal sizzled with ghee and added with pippali and honey. This potion promotes muscles tissues and blood.
 
The  patient having injury to the chest and diminution of semen, should take sali rice mixed with ghee which latter is prepared of the milk boiled with nyagrodha, udumbara, ashvattha, plaksha, sala, priyangu, tuft of tala, bark of jambu, priyala, padmaka and asvakarna.
 
Yashtvahvadi ghrita:
 
Ghee should be cooked with equal quantity of milk, the decoction of madhuyashti and nagabala [four times of ghee in total], and the paste of payasya, pippali and vamshi [one fourth in total of ghee]. The medicated ghee is useful in the treatment of kshata (injury to chest).
 
Koladi ghrita:
 
Similarly, ghee should be cooked with the decoction of kola and laksha [four times in total of ghee], eight times of milk, and the paste of the bark of kaivanga, bark of darvi, bark of kutaja and fruit of kutaja [one fourth in total of ghee]. This medicated ghee is useful in the treatment of kshata.                                                                                                                    [27-34] 
 
   
 
==== Amrutaprasha ghee ====
 
  
जीवकर्षभकौ वीरां जीवन्तीं नागरं शटीम्|
+
कुर्यात्तान् भक्षयेत् क्षीणः क्षतः शुष्कश्च मानवः| <br />
चतस्रः पर्णिनीर्मेदे काकोल्यौ द्वे निदिग्धिके||३५||
+
तेन सद्यो रसादीनां वृद्ध्या पुष्टिं स विन्दति||६९|| <br />
पुनर्नवे द्वे मधुकमात्मगुप्तां शतावरीम्|
 
ऋद्धिं  परूषकं भार्गीं मृद्वीकां बृहतीं तथा||३६||
 
शृङ्गाटकं तामलकीं पयस्यां पिप्पलीं बलाम्|
 
बदराक्षोटखर्जूरवातामाभिषुकाण्यपि||३७||
 
फलानि चैवमादीनि कल्कान् कुर्वीत कार्षिकान्|
 
धात्रीरसविदारीक्षुच्छागमांसरसं पयः||३८||
 
कुर्यात् प्रस्थोन्मितं तेन घृतप्रस्थं विपाचयेत्|
 
प्रस्थार्धं मधुनः शीते शर्करार्धतुलां तथा||३९||  
 
द्विकार्षिकाणि[१] पत्रैलाहेमत्वङ्मरिचानि च|
 
विनीय चूर्णितं तस्माल्लिह्यान्मात्रां सदा नरः||४०||
 
अमृतप्राशमित्येतन्नराणाममृतं घृतम्|
 
सुधामृतरसं प्राश्यं क्षीरमांसरसाशिना||४१||
 
नष्टशुक्रक्षतक्षीणदुर्बलव्याधिकर्शितान्|
 
स्त्रीप्रसक्तान् कृशान् वर्णस्वरहीनांश्च बृंहयेत्||४२||
 
कासहिक्काज्वरश्वासदाहतृष्णास्रपित्तनुत्|
 
पुत्रदं वमिमूर्च्छाहृद्योनिमूत्रामयापहम्||४३|| इत्यमृतप्राशघृतम्|
 
jīvakarṣabhakau vīrāṁ jīvantīṁ nāgaraṁ śaṭīm|
 
catasraḥ parṇinīrmēdē kākōlyau dvē nidigdhikē||35||
 
punarnavē dvē madhukamātmaguptāṁ śatāvarīm|
 
r̥ddhiṁ parūṣakaṁ bhārgīṁ mr̥dvīkāṁ br̥hatīṁ tathā||36||
 
śr̥ṅgāṭakaṁ tāmalakīṁ payasyāṁ pippalīṁ balām|
 
badarākṣōṭakharjūravātāmābhiṣukāṇyapi||37||
 
phalāni caivamādīni kalkān kurvīta kārṣikān|
 
dhātrīrasavidārīkṣucchāgamāṁsarasaṁ payaḥ||38||
 
kuryāt prasthōnmitaṁ tēna ghr̥taprasthaṁ vipācayēt|
 
prasthārdhaṁ madhunaḥ śītē śarkarārdhatulāṁ tathā||39||
 
dvikārṣikāṇi [2] patrailāhēmatvaṅmaricāni ca|
 
vinīya cūrṇitaṁ tasmāllihyānmātrāṁ sadā naraḥ||40||
 
amr̥taprāśamityētannarāṇāmamr̥taṁ ghr̥tam|
 
sudhāmr̥tarasaṁ prāśyaṁ kṣīramāṁsarasāśinā||41||
 
naṣṭaśukrakṣatakṣīṇadurbalavyādhikarśitān|
 
strīprasaktān kr̥śān varṇasvarahīnāṁśca br̥ṁhayēt||42||
 
kāsahikkājvaraśvāsadāhatr̥ṣṇāsrapittanut|
 
putradaṁ vamimūrcchāhr̥dyōnimūtrāmayāpaham||43||
 
ityamr̥taprāśaghr̥tam
 
  
jIvakarShabhakau vIrAM jIvantIM nAgaraM shaTIm|
+
इति चतुर्थसर्पिर्गुडाः| <br />
catasraH parNinIrmede kAkolyau dve nidigdhike||35||
+
<div class="mw-collapsible-content">
punarnave dve madhukamAtmaguptAM shatAvarIm|
 
RuddhiM parUShakaM bhArgIM mRudvIkAM bRuhatIM tathA||36||
 
shRu~ggATakaM tAmalakIM payasyAM pippalIM balAm| badarAkShoTakharjUravAtAmAbhiShukANyapi||37||
 
phalAni caivamAdIni kalkAn kurvIta kArShikAn|
 
dhAtrIrasavidArIkShucchAgamAMsarasaM payaH||38||
 
kuryAt prasthonmitaM tena ghRutaprasthaM vipAcayet|
 
prasthArdhaM madhunaH shIte sharkarArdhatulAM tathA||39||
 
dvikArShikANi patrailAhematva~gmaricAni ca|
 
vinIya cUrNitaM tasmAllihyAnmAtrAM sadA naraH||40||
 
amRutaprAshamityetannarANAmamRutaM ghRutam|
 
sudhAmRutarasaM prAshyaM kShIramAMsarasAshinA||41||
 
naShTashukrakShatakShINadurbalavyAdhikarshitAn|
 
strIprasaktAn kRushAn varNasvarahInAMshca bRuMhayet||42||
 
kAsahikkAjvarashvAsadAhatRuShNAsrapittanut|
 
putradaM vamimUrcchAhRudyonimUtrAmayApaham||43||
 
ityamRutaprAshaghRutam|
 
  
Two prasthas of ghee should be cooked with the juice dhatri (two prasthas), juice of vidari (two prasthas), sugarcane juice (two prasthas), soup of the meat of goat (two prasthas), milk (two prasthas), and the paste (one karsa each) of jivaka, rsabhaka, vira, jivanti, nagara, shati, shalaparni, prushniparni, mashaparni, mudgaparni,meda, mahameda, kakoli, kshirakakoli, kantakari, bruhati, shveta punarnava, rakta punarnava,madhuka, atmagupta, shatavari, riddhi,parushaka, bharangi, mrudvika, bruhati, shrungataka,tamalaki, payasya (kshiravidari), pippali, badara, akshota, kharjura, vatama, abhishuka (pista) and such other fruits  which are alleviators of vayu and pitta.After cooking when the the recipe is cooled, one prastha of honey, half tula of sugar, and the powder [ two karshas each ] of  patra, ela, hema, tvak and marica should be added to it. This medicated ghee should be taken by a person in appropriate dose regularly. This is called ‘amruta prasa ghrita’ and it is like amruta (ambrosia) for human beings.  This linctus is like sudha (ambrosia worth the consumption of wordly creatures) and the amruta (ambrosia worth the consumption of the gods). It should be taken along with milk and meat soup. It promotes nourishment of persons who had depleted shukra ( as in azoospermia or oligospermia), who are suffering from kshata kshina, who are weak, who are emaciated because of chronic diseases, who are cachectic and who have lost their complexion and voice. It cures cough, hiccup, fever, asthma, burning sensation, morbid thirst, rakta-pitta, vomiting, fainting and diseases of the heart, female genital tract and urinary tract. It helps in the treatment of infertility. [35-43]
+
navamāmalakaṁ drākṣāmātmaguptāṁ punarnavām| <br />
 +
śatāvarīṁ vidārīṁ ca samaṅgāṁ pippalīṁ tathā||66|| <br />
  
==== Shvadamshtradi ghee ====
+
pr̥thagdaśapalān bhāgān palānyaṣṭau ca nāgarāt| <br />
 +
yaṣṭyāhvasauvarcalayōrdvipalaṁ maricasya ca||67|| <br />
  
श्वदंष्ट्रोशीरमञ्जिष्ठाबलाकाश्मर्यकत्तृणम्|  
+
kṣīratailaghr̥tānāṁ ca tryāḍhakē śarkarāśatē| <br />
दर्भमूलं पृथक्पर्णीं पलाशर्षभकौ स्थिराम्||४४||
+
kvathitē tāni cūrṇāni dattvā bilvasamān guḍān||68|| <br />
पलिकं साधयेत्तेषां रसे क्षीरचतुर्गुणे|
 
कल्कः स्वगुप्ताजीवन्तीमेदर्षभकजीवकैः||४५||
 
शतावर्यृद्धिमृद्वीकाशर्कराश्रावणीबिसैः|
 
प्रस्थः सिद्धो घृताद्वातपित्तहृद्द्र(द्भ)वशूलनुत्||४६||
 
मूत्रकृच्छ्रप्रमेहार्शःकासशोषक्षयापहः|
 
धनुःस्त्रीमद्यभाराध्वखिन्नानां बलमांसदः||४७|| इति श्वदंष्ट्रादिघृतम्|
 
śvadaṁṣṭrōśīramañjiṣṭhābalākāśmaryakattr̥ṇam|
 
darbhamūlaṁ pr̥thakparṇīṁ palāśarṣabhakau sthirām||44||
 
palikaṁ sādhayēttēṣāṁ rasē kṣīracaturguṇē|
 
kalkaḥ svaguptājīvantīmēdarṣabhakajīvakaiḥ||45||
 
śatāvaryr̥ddhimr̥dvīkāśarkarāśrāvaṇībisaiḥ|
 
prasthaḥ siddhō ghr̥tādvātapittahr̥ddra(dbha)vaśūlanut||46||
 
mūtrakr̥cchrapramēhārśaḥkāsaśōṣakṣayāpahaḥ|
 
dhanuḥstrīmadyabhārādhvakhinnānāṁ balamāṁsadaḥ||47||
 
iti śvadaṁṣṭrādighr̥tam
 
  
shvadaMShTroshIrama~jjiShThAbalAkAshmaryakattRuNam|  
+
kuryāttān bhakṣayēt kṣīṇaḥ kṣataḥ śuṣkaśca mānavaḥ| <br />
darbhamUlaM pRuthakparNIM palAsharShabhakau sthirAm||44||  
+
tēna sadyō rasādīnāṁ vr̥ddhyā puṣṭiṁ sa vindati||69|| <br />
palikaM sAdhayetteShAM rase kShIracaturguNe|
+
kalkaH svaguptAjIvantImedarShabhakajIvakaiH||45|| shatAvaryRuddhimRudvIkAsharkarAshrAvaNIbisaiH|
+
iti caturthasarpirguḍāḥ <br />
prasthaH siddho ghRutAdvAtapittahRuddra(dbha)vashUlanut||46|| mUtrakRucchrapramehArshaHkAsashoShakShayApahaH| dhanuHstrImadyabhArAdhvakhinnAnAM balamAMsadaH||47|| iti
 
shvadaMShTrAdighRutam|
 
  
One pala of each of shvadamshtra, ushira, manjishtha, bala, kashmarya, katrna, the root of darbha, pruthak parni, palasha, rushabhaka, and sthira should be made to decoction. Two prasthas of ghee should be mixed with the above mentioned decoction, eight prasthas of milk, and the paste of svagupta, jivanti, meda, rushabhaka, jivaka, shatavari, riddhi, mrudvika, sharkara, shravani and bias (lotus stalk), [half prastha in total] and cooked. This medicated ghee cures hrudaya shula caused by vayu and pitta, mutrakrucchra (dysuria), prameha (diabetes mellitus), piles, bronchitis, and consumption and kshata kshina. It promotes strength of muscles tissues of persons emaciated because of indulgence in archery, women, alcohol, carrying heavy weight and walking a long distance. [44-47]
+
navamAmalakaM drAkShAmAtmaguptAM punarnavAm| <br />
 +
shatAvarIM vidArIM ca sama~ggAM pippalIM tathA||66||<br />
 +
   
 +
pRuthagdashapalAn bhAgAn palAnyaShTau ca nAgarAt| <br />
 +
yaShTyAhvasauvarcalayordvipalaM maricasya ca||67|| <br />
  
==== Samasaktu ghee ====
+
kShIratailaghRutAnAM ca tryADhake sharkarAshate| <br />
 +
kvathite tAni cUrNAni dattvA bilvasamAn guDAn||68|| <br />
  
मधुकाष्टपलद्राक्षाप्रस्थक्वाथे घृतं पचेत्|  
+
kuryAttAn bhakShayet kShINaH kShataH shuShkashca mAnavaH| <br />
पिप्पल्यष्टपले कल्के प्रस्थं सिद्धे च शीतले||४८||
+
tena sadyo rasAdInAM vRuddhyA puShTiM sa vindati||69|| <br />
पृथगष्टपलं क्षौद्रशर्कराभ्यां विमिश्रयेत्|
 
समसक्तु क्षतक्षीणे रक्तगुल्मे च तद्धितम्||४९||
 
madhukāṣṭapaladrākṣāprasthakvāthē ghr̥taṁ pacēt|
 
pippalyaṣṭapalē kalkē prasthaṁ siddhē ca śītalē||48||
 
pr̥thagaṣṭapalaṁ kṣaudraśarkarābhyāṁ vimiśrayēt|
 
samasaktu kṣatakṣīṇē raktagulmē ca taddhitam||49||
 
  
madhukAShTapaladrAkShAprasthakv the ghRutaM pacet|  
+
iti caturthasarpirguDAH| <br />
pippalyaShTapale kalke prasthaM siddhe ca shItale||48||
+
</div></div>
pRuthagaShTapalaM kShaudrasharkarAbhyAM vimishrayet|
 
samasaktu kShatakShINe raktagulme ca taddhitam||49||
 
  
Two prasthas of ghee should be cooked by adding the decoction of madhuka (eight palas) and draksha (one prastha), and the paste of pippali (eight palas). After it is cooked and cooled, eight palas of each of honey and sugar should be added and mixed well. This medicated ghee should be administered by adding saktu (roasted barley flour) in equal quantity. It is useful in the treatment of kshata kshina and rakta gulma. [48-49]
+
Freshly collected and dried ''amalaki'' (ten ''palas''), ''draksha'' (ten ''palas''), ''atmagupta'' (ten ''palas''), ''punarnava'' (ten ''palas''), ''shatavari'' (ten ''palas''), ''vidari'' (ten ''palas''), ''samanga'' (ten ''palas''), ''pippali'' (ten ''palas''), ''nagara'' (eight ''palas''), ''madhuyashti'' (one ''palas''), ''saurvachala'' (one ''pala'') and ''maricha'' (two ''palas'') – all these drugs should be made to powders. Milk (two ''adhakas''), ''tila taila'' (two ''adhakas''), ghee (two ''adhakas'') and sugar (one hundred ''palas'') should be cooked together. Thereafter, the above mentioned powder should be added to it. Out of this, cakes of one ''bilva'' or ''pala'' each should be prepared. These cakes should be taken by the person suffering from ''kshatakshina'' and consumption. Intake of these cakes instantaneously promote tissues elements like ''rasa'' etc. as a result of which the individual gets nourished. [66-69]
  
==== Sarpi-guda ====
+
=== ''Sarpi modaka'' (fifth recipe) ===
 +
<div class="mw-collapsible mw-collapsed">
  
धात्रीफलविदारीक्षुजीवनीयरसैर्घृतम्|  
+
गोक्षीरार्धाढकं सर्पिः प्रस्थमिक्षुरसाढकम्| <br />
अजागोपयसोश्चैव सप्त प्रस्थान् पचेद्भिषक्||५०||
+
विदार्याः स्वरसात्प्रस्थं रसात्प्रस्थं तैत्तिरात्||७०|| <br />
सिद्धशीते सिताक्षौद्रद्विप्रस्थं  विनयेच्च तत्|
 
यक्ष्मापस्मारपित्तासृक्कासमेहक्षयापहम्||५१||
 
वयःस्थापनमायुष्यं मांसशुक्रबलप्रदम्|
 
घृतं तु पित्तेऽभ्यधिके लिह्याद्वातेऽधिके पिबेत्||५२||
 
लीढं निर्वापयेत् पित्तमल्पत्वाद्धन्ति नानलम्|
 
आक्रामत्यनिलं पीतमूष्माणं  निरुणद्धि च||५३||
 
क्षामक्षीणकृशाङ्गानामेतान्येव घृतानि तु|
 
त्वक्क्षीरीशर्करालाजचूर्णैः स्त्यानानि योजयेत्||५४||
 
सर्पिर्गुडान् समध्वंशाञ्जग्ध्वा चानु पयः पिबेत्|
 
रेतो वीर्यं बलं पुष्टिं तैराशुतरमाप्नुयात्||५५|| इति सर्पिर्गुडाः|
 
dhātrīphalavidārīkṣujīvanīyarasairghr̥tam|
 
ajāgōpayasōścaiva sapta prasthān pacēdbhiṣak||50||
 
siddhaśītē sitākṣaudradviprasthaṁ vinayēcca tat|
 
yakṣmāpasmārapittāsr̥kkāsamēhakṣayāpaham||51||
 
vayaḥsthāpanamāyuṣyaṁ māṁsaśukrabalapradam|
 
ghr̥taṁ tu pittē'bhyadhikē lihyādvātē'dhikē pibēt||52||
 
līḍhaṁ nirvāpayēt pittamalpatvāddhanti nānalam|
 
ākrāmatyanilaṁ pītamūṣmāṇaṁ niruṇaddhi ca||53||
 
kṣāmakṣīṇakr̥śāṅgānāmētānyēva ghr̥tāni tu|
 
tvakkṣīrīśarkarālājacūrṇaiḥ [3] styānāni yōjayēt||54||
 
sarpirguḍān samadhvaṁśāñjagdhvā cānu payaḥ pibēt|
 
rētō vīryaṁ balaṁ puṣṭiṁ tairāśutaramāpnuyāt||55||
 
iti sarpirguḍāḥ
 
  
dhAtrIphalavidArIkShujIvanIyarasairghRutam|  
+
दद्यात्  सिध्यति तस्मिंस्तु पिष्टानिक्षुरसैरिमान्| <br />
ajAgopayasoshcaiva sapta prasthAn pacedbhiShak||50||
+
मधूकपुष्पकुडवं  प्रियालकुडवं तथा||७१|| <br />
siddhashIte sitAkShaudradviprasthaM vinayecca tat|
 
yakShmApasmArapittAsRukkAsamehakShayApaham||51||
 
vayaHsthApanamAyuShyaM mAMsashukrabalapradam|
 
ghRutaM tu pitte~abhyadhike lihyAdvAte~adhike pibet||52||
 
lIDhaM nirvApayet pittamalpatvAddhanti nAnalam|
 
AkrAmatyanilaM pItamUShmANaM niruNaddhi ca||53||
 
kShAmakShINakRushA~ggAnAmetAnyeva ghRutAni tu|
 
tvakkShIrIsharkarAlAjacUrNaiH styAnAni yojayet||54||
 
sarpirguDAn samadhvaMshA~jjagdhvA cAnu payaH pibet|
 
reto vIryaM balaM puShTiM tairAshutaramApnuyAt||55|| iti sarpirguDAH|
 
  
Two prasthas of ghee should be added with the juice of amalaka (two prasthas), vidari (two prasthas) and ikshu (two prasthas) decoction of drugs belonging to jivaniya group (two prasthas), goat’s milk (two prasthas) and cow’s milk (two prasthas) and cooked. After the cooking is over and the recipe is cooled, sugar (one prastha) and honey (two prasthas) should be added and mixed well. This medicated ghee is useful in the treatment of rajayaskshma, apasmara, raktapitta, prameha, and kshaya. It prevents aging, promotes longevity and endows the person with muscle tissues, semen as well as strength. If the disease is caused by excess of pitta, then this recipe should be used as linctus. If, however, the disease is caused by the excess of vayu, then it should be taken as a drink.
+
कुडवार्धं तुगाक्षीर्याः खर्जूराणां च  विंशतिम्| <br />
When this medicated ghee is used (licked) in the form of a linctus, it alleviates pitta. Since it is in small quantity, it however, doesn’t suppress the agni (power of digestion).
+
पृथग्बिभीतकानां च पिप्पल्याश्च चतुर्थिकाम्||७२|| <br />
When it is used in the form of a drink, it alleviates vayu and obstructs pitta ushma.
 
This and such other medicated ghee should be made to a thick paste by adding the powder of tvakkshiri, sugar and lajja (fried paddy), which should then be given to persons who are tired, weak and emaciated.
 
This and such other recipes of sarpiguda [recipes of medicated ghee in which sugar, honey etc. are added] should be added with honey (which should be equal in quantity with the powder of tvak-kshiri, etc.) and taken. Thereafter, the patient should drink milk. This instantaneously promotes semen, potency, strength and nourishment.  [50-55]
 
  
==== Sarpi guda (second recipe) ====
+
त्रिंशत्पलानि खण्डाच्च मधुकात् कर्षमेव च| <br />
 +
तथाऽर्धपलिकान्यत्र जीवनीयानि दापयेत्||७३|| <br />
  
बला विदारी ह्रस्वा च पञ्चमूली पुनर्नवा|
+
सिद्धेऽस्मिन् कुडवं क्षौद्रं शीते क्षिप्त्वाऽथ मोदकान्| <br />
पञ्चानां क्षीरिवृक्षाणां शुङ्गा मुष्ट्यंशका अपि||५६||
+
कारयेन्मरिचाजाजीपलचूर्णावचूर्णितान्||७४|| <br />
एषां कषाये द्विक्षीरे विदार्याजरसांशिके|
 
जीवनीयैः पचेत् कल्कैरक्षमात्रैर्घृताढकम्||५७||
 
सितापलानि पूते च शीते द्वात्रिंशतं क्षिपेत्|
 
गोधूमपिप्पलीवांशीचूर्णं शृङ्गाटकस्य च||५८||
 
समाक्षिकं कौडविकं तत् सर्वं खजमूर्च्छितम्|
 
स्त्यानं सर्पिर्गुडान् कृत्वा भूर्जपत्रेण वेष्टयेत्||५९||
 
ताञ्जग्ध्वा पलिकान् क्षीरं मद्यं वाऽनुपिबेत् कफे|  
 
शोषे कासे क्षते क्षीणे श्रमस्त्रीभारकर्शिते||६०||
 
रक्तनिष्ठीवने तापे पीनसे चोरसि स्थिते|
 
शस्ताः पार्श्वशिरःशूले भेदे च स्वरवर्णयोः||६१|| इति द्वितीयसर्पिर्गुडाः|
 
  
balā vidārī hrasvā ca pañcamūlī punarnavā|  
+
वातासृक्पित्तरोगेषु क्षतकासक्षयेषु च| <br />
pañcānāṁ kṣīrivr̥kṣāṇāṁ śuṅgā muṣṭyaṁśakā api||56||  
+
शुष्यतां क्षीणशुक्राणां रक्ते चोरसि संस्थिते||७५|| <br />
ēṣāṁ kaṣāyē dvikṣīrē vidāryājarasāṁśikē|
 
jīvanīyaiḥ pacēt kalkairakṣamātrairghr̥tāḍhakam||57||
 
sitāpalāni pūtē ca śītē dvātriṁśataṁ kṣipēt|
 
gōdhūmapippalīvāṁśīcūrṇaṁ śr̥ṅgāṭakasya ca||58||
 
samākṣikaṁ kauḍavikaṁ tat sarvaṁ khajamūrcchitam|
 
styānaṁ sarpirguḍān kr̥tvā bhūrjapatrēṇa vēṣṭayēt||59||
 
tāñjagdhvā palikān kṣīraṁ madyaṁ vā'nupibēt kaphē|
 
śōṣē kāsē kṣatē kṣīṇē śramastrībhārakarśitē||60||
 
raktaniṣṭhīvanē tāpē pīnasē cōrasi sthitē|
 
śastāḥ pārśvaśiraḥśūlē bhēdē ca svaravarṇayōḥ||61||
 
iti dvitīyasarpirguḍāḥ
 
  
balA vidArI hrasvA ca pa~jcamUlI punarnavA|  
+
कृशदुर्बलवृद्धानां पुष्टिवर्णबलार्थिनाम्| <br />
pa~jcAnAM kShIrivRukShANAM shu~ggA muShTyaMshakA api||56||  
+
योनिदोषकृतस्रावहतानां चापि योषिताम्||७६|| <br />
eShAM kaShAye dvikShIre vidAryAjarasAMshike|
 
jIvanIyaiH pacet kalkairakShamAtrairghRutADhakam||57||
 
sitApalAni pUte ca shIte dvAtriMshataM kShipet|
 
godhUmapippalIvAMshIcUrNaM shRu~ggATakasya ca||58||
 
samAkShikaM kauDavikaM tat sarvaM khajamUrcchitam|
 
styAnaM sarpirguDAn kRutvA bhUrjapatreNa veShTayet||59||
 
tA~jjagdhvA palikAn kShIraM madyaM vA~anupibet kaphe|
 
shoShe kAse kShate kShINe shramastrIbhArakarshite||60||
 
raktaniShThIvane tApe pInase corasi sthite|
 
shastAH pArshvashiraHshUle bhede ca svaravarNayoH||61|| iti dvitIyasarpirguDAH|
 
  
Bala, vidari, hrasva panchamula (shalaparni, prsniparni, bruhati, kantakari and goksura), punarnava, and the sungas (terminal buds) of five ksirivrksas (nyagrodha, udumbara, asvattha, madhuka and plaksa)- one pala of each of these drugs should be made to a decoction. To this, milk (two parts, i.e.double the quantity of the decoction), juice of vidari (one part), soup of goat meat (one part), ghee (two adhakas) [in the text, actually one adhaka is mentioned. But in practice, it is to be taken double the quantity according to the general rule], and the paste of drugs belonging to the jivaniya group (one aksa each) should be added and cooked. When it is well cooked and cooled, thirty two palas of sugar should be added. Therafter, one kudava of each of the powder of godhuma, pippali, vamsha lochana, shringataka and honey should be added. All of them should be stirred with the help of a stirrer. When it becomes dense, cakes (sarpigudas) should be prepared and each of them should be wrapped with thin bark of bhurja tree. Having taken this cake one pala in weight, the patient should take milk or alcohol as post-prandial drink. These are useful in the treatment of disease caused by kapha, sosa, kasa and kshata-kshina. These are also helpful for persons who are emaciated because of excessive exertion, overindulgence in sex and exhaustion by lifting excessive weight. These cakes are efficacious in the treatment of rakta-nishthivana (hemoptysis), burning sensation, chronic rhinitis (pinasa), having residual infection in the chest, pain in the sides of the chest, headache, hoarseness of voice and loss of complexion.  [56-61]
+
गर्भार्थिनीनां गर्भश्च स्रवेद्यासां म्रियेत वा| <br />
 +
धन्या बल्या हितास्ताभ्यः शुक्रशोणितवर्धनाः||७७|| <br />
  
==== Sarpi guda (third recipe) ====
+
इति पञ्चमसर्पिर्मोदकाः| <br />
 +
<div class="mw-collapsible-content">
  
त्वक्क्षीरीश्रावणीद्राक्षामूर्वर्षभकजीवकैः| वीरर्धिक्षीरकाकोलीबृहतीकपिकच्छुभिः||६२||
+
gōkṣīrārdhāḍhakaṁ sarpiḥ prasthamikṣurasāḍhakam| <br />
खर्जूरफलमेदाभिः क्षीरपिष्टैः पलोन्मितैः| धात्रीविदारीक्षुरसप्रस्थैः प्रस्थं घृतात् पचेत्||६३||  
+
vidāryāḥ svarasātprasthaṁ rasātprasthaṁ ca taittirāt||70|| <br />
शर्करार्धतुलां शीते क्षौद्रार्धप्रस्थमेव च| दत्त्वा सर्पिर्गुडान् कुर्यात्कासहिक्काज्वरापहान्||६४||
 
यक्ष्माणं तमकं श्वासं रक्तपित्तं हलीमकम्| शुक्रनिद्राक्षयं तृष्णां हन्युः कार्श्यं सकामलम्||६५||
 
इति तृतीयाः सर्पिर्गुडाः|
 
  
tvakkṣīrīśrāvaṇīdrākṣāmūrvarṣabhakajīvakaiḥ|  
+
dadyāt sidhyati tasmiṁstu piṣṭānikṣurasairimān| <br />
vīrardhikṣīrakākōlībr̥hatīkapikacchubhiḥ||62||  
+
madhūkapuṣpakuḍavaṁ priyālakuḍavaṁ tathā||71|| <br />
kharjūraphalamēdābhiḥ kṣīrapiṣṭaiḥ palōnmitaiḥ|
 
dhātrīvidārīkṣurasaprasthaiḥ prasthaṁ ghr̥tāt pacēt||63||
 
śarkarārdhatulāṁ śītē kṣaudrārdhaprasthamēva ca|
 
dattvā sarpirguḍān kuryātkāsahikkājvarāpahān||64||
 
yakṣmāṇaṁ tamakaṁ śvāsaṁ raktapittaṁ halīmakam|
 
śukranidrākṣayaṁ tr̥ṣṇāṁ hanyuḥ kārśyaṁ sakāmalam||65||
 
iti tr̥tīyāḥ sarpirguḍāḥ
 
  
tvakkShIrIshrAvaNIdrAkShAmUrvarShabhakajIvakaiH|
+
kuḍavārdhaṁ tugākṣīryāḥ kharjūrāṇāṁ ca viṁśatim| <br />
vIrardhikShIrakAkolIbRuhatIkapikacchubhiH||62||
+
pr̥thagbibhītakānāṁ ca pippalyāśca caturthikām||72|| <br />
kharjUraphalamedAbhiH kShIrapiShTaiH palonmitaiH|
 
dhAtrIvidArIkShurasaprasthaiH prasthaM ghRutAt pacet||63||  
 
sharkarArdhatulAM shIte kShaudrArdhaprasthameva ca|
 
dattvA sarpirguDAn kuryAtkAsahikkAjvarApahAn||64||
 
yakShmANaM tamakaM shvAsaM raktapittaM halImakam|
 
shukranidrAkShayaM tRuShNAM hanyuH kArshyaM sakAmalam||65||  
 
iti tRutIyAH sarpirguDAH|
 
  
One pala of each of tvakkshiri, shravani (munditika), draksha, murva, rushabhaka, jivaka, vira (vidarikanda), riddhi, kshirakakoli, bruhati, kapikacchu, fruit of kharjura and meda should be made into paste by triturating with milk. This paste, juice of dhatri (two prasthas), juice of vidari (two prasthas), sugarcane juice (two prasthas), and ghee (two prasthas) should be cooked together. After the ghee is well cooked and cooled, half tulas of sugar and one prastha of honey should be added, out of which cakes (sarpi guda) should be prepared. These cakes cures cough, hiccup, fever, rajayakshma, tamaka svasa, rakta-pitta, halimaka ( a srious type of jaundice), shukra kshaya (diminution of shukra), insomnia, trishna (morbid thirst), karshya (emaciation) and kamala (jaundice). [In transalation liquids, ghee and honey are taken double the prescribed quantity according to the rule ][ 62-65]
+
triṁśatpalāni khaṇḍācca madhukāt karṣamēva ca| <br />
 +
tathā'rdhapalikānyatra jīvanīyāni dāpayēt||73|| <br />
  
==== Sarpi guda (fourth recipe) ====
+
siddhē'smin kuḍavaṁ kṣaudraṁ śītē kṣiptvā'tha mōdakān| <br />
 +
kārayēnmaricājājīpalacūrṇāvacūrṇitān||74|| <br />
  
नवमामलकं द्राक्षामात्मगुप्तां पुनर्नवाम्| शतावरीं विदारीं च समङ्गां पिप्पलीं तथा||६६|| पृथग्दशपलान् भागान् पलान्यष्टौ  च नागरात्| यष्ट्याह्वसौवर्चलयोर्द्विपलं मरिचस्य च||६७|| क्षीरतैलघृतानां च त्र्याढके शर्कराशते| क्वथिते तानि चूर्णानि दत्त्वा बिल्वसमान् गुडान्||६८|| कुर्यात्तान् भक्षयेत् क्षीणः क्षतः शुष्कश्च मानवः| तेन सद्यो रसादीनां वृद्ध्या पुष्टिं स विन्दति||६९|| इति चतुर्थसर्पिर्गुडाः|
+
vātāsr̥kpittarōgēṣu kṣatakāsakṣayēṣu ca| <br />
 +
śuṣyatāṁ kṣīṇaśukrāṇāṁ raktē cōrasi saṁsthitē||75|| <br />
  
navamāmalakaṁ drākṣāmātmaguptāṁ punarnavām|  
+
kr̥śadurbalavr̥ddhānāṁ puṣṭivarṇabalārthinām| <br />
śatāvarīṁ vidārīṁ ca samaṅgāṁ pippalīṁ tathā||66||  
+
yōnidōṣakr̥tasrāvahatānāṁ cāpi yōṣitām||76|| <br />
pr̥thagdaśapalān bhāgān palānyaṣṭau ca nāgarāt|
 
yaṣṭyāhvasauvarcalayōrdvipalaṁ maricasya ca||67||
 
kṣīratailaghr̥tānāṁ ca tryāḍhakē śarkarāśatē|
 
kvathitē tāni cūrṇāni dattvā bilvasamān guḍān||68||
 
kuryāttān bhakṣayēt kṣīṇaḥ kṣataḥ śuṣkaśca mānavaḥ|
 
tēna sadyō rasādīnāṁ vr̥ddhyā puṣṭiṁ sa vindati||69||
 
iti caturthasarpirguḍāḥ
 
  
navamAmalakaM drAkShAmAtmaguptAM punarnavAm|  
+
garbhārthinīnāṁ garbhaśca sravēdyāsāṁ mriyēta vā| <br />
shatAvarIM vidArIM ca sama~ggAM pippalIM tathA||66||  
+
dhanyā balyā hitāstābhyaḥ śukraśōṇitavardhanāḥ||77|| <br />
pRuthagdashapalAn bhAgAn palAnyaShTau ca nAgarAt| yaShTyAhvasauvarcalayordvipalaM maricasya ca||67||
 
kShIratailaghRutAnAM ca tryADhake sharkarAshate|
 
kvathite tAni cUrNAni dattvA bilvasamAn guDAn||68||
 
kuryAttAn bhakShayet kShINaH kShataH shuShkashca mAnavaH|
 
tena sadyo rasAdInAM vRuddhyA puShTiM sa vindati||69|| iti caturthasarpirguDAH|
 
  
Freshly collected and dried amalaki (ten palas), draksha (ten palas), atmagupta (ten palas), punarnava (ten palas) shatavari (ten palas), vidari (ten palas), samanga (ten palas), pippali (ten palas), nagara (eight palas), madhuyashti (one palas), saurvachala (one pala) and maricha (two palas) – all these drugs should be made to powders. Milk (two adhakas), tila taila (two adhakas), ghee (two adhakas) and sugar (one hundred palas) should be cooked together. Thereafter, the above mentioned powder should be added to it. Out of this, cakes of one bilva or pala each should be prepared. These cakes should be taken by the person suffering from kshata kshina and consumption. Intake of these cakes instantaneously promot tissues elements like rasa etc. as a result of which the individual gets nourished.  [66-69]
+
iti pañcamasarpirmōdakāḥ <br />
  
==== Sarpi modaka (fifth recipe) ====
+
gokShIrArdhADhakaM sarpiH prasthamikShurasADhakam| <br />
 +
vidAryAH svarasAtprasthaM rasAtprasthaM ca taittirAt||70|| <br />
  
गोक्षीरार्धाढकं सर्पिः प्रस्थमिक्षुरसाढकम्| विदार्याः स्वरसात्प्रस्थं रसात्प्रस्थं च तैत्तिरात्||७०|| दद्यात्  सिध्यति तस्मिंस्तु पिष्टानिक्षुरसैरिमान्| मधूकपुष्पकुडवं  प्रियालकुडवं तथा||७१||
+
dadyAt sidhyati tasmiMstu piShTAnikShurasairimAn| <br />
कुडवार्धं तुगाक्षीर्याः खर्जूराणां च  विंशतिम्| पृथग्बिभीतकानां च पिप्पल्याश्च चतुर्थिकाम्||७२|| त्रिंशत्पलानि खण्डाच्च मधुकात् कर्षमेव च| तथाऽर्धपलिकान्यत्र जीवनीयानि दापयेत्||७३|| सिद्धेऽस्मिन् कुडवं क्षौद्रं शीते क्षिप्त्वाऽथ मोदकान्| कारयेन्मरिचाजाजीपलचूर्णावचूर्णितान्||७४|| वातासृक्पित्तरोगेषु क्षतकासक्षयेषु च| शुष्यतां क्षीणशुक्राणां रक्ते चोरसि संस्थिते||७५|| कृशदुर्बलवृद्धानां पुष्टिवर्णबलार्थिनाम्| योनिदोषकृतस्रावहतानां चापि योषिताम्||७६||  
+
madhUkapuShpakuDavaM priyAlakuDavaM tathA||71|| <br />
गर्भार्थिनीनां गर्भश्च स्रवेद्यासां म्रियेत वा| धन्या बल्या हितास्ताभ्यः शुक्रशोणितवर्धनाः||७७||  
 
इति पञ्चमसर्पिर्मोदकाः|
 
  
gōkṣīrārdhāḍhakaṁ sarpiḥ prasthamikṣurasāḍhakam|
+
kuDavArdhaM tugAkShIryAH kharjUrANAM ca viMshatim| <br />
vidāryāḥ svarasātprasthaṁ rasātprasthaṁ ca taittirāt||70||
+
pRuthagbibhItakAnAM ca pippalyAshca caturthikAm||72|| <br />
dadyāt sidhyati tasmiṁstu piṣṭānikṣurasairimān|
+
 
madhūkapuṣpakuḍavaṁ priyālakuḍavaṁ tathā||71||  
+
triMshatpalAni  khaNDAcca madhukAt karShameva ca| <br />
kuḍavārdhaṁ tugākṣīryāḥ kharjūrāṇāṁ ca viṁśatim|
+
tathA~ardhapalikAnyatra jIvanIyAni dApayet||73|| <br />
pr̥thagbibhītakānāṁ ca pippalyāśca caturthikām||72||  
 
triṁśatpalāni khaṇḍācca madhukāt karṣamēva ca|  
 
tathā'rdhapalikānyatra jīvanīyāni dāpayēt||73||  
 
siddhē'smin kuḍavaṁ kṣaudraṁ śītē kṣiptvā'tha mōdakān|
 
kārayēnmaricājājīpalacūrṇāvacūrṇitān||74||
 
vātāsr̥kpittarōgēṣu kṣatakāsakṣayēṣu ca|
 
śuṣyatāṁ kṣīṇaśukrāṇāṁ raktē cōrasi saṁsthitē||75||
 
kr̥śadurbalavr̥ddhānāṁ puṣṭivarṇabalārthinām|
 
yōnidōṣakr̥tasrāvahatānāṁ cāpi yōṣitām||76||
 
garbhārthinīnāṁ garbhaśca sravēdyāsāṁ mriyēta vā|
 
dhanyā balyā hitāstābhyaḥ śukraśōṇitavardhanāḥ||77||
 
iti pañcamasarpirmōdakāḥ
 
  
gokShIrArdhADhakaM sarpiH prasthamikShurasADhakam|
+
siddhe~asmin kuDavaM kShaudraM shIte kShiptvA~atha modakAn| <br />
vidAryAH svarasAtprasthaM rasAtprasthaM ca taittirAt||70||
+
kArayenmaricAjAjIpalacUrNAvacUrNitAn||74|| <br />
dadyAt sidhyati tasmiMstu piShTAnikShurasairimAn|
 
madhUkapuShpakuDavaM priyAlakuDavaM tathA||71||
 
kuDavArdhaM tugAkShIryAH kharjUrANAM ca viMshatim|
 
pRuthagbibhItakAnAM ca pippalyAshca caturthikAm||72||   
 
triMshatpalAni  khaNDAcca madhukAt karShameva ca|
 
tathA~ardhapalikAnyatra jIvanIyAni dApayet||73||
 
siddhe~asmin kuDavaM kShaudraM shIte kShiptvA~atha modakAn| kArayenmaricAjAjIpalacUrNAvacUrNitAn||74||  
 
vAtAsRukpittarogeShu kShatakAsakShayeShu ca|
 
shuShyatAM kShINashukrANAM rakte corasi saMsthite||75|| kRushadurbalavRuddhAnAM puShTivarNabalArthinAm| yonidoShakRutasrAvahatAnAM cApi yoShitAm||76||
 
garbhArthinInAM garbhashca sravedyAsAM mriyeta vA|
 
dhanyA balyA hitAstAbhyaH shukrashoNitavardhanAH||77||
 
iti pa~jcamasarpirmodakAH|
 
  
Cow’s milk (one adhaka), ghee (two prasthas), sugar cane juice (two adhakas), juice of vidari (two prasthas) and soup of meat of tittira (two prasthas) should be cooked together. During the final stage of cooking, the paste of madhuka pushpa (one kudava), priyala (one kudava), tugakshiri (half kudava), kharjura (twenty fruits), bibhitaki (twenty fruits), pippali (one pala), sugar (thirty palas), madhuka (one karsa) and drugs belonging to jivaniya group (half pala each) should be added. The above mentioned drugs should be made to a paste by triturating with sugarcane juice before adding to the recipe. After the recipe is fully cooked and cooled, honey (two kudavas) should be added and from it, modaka (large size pills) should be prepared.  Over these modaks, one pala of the powder of maricha and ajaji should be sprinkled. These modakas cure vatasruk, diseases caused by pitta, kshata-kshina, kasa and kshaya. These are useful for persons suffering from emaciation, who have reduced semen, whose blood is blocked in the chest, who are thin, weak and old, and also for those desirous of having nourishment, complexion and strength. These modakas are also helpful for ladies suffering from exudations through the vitiated genital tract, who desire conception and who suffer from miscarriages and death of the foetus in the womb. By the use of these pills, ladies are endowed with auspiciousness strength and wholesomeness. These are promoters of shukra (sperm) and shonita (ovum). [70-77]
+
vAtAsRukpittarogeShu kShatakAsakShayeShu ca| <br />
 +
shuShyatAM kShINashukrANAM rakte corasi saMsthite||75|| <br />
  
==== Recipes ====
+
kRushadurbalavRuddhAnAM puShTivarNabalArthinAm| <br />
 +
yonidoShakRutasrAvahatAnAM cApi yoShitAm||76|| <br />
  
बस्तिदेशे विकुर्वाणे स्त्रीप्रसक्तस्य  मारुते|  
+
garbhArthinInAM garbhashca sravedyAsAM mriyeta vA| <br />
वातघ्नान् बृंहणान् वृष्यान् योगांस्तस्य प्रयोजयेत्||७८||
+
dhanyA balyA hitAstAbhyaH shukrashoNitavardhanAH||77|| <br />
शर्करापिप्पलीचूर्णैः सर्पिषा माक्षिकेण च|
 
संयुक्तं वा शृतं क्षीरं पिबेत् कासज्वरापहम्||७९||
 
फलाम्लं सर्पिषा भृष्टं विदारीक्षुरसे शृतम्|
 
स्त्रीषु क्षीणः पिबेद्यूषं जीवनं बृंहणं परम्||८०||
 
सक्तूनां वस्त्रपूतानां मन्थं क्षौद्रघृतान्वितम्|
 
यवान्नसात्म्यो दीप्ताग्निः क्षतक्षीणः पिबेन्नरः||८१||
 
जीवनीयोपसिद्धं वा जाङ्गलं घृतभर्जितम्|
 
रसं प्रयोजयेत् क्षीणे व्यञ्जनार्थं सशर्करम्||८२||
 
गोमहिष्यश्वनागाजैः क्षीरैर्मांसरसैस्तथा|
 
यवान्नं भोजयेद्यूषैः फलाम्लैर्घृतसंस्कृतैः||८३||
 
दीप्तेऽग्नौ विधिरेषः स्यान्मन्दे दीपनपाचनः|
 
यक्ष्मिणां विहितो ग्राही भिन्ने शकृति चेष्यते||८४||
 
bastidēśē vikurvāṇē strīprasaktasya mārutē|
 
vātaghnān br̥ṁhaṇān vr̥ṣyān yōgāṁstasya prayōjayēt||78||
 
śarkarāpippalīcūrṇaiḥ sarpiṣā mākṣikēṇa ca|
 
saṁyuktaṁ vā śr̥taṁ kṣīraṁ pibēt kāsajvarāpaham||79||
 
phalāmlaṁ sarpiṣā bhr̥ṣṭaṁ vidārīkṣurasē śr̥tam|
 
strīṣu kṣīṇaḥ pibēdyūṣaṁ jīvanaṁ br̥ṁhaṇaṁ param||80||
 
saktūnāṁ vastrapūtānāṁ manthaṁ kṣaudraghr̥tānvitam|
 
yavānnasātmyō [4] dīptāgniḥ kṣatakṣīṇaḥ pibēnnaraḥ||81||
 
jīvanīyōpasiddhaṁ vā jāṅgalaṁ ghr̥tabharjitam|
 
rasaṁ prayōjayēt kṣīṇē vyañjanārthaṁ saśarkaram||82||
 
gōmahiṣyaśvanāgājaiḥ kṣīrairmāṁsarasaistathā|
 
yavānnaṁ [5] bhōjayēdyūṣaiḥ phalāmlairghr̥tasaṁskr̥taiḥ||83||
 
dīptē'gnau vidhirēṣaḥ syānmandē dīpanapācanaḥ|
 
yakṣmiṇāṁ vihitō grāhī bhinnē śakr̥ti cēṣyatē||84||
 
  
Bastideshe vikurvANe strIprasaktasya mArute|
+
iti pa~jcamasarpirmodakAH| <br />
vAtaghnAn bRuMhaNAn vRuShyAn yogAMstasya prayojayet||78|| sharkarApippalIcUrNaiH sarpiShA mAkShikeNa ca|
+
</div></div>
saMyuktaM vA shRutaM kShIraM pibet kAsajvarApaham||79||
 
phalAmlaM sarpiShA bhRuShTaM vidArIkShurase shRutam|
 
strIShu kShINaH pibedyUShaM jIvanaM bRuMhaNaM param||80||
 
saktUnAM vastrapUtAnAM manthaM kShaudraghRutAnvitam|
 
yavAnnasAtmyo dIptAgniH kShatakShINaH pibennaraH||81||
 
jIvanIyopasiddhaM vA jA~ggalaM ghRutabharjitam|
 
rasaM prayojayet kShINe vya~jjanArthaM sasharkaram||82||
 
gomahiShyashvanAgAjaiH kShIrairmAMsarasaistathA|  
 
yavAnnaM bhojayedyUShaiH phalAmlairghRutasaMskRutaiH||83||
 
dIpte~agnau vidhireShaH syAnmande dIpanapAcanaH|
 
yakShmiNAM vihito grAhI bhinne shakRuti ceShyate||84||
 
  
In person induging in excess sexual intercourse with women, (vitiated) vayu afflicts pelvic region. To such patients, recipes which are alleviators of vayu, promoters of nourishment and aphrodisiacs are to be administered.
+
Cow’s milk (one ''adhaka''), ghee (two ''prasthas''), sugar cane juice (two ''adhakas''), juice of ''vidari'' (two ''prasthas'') and soup of meat of ''tittira'' (two ''prasthas'') should be cooked together. During the final stage of cooking, the paste of ''madhuka pushpa'' (one ''kudava''), ''priyala'' (one ''kudava''), ''tugakshiri'' (half ''kudava''), ''kharjura'' (twenty fruits), ''bibhitaki'' (twenty fruits), ''pippali'' (one ''pala''), sugar (thirty ''palas''), ''madhuka'' (one ''karsa'') and drugs belonging to ''jivaniya'' group (half ''pala'' each) should be added. The above mentioned drugs should be made to a paste by triturating with sugarcane juice before adding to the recipe. After the recipe is fully cooked and cooled, honey (two ''kudavas'') should be added and from it, ''modaka'' (large size pills) should be prepared. Over these ''modakas'', one pala of the powder of ''maricha'' and ''ajaji'' should be sprinkled. These ''modakas'' cure ''vatasruka'', diseases caused by ''pitta, kshatakshina, kasa'' and ''kshaya''. These are useful for persons suffering from emaciation, who have reduced semen, whose blood is blocked in the chest, who are thin, weak and old, and also for those desirous of having nourishment, complexion and strength. These ''modakas'' are also helpful for ladies suffering from exudations through the vitiated genital tract, who desire conception and who suffer from miscarriages and death of the fetus in the womb. By the use of these pills, ladies are endowed with auspiciousness strength and wholesomeness. These are promoters of ''shukra'' (sperm) and ''shonita'' (ovum). [70-77]
Sugar, powder of pippali ghee and/or honey should be added to milk and given to patient to drink for the cure of cough and fever. These ingredients can be added to milk after or before boiling, appropriately. [Whenever honey is to be used, it should be added to the milk after it is boiled and cooled.]
 
Phalamla should be fried in ghee and boiled with the juice of vidari and sugar-cane. The vegetable soup, thus prepared, is useful for a patient who is emaciated because of excessive indulgence in women. This is an excellent recipe for the promotion of longevity and nourishment.
 
Roasted barley flour should be sieved through a cloth, and mantha (thin gruel) should be prepared out of it. This gruel should be added with honey and ghee, and given to a patient suffering from kshata-kshina, provided that he is accoustomed to taking barley as one of the ingredients of the food and if he has strong power of digestion.
 
Altrenatively, meat of animal inhabiting arid zone (jangala) should be boiled with the drugs belonging to the jivaniya group. The meat soup, thus prepared, should be sizzled with ghee, added with sugar and used as a said dish (vyanjana) for a patient suffering from kshata-kshina.
 
Boiled barley should be given to a patient suffering from kshata-kshina along with the milk of she- buffalo, mare, she-elephant and she-goat or with the meat soup or with vegetable soup or with phalamla sizzled with ghee.
 
The above mentioned recipes should be given to a patient having strong power of digestion. If the power of digestion is suppressed, then the patient should be given recipes which are stimulants of digestion and carminative. If there is diarrhea in a patient suffering from kshata- kshina, then the bowel – binding recipes prescribed for the treatment of rajayakshma (chapter-8) should be used. [78-84]
 
  
==== Saindhavadi churna ====
+
=== Recipes ===
 +
<div class="mw-collapsible mw-collapsed">
  
पलिकं सैन्धवं शुण्ठी द्वे च सौवर्चलात् पले| कुडवांशानि वृक्षाम्लं दाडिमं पत्रमर्जकात्||८५||  
+
बस्तिदेशे विकुर्वाणे स्त्रीप्रसक्तस्य  मारुते| <br />
एकैकं मरिचाजाज्योर्धान्यकाद्द्वे चतुर्थिके| शर्करायाः पलान्यत्र दश द्वे च प्रदापयेत्||८६||
+
वातघ्नान् बृंहणान् वृष्यान् योगांस्तस्य प्रयोजयेत्||७८|| <br />
कृत्वा चूर्णमतो मात्रामन्नपाने प्रयोजयेत्| रोचनं दीपनं बल्यं पार्श्वार्तिश्वासकासनुत्||८७||  
 
इति सैन्धवादिचूर्णम्|
 
  
palikaṁ saindhavaṁ śuṇṭhī dvē ca sauvarcalāt palē|  
+
शर्करापिप्पलीचूर्णैः सर्पिषा माक्षिकेण च| <br />
kuḍavāṁśāni vr̥kṣāmlaṁ dāḍimaṁ patramarjakāt||85||  
+
संयुक्तं वा शृतं क्षीरं पिबेत् कासज्वरापहम्||७९|| <br />
ēkaikaṁ maricājājyōrdhānyakāddvē caturthikē|
 
śarkarāyāḥ palānyatra daśa dvē ca pradāpayēt||86||
 
kr̥tvā cūrṇamatō mātrāmannapānē prayōjayēt|
 
rōcanaṁ dīpanaṁ balyaṁ pārśvārtiśvāsakāsanut||87||
 
iti saindhavādicūrṇam
 
  
palikaM saindhavaM shuNThI dve ca sauvarcalAt pale|  
+
फलाम्लं सर्पिषा भृष्टं विदारीक्षुरसे शृतम्| <br />
kuDavAMshAni vRukShAmlaM dADimaM patramarjakAt||85||  
+
स्त्रीषु क्षीणः पिबेद्यूषं जीवनं बृंहणं परम्||८०|| <br />
ekaikaM maricAjAjyordhAnyakAddve caturthike|
 
sharkarAyAH palAnyatra dasha dve ca pradApayet||86||
 
kRutvA cUrNamato mAtrAmannapAne prayojayet|
 
rocanaM dIpanaM balyaM pArshvArtishvAsakAsanut||87|| iti saindhavAdicUrNam|
 
  
Saindhava (one pala), shunthi (one pala), sauvarchala (two palas), vrukshamla (one kudava), dadima (one kudava), leaf of arjaka (one kudava), maricha (one pala), ajaji (one pala), dhanyaka (two palas) and sugar (twelve palas) should be made in to powder and mixed together. In appropriate quantity, this powder should be added to food and drinks. It is appetizer, stimulant of digestion and promoter of strength. It cures parshvashula (pain in the sides of the chest), shvasa (respiratory disorders including asthma) and kasa (cough).  [85-87]
+
सक्तूनां वस्त्रपूतानां मन्थं क्षौद्रघृतान्वितम्| <br />
 +
यवान्नसात्म्यो दीप्ताग्निः क्षतक्षीणः पिबेन्नरः||८१|| <br />
  
==== Shadava recipe ====
+
जीवनीयोपसिद्धं वा जाङ्गलं घृतभर्जितम्| <br />
 +
रसं प्रयोजयेत् क्षीणे व्यञ्जनार्थं सशर्करम्||८२|| <br />
  
एका षोडशिका धान्याद्द्वे द्वेऽजाज्यजमोदयोः|  
+
गोमहिष्यश्वनागाजैः क्षीरैर्मांसरसैस्तथा| <br />
ताभ्यां दाडिमवृक्षाम्लं द्विर्द्विः सौवर्चलात्पलम्||८८||
+
यवान्नं भोजयेद्यूषैः फलाम्लैर्घृतसंस्कृतैः||८३|| <br />
शुण्ठ्याः कर्षं दधित्थस्य मध्यात् पञ्च पलानि च|
 
तच्चूर्णं षोडशपले शर्कराया विमिश्रयेत्||८९||
 
षाडवोऽयं प्रदेयः स्यादन्नपानेषु पूर्ववत्|
 
मन्दानले शकृद्भेदे यक्ष्मिणामग्निवर्धनः||९०|| इति षाडवः|
 
ēkā ṣōḍaśikā dhānyāddvē dvē'jājyajamōdayōḥ|
 
tābhyāṁ dāḍimavr̥kṣāmlaṁ dvirdviḥ sauvarcalātpalam||88||
 
śuṇṭhyāḥ karṣaṁ dadhitthasya madhyāt pañca palāni ca|
 
taccūrṇaṁ ṣōḍaśapalē śarkarāyā vimiśrayēt||89||
 
ṣāḍavō'yaṁ pradēyaḥ syādannapānēṣu pūrvavat|
 
mandānalē śakr̥dbhēdē yakṣmiṇāmagnivardhanaḥ||90||
 
iti ṣāḍavaḥ
 
  
ekA ShoDashikA dhAnyAddve dve~ajAjyajamodayoH|
+
दीप्तेऽग्नौ विधिरेषः स्यान्मन्दे दीपनपाचनः| <br />
tAbhyAM dADimavRukShAmlaM dvirdviH sauvarcalAtpalam||88||  
+
यक्ष्मिणां विहितो ग्राही भिन्ने शकृति चेष्यते||८४|| <br />
shuNThyAH karShaM dadhitthasya madhyAt pa~jca palAni ca|
+
<div class="mw-collapsible-content">
taccUrNaM ShoDashapale sharkarAyA vimishrayet||89||
 
ShADavo~ayaM pradeyaH syAdannapAneShu pUrvavat|
 
mandAnale shakRudbhede yakShmiNAmagnivardhanaH||90||
 
iti ShADavaH|
 
  
Powders of dhanyaka (one pala), ajaji (two palas), ajamoda (two palas), dadima (four palas), vrukshamla (four palas), sauvarchala (one pala), shunthi (one karsa), pulp of kapittha (five palas) and sugar (sixteen palas) should be mixed together. Like the other recipe, the present shadava [delicious recipe having sweet and sour tastes] should be administered along with food and drinks for the treatment of mandanala (suppression of the power of digestion) and diarrhea. It promotes the digestive power of patients suffering from rajayakshma. [88-90]
+
bastidēśē vikurvāṇē strīprasaktasya mārutē| <br />
 +
vātaghnān br̥ṁhaṇān vr̥ṣyān yōgāṁstasya prayōjayēt||78|| <br />
  
==== Nagabala kalpa ====
+
śarkarāpippalīcūrṇaiḥ sarpiṣā mākṣikēṇa ca| <br />
 +
saṁyuktaṁ vā śr̥taṁ kṣīraṁ pibēt kāsajvarāpaham||79|| <br />
  
पिबेन्नागबलामूलमर्धकर्षविवर्धितम्[ |  
+
phalāmlaṁ sarpiṣā bhr̥ṣṭaṁ vidārīkṣurasē śr̥tam| <br />
पलं क्षीरयुतं मासं क्षीरवृत्तिरनन्नभुक्||९१||
+
strīṣu kṣīṇaḥ pibēdyūṣaṁ jīvanaṁ br̥ṁhaṇaṁ param||80|| <br />
एष प्रयोगः पुष्ट्यायुर्बलारोग्यकरः परः|
 
मण्डूकपर्ण्याः कल्पोऽयं शुण्ठीमधुकयोस्तथा||९२||
 
pibēnnāgabalāmūlamardhakarṣavivardhitam [6] |
 
palaṁ kṣīrayutaṁ māsaṁ kṣīravr̥ttiranannabhuk||91||
 
ēṣa prayōgaḥ puṣṭyāyurbalārōgyakaraḥ paraḥ|
 
maṇḍūkaparṇyāḥ kalpō'yaṁ śuṇṭhīmadhukayōstathā||92||
 
  
pibennAgabalAmUlamardhakarShavivardhitam|  
+
saktūnāṁ vastrapūtānāṁ manthaṁ kṣaudraghr̥tānvitam| <br />
palaM kShIrayutaM mAsaM kShIravRuttiranannabhuk||91||
+
yavānnasātmyō [4] dīptāgniḥ kṣatakṣīṇaḥ pibēnnaraḥ||81|| <br />
eSha prayogaH puShTyAyurbalArogyakaraH paraH|
 
maNDUkaparNyAH kalpo~ayaM shuNThImadhukayostathA||92||
 
  
Half karsha of the root (bark) of nagabala should be boiled with milk and given to the patient on the first day. Thereafter, the powder of nagabala root (bark) should be increased by half karsha every day, and given by boiling with milk. On eighth day, the quantity of nagabala- root will be one pala. Thereafter the patient should continue to take this drug in the dose of one pala for one month. While taking this drug boiled with milk, the patient should refrain from taking any cereals. Whenever he feels hungry, he should take only milk. The recipe is excellent for the promotion of nourishment, longevity, strength and immunity to diseases.
+
jīvanīyōpasiddhaṁ vā jāṅgalaṁ ghr̥tabharjitam| <br />
In the above mentioned manner, mandukaparni, sunthi and madhuka should be administered for therapeutic effects described above.  [91-92]
+
rasaṁ prayōjayēt kṣīṇē vyañjanārthaṁ saśarkaram||82|| <br />
  
==== Diet and Drinks ====
+
gōmahiṣyaśvanāgājaiḥ kṣīrairmāṁsarasaistathā| <br />
 +
yavānnaṁ [5] bhōjayēdyūṣaiḥ phalāmlairghr̥tasaṁskr̥taiḥ||83|| <br />
  
यद्यत् सन्तर्पणं शीतमविदाहि हितं लघु|  
+
dīptē'gnau vidhirēṣaḥ syānmandē dīpanapācanaḥ| <br />
अन्नपानं निषेव्यं तत्क्षतक्षीणैः सुखार्थिभिः||९३||
+
yakṣmiṇāṁ vihitō grāhī bhinnē śakr̥ti cēṣyatē||84||<br />
यच्चोक्तं यक्ष्मिणां पथ्यं कासिनां रक्तपित्तिनाम्|
 
तच्च कुर्यादवेक्ष्याग्निं व्याधिं सात्म्यं बलं तथा||९४||
 
yadyat santarpaṇaṁ śītamavidāhi hitaṁ laghu|
 
annapānaṁ niṣēvyaṁ tatkṣatakṣīṇaiḥ sukhārthibhiḥ||93||
 
yaccōktaṁ yakṣmiṇāṁ pathyaṁ kāsināṁ raktapittinām|
 
tacca kuryādavēkṣyāgniṁ vyādhiṁ sātmyaṁ balaṁ tathā||94||
 
  
Yadyat santarpaNaM shItamavidAhi hitaM laghu|  
+
Bastideshe vikurvANe strIprasaktasya mArute| <br />
annapAnaM niShevyaM tatkShatakShINaiH sukhArthibhiH||93||
+
vAtaghnAn bRuMhaNAn vRuShyAn yogAMstasya prayojayet||78|| <br />
yaccoktaM yakShmiNAM pathyaM kAsinAM raktapittinAm|
 
tacca kuryAdavekShyAgniM vyAdhiM sAtmyaM balaM tathA||94||
 
  
Food and drinks which are nourishing, cooling, avidahi (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from kshata- kshina and who is desirous of regaining health. With due regard to the agni (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for rajayakshma, kasa and raktapitta.[93-94]
+
sharkarApippalIcUrNaiH sarpiShA mAkShikeNa ca| <br />
 +
saMyuktaM vA shRutaM kShIraM pibet kAsajvarApaham||79|| <br />
  
==== Need for prompt attention ====
+
phalAmlaM sarpiShA bhRuShTaM vidArIkShurase shRutam| <br />
 +
strIShu kShINaH pibedyUShaM jIvanaM bRuMhaNaM param||80|| <br />
  
उपेक्षिते भवेत्तस्मिन्ननुबन्धो हि यक्ष्मणः|  
+
saktUnAM vastrapUtAnAM manthaM kShaudraghRutAnvitam| <br />
प्रागेवागमनात्तस्य तस्मात्तं त्वरया जयेत्||९५||
+
yavAnnasAtmyo dIptAgniH kShatakShINaH pibennaraH||81|| <br />
upēkṣitē bhavēttasminnanubandhō hi yakṣmaṇaḥ|
 
prāgēvāgamanāttasya tasmāttaṁ tvarayā jayēt||95||
 
  
upekShite bhavettasminnanubandho hi yakShmaNaH|  
+
jIvanIyopasiddhaM vA jA~ggalaM ghRutabharjitam| <br />
prAgevAgamanAttasya tasmAttaM tvarayA jayet||95||
+
rasaM prayojayet kShINe vya~jjanArthaM sasharkaram||82|| <br />
If the patient suffering from kshata- kshina is not given appropriate treatment on time, then this may lead to rajayakshma. Therefore well before the appearance of  rajayakshma, the kshata- khsina should be treated, subdued (cured). [95]
 
  
==== Summary ====
+
gomahiShyashvanAgAjaiH kShIrairmAMsarasaistathA| <br />
 +
yavAnnaM bhojayedyUShaiH phalAmlairghRutasaMskRutaiH||83|| <br />
  
तत्र श्लोकौ-
+
dIpte~agnau vidhireShaH syAnmande dIpanapAcanaH| <br />
क्षतक्षयसमुत्थानं सामान्यपृथगाकृतिम्|  
+
yakShmiNAM vihito grAhI bhinne shakRuti ceShyate||84||<br />
असाध्ययाप्यसाध्यत्वं साध्यानां सिद्धिमेव च||९६||
+
</div></div>
उक्तवाञ्ज्येष्ठशिष्याय क्षतक्षीणचिकित्सिते|  
 
तत्त्वार्थविद्वीतरजस्तमोदोषः[१] पुनर्वसुः||९७||
 
  
tatra ślōkau-
+
In person induging in excess sexual intercourse with women, (vitiated) ''[[vata]]'' afflicts pelvic region. To such patients, recipes which are alleviators of ''[[vata]],'' promoters of nourishment and aphrodisiacs are to be administered.
kṣatakṣayasamutthānaṁ sāmānyapr̥thagākr̥tim|
 
asādhyayāpyasādhyatvaṁ sādhyānāṁ siddhimēva ca||96||
 
uktavāñjyēṣṭhaśiṣyāya kṣatakṣīṇacikitsitē|
 
tattvārthavidvītarajastamōdōṣaḥ [7] punarvasuḥ||97||
 
  
tatra shlokau-
+
Sugar, powder of ''pippali'' ghee and/or honey should be added to milk and given to patient to drink for the cure of cough and fever. These ingredients can be added to milk after or before boiling, appropriately. (Whenever honey is to be used, it should be added to the milk after it is boiled and cooled.)
kShatakShayasamutthAnaM sAmAnyapRuthagAkRutim|
 
asAdhyayApyasAdhyatvaM sAdhyAnAM siddhimeva ca||96||
 
uktavA~jjyeShThashiShyAya kShatakShINacikitsite|
 
tattvArthavidvItarajastamodoShaH punarvasuH||97||
 
  
To sum up:
+
''Phalamla'' should be fried in ghee and boiled with the juice of ''vidari'' and sugar-cane. The vegetable soup, thus prepared, is useful for a patient who is emaciated because of excessive indulgence in women. This is an excellent recipe for the promotion of longevity and nourishment.
In this chapter, on the treatment of kshata-kshina, Lord Punarvasu who is conversant with truth and who is free from rajas (one of the three attributer representing fickle mindedness including passion) and tamas (one of the three attributes representing slackness including ignorance) imparted instincts to the senior disciple on the following points:
+
 
i) Etiology of kshata-kshina;
+
Roasted barley flour should be sieved through a cloth, and ''mantha'' (thin gruel) should be prepared out of it. This gruel should be added with honey and ghee, and given to a patient suffering from ''kshatakshina'', provided that he is accustomed to taking barley as one of the ingredients of the food and if he has strong power of digestion.
ii) Signs and symptoms of kshata-kshina in general and of each variety;
+
 
iii) Incurability, palliability and curability of kshata-kshina; and
+
Alternatively, meat of animal inhabiting arid zone (''jangala'') should be boiled with the drugs belonging to the ''jivaniya'' group. The meat soup, thus prepared, should be sizzled with ghee, added with sugar and used as a said dish (''vyanjana'') for a patient suffering from ''kshatakshina''.
iv) Successful treatment of curable variety of kshata-kshina.   [96-97]
+
 
 +
Boiled barley should be given to a patient suffering from ''kshatakshina'' along with the milk of buffalo, mare, elephant and goat or with the meat soup or with vegetable soup or with ''phalamla'' sizzled with ghee.
 +
 
 +
The above mentioned recipes should be given to a patient having strong power of digestion. If the power of digestion is suppressed, then the patient should be given recipes which are stimulants of digestion and carminative. If there is diarrhea in a patient suffering from ''kshatakshina'', then the bowel – binding recipes prescribed for the treatment of ''rajayakshma'' (chapter-8) should be used. [78-84]
 +
 
 +
=== ''Saindhavadi churna'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
पलिकं सैन्धवं शुण्ठी द्वे च सौवर्चलात् पले| <br />
 +
कुडवांशानि वृक्षाम्लं दाडिमं पत्रमर्जकात्||८५|| <br />
 +
 
 +
एकैकं मरिचाजाज्योर्धान्यकाद्द्वे चतुर्थिके| <br />
 +
शर्करायाः पलान्यत्र दश द्वे च प्रदापयेत्||८६||<br />
 +
 +
कृत्वा चूर्णमतो मात्रामन्नपाने प्रयोजयेत्| <br />
 +
रोचनं दीपनं बल्यं पार्श्वार्तिश्वासकासनुत्||८७|| <br />
 +
 
 +
इति सैन्धवादिचूर्णम्| <br />
 +
<div class="mw-collapsible-content">
 +
 
 +
palikaṁ saindhavaṁ śuṇṭhī dvē ca sauvarcalāt palē|<br />
 +
kuḍavāṁśāni vr̥kṣāmlaṁ dāḍimaṁ patramarjakāt||85|| <br />
 +
 
 +
ēkaikaṁ maricājājyōrdhānyakāddvē caturthikē| <br />
 +
śarkarāyāḥ palānyatra daśa dvē ca pradāpayēt||86|| <br />
 +
 
 +
kr̥tvā cūrṇamatō mātrāmannapānē prayōjayēt| <br />
 +
rōcanaṁ dīpanaṁ balyaṁ pārśvārtiśvāsakāsanut||87|| <br />
 +
 
 +
iti saindhavādicūrṇam <br />
 +
 
 +
palikaM saindhavaM shuNThI dve ca sauvarcalAt pale| <br />
 +
kuDavAMshAni vRukShAmlaM dADimaM patramarjakAt||85|| <br />
 +
 
 +
ekaikaM maricAjAjyordhAnyakAddve caturthike| <br />
 +
sharkarAyAH palAnyatra dasha dve ca pradApayet||86||<br />
 +
 
 +
kRutvA cUrNamato mAtrAmannapAne prayojayet| <br />
 +
rocanaM dIpanaM balyaM pArshvArtishvAsakAsanut||87|| <br />
 +
 
 +
iti saindhavAdicUrNam| <br />
 +
</div></div>
 +
 
 +
''Saindhava'' (one ''pala''), ''shunthi'' (one ''pala''), ''sauvarchala'' (two ''palas''), ''vrikshamla'' (one ''kudava''), ''dadima'' (one ''kudava''), leaf of ''arjaka'' (one ''kudava''), ''maricha'' (one ''pala''), ''ajaji'' (one ''pala''), ''dhanyaka'' (two ''palas'') and sugar (twelve ''palas'') should be made in to powder and mixed together. In appropriate quantity, this powder should be added to food and drinks. It is appetizer, stimulant of digestion and promoter of strength. It cures ''parshvashula'' (pain in the sides of the chest), ''shvasa'' (respiratory disorders including asthma) and ''kasa'' (cough).  [85-87]
 +
 
 +
=== ''Shadava'' recipe ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
एका षोडशिका धान्याद्द्वे द्वेऽजाज्यजमोदयोः| <br />
 +
ताभ्यां दाडिमवृक्षाम्लं द्विर्द्विः सौवर्चलात्पलम्||८८|| <br />
 +
 
 +
शुण्ठ्याः कर्षं दधित्थस्य मध्यात् पञ्च पलानि च| <br />
 +
तच्चूर्णं षोडशपले शर्कराया विमिश्रयेत्||८९|| <br />
 +
 
 +
षाडवोऽयं प्रदेयः स्यादन्नपानेषु पूर्ववत्| <br />
 +
मन्दानले शकृद्भेदे यक्ष्मिणामग्निवर्धनः||९०|| <br />
 +
 
 +
इति षाडवः| <br />
 +
<div class="mw-collapsible-content">
 +
 
 +
ēkā ṣōḍaśikā dhānyāddvē dvē'jājyajamōdayōḥ| <br />
 +
tābhyāṁ dāḍimavr̥kṣāmlaṁ dvirdviḥ sauvarcalātpalam||88|| <br />
 +
 
 +
śuṇṭhyāḥ karṣaṁ dadhitthasya madhyāt pañca palāni ca| <br />
 +
taccūrṇaṁ ṣōḍaśapalē śarkarāyā vimiśrayēt||89|| <br />
 +
 
 +
ṣāḍavō'yaṁ pradēyaḥ syādannapānēṣu pūrvavat| <br />
 +
mandānalē śakr̥dbhēdē yakṣmiṇāmagnivardhanaḥ||90|| <br />
 +
 
 +
iti ṣāḍavaḥ <br />
 +
 
 +
ekA ShoDashikA dhAnyAddve dve~ajAjyajamodayoH|<br />
 +
tAbhyAM dADimavRukShAmlaM dvirdviH sauvarcalAtpalam||88|| <br />
 +
 
 +
shuNThyAH karShaM dadhitthasya madhyAt pa~jca palAni ca|<br />
 +
taccUrNaM ShoDashapale sharkarAyA vimishrayet||89|| <br />
 +
 
 +
ShADavo~ayaM pradeyaH syAdannapAneShu pUrvavat| <br />
 +
mandAnale shakRudbhede yakShmiNAmagnivardhanaH||90|| <br />
 +
 
 +
iti ShADavaH| <br />
 +
</div></div>
 +
 
 +
Powders of ''dhanyaka'' (one ''pala''), ''ajaji'' (two ''palas''), ''ajamoda'' (two ''palas''), ''dadima'' (four ''palas''), ''vrikshamla'' (four ''palas''), ''sauvarchala'' (one ''pala''), ''shunthi'' (one ''karsa''), pulp of ''kapittha'' (five ''palas'') and sugar (sixteen ''palas'') should be mixed together. Like the other recipe, the present ''shadava'' (delicious recipe having sweet and sour tastes) should be administered along with food and drinks for the treatment of ''mandanala'' (suppression of the power of digestion) and diarrhea. It promotes the digestive power of patients suffering from ''rajayakshma''. [88-90]
 +
 
 +
=== ''Nagabala kalpa'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
पिबेन्नागबलामूलमर्धकर्षविवर्धितम्[ | <br />
 +
पलं क्षीरयुतं मासं क्षीरवृत्तिरनन्नभुक्||९१|| <br />
 +
 
 +
एष प्रयोगः पुष्ट्यायुर्बलारोग्यकरः परः| <br />
 +
मण्डूकपर्ण्याः कल्पोऽयं शुण्ठीमधुकयोस्तथा||९२||<br />
 +
<div class="mw-collapsible-content">
 +
 
 +
pibēnnāgabalāmūlamardhakarṣavivardhitam [6] | <br />
 +
palaṁ kṣīrayutaṁ māsaṁ kṣīravr̥ttiranannabhuk||91|| <br />
 +
 
 +
ēṣa prayōgaḥ puṣṭyāyurbalārōgyakaraḥ paraḥ| <br />
 +
maṇḍūkaparṇyāḥ kalpō'yaṁ śuṇṭhīmadhukayōstathā||92||<br />
 +
 
 +
pibennAgabalAmUlamardhakarShavivardhitam| <br />
 +
palaM kShIrayutaM mAsaM kShIravRuttiranannabhuk||91|| <br />
 +
 
 +
eSha prayogaH puShTyAyurbalArogyakaraH paraH| <br />
 +
maNDUkaparNyAH kalpo~ayaM shuNThImadhukayostathA||92||<br />
 +
</div></div>
 +
 
 +
Half ''karsha'' of the root (bark) of ''nagabala'' should be boiled with milk and given to the patient on the first day. Thereafter, the powder of ''nagabala'' root (bark) should be increased by half ''karsha'' every day, and given by boiling with milk. On eighth day, the quantity of ''nagabala''- root will be one ''pala''. Thereafter the patient should continue to take this drug in the dose of one ''pala'' for one month. While taking this drug boiled with milk, the patient should refrain from taking any cereals. Whenever he feels hungry, he should take only milk. The recipe is excellent for the promotion of nourishment, longevity, strength and immunity to diseases.
 +
 
 +
In the above mentioned manner, ''mandukaparni, sunthi'' and ''madhuka'' should be administered for therapeutic effects described above.[91-92]
 +
 
 +
=== Diet and Drinks ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
यद्यत् सन्तर्पणं शीतमविदाहि हितं लघु| <br />
 +
अन्नपानं निषेव्यं तत्क्षतक्षीणैः सुखार्थिभिः||९३|| <br />
 +
 
 +
यच्चोक्तं यक्ष्मिणां पथ्यं कासिनां रक्तपित्तिनाम्| <br />
 +
तच्च कुर्यादवेक्ष्याग्निं व्याधिं सात्म्यं बलं तथा||९४||<br />
 +
<div class="mw-collapsible-content">
 +
 
 +
yadyat santarpaṇaṁ śītamavidāhi hitaṁ laghu| <br />
 +
annapānaṁ niṣēvyaṁ tatkṣatakṣīṇaiḥ sukhārthibhiḥ||93|| <br />
 +
 
 +
yaccōktaṁ yakṣmiṇāṁ pathyaṁ kāsināṁ raktapittinām| <br />
 +
tacca kuryādavēkṣyāgniṁ vyādhiṁ sātmyaṁ balaṁ tathā||94||<br />
 +
 
 +
Yadyat santarpaNaM shItamavidAhi hitaM laghu| <br />
 +
annapAnaM niShevyaM tatkShatakShINaiH sukhArthibhiH||93||<br />
 +
 +
yaccoktaM yakShmiNAM pathyaM kAsinAM raktapittinAm| <br />
 +
tacca kuryAdavekShyAgniM vyAdhiM sAtmyaM balaM tathA||94||<br />
 +
</div></div>
 +
 
 +
Food and drinks which are nourishing, cooling, ''avidahi'' (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from ''kshatakshina'' and who is desirous of regaining health. With due regard to the ''agni'' (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for ''rajayakshma, kasa'' and ''raktapitta''.[93-94]
 +
 
 +
=== Need for prompt attention ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
उपेक्षिते भवेत्तस्मिन्ननुबन्धो हि यक्ष्मणः| <br />
 +
प्रागेवागमनात्तस्य तस्मात्तं त्वरया जयेत्||९५||<br />
 +
<div class="mw-collapsible-content">
 +
 
 +
upēkṣitē bhavēttasminnanubandhō hi yakṣmaṇaḥ| <br />
 +
prāgēvāgamanāttasya tasmāttaṁ tvarayā jayēt||95||<br />
 +
 
 +
upekShite bhavettasminnanubandho hi yakShmaNaH| <br />
 +
prAgevAgamanAttasya tasmAttaM tvarayA jayet||95||<br />
 +
</div></div>
 +
 
 +
If the patient suffering from ''kshatakshina'' is not given appropriate treatment on time, then this may lead to ''rajayakshma''. Therefore well before the appearance of ''rajayakshma'', the ''kshatakhsina'' should be treated, subdued (cured). [95]
 +
 
 +
=== Summary ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 
 +
तत्र श्लोकौ- <br />
  
इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलपूरिते चिकित्सितस्थाने क्षतक्षीणचिकित्सितं नामैकादशोऽध्यायः||११||
+
क्षतक्षयसमुत्थानं सामान्यपृथगाकृतिम्| <br />
ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalapūritē cikitsitasthānē
+
असाध्ययाप्यसाध्यत्वं साध्यानां सिद्धिमेव च||९६||<br />
kṣatakṣīṇacikitsitaṁ nāmaikādaśō'dhyāyaḥ||11||
 
  
ityagniveshakRute tantre~aprApte dRuDhabalapUrite cikitsitasthAne kShatakShINacikitsitaM nAmaikAdasho~adhyAyaH||11||
+
उक्तवाञ्ज्येष्ठशिष्याय क्षतक्षीणचिकित्सिते| <br />
 +
तत्त्वार्थविद्वीतरजस्तमोदोषः[१] पुनर्वसुः||९७||<br />
 +
<div class="mw-collapsible-content">
  
 +
tatra ślōkau- <br />
  
Thus, ends the eleventh chapter dealing with the treatment of kshata-kshina; in the section on the therapeutics of Agnivesa’s work as redacted by Caraka and not being available, restored by Drdhabala.
+
kṣatakṣayasamutthānaṁ sāmānyapr̥thagākr̥tim| <br />
 +
asādhyayāpyasādhyatvaṁ sādhyānāṁ siddhimēva ca||96|| <br />
  
===Tattva Vimarsha ===
+
uktavāñjyēṣṭhaśiṣyāya kṣatakṣīṇacikitsitē| <br />
 +
tattvārthavidvītarajastamōdōṣaḥ [7] punarvasuḥ||97||<br />
  
• In Kshata ksheena, kshata (injury) is caused due to indulgence in various physical activities beyond one’s capacity. Ksheena is a consequence of that injury with improper dietary habit and excess sexual intercourse.
+
tatra shlokau- <br />
• The dhatu kshaya (depletion of tissues) is major pathological event in this disease. Hence bruhana(nourishment) and replenishment of depleted tissues is principle of management.
 
• The onset is acute without appearance of any premonitory symptom.
 
• If the manifestation of disease is mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. The disease is yapya (palliable), if the disease is chronic i.e. more than one year. If however, all the signs and symptoms of the disease are simultaneously manifested, then the condition is incurable.
 
• Milk, meat, ghee and honey processed with jivaniya herbs have significant role in treatment of kshata ksheena. Fresh blood of animals is also used in treatment of excess bleeding.
 
• Food and drinks which are nourishing, cooling, avidahi (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from kshata- kshina.
 
• With due regard to the agni (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for rajayakshma, kasa and raktapitta. 
 
• Kshata- kshina , if untreated, results in rajayakshma. Therefore, treatment at appropriate time is necessary to prevent rajayakshma.
 
  
=== Vidhi Vimarsha ===
+
kShatakShayasamutthAnaM sAmAnyapRuthagAkRutim| <br />
 +
asAdhyayApyasAdhyatvaM sAdhyAnAM siddhimeva ca||96||<br />
  
==== Derivation of term ====
+
uktavA~jjyeShThashiShyAya kShatakShINacikitsite| <br />
 +
tattvArthavidvItarajastamodoShaH punarvasuH||97||<br />
 +
</div></div>
  
Another reading of this term ‘kshata kshina’ is ‘kshina kshata’. This term implies that the injury to the chest (kshata) is caused by diminution of vital elements, like semen and ojas (kshina).
+
To sum up:
Some other scholar read ‘kshata kshina’ as ‘kshata kshaya’. According to them, description of this chapter refers to two diseases, viz. ‘kshata’ and ‘kshaya’. In this context, vide the description in the verse no.13, the cardinal sign of both ‘kshata’ and ‘kshina’ are described. This view is not tenable, because this disease is described in the singular form, while describing the premonitory signs and symptoms (vide verse 12) and prognostic signs and symptoms (vide verse 14).
 
From the above it appears that the ‘kshata kshina’ is a singular entity as a disease, and as a result of causative factors, its signs and symptoms are manifested in two different ways.
 
  
==== Nirghata ====
+
In this chapter, on the treatment of ''kshatakshina'', Lord Punarvasu who is conversant with truth and who is free from ''[[rajas]]'' (one of the three attributes representing fickle mindedness including passion) and ''[[[tamas]]'' (one of the three attributes representing slackness including ignorance) imparted instincts to the senior disciple on the following points:
 +
#Etiology of ''kshatakshina'';
 +
#Signs and symptoms of ''kshatakshina'' in general and of each variety;
 +
#Incurability, palliability and curability of ''kshatakshina''; and
 +
#Successful treatment of curable variety of ''kshatakshina''. [96-97]
 +
<div class="mw-collapsible mw-collapsed">
  
“Nirghata” is a type of weapon.  Alternattively, the term ‘nirghata’ implies throwing a substance with the impact of excessive strength.
+
इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलपूरिते चिकित्सितस्थाने क्षतक्षीणचिकित्सितं नामैकादशोऽध्यायः||११||
Difference between kshata kshina and rajayakshma:
+
<div class="mw-collapsible-content">
Though kshata kshina resembles with rajayakshma, the latter is caused by the simultaneous vitiation of all the three doshas, and it has a different etio-pathogenic processs (vide chikitsa 8:15). Signs and symptoms of these two diseases, namely ‘kshata kshina’ and ‘rajayakshma’ are different in presentation. Negligence in the treatment of kshata kshina leads to rajayakshma. 
 
Onset of diseaes: The tern ‘Avyakta’ literally means unmanifested. But in the present context it implies less manifested. This shows that the disease has acute onset/sudden onset without any incubation period. The term ‘vaisesika’, in the verse 13 implies ‘specially manifested’ or ‘excessively manifested’
 
The term kshina, meaning diminution of tissue elements, implies diminution of semen and ojas (vital essence).
 
According to some other scholars, the description in verse 13, pertains to the two groups of signs and symptoms, which are manifested in two different stages (type of this disease).
 
  
==== Etiological factors ====
+
ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalapūritē cikitsitasthānē
 +
kṣatakṣīṇacikitsitaṁ nāmaikādaśō'dhyāyaḥ||11||
  
All the mentioned etiological factors can be divided into two categories viz. (1) exogenous factors related to over-exertion/ strenuous malpractice of physical activity that causes trauma to the lung tissues, (2) endogenous factors related to malnutrition that causes depletion of body tissues. The etiological factors described for kshata are related to those that causes spontaneous lung injury and the clinical feature suggest that it is a condition of pneumothorax. Studies showed that strenuous athletic activites like vigorous swimming, heavy weight lifting, jolting, etc. can cause pneumothorax (PTX) and pneumomediastinum (PTM).
+
ityagniveshakRute tantre~aprApte dRuDhabalapUrite cikitsitasthAne kShatakShINacikitsitaM nAmaikAdasho~adhyAyaH||11||
 +
</div></div>
  
==== Differential diagnosis ====
+
Thus, ends the eleventh chapter (on the treatment of ''Kshatakshina'') of the [[Chikitsa Sthana]]; in the section on the therapeutics of Agnivesha’s work as redacted by Charak and not being available, restored by Dridhabala.
  
Clinical Features of Sahasajanya Rajayaksma Clinical Features of Kshata-Kshina Clinical Features of Kshataja Kasa
+
== Tattva Vimarsha (Fundamental Principles) ==
1. Chest pain
 
2. Cough
 
3. Hemoptysis, along with other 8 sympoms. 1. Chest pain
 
2. Cough
 
3. Hemoptysis
 
May accoompained with Atisara (Ca.Ci. 8/16) 1.Dry cough followed by hemoptysis,
 
2. Pricking, sharp, piercing, tearing, intense chest pain,
 
3. Fever (jvara), dyspnea (svasa), morbid thirst (trisna), and change in voice (vaisvarya) is also present.
 
  
Examing the etiological factors, pathogenesis and clinical features it is clear all the three disease have same etiopathogenesis as well as clinical manifestation. Now the question arise that if all these three disease are same then what is the reason for their separate description? To answer this question it is necessary to explore the similarity and distinction between these three diseases. The main difference between these three appears in their management as follows:
+
*In ''Kshatakshina, kshata'' (injury) is caused due to indulgence in various physical activities beyond one’s capacity. ''Kshina'' is a consequence of that injury with improper dietary habit and excess sexual intercourse.
 +
*The ''[[dhatu]] kshaya'' (depletion of tissues) is major pathological event in this disease. Hence ''[[brimhana]]''(nourishment) and replenishment of depleted tissues is principle of management.
 +
*The onset is acute without appearance of any premonitory symptom.
 +
*If the manifestation of disease is mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. The disease is ''yapya'' (palliable), if the disease is chronic i.e. more than one year. If however, all the signs and symptoms of the disease are simultaneously manifested, then the condition is incurable.
 +
*Milk, meat, ghee and honey processed with ''jivaniya'' herbs have significant role in treatment of ''kshatakshina''. Fresh blood of animals is also used in treatment of excess bleeding.
 +
*Food and drinks which are nourishing, cooling, ''avidahi'' (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from ''kshatakshina''.
 +
*With due regard to the ''agni'' (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for ''rajayakshma, kasa'' and ''raktapitta''. 
 +
*''Kshatakshina'' , if untreated, results in ''rajayakshma''. Therefore, treatment at appropriate time is necessary to prevent ''rajayakshma''.
  
Table 1: Difference in the treatment of Sahasajanya Rajayakshma and Kshata-Kshina
+
== Vidhi Vimarsha (Applied Inferences) ==
  
Treatment of Sahasajanya Rajayakshma Treatment of Kshata-Kshina Treatment of Kshataja Kasa
+
''Kshatakshina'' is a disease characterized by depletion of body tissues due to chest injury. In present era, the condition occurs due to over exertion, strenuous work  beyond one’s capacity, direct or indirect injury to the chest. The conditions like pneumothorax, pleural effusion and related respiratory conditions need to be addressed simultaneously by the surgical team to prevent progression of emaciation and complications of injury to vital lung tissues.  
1. Management of Sahasajanya Rajayaksma is not mentioned separately,
 
2. Management is given according to the symptoms,
 
3. For the management of Kasa and Parsvasula present in all types of Rajayaksma external as well internal treatment is given.
 
4. Mild vamana and virecana is indicated,
 
5. Use of different types of svedana like nadi, samkara, pariseka is indicated (Ca.Ci.8/71-76),
 
6. Raktamoksana is indicated in Parsvasula (Ca.Ci.8/82)
 
7. Use of external applications like pradeha, aalepa, pariseka, etc is given.
 
8. Use of Sandhaniya drugs like laksha, madhuyasti is not mentioned. 1. Atyayika cikitsa (emergency management),
 
2. Use of Sandhaniya, jeevaniya, brnhaniya drugs like laksha, madhuyasti, amalaki, vidarikanda, etc.
 
1. Atyayika cikitsa (emergency management),
 
2. Use of jeevaniya and brnhaniya drugs like ghrta, kseera, etc.
 
3. Use of Dhumapana when the traumatic injury heals.
 
4. Use of Sandhaniya drugs like laksha, madhuyasti is not mentioned.
 
5. Pancakarma is not indicated.
 
  
Kshaya is described as one among the four causes of rajayakshma and at some place it is used as synonym of rajayakshma like kshayaja kasa, kshayaja grahani etc.
+
=== Etiopathology ===
Sushruta describes 8 types of kshaya as–vyavaya (sexual intercourse), shoka(grief), sthavirya (old age), vyayam (exercise), adhva (excess walking), upvasa(fasting), vrana (traumatic injury) and urahkshata (chest injury) (Su. Ut. 41/21). Some scholar hold the view that kshaya and rajayaksma are two different diseases, kshaya is a condition of excessive depletion of dhatus whereas rajayakshma is an aoupsargika disease i.e. infectious state. According to them when infection occurs in an immunocompromised state then only it can be called rajayakshma. 
 
According to Ayurveda rajayakshma is a syndrome that has many associated diseases both as predromal disease as well as  complication and therefore vivid description of rajayakshma is available in the Ayurvedic texts. Cluster of eleven, six or three symptoms that may persist as an independent disease, is termed as rajayakshma.  Many synonyms are given for rajayakshma describing the disease from different angles as the two synonyms we described above and many others. Basically the vast diversity of the disease can’t be wrapped in a single term and therefore Acharya used various terminologies for full description of this multifactorial and multidimensional disease. Rajayakshma means an immunocompromised state that is more suspectible for developing secondary infections.
 
Examing the etiology and clinical feature of ksayaja kasa and rajayakshma make it clearer:
 
Table 2: Similarity between nidana (etiological factors) of ksayaja kasa and rajayakshma:
 
  
Nidana (etiological factors) of ksayaja kasa Nidana (etiological factors) of rajayakshma
+
The etiological factors can be divided into two categories viz. (1) Exogenous factors related to over-exertion/ strenuous physical activity that causes trauma to the lung tissues, excess weight lifting and excess sexual intercourse. Studies showed that strenuous athletic activities like vigorous swimming, heavy weight lifting, jolting, etc. can cause pneumothorax (PTX), pleural effusion and pneumomediastinum (PTM) etc.  (2) Endogenous factors related to malnutrition that cause depletion of body tissues and excess intake of food having dry properties (less intake of unctuous dietary substances like ghee, oil, fats. Lipids leading to dryness in body)
1. Visamasana (irregular, faulty dietary habit)
+
The etiological factors described for ''kshata'' are related to those that cause spontaneous lung injury.  
2.Vegavighata (suppression of natural urge)
 
3.  Ativyavaya (excessive sexual intercourse)
 
4. Excessive thinking of hatred things.
 
5.  --- 1.Visamasana (irregular, faulty dietary habit)
 
2.Vegavighata (suppression of natural urge)
 
3Ativyavaya (excessive sexual intercourse)
 
4.  Excessive grief, anxiety, envy, ambitions, fear, anger etc.,
 
5. Sahasa (excessive strenuous physical activity)
 
Table 3: Similarity between clinical features of ksayaja kasa and rajayakshmajanya kasa
 
  
Clinical features of ksayaja kasa Clinical features of rajayakshmajanya kasa
+
=== Pathogenesis ===
1. Foul smelling, greenish, mucopurulent sputum, hemoptysis
 
2.Jwara (fever),
 
3. Atisara (diarrhea),
 
4.Parsvaruka (chest pain),
 
5.Pinasa (rhinitis),
 
6. Aruchi (anorexia),
 
7. Svarabheda (hoarseness of voice),
 
8. Kasa (cough) (Ca.Ci.18/25-28) 1. Picchila (sticky), bahula (excessive), visram (foul smelling), harita (greenish in colour), svetapitakam (muco-purulent) (Ca.Ci. 8/51)
 
2.Jwara (fever),
 
3. Atisara (diarrhea),
 
4.Parsvaruka (chest pain),
 
5.Pinasa (rhinitis),
 
6. Aruci (anorexia),
 
7. Svarabheda (hoarseness of voice),
 
8. Kasa (cough)
 
  
From the above discussion it is very clear that ksayaja kasa refers to kasa in rajayakshma i.e. ksaya is used as a synonym of rajayakshma and it denotes a state where the disease causes so much debility and immunity is compromised to such extent that secondary infection becomes more severeWhile describing the management of ksayaja kasa, Acharya Caraka describes the treatment of discoloration of urine and dysuria as:
+
The disease has acute onset without any premonitory signs. This shows sudden appearance of clinical features due to traumatic etiologyAs disease progresses, it leads to depletion of body tissues causing emaciation.
 +
*''[[Dosha]]'' : ''[[Vata]]-[[pitta]]'' aggravation, ''[[kapha]]'' depletion
 +
*''[[Dhatu]]'': [[Rasa]], [[shukra]], [[mamsa]] and [[ojas]]
 +
*''Samprapti'' type: ''Atipravritti'' and ''dhatukshaya janya''
 +
*Clinical features and conditions resembling the disease
  
Charaka says that if the patient of ksayaja kasa suffers from discoloration of urine or dysuria then he should be given ghrit processed with the decoction of kadamba, vidarikanda and tala.
+
The patient suffers from fever, pain, mental depression, diarrhea, anorexia, indigestion, cough with putrid sputum grayish in color, foul smelling, and yellow and knotty, in large quantities, with blood.
This shows that discoloration of urine (hematuria) is associated with Ksaya or rajayakshma. Genitourinary tuberculosis is the most common cause of painless hematuria.With one-third of the world's population currently harboring latent mycobacterium tuberculosis infection, many modern day texts on nephrology do not discuss genitourinary TB as a serious cause of urological infections and advanced renal disease. Classic TB symptoms are rarely observed in these patients, compounding the difficulty of a diagnosis. Many times treatment of renal TB is delayed due to the vagueness of chronic, intermittent, and nonspecific urinary symptoms. Thus it is clear that the clinical features described for kshina are the features of renal tuberculosis that may appear abruptly (like sudden onset of hematuria in a patient of renal tuberculosis requiring prompt management).
+
*Subjective and objective parameters (scales with references)  
Now let us try to understand the meaning of second word- kshata and its significance as a disease.  Kshata means trauma or injury. Sahasajanya rajayakshma cause kshata in the urah(chest) similarly in kshataja kasa also there is urahkshata. Thus there are three places where urahkshata is encountered in Ayurvedic texts namely- sahasajanya rajayakshma, kshataja kasa and kshatakshina. Let us discuss the similarity between these three conditions to draw a conclusion.
+
*Clinical examination: Chest auscultation for added sounds, decreased air entry, Body mass index. Lung function tests including spirometry
Table 4: Similarity between the nidana (etiological factors) of sahasajanya rajayaksma, Kshata-kshina and kshataja kasa
+
*Pathological/radiological/ investigations:  Sputum test for presence of Acid fast bacilli, RBCs, Chest X ray for fracture of ribs, opacity in lungs, pneumonia patch, pneumothorax, plural effusion etc.  
 +
*Differential diagnosis:Pulmonary tuberculosis, Carcinoma of lungs, oesophageal varieces
 +
*Complications
 +
**Pulmonary tuberculosis  
 +
*Prognosis: Curable if newly developed, and mildly emaciated, palliable in chronic stage, incurable in advanced stage and severely emaciated with multiple system involvement 
  
Nidana of Sahasajanya Rajayaksma Nidana of  Kshata- Kshina Nidana of  Kshataja- Kasa
+
==== Management of disease ====
1. Battle,
 
2. Excessive reading,
 
3. Lifting heavy weight,
 
4.  Covering a long distance, walking on foot,
 
5. Excessive swimming,
 
6. Jumping,
 
7.  Falling from high altitude,
 
8. Excessive trauma.
 
1. Fighting with stronger person,
 
2. Reciting scriptures at the top of voice,
 
3. Lifting heavy weight,
 
4. Covering a long distance walking on foot,
 
5. Crossing a big river by swimming,
 
6. Sudden long and high jump,
 
7. Falling while walking over uneven place or from high altitude,
 
8. Being excessively injured by other violent and curel acts. 1.Fighting with stronger person,
 
2. Excessive battling
 
3.Lifting heavy weight
 
4.Excessive walking,  covering a long distance walking on foot,
 
5. Fighting with strong animal or try to restrain them,
 
6. Excessive sexual indulgence.
 
  
Table 5: Similarity between the samprapti (pathogenesis) of sahasajanya rajayaksma, kshata-kshina and kshataja kasa:
+
*Experience based clinical practices:  
 +
**Applied principles in management of disease conditions
 +
**Styptic agents to stop bleeding
 +
**Binding agents for union of bones and injured tissues
 +
**Nourishing regimen for depletion of body tissues 
 +
**Rejuvenation therapies
  
Samprapti (Pathogenesis) of Sahasajanya Rajayaksma Samprapti (Pathogenesis) of Kshata-Kshina
+
==== ''[[Shodhana]] chikitsa'' (body purification treatments) and procedures ====
Samprapti (Pathogenesis) of Kshataja Kasa
 
  
Indulgence in strenuous physical activity causes injury to the chest.
+
Purification treatments are not indicated in this disease.  
  
| Kshata kshina gets manifested as a result of the injury to the chest due to the excessive strenuous physical activity. Indulgence in strenuous physical activity causes injury to the chest.
+
Therapeutic massage with ''kshirabala'' oil, ''Bala-ashwagandha lakshadi'' oil is done.
  
From the above table it is obvious that Kasa appears in Kshayaja rajayakshma is elaborated under the heading of Kshataja Kasa. As the Sahasajanya Rajayaskshma is a very serious and emergency condition and managemnt of which is lacking in the chapter of Rajayakshma. its emergency management is described in a separate chapter under the heading of Kshata Kshina. Use of Sandhaniya drugs like laksha (mainly indicated for the healing of fracture of bone) and madhuyashti clearly indicates that in Kshata Kshina there is external trauma (ribs fracture leading to pneumothorax) that should be managed with quick remedies. As Acharya has given only conservative management for the Kshata- Kshina it excludes the possibility of surgical interventions in Kshata-Kshina (tube drainage with or without medical pleurodesis, vacuum-assisted thoracostomy (VATS) with pleurodesis and/or closure of leaks and bullectomy, and open surgical procedures such as thoracotomy for pleurectomy or pleurodesis) at that time. In the chapter of Rajayakshma, the symptomatic treatment is described and therefore it is necessary to elaborate the management of acute dreaded complications like pneumothorax and hematuria in separate chapter.
+
Chest physiotherapy for improving lung functions is advised.  
  
==== Kshata –Kshina as complication of Rajayakshma ====
+
==== ''Shamana chikitsa'' (pacification treatments) with list of formulations and medicines ====
यच्चोपदेक्ष्यते पथ्यं क्षतक्षीणचिकित्सिते| यक्ष्मिणस्तत् प्रयोक्तव्यं बलमांसाभिवृद्धये| (Ca.Ci.8/183)
 
Here, Acharya Caraka says that the regimens as described in next chapter of Kshata – Kshina should also use for the management of Rajayaksma for enhancing strength and muscle mass.
 
यच्चोक्तं यक्ष्मिणां पथ्यं कासिनां रक्तपित्तिनाम्| तच्च कुर्यादवेक्ष्याग्निं व्याधिं सात्म्यं बलं तथा| (Ca.Ci. 11/94)
 
In the chapter Kshata- kshina that is restore by Acharya Dalhana, it is mentioned that with due regard to the agni (power of digestion), nature of disease, wholesomeness diet and regimens prescribed for rajayakshma, kasa and raktapitta should be used for the management of Kshata- kshina.       
 
Thus it is clear that the management of kshata- kshina should be adjuvant with the management of Rajayakshma for proper treatment or it can be said that Kshata kshina management is applicable in emergency condition with acute manifestations like hemoptysis and hematuria whereas management of Rajayaksma is applicable for chronic stage of disease.
 
Basically the controversy in accepting Kshata-Kshina as advanced state or complication of Rajayaksma appears because of misinterpretation of following sloka:
 
उपेक्षिते भवेत्तस्मिन्ननुबन्धो हि यक्ष्मणः| प्रागेवागमनात्तस्य तस्मात्तं त्वरया जयेत्| (Ca. Ci. 11/95)
 
If the patient suffering from kshata- kshina is not given appropriate treatment on time, then this may lead to rajayakshma. Therefore well before the arrival of this ailment (attack of rajayakshma), the kshata- kshina should be treated, subdued (cured).   
 
In the above discussion, we see that there is conflict between the statements given in chapter originally written by Acharya Caraka (Ca.Ci. 8/183) and that restored by Acharya Dalhana (Ca. Ci.11/94). In chapter 8th, Acharya says that the treatment given in next chapter is also applicable for Rajayaksma whereas in chapter 11th, Acharya says that the regimens given in the chapter of Rajayaksma should be given to the patient of Kshata- Kshina. Thus it is clear that the management of both the diseases is interrelated but the controversy appears in accepting the sequence of protocol to be followed for the management of diseases. Therefore it can be concluded that Kshata- Kshina is the specific state of Rajayaksma that appears acutely and required prompt treatment. Accepting Kshata- Kshina as a singular disease refers to a cascade of autoimmune reactions that results in a complex syndrome known as Pulmonary- Renal Syndrome. Indulgence in the specific etiological factors provokes the activity of specific autoantibodies pervading the specific loci and destructing the body tissues that ultimately results in dreaded consequences.
 
  
==== Management of kshata-kshina ====
+
{| class="wikitable"
 +
|-
 +
! scope="col"| S.No.
 +
! scope="col"| Name of Medicine
 +
! scope="col"| Dose
 +
! scope="col"| Time of Administration
 +
! scope="col"| Mode of Administration (''Anupana'')
 +
|-
 +
| 1
 +
| ''Laksha Mixture''
 +
| 10-20 grams
 +
| Frequently
 +
| ''Vasavaleha''
 +
|-
 +
| 2
 +
| ''Amritaprasha ghee''
 +
| 10-20 grams
 +
| After meals
 +
| Milk
 +
|-
 +
| 3
 +
| ''Suvarna malini vasanta''
 +
| 120-240 mg
 +
| In between two meals
 +
| Milk
 +
|-
 +
| 4
 +
| ''Lakshmi Vilasa''
 +
| 60-120 mg
 +
| In between two meals
 +
| Milk
 +
|-
 +
| 5
 +
| ''Vanga mishrana''
 +
| 250-500 mg
 +
| In between two meals
 +
| Milk
 +
|}
  
Herbs used for the management of Kshata-kshina can be classified in two category viz. (1) having antioxidant properties and (2) having hemostatic and bone healing properties.
+
*''Pathya'' or recommended diet: Light to digest food like ''shali'' rice, wheat, green gram, pomegranate, dry grapes, mango, ''amalaka'', goat milk and ghee prepared of it, medicated milk, meat juice of goat
Different views on formulations:  
+
*''Pathya'' or recommended activity: Total bed rest
In the verse 16, in the place of ‘savatsaka’ there is a variant reading ‘dvivatsaka’. If this variant reading is accepted, then two parts of vatsaka are to be added in this recipe, other being one part each. According to some scholars, both the male and female varities of vatsaka, described in Kalpa 5:5, are to be used in this recipe.
+
*''Apathya'' or contraindicated diet: Excess hot, pungent, salty food causing burning sensation, heavy to digest food.
In the above recipe, the quantity of honey to be added is not mentioned. It should be taken in sufficient quantity and added to the powder for making paste, from out of which pills could be conveniently prepared.
+
*''Apathya'' or contraindicated activity: Over exertion, strenuous exercise, weight lifting etc.
When there are five or more liquids mentioned to be added in a recipe of medicated ghee, then each of them, according to the general rule, should be taken in the quantity equal to that of ghee. However the quantity of each of these liquids is specially described here to strengthen that general rule.
 
In verse 40, patra etc. are described to be taken in the quantity of two karsas. This quantity applies to all the ingredients taken together. However, experiences physician use each of ingredients in the prescribed quantities, i.e. two karshas each.
 
For the preparation of the decoction, the eleven drugs mentioned above should be added with eight times of water and reduced to one forth. Thus the quantity of the decoction will be twenty two palas. [This is in accordance with the commentary of Gangadhara. Cakrapani’s commentary in Nirnayasagara edition is different from C.K. Sen & Co. edition. Both of them perhaps, full of textual incongruities]. The quantity of milk should be four times of ghee. According to some scholars, milk should be four times of the quantity of the decoction.
 
For the preparation of decoction, eight palas of madhuka and one prastha of draksha should be added with four times of water and reduced to one fourth. Thus in total, the quantity of decoction will be one and half prastha. [According to general rule (paribhasha), the total quantity of liquid should be four times of ghee. But if the quantity of decoction is taken according to the above mentioned commentary of Cakrapani, then it will be less than the quantity of ghee. This may, however be treated as an exception to the general rule.]
 
  
==== Sarpi guda ====
+
==== Parallel management of chest injury ====
  
This medicated ghee is prescribed to be prepared by adding sugar and honey. This will reduce the ghee to the form of a paste and it is suitable only to be used as linctus. This should be given to the patient having aggravated pitta. If sugar and honey are not added to the medicated ghee, then it remains in the liquid form (in warm condition). This liquid form of medicated ghee should be given to the patient having aggravated vayu, to drink. Alternatively, the medicated ghee mixed with the powders, prescribed in verse 54, and made to a paste form, should be used by the patient having aggravated pitta. When it is in a melted state, it should be given to the patient having aggravated vayu.
+
Use of ''sandhaniya'' drugs like ''laksha'' (mainly indicated for the healing of fracture of bone) and ''madhuyashti'' clearly indicates that in ''kshatakshina'' there is external trauma (ribs fracture leading to pneumothorax) that should be managed with quick remedies. As only conservative management for the ''kshatakshina'' is described, it excludes the possibility of surgical interventions in ''kshatakshina'' in that era. However nowadays the surgical procedures like tube drainage with or without medical pleurodesis, vacuum-assisted thoracostomy (VATS) with pleurodesis and/or closure of leaks and bullectomy, and open surgical procedures such as thoracotomy for pleurectomy or pleurodesis) are conducted to decrease the chances of incurability of ''kshatakshina''. At the present time, it is necessary to elaborate the management of acute dreaded complications like pneumothorax and hematuria in separate chapter.
The medicated ghee is generally given in a small dose, i.e. one karsha (12ml). This quantity is enough to alleviate pitta, but it does not suppress the agni (the power of digestion).
 
The term ‘nirunaddhi’, in verse 53, has a different reading as ‘na runaddhi’. If the latter reading is accepted, then the last foot of the verse 53 will mean “ghee when used as drink, alleviate vayu, but it does not suppress the agni” (power of digestion). [The latter reading appears to be more appropriate]
 
In the verse 54, the ghee is to be made to a paste form by adding the powder tvakksiri, sarkara and laja. The quantity of these powders is not specified. Therefore, these have to be taken in such quantities as are capable of making the ghee into a thick paste form. Vata, udumbara, asvattha, plaksa and kapittha- these are the ksirivrksas (plant having milky latex). According to salakya tantra, udumbara, vata, asvattha, madhuka and plaksa- these five are called ksirivrksas. [Chakrapani’s statement and the reference are at variance in as much as in the place of kapitna, madhuka (madhuka according to C.K.Sen & Co. edition) is used kapitana is generally used as a synonym of other drugs like sirisa and amrataka and not of madhuka. Bhavaprakasa has included parisa (according to some, sirisa or vetaasa) in the place of kapitana.
 
Thirteen drugs mentioned in the verse no.56 are to be taken (One pala each). To this, eight times of water should be added and reduced to one fourth. Thus the quantity of the decoction will be twenty six palas. To this, fifty two palas of milk and twenty six palas of each of vidari (juice) and goat meat (soup) should be added. Thus, in total, one hundred and thirty palas of liquid should be added to ghee and cooked. According to some scholars, the decoction should be prepared by adding sixteen times of water and reduced to one fourth. Thus, the quantity of the decoction will be fifty two palas. If this is accepted, then the quantity of other liquids should be increased. But for practical purpose, these drugs mentioned in the verse 56, should be made to a decoction in such a way that it become equal to the quantity of ghee.If this is accepted, then the decoction (one part), milk (two parts), the juice of vidari (one part) and the goat meat soup (one part) – these four liquids are to be used in the preparation this medicated ghee in which the ghee and the decoction should be in equal quantities. Alternatively, the juice of vidari and goat-meat soup taken together should be one part. Thus the ghee should be cooked with four parts of liquid in conformity with the general rule. A similar recipe is also described in Jatukarana.
 
In this recipe, decoction should be same in quantity as ghee and the quatity of the drug to be used for decoction may be varied as a special case.
 
Khaj means a stirrer and the rod of the stirre can be ten angulas (19-50 cm) or one hasta (45-72cm) in length. Wrapping the cakes with bhurjapatra promotes therapeutic potency.
 
A similar recipe is available in the work of Jatukarana.
 
For the preparation of this recipe, milk, oil, ghee and sugar should first of all be cooked till the water content of milk evaporates. This is indicated by the term ‘kvathita’ in verse 68. Thereafter, powders of drugs mentioned in the verse 66-67, should be added and mixed well.
 
Cakrapanidatta’s commentary on verse number 70 is not very clear. However, it can be explained as follows:
 
Cow’s milk intended to be used in this recipe, is not for the sake of ‘ghrtapaka’, but for intial preparation (karanataya). It seems that the various ingredients prescribed to be used for this recipe are not required to be mixed up with the prescribed quantity of milk in its intial stage. It is only after cow’s milk is sufficiently boiled and become considerably thick, that various ingredients should be mixed up there with and the process of the cooking of the recipe should be started. Otherwise, if all the ingredients are mixed up with cow’s milk in the very early stage, it may not be possible to have the desired density of the preparation.
 
The quantity of milk should be determined on the basis of the dose of nagabala- root etc. [According to the general rule, milk should be eight times of the drug, and of this thirty two times of water should be added, boiled and reduced to one- forth. The drug which is generally used in a coarsely powdered form, should then be strained out and the milk should be given to the patient.]
 
Present clinical management of kshata-kshina:
 
Name of medicine Dose Time of administration Anupana(vehicle)
 
1.Laksha mixture 10-20 grams Frequently Vasavaleha
 
2. Amruta prasha ghee 10 -20 grams After lunch and dinner Milk
 
3. Suvarna malini vasant 120-240 mg In between two meals Milk
 
4. Lakshm vilasa 60-120 mg In between two meals Milk
 
5.Vanga mishrana 250 to 500 mg In between two meals Milk
 
  
 
=== Future Scope for Research ===
 
=== Future Scope for Research ===
  
Exploring the clinical evidences for the immunomodulator and hemostatic properties of Sida Veronicaefolia Lam. (Nagabala).
+
*Exploring the clinical evidences for the immunomodulator and hemostatic properties of Sida Veronicaefolia Lam. (''Nagabala'').
In vitro and in-vivo evaluation of hemostatic property of Boerhavia diffusa and clinical demonstration of its use in hemoptysis.
+
*In-vitro and in-vivo evaluation of hemostatic property of Boerhavia diffusa and clinical demonstration of its use in hemoptysis.
Exploring the role of autoantibodies in the pathogenesis of tuberculosis and its relation with genetic suspectibility.
+
*Exploring the role of auto-antibodies in the pathogenesis of tuberculosis and its relation with genetic suspectibility.
Evaluating the role of Laksha (Laccifer lacca) and Madhuyasti (Glycyrrhiza glabra) in rehabiliting pulmory tissues in acute pulmonary injury.
+
*Evaluating the role of ''laksha'' (Laccifer lacca) and ''madhuyasti'' (Glycyrrhiza glabra) in rehabilitating pulmonary tissues in acute pulmonary injury.
Evaluating role of anti-oxidant drugs [like amalaki (Emblica officinalis)] and vitamin C in the management of chronic inflammatory as well as infectious pulmonary diseases.  
+
*Evaluating role of anti-oxidant drugs [like amalaki (Emblica officinalis)] and vitamin C in the management of chronic inflammatory as well as infectious pulmonary diseases.  
Further reading:
+
 
[1] Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
+
=== Further reading ===
[2] Miles JW, Barrett GR. Rib fractures in athletes. Sports Med 1991;12:66 – 9.
+
[3] Garcia VF, Gotschall CS, Eichelberger MR, Bowman LM. Rib fractures in children: a marker of severe trauma. J Trauma 1990;30:695 – 700.
+
#Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
[4] Armstrong CP, Vanderspuy J. The fractured scapula: importance in management based on series of 62 patients. Injury 1984;15:324 – 9.
+
#Miles JW, Barrett GR. Rib fractures in athletes. Sports Med 1991;12:66 – 9.
[5] Ferro RT, McKeag DB. Neck pain and dyspnea in a swimmer. Phys Sports Med 1999;27.
+
#Garcia VF, Gotschall CS, Eichelberger MR, Bowman LM. Rib fractures in children: a marker of severe trauma. J Trauma 1990;30:695 – 700.
[6] Neer II CS. Fractures about the shoulder. In: Rockwood Jr CA, Green DP, editors. Fractures. Philadelphia: JD Lippincott; 1984. p. 713 – 21.
+
#Armstrong CP, Vanderspuy J. The fractured scapula: importance in management based on series of 62 patients. Injury 1984;15:324 – 9.
[7] Pfeiffer RP, Young TR. Case report: spontaneous pneumothorax in a jogger. Phys Sportsmed 1980;8:65 – 7.
+
#Ferro RT, McKeag DB. Neck pain and dyspnea in a swimmer. Phys Sports Med 1999;27.
[8] Marnejon T, Sarac S, Cropp AJ. Spontaneous pneumothorax in weightlifters. J Sports Med
+
#Neer II CS. Fractures about the shoulder. In: Rockwood Jr CA, Green DP, editors. Fractures. Philadelphia: JD Lippincott; 1984. p. 713 – 21.
Phys Fitness 1995;35:124 – 6.
+
#Pfeiffer RP, Young TR. Case report: spontaneous pneumothorax in a jogger. Phys Sportsmed 1980;8:65 – 7.
[9] Simoneaux SF, Murphy BJ, Tehranzadeh J. Spontaneous pneumothorax in a weightlifter. Am J Sports Med 1990;18:647 – 8.
+
#Marnejon T, Sarac S, Cropp AJ. Spontaneous pneumothorax in weightlifters. J Sports Med Phys Fitness 1995;35:124 – 6.
[10] Harker CP, Neuman TS, Olson LK, et al. The roentgenographic findings associated with air
+
#Simoneaux SF, Murphy BJ, Tehranzadeh J. Spontaneous pneumothorax in a weightlifter. Am J Sports Med 1990;18:647 – 8.
embolism in sport scuba divers. J Emerg Med 1993;11:443 – 9.
+
#Harker CP, Neuman TS, Olson LK, et al. The roentgenographic findings associated with air embolism in sport scuba divers. J Emerg Med 1993;11:443 – 9.
[11] Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
+
#Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
[12] Partridge RA, Coley A, Bowie R, Woolard RH. Sports-related pneumothorax. Ann Emerg Med1997;30:539 – 41.
+
#Partridge RA, Coley A, Bowie R, Woolard RH. Sports-related pneumothorax. Ann Emerg Med1997;30:539 – 41.
[13] Funk DA, McGanity PL, Hagemeier III KF, Schenck Jr RC. Pneumothorax in high school
+
#Funk DA, McGanity PL, Hagemeier III KF, Schenck Jr RC. Pneumothorax in high school football. Tex Med 1998;94:72 – 4.
football. Tex Med 1998;94:72 – 4.
+
#Ziser A, Vaananen A, Melamed Y. Diving and chronic spontaneous pneumothorax. Chest 1985;87:264 – 5.
[14] Ziser A, Vaananen A, Melamed Y. Diving and chronic spontaneous pneumothorax. Chest 1985;87:264 – 5.
+
#Belham GJ, Adler M. Pneumothorax in a boxer. Br J Sports Med 1985;19:45.
[15] Belham GJ, Adler M. Pneumothorax in a boxer. Br J Sports Med 1985;19:45.
+
#Sadat-Ali M, Al-Arfaj AL, Mohanna J. Pneumothorax due to soccer injury. Br J Sports Med 1986;20(2):91.
[16] Sadat-Ali M, Al-Arfaj AL, Mohanna J. Pneumothorax due to soccer injury. Br J Sports Med
+
#Ciocca M. Pneumothorax in a weight lifter. Phys Sportsmed 2000;28.
1986;20(2):91.
+
#Harmer PA, Moriarty J, Walsh M, Bean M, Cramer J. Distant entry pneumothorax in a competitive fencer. Br J Sports Med 1996;30:265–6.
[17] Ciocca M. Pneumothorax in a weight lifter. Phys Sportsmed 2000;28.
+
#Fischer RP, Flynn TC, Miller PW, Thompson DA. Scapular fractures and major ipsilateral upper torso injuries. Curr Concepts Trauma Care 1985;1:14– 6.
[18] Harmer PA, Moriarty J, Walsh M, Bean M, Cramer J. Distant entry pneumothorax in a competitive fencer. Br J Sports Med 1996;30:265–6.
+
#Morgan EJ, Henderson DA. Pneumomediastinum as a complication of athletic competition. Thorax 1981;36:155–6.
[20] Fischer RP, Flynn TC, Miller PW, Thompson DA. Scapular fractures and major ipsilateral upper torso injuries. Curr Concepts Trauma Care 1985;1:14– 6.
+
#O’Kane J, O’Kane E, Marquet J. Delayed complication of a rib fracture. Phys Sports med 1998;26.
[21] Morgan EJ, Henderson DA. Pneumomediastinum as a complication of athletic competition.
+
#Kizer KW, MacQuarrie MB. Pulmonary air leaks resulting from outdoor sports. A clinical series and literature review. Am J Sports Med 1999;27:517– 20.
Thorax 1981;36:155–6.
+
#Volk CP, McFarland EG, Horsmon G. Pneumothorax: on field recognition. Phys Sportsmed 1995;23:43 – 6.
[22] O’Kane J, O’Kane E, Marquet J. Delayed complication of a rib fracture. Phys Sportsmed
+
#Pasternak, M.S., & Rubin, R.H. (2001). Urinary tract tuberculosis. In R.W. Schrier (Ed.), Diseases of the kidney and urinary tract. (7th ed.) (pp. 1017-1037). Philadelphia: Lippincott Wil liams & Wilkins.
1998;26.
+
#Gibson, M.S., Puckett, M.L., & Shelly, M.E. (2004). Renal tuberculosis. RadioGraphics, 24, 251-256.
[23] Kizer KW, MacQuarrie MB. Pulmonary air leaks resulting from outdoor sports. A clinical series and literature review. Am J Sports Med 1999;27:517– 20.
+
#Anwar, N., & Azher, A. (2002). Tuberculosis in a solitary kidney. Pakistan Journal of Medical Research, 41(4), 173-174.
[24] Volk CP, McFarland EG, Horsmon G. Pneumothorax: on field recognition. Phys Sportsmed
+
#Soliman, M.S., Lessnau, K., & Hashmat, A. (2006). Tuberculosis of the genitourinary system. Retrieved March 11,2007, from http://www.emedicine.com/med/topic3073..htm.
1995;23:43 – 6.
+
#Centers for Disease Control and Prevention. (2005). Controlling tuberculosis in the United States. Mortality and Morbidity Weekly Reports (MMWR): Recommended Reports 54 (RR-12), 1-77.
[25]. Pasternak, M.S., & Rubin, R.H. (2001). Urinary tract tuberculosis. In R.W. Schrier (Ed.), Diseases of the kidney and urinary tract. (7th ed.) (pp. 1017-1037). Philadelphia: Lippincott Wil liams & Wilkins.
+
#Khan, A.N., Chandramohan, M., & MacDonald, S. (2004, November 5). Tuberculosis, genitourinary tract. Retrieved March 11, 2007from http://www.emedicine.com/radio/topic721.ht
[26]. Gibson, M.S., Puckett, M.L., & Shelly, M.E. (2004). Renal tuberculosis. RadioGraphics, 24, 251-256.
+
#Ahmed, M., & Murty, K. V. (2003). Isolated tuberculous pyonephrosis of a native kidney in a renal allograft recipient,an unusual manifestation of tuberculosis – A case report. Indian Journal of Nephrology, 13, 75-79.  
[27]. Anwar, N., & Azher, A. (2002). Tuberculosis in a solitary kidney. Pakistan Journal of Medical Research, 41(4), 173-174.
+
#Kenney, P.J. (1990). Imaging of chronic renal infections. American Journal of Radiology, 155, 485-494.
[28]. Soliman, M.S., Lessnau, K., & Hashmat, A. (2006). Tuberculosis of the genitourinary system. Retrieved March 11,2007, from http://www.emedicine.com/med/topic3073..htm.
+
#Christensen, W. (1974). Genitourinary tuberculosis: Review of 102 cases. Medicine (Baltimore), 53, 377-390.
[29]. Centers for Disease Control and Prevention. (2005). Controlling tuberculosis in the United States. Mortality and Morbidity Weekly Reports (MMWR): Recommended Reports 54 (RR-12), 1-77.
+
#Kathuria, P; Sanghera, P; Stevenson, FT; Sharma, S; Lederer, E; Lohr, JW; Talavera, F; Verrelli, M (21 May 2013). "Goodpasture Syndrome Clinical Presentation". In Batuman, C. Medscape Reference. WebMD. Retrieved 14 March 2014.
[30]. Khan, A.N., Chandramohan, M., & MacDonald, S. (2004, November 5). Tuberculosis, genitourinary tract. Retrieved March 11, 2007from http://www.emedicine.com/radio/topic721.ht
+
#Schwarz, MI (November 2013). "Goodpasture Syndrome: Diffuse Alveolar Hemorrhage and Pulmonary-Renal Syndrome". Merck Manual Professional. Retrieved 14 March 2014.
[31] Ahmed, M., & Murty, K. V. (2003). Isolated tuberculous pyonephrosis of a native kidney in a renal allograft recipient,an unusual manifestation of tuberculosis – A case report. Indian Journal of Nephrology, 13, 75-79.  
+
#Seo P, Stone JH (July 2004). "The antineutrophil cytoplasmic antibody-associated vasculitides". Am. J. Med. 117 (1): 39–50.
[32]. Kenney, P.J. (1990). Imaging of chronic renal infections. American Journal of Radiology, 155, 485-494.
+
#Berden, A; Göçeroglu, A; Jayne, D; Luqmani, R; Rasmussen, N; Bruijn, JA; Bajema, I (January 2012). "Diagnosis and management of ANCA associated vasculitis.". BMJ 344: e26.  
[33]. Christensen, W. (1974). Genitourinary tuberculosis: Review of 102 cases. Medicine (Baltimore), 53, 377-390.
+
#Pandey Manisha, Sonker Kanchan, Kanoujia Jovita, Koshy M. K., Saraf Shubhini A. Sida Veronicaefolia as a Source of Natural Antioxidant. International Journal of Pharmaceutical Sciences and Drug Research 2009; 1(3): 180-182.  
[34] Kathuria, P; Sanghera, P; Stevenson, FT; Sharma, S; Lederer, E; Lohr, JW; Talavera, F; Verrelli, M (21 May 2013). "Goodpasture Syndrome Clinical Presentation". In Batuman, C. Medscape Reference. WebMD. Retrieved 14 March 2014.
+
#Bhattacharya A, Chatterjee A, Ghosal S, Bhattacharya SK. Antioxidant activity of active tannoid principles of Emblica officinalis (amla). Indian J Exp Biol. 1999 Jul;37(7):676-80.
[35] Schwarz, MI (November 2013). "Goodpasture Syndrome: Diffuse Alveolar Hemorrhage and Pulmonary-Renal Syndrome". Merck Manual Professional. Retrieved 14 March 2014.
+
 
[36] Seo P, Stone JH (July 2004). "The antineutrophil cytoplasmic antibody-associated vasculitides". Am. J. Med. 117 (1): 39–50.
+
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[37] Berden, A; Göçeroglu, A; Jayne, D; Luqmani, R; Rasmussen, N; Bruijn, JA; Bajema, I (January 2012). "Diagnosis and management of ANCA associated vasculitis.". BMJ 344: e26.  
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[38] Pandey Manisha, Sonker Kanchan, Kanoujia Jovita, Koshy M. K., Saraf Shubhini A. Sida Veronicaefolia as a Source of Natural Antioxidant. International Journal of Pharmaceutical Sciences and Drug Research 2009; 1(3): 180-182.  
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Chikitsa Sthana Chapter 11. Management of Kshata-kshina (Emaciation due to Trauma)

Kshatakshina Chikitsa
Section/Chapter Chikitsa Sthana Chapter 11
Preceding Chapter Apasmara Chikitsa
Succeeding Chapter Shvayathu Chikitsa
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Kalpa Sthana, Siddhi Sthana
Translator and commentator Tiwari S.K., Deole Y. S.
Reviewer Singh G., Ghadi R.
Editors Singh G. & Goyal M., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s06.012

Abstract

Kshatakshina is a condition with kshaya (wasting, debility, emaciation) due to injury/trauma. Trauma is usually from external injury but in the present context this term signifies rupture of lung tissue due to exogenous as well as endogenous causes. The etiology includes significant exertion beyond one’s capacity. The disease shows close resemblance with rajayakshma in pathogenesis, as both involve anuloma kshaya (the depletion of dhatus takes place in the direction of their nourishment i.e. rasa then rakta then mamsa and so on) and pratiloma kshaya (depletion of dhatus in the direction opposite to their nourishment i.e. shukra then majja then asthi and so on). Nourishment therapy is the principle of management in kshatakshina. Various formulations to regain strength and replenishment of depleted tissues are described in this chapter.
Keywords: Kshatakshina, adventures, occupational disease, pneumo-thorax, tuberculosis, nourishment therapy.

Introduction

In Ayurveda, rather than disease, mainly the syndromes are described and kshatakshina is also a syndrome. Kshata means injury and kshina means depletion of tissue. The term literally means depletion of tissues due to injury. It includes various pathologies leading to depletion of tissues in the body as a result of external and internal injuries. It shows close resemblance with tuberculosis, however the cardinal cause in kshatakshina is injury. Hemoptysis (symptom of pulmonary tuberculosis), hematuria (symptom of renal tuberculosis) and diarrhea (symptom of intestinal tuberculosis) all have cardinal symptoms of tuberculosis which are described as the symptom of kshatakshina. It refers to those dreaded complications of tuberculosis that appear suddenly and require prompt treatment just as acute onset of chest-pain in patient of tuberculosis who suddenly develops pneumothorax due to rupture of subpleural blebs and massive painless hematuria in the patient of genitourinary tuberculosis. Similar to tuberculosis, there is impaired immunity in kshatakshina patients also. Kshatakshina refers to cluster of diseases like spontaneous pneumothorax and renal tuberculosis, whereas presence of hemoptysis and hematuria in a single disease suggests a pulmonary-renal syndrome (eg, Goodpasture's syndrome, Wegener's granulomatosis). The diseases due to excess exertion during work or occupational hazards can also be referred to kshatakshina.

Sanskrit text, Transliteration and English Translation

अथातः क्षतक्षीणचिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ kṣatakṣīṇacikitsitaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH kShatakShINacikitsitaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Kshatakshina Chikitsa ( Management of emaciation due to trauma).Thus said Lord Atreya. [1-2]

उदारकीर्तिर्ब्रह्मर्षिरात्रेयः परमार्थवित्|
क्षतक्षीणचिकित्सार्थमिदमाह चिकित्सितम्||३||

udārakīrtirbrahmarṣirātrēyaḥ paramārthavit|
kṣatakṣīṇacikitsārthamidamāha cikitsitam||3||

udArakIrtirbrahmarShirAtreyaH paramArthavit|
kShatakShINacikitsArthamidamAha cikitsitam||3||

Atreya, the illustrious sage, the brahmin-seer and the knower of ultimate truth, (thereafter) expounded therapeutics for the treatment of kshatakshina, as given below. [3]

Nidana (Etiology) of kshatakshina

धनुषाऽऽयस्यतोऽत्यर्थं भारमुद्वहतो गुरुम्|
पततो विषमोच्चेभ्यो बलिभिः सह युध्यतः||४||

वृषं हयं वा धावन्तं दम्यं वाऽन्यं निगृह्णतः|
शिलाकाष्ठाश्मनिर्घातान्क्षिपतो निघ्नतः परान्||५||

अधीयानस्य वाऽत्युच्चैर्दूरं वा व्रजतो द्रुतम्|
महानदीं वा तरतो हयैर्वा सह धावतः||६||

सहसोत्पततो दूरं[१] तूर्णं चातिप्रनृत्यतः|
तथाऽन्यैः कर्मभिः क्रूरैर्भृशमभ्याहतस्य च||७||

विक्षते वक्षसि व्याधिर्बलवान् समुदीर्यते|
स्त्रीषु चातिप्रसक्तस्य रूक्षाल्पप्रमिताशिनः||८||

dhanuṣāyasyatō'tyarthaṁ bhāramudvahatō gurum|
patatō viṣamōccēbhyō balibhiḥ saha yudhyataḥ||4||

vr̥ṣaṁ hayaṁ vā dhāvantaṁ damyaṁ vā'nyaṁ nigr̥hṇataḥ|
śilākāṣṭhāśmanirghātān kṣipatō nighnataḥ parān||5||

adhīyānasya vā'tyuccairdūraṁ vā vrajatō drutam|
mahānadīṁ vā taratō hayairvā saha dhāvataḥ||6||

sahasōtpatatō dūraṁ [1] tūrṇaṁ cātipranr̥tyataḥ|
tathā'nyaiḥ karmabhiḥ krūrairbhr̥śamabhyāhatasya ca||7||

vikṣatē vakṣasi vyādhirbalavān samudīryatē|
strīṣu cātiprasaktasya rūkṣālpapramitāśinaḥ||8||

dhanuShA~a~ayasyato~atyarthaM bhAramudvahato gurum|
patato viShamoccebhyo balibhiH saha yudhyataH||4||

vRuShaM hayaM vA dhAvantaM damyaM vA~anyaM nigRuhNataH|
shilAkAShThAshmanirghAtAn kShipato nighnataH parAn||5||

adhIyAnasya vA~atyuccairdUraM vA vrajato drutam|
mahAnadIM vA tarato hayairvA saha dhAvataH||6||

sahasotpatato dUraM tUrNaM cAtipranRutyataH|
tathA~anyaiH karmabhiH krUrairbhRushamabhyAhatasya ca||7||

vikShate vakShasi vyAdhirbalavAn samudIryate|
strIShu cAtiprasaktasya rUkShAlpapramitAshinaH||8||

The person who (beyond his own power) subjects himself to following activities:

  1. Straining in excess with a hard bow
  2. Carrying heavy weight
  3. Falling or jumping over uneven place or from high altitude.
  4. Wrestling or fighting with stronger persons.
  5. Restraining a running bull, stallion or any other strong animal requiring control
  6. Throwing heavy stones, wooden blocks, or equipment made of stone or beating others with these
  7. Reciting scriptures loudly
  8. Running a long distance or walking too fast.
  9. Crossing a big river by swimming
  10. Running along with horse
  11. Sudden long and high jump
  12. Practicing violent dance for a long time; and
  13. Being excessively injured by other violent and cruel acts.
  14. One who indulges excessively in sexual intercourse
  15. Who indulges in excess dry, less quantity food or limited food

Kshatakshina, the formidable disease, gets manifested, as a result of the injury to the chest due to the above causative factors. [4-8]

Pathogenesis and clinical features

उरो विरुज्यते तस्य भिद्यतेऽथ विभज्यते|
प्रपीड्येते ततः पार्श्वे शुष्यत्यङ्गं प्रवेपते||९||

क्रमाद्वीर्यं बलं वर्णो रुचिरग्निश्च हीयते|
ज्वरो व्यथा मनोदैन्यं विड्भेदोऽग्निवधादपि||१०||

दुष्टः श्यावः सुदुर्गन्धः पीतो विग्रथितो बहुः|
कासमानस्य च[१] श्लेष्मा सरक्तः सम्प्रवर्तते||११||

स क्षतः क्षीयतेऽत्यर्थं तथा शुक्रौजसोः क्षयात्|१२|

urō virujyatē tasya bhidyatē'tha vibhajyatē|
prapīḍyētē tataḥ pārśvē śuṣyatyaṅgaṁ pravēpatē||9||

kramādvīryaṁ balaṁ varṇō ruciragniśca hīyatē|
jvarō vyathā manōdainyaṁ viḍbhēdō'gnivadhādapi||10||

duṣṭaḥ śyāvaḥ sudurgandhaḥ pītō vigrathitō bahuḥ|
kāsamānasya ca [1] ślēṣmā saraktaḥ sampravartatē||11||

sa kṣataḥ kṣīyatē'tyarthaṁ tathā śukraujasōḥ kṣayāt|

uro virujyate tasya bhidyate~atha vibhajyate|
prapIDyete tataH pArshve shuShyatya~ggaM pravepate||9||

kramAdvIryaM balaM varNo ruciragnishca hIyate|
jvaro vyathA manodainyaM viDbhedo~agnivadhAdapi||10||

duShTaH shyAvaH sudurgandhaH pIto vigrathito bahuH|
kAsamAnasya ca shleShmA saraktaH sampravartate||11||

sa kShataH kShIyate~atyarthaM tathA shukraujasoH kShayAt|12|

Because of the above mentioned causative factors, the chest gets broken, punctured and cracked; sides of the chest get pressed and there is emaciation as well as tremor in the limbs. Gradually the potency, strength, complexion, appetite and agni (the power of digestion) of the patient get reduced. The patient suffers from fever, pain, mental depression and diarrhea even with the diminution of agni (decreased power of digestion).

While coughing, the patient spits out phlegm which is putrid, grayish in color, foul smelling, and yellow and knotty, in large quantities along with blood. The person suffering from kshatakshina becomes excessively emaciated due to further wastage of shukra and ojas. [9-12]

Prodromal signs and symptoms

अव्यक्तं लक्षणं तस्य पूर्वरूपमिति स्मृतम्||१२||

उरोरुक्शोणितच्छर्दिः कासो वैशेषिकः क्षते|
क्षीणे सरक्तमूत्रत्वं पार्श्वपृष्ठकटिग्रहः||१३||

avyaktaṁ lakṣaṇaṁ tasya pūrvarūpamiti smr̥tam||12||

urōrukśōṇitacchardiḥ kāsō vaiśēṣikaḥ kṣatē|
kṣīṇē saraktamūtratvaṁ pārśvapr̥ṣṭhakaṭigrahaḥ||13||

avyaktaM lakShaNaM tasya pUrvarUpamiti smRutam||12||

urorukshoNitacchardiH kAso vaisheShikaH kShate|
kShINe saraktamUtratvaM pArshvapRuShThakaTigrahaH||13||

Signs and symptoms in unmanifested form (less manifested) constitute the premonitory signs and symptoms of this disease. (There is no appearance of premonitory sings).

However, if there is kshata (injury), pain in the chest, blood vomiting and cough are specially manifested, and if there is kshaya (diminution of tissue elements), then hematuria and stiffness of the sides of the chest, back and lumbar region are specially manifested [121/2-13]

Prognosis

अल्पलिङ्गस्य दीप्ताग्नेः साध्यो बलवतो नवः|
परिसंवत्सरो याप्यः सर्वलिङ्गं तु वर्जयेत्||१४||

alpaliṅgasya dīptāgnēḥ sādhyō balavatō navaḥ|
parisaṁvatsarō yāpyaḥ sarvaliṅgaṁ tu varjayēt||14||

alpali~ggasya dIptAgneH sAdhyo balavato navaH|
parisaMvatsaro yApyaH sarvali~ggaM tu varjayet||14||

If the signs and symptoms are mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. If the disease is chronic i.e. more than one year, then it is yapya (palliable). If however, all the signs and symptoms of the disease are simultaneously manifested, then such a patient should not be treated, because the condition is incurable.[14]

Management

उरो मत्वा क्षतं लाक्षां पयसा मधुसंयुताम्|
सद्य एव पिबेज्जीर्णे पयसाऽद्यात् सशर्करम्||१५||

पार्श्वबस्तिरुजी चाल्पपित्ताग्निस्तां सुरायुताम्|
भिन्नविट्कः समुस्तातिविषापाठां सवत्सकाम्||१६||

लाक्षां सर्पिर्मधूच्छिष्टं जीवनीयगणं सिताम्|
त्वक्क्षीरीं समितां क्षीरे पक्त्वा दीप्तानलः पिबेत्||१७||

इक्ष्वालिकाबिसग्रन्थिपद्मकेशरचन्दनैः|
शृतं पयो मधुयुतं सन्धानार्थं पिबेत् क्षती||१८||

यवानां चूर्णमादाय क्षीरसिद्धं घृतप्लुतम्|
ज्वरे दाहे सिताक्षौद्रसक्तून् वा पयसा पिबेत्||१९||

मधूकमधुकद्राक्षात्वक्क्षीरीपिप्पलीबलाः|
कासी पार्श्वास्थिशूली च लिह्यात्सघृतमाक्षिकाः||२०||

urō matvā kṣataṁ lākṣāṁ payasā madhusaṁyutām|
sadya ēva pibējjīrṇē payasā'dyāt saśarkaram||15||

pārśvabastirujī cālpapittāgnistāṁ surāyutām|
bhinnaviṭkaḥ samustātiviṣāpāṭhāṁ savatsakām||16||

lākṣāṁ sarpirmadhūcchiṣṭaṁ jīvanīyagaṇaṁ sitām|
tvakkṣīrīṁ samitāṁ kṣīrē paktvā dīptānalaḥ pibēt||17||

ikṣvālikābisagranthipadmakēśaracandanaiḥ|
śr̥taṁ payō madhuyutaṁ sandhānārthaṁ pibēt kṣatī||18||

yavānāṁ cūrṇamādāya kṣīrasiddhaṁ ghr̥taplutam|
jvarē dāhē sitākṣaudrasaktūn vā payasā pibēt||19||

madhūkamadhukadrākṣātvakkṣīrīpippalībalāḥ|
kāsī pārśvāsthiśūlī ca lihyātsaghr̥tamākṣikāḥ||20||

Uro matvA kShataM lAkShAM payasA madhusaMyutAm|
sadya eva pibejjIrNe payasA~adyAt sasharkaram||15||

pArshvabastirujI cAlpapittAgnistAM surAyutAm|
bhinnaviTkaH samustAtiviShApAThAM savatsakAm||16||

lAkShAM sarpirmadhUcchiShTaM jIvanIyagaNaM sitAm|
tvakkShIrIM samitAM kShIre paktvA dIptAnalaH pibet||17||

ikShvAlikAbisagranthipadmakesharacandanaiH|
shRutaM payo madhuyutaM sandhAnArthaM pibet kShatI||18||

yavAnAM cUrNamAdAya kShIrasiddhaM ghRutaplutam|
jvare dAhe sitAkShaudrasaktUn vA payasA pibet||19||

madhUkamadhukadrAkShAtvakkShIrIpippalIbalAH|
kAsI pArshvAsthishUlI ca lihyAtsaghRutamAkShikAH||20||

If there is fresh injury to the chest, then the patient should be given laksha (lac) along with milk and honey. After the potion is digested, he should be given food along with milk and sugar.

If there is pain in the sides of the chest or in the region of the urinary bladder, and if there is less of pitta and agni (digestive power), then the patient should be given laksha (lac) along with sura (alcoholic drink).

If there is diarrhea, then the patient should be given laksha along with musta, ativisha, patha and vatsaka.

If the patient has strong power of digestion, then he should be given milk cooked with laksha, ghee, bee’s wax, and drugs belonging to jivaniya group, sugar and tvaksiri.

For healing of the injury, the patient should take milk boiled with ikshuvalika, bisagranthi, padma kesara and chandana with added honey.

If there is fever and burning sensation in the body, then the patient should take barley powder cooked with milk and added ghee. Alternatively, such a patient should take sugar, honey and saktu (roasted corn-flour) mixed with milk.

If the patient is suffering from cough and pain in the sides of the chest as well as bones, then he should take linctus prepared of the powder madhuka (flower), madhu, draksha, tvakshiri, pippali and bala mixed with ghee and honey. [15-20]

Eladi gutika

एलापत्रत्वचोऽर्धाक्षाः पिप्पल्यर्धपलं तथा|
सितामधुकखर्जूरमृद्वीकाश्च पलोन्मिताः||२१||

सञ्चूर्ण्य मधुना युक्ता गुटिकाः सम्प्रकल्पयेत्|
अक्षमात्रां ततश्चैकां भक्षयेन्ना दिने दिने||२२||

कासं श्वासं ज्वरं हिक्कां छर्दिं मूर्च्छां मदं भ्रमम्|
रक्तनिष्ठीवनं तृष्णां पार्श्वशूलमरोचकम्||२३||

शोषप्लीहाढ्यवातांश्च स्वरभेदं क्षतं क्षयम्|
गुटिका तर्पणी वृष्या रक्तपित्तं च नाशयेत्||२४||

इत्येलादिगुटिका|

ēlāpatratvacō'rdhākṣāḥ pippalyardhapalaṁ tathā|
sitāmadhukakharjūramr̥dvīkāśca palōnmitāḥ||21||

sañcūrṇya madhunā yuktā guṭikāḥ samprakalpayēt|
akṣamātrāṁ tataścaikāṁ bhakṣayēnnā dinē dinē||22||

kāsaṁ śvāsaṁ jvaraṁ hikkāṁ chardiṁ mūrcchāṁ madaṁ bhramam|
raktaniṣṭhīvanaṁ tr̥ṣṇāṁ pārśvaśūlamarōcakam||23||

śōṣaplīhāḍhyavātāṁśca svarabhēdaṁ kṣataṁ kṣayam|
guṭikā tarpaṇī vr̥ṣyā raktapittaṁ ca nāśayēt||24||

ityēlādiguṭikā

elApatratvaco~ardhAkShAH pippalyardhapalaM tathA|
sitAmadhukakharjUramRudvIkAshca palonmitAH||21||

sa~jcUrNya madhunA yuktA guTikAH samprakalpayet|
akShamAtrAM tatashcaikAM bhakShayennA dine dine||22||

kAsaM shvAsaM jvaraM hikkAM chardiM mUrcchAM madaM bhramam|
raktaniShThIvanaM tRuShNAM pArshvashUlamarocakam||23||

shoShaplIhADhyavAtAMshca svarabhedaM kShataM kShayam|
guTikA tarpaNI vRuShyA raktapittaM ca nAshayet||24||

ityelAdiguTikA|

Half aksha (five grams) each of ela, patra and tvak, half pala (twenty grams) of pippali, one pala each of sita(forty grams), madhuka, kharjura and mridvika should be made to a powder. Honey should be added to this powder to make a paste. From this paste, pills of one aksha each should be prepared. One such pill should be taken every day. It cures kasa (cough), shvasa (dyspnea), jwara (fever), hiccup, vomiting, fainting, hemoptysis, morbid thirst, pain in the sides of the chest, anorexia, consumption, splenic enlargement, adhyavata (rheumatoid arthritis), hoarseness of voice, kshata (injury to the chest), kshaya (diminution of tissues elements) and raktapitta (a condition charcterised by bleeding from different parts of the body). This pill is refreshing and aphrodisiac. [21-24]

Treatment of excessive bleeding

रक्तेऽतिवृत्ते दक्षाण्डं यूषैस्तोयेन वा पिबेत्|
चटकाण्डरसं वाऽपि रक्तं वा छागजाङ्गलम्||२५||

चूर्णं पौनर्नवं रक्तशालितण्डुलशर्करम्|
रक्तष्ठीवी पिबेत् सिद्धं द्राक्षारसपयोघृतैः||२६||

raktē'tivr̥ttē dakṣāṇḍaṁ yūṣaistōyēna vā pibēt|
caṭakāṇḍarasaṁ vā'pi raktaṁ vā chāgajāṅgalam||25||

cūrṇaṁ paunarnavaṁ raktaśālitaṇḍulaśarkaram|
raktaṣṭhīvī pibēt siddhaṁ drākṣārasapayōghr̥taiḥ||26||

rakte~ativRutte dakShANDaM yUShaistoyena vA pibet|
caTakANDarasaM vA~api raktaM vA chAgajA~ggalam||25||

cUrNaM paunarnavaM raktashAlitaNDulasharkaram|
raktaShThIvI pibet siddhaM drAkShArasapayoghRutaiH||26||

If there is excessive bleeding, then the patient should take eggs of daksha (wild hen) along with green gram soup or water. He may also take the soup of eggs of sparrow or (preparations) of the blood of goat or wild animals (like deer, etc).

The patient having hemoptysis should take the powder of punarnava, red variety of shali rice and sugar cooked along with grape juice, milk and ghee. [25-26]

Various formulations

मधूकमधुकक्षीरसिद्धं वा तण्डुलीयकम्|
मूढवातस्त्वजामेदः सुराभृष्टं ससैन्धवम्||२७||

क्षामः क्षीणः क्षतोरस्कस्त्वनिद्रः सबलेऽनिले|
शृतक्षीरसरेणाद्यात् सक्षौद्रघृतशर्करम्||२८||

शर्करां यवगोधूमौ जीवकर्षभकौ मधु|
शृतक्षीरानुपानं वा लिह्यात् क्षीणः क्षती कृशः||२९||

क्रव्यादमांसनिर्यूहं घृतभृष्टं पिबेच्च सः|
पिप्पलीक्षौद्रसंयुक्तं मांसशोणितवर्धनम्||३०||

न्यग्रोधोदुम्बराश्वत्थप्लक्षशालप्रियङ्गुभिः|
तालमस्तकजम्बूत्वक्प्रियालैश्च सपद्मकैः||३१||

साश्वकर्णैः शृतात् क्षीरादद्याज्जातेन सर्पिषा|
शाल्योदनं क्षतोरस्कः क्षीणशुक्रश्च मानवः||३२||

यष्ट्याह्वनागबलयोः क्वाथे क्षीरसमं घृतम्|
पयस्यापिप्पलीवांशीकल्कसिद्धं क्षते शुभम्||३३||

कोललाक्षारसे तद्वत् क्षीराष्टगुणसाधितम्|
कल्कैः कट्वङ्गदार्वीत्वग्वत्सकत्वक्फलैर्घृतम्||३४||

madhūkamadhukakṣīrasiddhaṁ vā taṇḍulīyakam|
mūḍhavātastvajāmēdaḥ surābhr̥ṣṭaṁ sasaindhavam||27||

kṣāmaḥ kṣīṇaḥ kṣatōraskastvanidraḥ sabalē'nilē|
śr̥takṣīrasarēṇādyāt sakṣaudraghr̥taśarkaram||28||

śarkarāṁ yavagōdhūmau jīvakarṣabhakau madhu|
śr̥takṣīrānupānaṁ vā lihyāt kṣīṇaḥ kṣatī kr̥śaḥ||29||

kravyādamāṁsaniryūhaṁ ghr̥tabhr̥ṣṭaṁ pibēcca saḥ|
pippalīkṣaudrasaṁyuktaṁ māṁsaśōṇitavardhanam||30||

nyagrōdhōdumbarāśvatthaplakṣaśālapriyaṅgubhiḥ|
tālamastakajambūtvakpriyālaiśca sapadmakaiḥ||31||

sāśvakarṇaiḥ śr̥tāt kṣīrādadyājjātēna sarpiṣā|
śālyōdanaṁ kṣatōraskaḥ kṣīṇaśukraśca mānavaḥ||32||

yaṣṭyāhvanāgabalayōḥ kvāthē kṣīrasamaṁ ghr̥tam|
payasyāpippalīvāṁśīkalkasiddhaṁ kṣatē śubham||33||

kōlalākṣārasē tadvat kṣīrāṣṭaguṇasādhitam|
kalkaiḥ kaṭvaṅgadārvītvagvatsakatvakphalairghr̥tam||34||

madhUkamadhukakShIrasiddhaM vA taNDulIyakam|
mUDhavAtastvajAmedaH surAbhRuShTaM sasaindhavam||27||

kShAmaH kShINaH kShatoraskastvanidraH sabale~anile|
shRutakShIrasareNAdyAt sakShaudraghRutasharkaram||28||

sharkarAM yavagodhUmau jIvakarShabhakau madhu|
shRutakShIrAnupAnaM vA lihyAt kShINaH kShatI kRushaH||29||

kravyAdamAMsaniryUhaM ghRutabhRuShTaM pibecca saH|
pippalIkShaudrasaMyuktaM mAMsashoNitavardhanam||30||

nyagrodhodumbarAshvatthaplakShashAlapriya~ggubhiH|
tAlamastakajambUtvakpriyAlaishca sapadmakaiH||31||

sAshvakarNaiH shRutAt kShIrAdadyAjjAtena sarpiShA|
shAlyodanaM kShatoraskaH kShINashukrashca mAnavaH||32||

yaShTyAhvanAgabalayoH kvAthe kShIrasamaM ghRutam|
payasyApippalIvAMshIkalkasiddhaM kShate shubham||33||

kolalAkShArase tadvat kShIrAShTaguNasAdhitam|
kalkaiH kaTva~ggadArvItvagvatsakatvakphalairghRuta ||34||

Milk should be boiled with the paste of madhooka and madhuka. With this milk, tanduliyaka should be cooked (which is useful for the patient suffering from the hemoptysis).

If there is mudhavata (claudication of vata), the patient should take the fat of goat fried with sura (type of liquor) and mixed with rock salt.

If the patient is weak, emaciated and having injury in the chest, sleeplessness and excessive aggravation of vayu, then he should take goat’s fat boiled with the cream of milk and added with honey, ghee and sugar.

If the patient is emaciated, having injury in the chest and cachectic, he may be given sugar, barley, wheat, jivaka, rushabhaka and honey in linctus form. Thereafter, he should take boiled milk.

The above mentioned patient should take the decoction of the meat of carnivorous animal sizzled with ghee and added with pippali and honey. This potion promotes muscles tissues and blood.

The patient having injury to the chest and diminution of semen, should take sali rice mixed with ghee which latter is prepared of the milk boiled with nyagrodha, udumbara, ashvattha, plaksha, sala, priyangu, tuft of tala, bark of jambu, priyala, padmaka and asvakarna.

Yashtyavahadi ghrita

Ghee should be cooked with equal quantity of milk, the decoction of madhuyashti and nagabala (four times of ghee in total), and the paste of payasya, pippali and vamshi (one fourth in total of ghee). The medicated ghee is useful in the treatment of kshata (injury to chest).

Koladi ghrita

Similarly, ghee should be cooked with the decoction of kola and laksha (four times in total of ghee), eight times of milk, and the paste of the bark of kaivanga, bark of darvi, bark of kutaja and fruit of kutaja (one fourth in total of ghee). This medicated ghee is useful in the treatment of kshata.[27-34]

Amritaprasha ghee

जीवकर्षभकौ वीरां जीवन्तीं नागरं शटीम्|
चतस्रः पर्णिनीर्मेदे काकोल्यौ द्वे निदिग्धिके||३५||

पुनर्नवे द्वे मधुकमात्मगुप्तां शतावरीम्|
ऋद्धिं परूषकं भार्गीं मृद्वीकां बृहतीं तथा||३६||

शृङ्गाटकं तामलकीं पयस्यां पिप्पलीं बलाम्|
बदराक्षोटखर्जूरवातामाभिषुकाण्यपि||३७||

फलानि चैवमादीनि कल्कान् कुर्वीत कार्षिकान्|
धात्रीरसविदारीक्षुच्छागमांसरसं पयः||३८||

कुर्यात् प्रस्थोन्मितं तेन घृतप्रस्थं विपाचयेत्|
प्रस्थार्धं मधुनः शीते शर्करार्धतुलां तथा||३९||

द्विकार्षिकाणि[१] पत्रैलाहेमत्वङ्मरिचानि च|
विनीय चूर्णितं तस्माल्लिह्यान्मात्रां सदा नरः||४०||

अमृतप्राशमित्येतन्नराणाममृतं घृतम्|
सुधामृतरसं प्राश्यं क्षीरमांसरसाशिना||४१||

नष्टशुक्रक्षतक्षीणदुर्बलव्याधिकर्शितान्|
स्त्रीप्रसक्तान् कृशान् वर्णस्वरहीनांश्च बृंहयेत्||४२||

कासहिक्काज्वरश्वासदाहतृष्णास्रपित्तनुत्|
पुत्रदं वमिमूर्च्छाहृद्योनिमूत्रामयापहम्||४३||

इत्यमृतप्राशघृतम्|

jīvakarṣabhakau vīrāṁ jīvantīṁ nāgaraṁ śaṭīm|
catasraḥ parṇinīrmēdē kākōlyau dvē nidigdhikē||35||

punarnavē dvē madhukamātmaguptāṁ śatāvarīm|
r̥ddhiṁ parūṣakaṁ bhārgīṁ mr̥dvīkāṁ br̥hatīṁ tathā||36||

śr̥ṅgāṭakaṁ tāmalakīṁ payasyāṁ pippalīṁ balām|
badarākṣōṭakharjūravātāmābhiṣukāṇyapi||37||

phalāni caivamādīni kalkān kurvīta kārṣikān|
dhātrīrasavidārīkṣucchāgamāṁsarasaṁ payaḥ||38||

kuryāt prasthōnmitaṁ tēna ghr̥taprasthaṁ vipācayēt|
prasthārdhaṁ madhunaḥ śītē śarkarārdhatulāṁ tathā||39||

dvikārṣikāṇi [2] patrailāhēmatvaṅmaricāni ca|
vinīya cūrṇitaṁ tasmāllihyānmātrāṁ sadā naraḥ||40||

amr̥taprāśamityētannarāṇāmamr̥taṁ ghr̥tam|
sudhāmr̥tarasaṁ prāśyaṁ kṣīramāṁsarasāśinā||41||

naṣṭaśukrakṣatakṣīṇadurbalavyādhikarśitān|
strīprasaktān kr̥śān varṇasvarahīnāṁśca br̥ṁhayēt||42||

kāsahikkājvaraśvāsadāhatr̥ṣṇāsrapittanut|
putradaṁ vamimūrcchāhr̥dyōnimūtrāmayāpaham||43||

ityamr̥taprāśaghr̥tam

jIvakarShabhakau vIrAM jIvantIM nAgaraM shaTIm|
catasraH parNinIrmede kAkolyau dve nidigdhike||35||

punarnave dve madhukamAtmaguptAM shatAvarIm|
RuddhiM parUShakaM bhArgIM mRudvIkAM bRuhatIM tathA||36||

shRu~ggATakaM tAmalakIM payasyAM pippalIM balAm|
badarAkShoTakharjUravAtAmAbhiShukANyapi||37||

phalAni caivamAdIni kalkAn kurvIta kArShikAn|
dhAtrIrasavidArIkShucchAgamAMsarasaM payaH||38||

kuryAt prasthonmitaM tena ghRutaprasthaM vipAcayet|
prasthArdhaM madhunaH shIte sharkarArdhatulAM tathA||39||

dvikArShikANi patrailAhematva~gmaricAni ca|
vinIya cUrNitaM tasmAllihyAnmAtrAM sadA naraH||40||

amRutaprAshamityetannarANAmamRutaM ghRutam|
sudhAmRutarasaM prAshyaM kShIramAMsarasAshinA||41||

naShTashukrakShatakShINadurbalavyAdhikarshitAn|
strIprasaktAn kRushAn varNasvarahInAMshca bRuMhayet||42||

kAsahikkAjvarashvAsadAhatRuShNAsrapittanut|
putradaM vamimUrcchAhRudyonimUtrAmayApaham||43||

ityamRutaprAshaghRutam|

Two prasthas of ghee should be cooked with the juice dhatri (two prasthas), juice of vidari (two prasthas), sugarcane juice (two prasthas), soup of the meat of goat (two prasthas), milk (two prasthas), and the paste (one karsha each) of jivaka, rsabhaka, vira, jivanti, nagara, shati, shalaparni, prushniparni, mashaparni, mudgaparni,meda, mahameda, kakoli, kshirakakoli, kantakari, bruhati, shveta punarnava, rakta punarnava,madhuka, atmagupta, shatavari, riddhi,parushaka, bharangi, mridvika, brihati, shringataka,tamalaki, payasya (kshiravidari), pippali, badara, akshota, kharjura, vatama, abhishuka (pista) and such other fruits which alleviate vata and pitta. After cooking when the the recipe is cooled, one prastha of honey, half tula of sugar, and the powder (two karshas each) of patra, ela, hema, tvak and maricha should be added to it. This medicated ghee should be taken by a person in appropriate dose regularly. This is called amrita prasa ghrita and it is like amrita (ambrosia) for human beings. This linctus is like sudha (ambrosia worth the consumption of worldly creatures) and the amrita (ambrosia worth the consumption of the gods). It should be taken along with milk and meat soup. It promotes nourishment of persons who had depleted shukra ( as in azoospermia or oligospermia), who are suffering from kshatakshina, who are weak, who are emaciated because of chronic diseases, who are cachectic and who have lost their complexion and voice. It cures cough, hiccup, fever, asthma, burning sensation, morbid thirst, rakta-pitta, vomiting, fainting and diseases of the heart, female genital tract and urinary tract. It helps in the treatment of infertility. [35-43]

Shvadamshtradi ghee

श्वदंष्ट्रोशीरमञ्जिष्ठाबलाकाश्मर्यकत्तृणम्|
दर्भमूलं पृथक्पर्णीं पलाशर्षभकौ स्थिराम्||४४||

पलिकं साधयेत्तेषां रसे क्षीरचतुर्गुणे|
कल्कः स्वगुप्ताजीवन्तीमेदर्षभकजीवकैः||४५||

शतावर्यृद्धिमृद्वीकाशर्कराश्रावणीबिसैः|
प्रस्थः सिद्धो घृताद्वातपित्तहृद्द्र(द्भ)वशूलनुत्||४६||

मूत्रकृच्छ्रप्रमेहार्शःकासशोषक्षयापहः|
धनुःस्त्रीमद्यभाराध्वखिन्नानां बलमांसदः||४७||

इति श्वदंष्ट्रादिघृतम्|

śvadaṁṣṭrōśīramañjiṣṭhābalākāśmaryakattr̥ṇam|
darbhamūlaṁ pr̥thakparṇīṁ palāśarṣabhakau sthirām||44||

palikaṁ sādhayēttēṣāṁ rasē kṣīracaturguṇē|
kalkaḥ svaguptājīvantīmēdarṣabhakajīvakaiḥ||45||

śatāvaryr̥ddhimr̥dvīkāśarkarāśrāvaṇībisaiḥ|
prasthaḥ siddhō ghr̥tādvātapittahr̥ddra(dbha)vaśūlanut||46||

mūtrakr̥cchrapramēhārśaḥkāsaśōṣakṣayāpahaḥ|
dhanuḥstrīmadyabhārādhvakhinnānāṁ balamāṁsadaḥ||47||

iti śvadaṁṣṭrādighr̥tam

shvadaMShTroshIrama~jjiShThAbalAkAshmaryakattRuNam|
darbhamUlaM pRuthakparNIM palAsharShabhakau sthirAm||44||

palikaM sAdhayetteShAM rase kShIracaturguNe|
kalkaH svaguptAjIvantImedarShabhakajIvakaiH||45||

shatAvaryRuddhimRudvIkAsharkarAshrAvaNIbisaiH|
prasthaH siddho ghRutAdvAtapittahRuddra(dbha)vashUlanut||46||

mUtrakRucchrapramehArshaHkAsashoShakShayApahaH|
dhanuHstrImadyabhArAdhvakhinnAnAM balamAMsadaH||47||

iti shvadaMShTrAdighRutam|

One pala of each of shvadamshtra, ushira, manjishtha, bala, kashmarya, katrna, the root of darbha, prithak parni, palasha, rishabhaka, and sthira should be made to decoction. Two prasthas of ghee should be mixed with the above mentioned decoction, eight prasthas of milk, and the paste of svagupta, jivanti, meda, rishabhaka, jivaka, shatavari, riddhi, mridvika, sharkara, shravani and bias (lotus stalk), (half prastha in total) and cooked. This medicated ghee cures hridaya shula caused by vata and pitta, mutrakrucchra (dysuria), prameha (diabetes mellitus), piles, bronchitis, and consumption and kshatakshina. It promotes strength of muscles tissues of persons emaciated because of indulgence in archery, women, alcohol, carrying heavy weight and walking a long distance. [44-47]

Samasaktu ghee

मधुकाष्टपलद्राक्षाप्रस्थक्वाथे घृतं पचेत्|
पिप्पल्यष्टपले कल्के प्रस्थं सिद्धे च शीतले||४८||

पृथगष्टपलं क्षौद्रशर्कराभ्यां विमिश्रयेत्|
समसक्तु क्षतक्षीणे रक्तगुल्मे च तद्धितम्||४९||

madhukāṣṭapaladrākṣāprasthakvāthē ghr̥taṁ pacēt|
pippalyaṣṭapalē kalkē prasthaṁ siddhē ca śītalē||48||

pr̥thagaṣṭapalaṁ kṣaudraśarkarābhyāṁ vimiśrayēt|
samasaktu kṣatakṣīṇē raktagulmē ca taddhitam||49||

madhukAShTapaladrAkShAprasthakv the ghRutaM pacet|
pippalyaShTapale kalke prasthaM siddhe ca shItale||48||

pRuthagaShTapalaM kShaudrasharkarAbhyAM vimishrayet|
samasaktu kShatakShINe raktagulme ca taddhitam||49||

Two prasthas of ghee should be cooked by adding the decoction of madhuka (eight palas) and draksha (one prastha), and the paste of pippali (eight palas). After it is cooked and cooled, eight palas of each of honey and sugar should be added and mixed well. This medicated ghee should be administered by adding saktu (roasted barley flour) in equal quantity. It is useful in the treatment of kshatakshina and rakta gulma. [48-49]

Sarpi-gud

धात्रीफलविदारीक्षुजीवनीयरसैर्घृतम्|
अजागोपयसोश्चैव सप्त प्रस्थान् पचेद्भिषक्||५०||

सिद्धशीते सिताक्षौद्रद्विप्रस्थं विनयेच्च तत्|
यक्ष्मापस्मारपित्तासृक्कासमेहक्षयापहम्||५१||

वयःस्थापनमायुष्यं मांसशुक्रबलप्रदम्|
घृतं तु पित्तेऽभ्यधिके लिह्याद्वातेऽधिके पिबेत्||५२||

लीढं निर्वापयेत् पित्तमल्पत्वाद्धन्ति नानलम्|
आक्रामत्यनिलं पीतमूष्माणं निरुणद्धि च||५३||

क्षामक्षीणकृशाङ्गानामेतान्येव घृतानि तु|
त्वक्क्षीरीशर्करालाजचूर्णैः स्त्यानानि योजयेत्||५४||

सर्पिर्गुडान् समध्वंशाञ्जग्ध्वा चानु पयः पिबेत्|
रेतो वीर्यं बलं पुष्टिं तैराशुतरमाप्नुयात्||५५||

इति सर्पिर्गुडाः|

dhātrīphalavidārīkṣujīvanīyarasairghr̥tam|
ajāgōpayasōścaiva sapta prasthān pacēdbhiṣak||50||

siddhaśītē sitākṣaudradviprasthaṁ vinayēcca tat|
yakṣmāpasmārapittāsr̥kkāsamēhakṣayāpaham||51||

vayaḥsthāpanamāyuṣyaṁ māṁsaśukrabalapradam|
ghr̥taṁ tu pittē'bhyadhikē lihyādvātē'dhikē pibēt||52||

līḍhaṁ nirvāpayēt pittamalpatvāddhanti nānalam|
ākrāmatyanilaṁ pītamūṣmāṇaṁ niruṇaddhi ca||53||

kṣāmakṣīṇakr̥śāṅgānāmētānyēva ghr̥tāni tu|
tvakkṣīrīśarkarālājacūrṇaiḥ [3] styānāni yōjayēt||54||

sarpirguḍān samadhvaṁśāñjagdhvā cānu payaḥ pibēt|
rētō vīryaṁ balaṁ puṣṭiṁ tairāśutaramāpnuyāt||55||

iti sarpirguḍāḥ

dhAtrIphalavidArIkShujIvanIyarasairghRutam|
ajAgopayasoshcaiva sapta prasthAn pacedbhiShak||50||

siddhashIte sitAkShaudradviprasthaM vinayecca tat|
yakShmApasmArapittAsRukkAsamehakShayApaham||51||

vayaHsthApanamAyuShyaM mAMsashukrabalapradam|
ghRutaM tu pitte~abhyadhike lihyAdvAte~adhike pibet||52||

lIDhaM nirvApayet pittamalpatvAddhanti nAnalam|
AkrAmatyanilaM pItamUShmANaM niruNaddhi ca||53||

kShAmakShINakRushA~ggAnAmetAnyeva ghRutAni tu|
tvakkShIrIsharkarAlAjacUrNaiH styAnAni yojayet||54||

sarpirguDAn samadhvaMshA~jjagdhvA cAnu payaH pibet|
reto vIryaM balaM puShTiM tairAshutaramApnuyAt||55||

iti sarpirguDAH|

Two prasthas of ghee should be added with the juice of amalaka (two prasthas), vidari (two prasthas) and ikshu (two prasthas) decoction of drugs belonging to jivaniya group (two prasthas), goat’s milk (two prasthas) and cow’s milk (two prasthas) and cooked. After the cooking is over and the recipe is cooled, sugar (one prastha) and honey (two prasthas) should be added and mixed well. This medicated ghee is useful in the treatment of rajayaskshma, apasmara, raktapitta, prameha, and kshaya. It prevents aging, promotes longevity and endows the person with muscle tissues, semen as well as strength. If the disease is caused by excess of [[pitta], then this recipe should be used as linctus. If, however, the disease is caused by the excess of vata, then it should be taken as a drink.

When this medicated ghee is used (licked) in the form of a linctus, it alleviates pitta. Since it is in small quantity, it however, doesn’t suppress the agni (power of digestion).

When it is used in the form of a drink, it alleviates vata and obstructs pitta ushma.

This and such other medicated ghee should be made to a thick paste by adding the powder of tvakkshiri, sugar and lajja (fried paddy), which should then be given to persons who are tired, weak and emaciated.

This and such other recipes of sarpigud [recipes of medicated ghee in which sugar, honey etc. are added] should be added with honey (which should be equal in quantity with the powder of tvak-kshiri, etc.) and taken. Thereafter, the patient should drink milk. This instantaneously promotes semen, potency, strength and nourishment. [50-55]

Sarpi gud (second recipe)

बला विदारी ह्रस्वा च पञ्चमूली पुनर्नवा|
पञ्चानां क्षीरिवृक्षाणां शुङ्गा मुष्ट्यंशका अपि||५६||

एषां कषाये द्विक्षीरे विदार्याजरसांशिके|
जीवनीयैः पचेत् कल्कैरक्षमात्रैर्घृताढकम्||५७||

सितापलानि पूते च शीते द्वात्रिंशतं क्षिपेत्|
गोधूमपिप्पलीवांशीचूर्णं शृङ्गाटकस्य च||५८||

समाक्षिकं कौडविकं तत् सर्वं खजमूर्च्छितम्|
स्त्यानं सर्पिर्गुडान् कृत्वा भूर्जपत्रेण वेष्टयेत्||५९||

ताञ्जग्ध्वा पलिकान् क्षीरं मद्यं वाऽनुपिबेत् कफे|
शोषे कासे क्षते क्षीणे श्रमस्त्रीभारकर्शिते||६०||

रक्तनिष्ठीवने तापे पीनसे चोरसि स्थिते|
शस्ताः पार्श्वशिरःशूले भेदे च स्वरवर्णयोः||६१||

इति द्वितीयसर्पिर्गुडाः|

balā vidārī hrasvā ca pañcamūlī punarnavā|
pañcānāṁ kṣīrivr̥kṣāṇāṁ śuṅgā muṣṭyaṁśakā api||56||

ēṣāṁ kaṣāyē dvikṣīrē vidāryājarasāṁśikē|
jīvanīyaiḥ pacēt kalkairakṣamātrairghr̥tāḍhakam||57||

sitāpalāni pūtē ca śītē dvātriṁśataṁ kṣipēt|
gōdhūmapippalīvāṁśīcūrṇaṁ śr̥ṅgāṭakasya ca||58||

samākṣikaṁ kauḍavikaṁ tat sarvaṁ khajamūrcchitam|
styānaṁ sarpirguḍān kr̥tvā bhūrjapatrēṇa vēṣṭayēt||59||

tāñjagdhvā palikān kṣīraṁ madyaṁ vā'nupibēt kaphē|
śōṣē kāsē kṣatē kṣīṇē śramastrībhārakarśitē||60||

raktaniṣṭhīvanē tāpē pīnasē cōrasi sthitē|
śastāḥ pārśvaśiraḥśūlē bhēdē ca svaravarṇayōḥ||61||

iti dvitīyasarpirguḍāḥ

balA vidArI hrasvA ca pa~jcamUlI punarnavA|
pa~jcAnAM kShIrivRukShANAM shu~ggA muShTyaMshakA api||56||

eShAM kaShAye dvikShIre vidAryAjarasAMshike|
jIvanIyaiH pacet kalkairakShamAtrairghRutADhakam||57||

sitApalAni pUte ca shIte dvAtriMshataM kShipet|
godhUmapippalIvAMshIcUrNaM shRu~ggATakasya ca||58||

samAkShikaM kauDavikaM tat sarvaM khajamUrcchitam|
styAnaM sarpirguDAn kRutvA bhUrjapatreNa veShTayet||59||

tA~jjagdhvA palikAn kShIraM madyaM vA~anupibet kaphe|
shoShe kAse kShate kShINe shramastrIbhArakarshite||60||

raktaniShThIvane tApe pInase corasi sthite|
shastAH pArshvashiraHshUle bhede ca svaravarNayoH||61||

iti dvitIyasarpirguDAH|

Bala, vidari, hrasva panchamula (shalaparni, prsniparni, brihati, kantakari and gokshura), punarnava, and the sungas (terminal buds) of five kshirivrikshas (nyagrodha, udumbara, asvattha, madhuka and plaksha)- one pala of each of these drugs should be made to a decoction. To this, milk (two parts, i.e., double the quantity of the decoction), juice of vidari (one part), soup of goat meat (one part), ghee (two adhakas) (in the text, actually one adhaka is mentioned. But in practice, it is to be taken double the quantity according to the general rule), and the paste of drugs belonging to the jivaniya group (one aksa each) should be added and cooked. When it is well cooked and cooled, thirty two palas of sugar should be added. Thereafter, one kudava of each of the powder of godhuma, pippali, vamsha lochana, shringataka and honey should be added. All of them should be stirred with the help of a stirrer. When it becomes dense, cakes (sarpigud) should be prepared and each of them should be wrapped with thin bark of bhurja tree. Having taken this cake one pala in weight, the patient should take milk or alcohol as post-prandial drink. These are useful in the treatment of disease caused by kapha, sosha, kasa and kshatakshina. These are also helpful for persons who are emaciated because of excessive exertion, overindulgence in sex and exhaustion by lifting excessive weight. These cakes are efficacious in the treatment of rakta-nishthivana (hemoptysis), burning sensation, chronic rhinitis (pinasa), having residual infection in the chest, pain in the sides of the chest, headache, hoarseness of voice and loss of complexion. [56-61]

Sarpi gud(third recipe)

त्वक्क्षीरीश्रावणीद्राक्षामूर्वर्षभकजीवकैः|
वीरर्धिक्षीरकाकोलीबृहतीकपिकच्छुभिः||६२||

खर्जूरफलमेदाभिः क्षीरपिष्टैः पलोन्मितैः|
धात्रीविदारीक्षुरसप्रस्थैः प्रस्थं घृतात् पचेत्||६३||

शर्करार्धतुलां शीते क्षौद्रार्धप्रस्थमेव च|
दत्त्वा सर्पिर्गुडान् कुर्यात्कासहिक्काज्वरापहान्||६४||

यक्ष्माणं तमकं श्वासं रक्तपित्तं हलीमकम्|
शुक्रनिद्राक्षयं तृष्णां हन्युः कार्श्यं सकामलम्||६५||

इति तृतीयाः सर्पिर्गुडाः|

tvakkṣīrīśrāvaṇīdrākṣāmūrvarṣabhakajīvakaiḥ|
vīrardhikṣīrakākōlībr̥hatīkapikacchubhiḥ||62||

kharjūraphalamēdābhiḥ kṣīrapiṣṭaiḥ palōnmitaiḥ|
dhātrīvidārīkṣurasaprasthaiḥ prasthaṁ ghr̥tāt pacēt||63||

śarkarārdhatulāṁ śītē kṣaudrārdhaprasthamēva ca|
dattvā sarpirguḍān kuryātkāsahikkājvarāpahān||64||

yakṣmāṇaṁ tamakaṁ śvāsaṁ raktapittaṁ halīmakam|
śukranidrākṣayaṁ tr̥ṣṇāṁ hanyuḥ kārśyaṁ sakāmalam||65||

iti tr̥tīyāḥ sarpirguḍāḥ

tvakkShIrIshrAvaNIdrAkShAmUrvarShabhakajIvakaiH|
vIrardhikShIrakAkolIbRuhatIkapikacchubhiH||62||

kharjUraphalamedAbhiH kShIrapiShTaiH palonmitaiH|
dhAtrIvidArIkShurasaprasthaiH prasthaM ghRutAt pacet||63||

sharkarArdhatulAM shIte kShaudrArdhaprasthameva ca|
dattvA sarpirguDAn kuryAtkAsahikkAjvarApahAn||64||

yakShmANaM tamakaM shvAsaM raktapittaM halImakam|
shukranidrAkShayaM tRuShNAM hanyuH kArshyaM sakAmalam||65||

iti tRutIyAH sarpirguDAH|

One pala of each of tvak-kshiri, shravani (munditika), draksha, murva, rushabhaka, jivaka, vira (vidarikanda), riddhi, kshirakakoli, brihati, kapikacchu, fruit of kharjura and meda should be made into paste by triturating with milk. This paste, juice of dhatri (two prasthas), juice of vidari (two prasthas), sugarcane juice (two prasthas), and ghee (two prasthas) should be cooked together. After the ghee is well cooked and cooled, half tulas of sugar and one prastha of honey should be added, out of which cakes (sarpi gud) should be prepared. These cakes cures cough, hiccup, fever, rajayakshma, tamaka svasa, rakta-pitta, halimaka ( a serious type of jaundice), shukra kshaya (diminution of shukra), insomnia, trishna (morbid thirst), karshya (emaciation) and kamala (jaundice). (In transalation liquids, ghee and honey are taken double the prescribed quantity according to the rule) [ 62-65]

Sarpi gud (fourth recipe)

नवमामलकं द्राक्षामात्मगुप्तां पुनर्नवाम्|
शतावरीं विदारीं च समङ्गां पिप्पलीं तथा||६६||

पृथग्दशपलान् भागान् पलान्यष्टौ च नागरात्|
यष्ट्याह्वसौवर्चलयोर्द्विपलं मरिचस्य च||६७||

क्षीरतैलघृतानां च त्र्याढके शर्कराशते|
क्वथिते तानि चूर्णानि दत्त्वा बिल्वसमान् गुडान्||६८||

कुर्यात्तान् भक्षयेत् क्षीणः क्षतः शुष्कश्च मानवः|
तेन सद्यो रसादीनां वृद्ध्या पुष्टिं स विन्दति||६९||

इति चतुर्थसर्पिर्गुडाः|

navamāmalakaṁ drākṣāmātmaguptāṁ punarnavām|
śatāvarīṁ vidārīṁ ca samaṅgāṁ pippalīṁ tathā||66||

pr̥thagdaśapalān bhāgān palānyaṣṭau ca nāgarāt|
yaṣṭyāhvasauvarcalayōrdvipalaṁ maricasya ca||67||

kṣīratailaghr̥tānāṁ ca tryāḍhakē śarkarāśatē|
kvathitē tāni cūrṇāni dattvā bilvasamān guḍān||68||

kuryāttān bhakṣayēt kṣīṇaḥ kṣataḥ śuṣkaśca mānavaḥ|
tēna sadyō rasādīnāṁ vr̥ddhyā puṣṭiṁ sa vindati||69||

iti caturthasarpirguḍāḥ

navamAmalakaM drAkShAmAtmaguptAM punarnavAm|
shatAvarIM vidArIM ca sama~ggAM pippalIM tathA||66||

pRuthagdashapalAn bhAgAn palAnyaShTau ca nAgarAt|
yaShTyAhvasauvarcalayordvipalaM maricasya ca||67||

kShIratailaghRutAnAM ca tryADhake sharkarAshate|
kvathite tAni cUrNAni dattvA bilvasamAn guDAn||68||

kuryAttAn bhakShayet kShINaH kShataH shuShkashca mAnavaH|
tena sadyo rasAdInAM vRuddhyA puShTiM sa vindati||69||

iti caturthasarpirguDAH|

Freshly collected and dried amalaki (ten palas), draksha (ten palas), atmagupta (ten palas), punarnava (ten palas), shatavari (ten palas), vidari (ten palas), samanga (ten palas), pippali (ten palas), nagara (eight palas), madhuyashti (one palas), saurvachala (one pala) and maricha (two palas) – all these drugs should be made to powders. Milk (two adhakas), tila taila (two adhakas), ghee (two adhakas) and sugar (one hundred palas) should be cooked together. Thereafter, the above mentioned powder should be added to it. Out of this, cakes of one bilva or pala each should be prepared. These cakes should be taken by the person suffering from kshatakshina and consumption. Intake of these cakes instantaneously promote tissues elements like rasa etc. as a result of which the individual gets nourished. [66-69]

Sarpi modaka (fifth recipe)

गोक्षीरार्धाढकं सर्पिः प्रस्थमिक्षुरसाढकम्|
विदार्याः स्वरसात्प्रस्थं रसात्प्रस्थं च तैत्तिरात्||७०||

दद्यात् सिध्यति तस्मिंस्तु पिष्टानिक्षुरसैरिमान्|
मधूकपुष्पकुडवं प्रियालकुडवं तथा||७१||

कुडवार्धं तुगाक्षीर्याः खर्जूराणां च विंशतिम्|
पृथग्बिभीतकानां च पिप्पल्याश्च चतुर्थिकाम्||७२||

त्रिंशत्पलानि खण्डाच्च मधुकात् कर्षमेव च|
तथाऽर्धपलिकान्यत्र जीवनीयानि दापयेत्||७३||

सिद्धेऽस्मिन् कुडवं क्षौद्रं शीते क्षिप्त्वाऽथ मोदकान्|
कारयेन्मरिचाजाजीपलचूर्णावचूर्णितान्||७४||

वातासृक्पित्तरोगेषु क्षतकासक्षयेषु च|
शुष्यतां क्षीणशुक्राणां रक्ते चोरसि संस्थिते||७५||

कृशदुर्बलवृद्धानां पुष्टिवर्णबलार्थिनाम्|
योनिदोषकृतस्रावहतानां चापि योषिताम्||७६||

गर्भार्थिनीनां गर्भश्च स्रवेद्यासां म्रियेत वा|
धन्या बल्या हितास्ताभ्यः शुक्रशोणितवर्धनाः||७७||

इति पञ्चमसर्पिर्मोदकाः|

gōkṣīrārdhāḍhakaṁ sarpiḥ prasthamikṣurasāḍhakam|
vidāryāḥ svarasātprasthaṁ rasātprasthaṁ ca taittirāt||70||

dadyāt sidhyati tasmiṁstu piṣṭānikṣurasairimān|
madhūkapuṣpakuḍavaṁ priyālakuḍavaṁ tathā||71||

kuḍavārdhaṁ tugākṣīryāḥ kharjūrāṇāṁ ca viṁśatim|
pr̥thagbibhītakānāṁ ca pippalyāśca caturthikām||72||

triṁśatpalāni khaṇḍācca madhukāt karṣamēva ca|
tathā'rdhapalikānyatra jīvanīyāni dāpayēt||73||

siddhē'smin kuḍavaṁ kṣaudraṁ śītē kṣiptvā'tha mōdakān|
kārayēnmaricājājīpalacūrṇāvacūrṇitān||74||

vātāsr̥kpittarōgēṣu kṣatakāsakṣayēṣu ca|
śuṣyatāṁ kṣīṇaśukrāṇāṁ raktē cōrasi saṁsthitē||75||

kr̥śadurbalavr̥ddhānāṁ puṣṭivarṇabalārthinām|
yōnidōṣakr̥tasrāvahatānāṁ cāpi yōṣitām||76||

garbhārthinīnāṁ garbhaśca sravēdyāsāṁ mriyēta vā|
dhanyā balyā hitāstābhyaḥ śukraśōṇitavardhanāḥ||77||

iti pañcamasarpirmōdakāḥ

gokShIrArdhADhakaM sarpiH prasthamikShurasADhakam|
vidAryAH svarasAtprasthaM rasAtprasthaM ca taittirAt||70||

dadyAt sidhyati tasmiMstu piShTAnikShurasairimAn|
madhUkapuShpakuDavaM priyAlakuDavaM tathA||71||

kuDavArdhaM tugAkShIryAH kharjUrANAM ca viMshatim|
pRuthagbibhItakAnAM ca pippalyAshca caturthikAm||72||

triMshatpalAni khaNDAcca madhukAt karShameva ca|
tathA~ardhapalikAnyatra jIvanIyAni dApayet||73||

siddhe~asmin kuDavaM kShaudraM shIte kShiptvA~atha modakAn|
kArayenmaricAjAjIpalacUrNAvacUrNitAn||74||

vAtAsRukpittarogeShu kShatakAsakShayeShu ca|
shuShyatAM kShINashukrANAM rakte corasi saMsthite||75||

kRushadurbalavRuddhAnAM puShTivarNabalArthinAm|
yonidoShakRutasrAvahatAnAM cApi yoShitAm||76||

garbhArthinInAM garbhashca sravedyAsAM mriyeta vA|
dhanyA balyA hitAstAbhyaH shukrashoNitavardhanAH||77||

iti pa~jcamasarpirmodakAH|

Cow’s milk (one adhaka), ghee (two prasthas), sugar cane juice (two adhakas), juice of vidari (two prasthas) and soup of meat of tittira (two prasthas) should be cooked together. During the final stage of cooking, the paste of madhuka pushpa (one kudava), priyala (one kudava), tugakshiri (half kudava), kharjura (twenty fruits), bibhitaki (twenty fruits), pippali (one pala), sugar (thirty palas), madhuka (one karsa) and drugs belonging to jivaniya group (half pala each) should be added. The above mentioned drugs should be made to a paste by triturating with sugarcane juice before adding to the recipe. After the recipe is fully cooked and cooled, honey (two kudavas) should be added and from it, modaka (large size pills) should be prepared. Over these modakas, one pala of the powder of maricha and ajaji should be sprinkled. These modakas cure vatasruka, diseases caused by pitta, kshatakshina, kasa and kshaya. These are useful for persons suffering from emaciation, who have reduced semen, whose blood is blocked in the chest, who are thin, weak and old, and also for those desirous of having nourishment, complexion and strength. These modakas are also helpful for ladies suffering from exudations through the vitiated genital tract, who desire conception and who suffer from miscarriages and death of the fetus in the womb. By the use of these pills, ladies are endowed with auspiciousness strength and wholesomeness. These are promoters of shukra (sperm) and shonita (ovum). [70-77]

Recipes

बस्तिदेशे विकुर्वाणे स्त्रीप्रसक्तस्य मारुते|
वातघ्नान् बृंहणान् वृष्यान् योगांस्तस्य प्रयोजयेत्||७८||

शर्करापिप्पलीचूर्णैः सर्पिषा माक्षिकेण च|
संयुक्तं वा शृतं क्षीरं पिबेत् कासज्वरापहम्||७९||

फलाम्लं सर्पिषा भृष्टं विदारीक्षुरसे शृतम्|
स्त्रीषु क्षीणः पिबेद्यूषं जीवनं बृंहणं परम्||८०||

सक्तूनां वस्त्रपूतानां मन्थं क्षौद्रघृतान्वितम्|
यवान्नसात्म्यो दीप्ताग्निः क्षतक्षीणः पिबेन्नरः||८१||

जीवनीयोपसिद्धं वा जाङ्गलं घृतभर्जितम्|
रसं प्रयोजयेत् क्षीणे व्यञ्जनार्थं सशर्करम्||८२||

गोमहिष्यश्वनागाजैः क्षीरैर्मांसरसैस्तथा|
यवान्नं भोजयेद्यूषैः फलाम्लैर्घृतसंस्कृतैः||८३||

दीप्तेऽग्नौ विधिरेषः स्यान्मन्दे दीपनपाचनः|
यक्ष्मिणां विहितो ग्राही भिन्ने शकृति चेष्यते||८४||

bastidēśē vikurvāṇē strīprasaktasya mārutē|
vātaghnān br̥ṁhaṇān vr̥ṣyān yōgāṁstasya prayōjayēt||78||

śarkarāpippalīcūrṇaiḥ sarpiṣā mākṣikēṇa ca|
saṁyuktaṁ vā śr̥taṁ kṣīraṁ pibēt kāsajvarāpaham||79||

phalāmlaṁ sarpiṣā bhr̥ṣṭaṁ vidārīkṣurasē śr̥tam|
strīṣu kṣīṇaḥ pibēdyūṣaṁ jīvanaṁ br̥ṁhaṇaṁ param||80||

saktūnāṁ vastrapūtānāṁ manthaṁ kṣaudraghr̥tānvitam|
yavānnasātmyō [4] dīptāgniḥ kṣatakṣīṇaḥ pibēnnaraḥ||81||

jīvanīyōpasiddhaṁ vā jāṅgalaṁ ghr̥tabharjitam|
rasaṁ prayōjayēt kṣīṇē vyañjanārthaṁ saśarkaram||82||

gōmahiṣyaśvanāgājaiḥ kṣīrairmāṁsarasaistathā|
yavānnaṁ [5] bhōjayēdyūṣaiḥ phalāmlairghr̥tasaṁskr̥taiḥ||83||

dīptē'gnau vidhirēṣaḥ syānmandē dīpanapācanaḥ|
yakṣmiṇāṁ vihitō grāhī bhinnē śakr̥ti cēṣyatē||84||

Bastideshe vikurvANe strIprasaktasya mArute|
vAtaghnAn bRuMhaNAn vRuShyAn yogAMstasya prayojayet||78||

sharkarApippalIcUrNaiH sarpiShA mAkShikeNa ca|
saMyuktaM vA shRutaM kShIraM pibet kAsajvarApaham||79||

phalAmlaM sarpiShA bhRuShTaM vidArIkShurase shRutam|
strIShu kShINaH pibedyUShaM jIvanaM bRuMhaNaM param||80||

saktUnAM vastrapUtAnAM manthaM kShaudraghRutAnvitam|
yavAnnasAtmyo dIptAgniH kShatakShINaH pibennaraH||81||

jIvanIyopasiddhaM vA jA~ggalaM ghRutabharjitam|
rasaM prayojayet kShINe vya~jjanArthaM sasharkaram||82||

gomahiShyashvanAgAjaiH kShIrairmAMsarasaistathA|
yavAnnaM bhojayedyUShaiH phalAmlairghRutasaMskRutaiH||83||

dIpte~agnau vidhireShaH syAnmande dIpanapAcanaH|
yakShmiNAM vihito grAhI bhinne shakRuti ceShyate||84||

In person induging in excess sexual intercourse with women, (vitiated) vata afflicts pelvic region. To such patients, recipes which are alleviators of vata, promoters of nourishment and aphrodisiacs are to be administered.

Sugar, powder of pippali ghee and/or honey should be added to milk and given to patient to drink for the cure of cough and fever. These ingredients can be added to milk after or before boiling, appropriately. (Whenever honey is to be used, it should be added to the milk after it is boiled and cooled.)

Phalamla should be fried in ghee and boiled with the juice of vidari and sugar-cane. The vegetable soup, thus prepared, is useful for a patient who is emaciated because of excessive indulgence in women. This is an excellent recipe for the promotion of longevity and nourishment.

Roasted barley flour should be sieved through a cloth, and mantha (thin gruel) should be prepared out of it. This gruel should be added with honey and ghee, and given to a patient suffering from kshatakshina, provided that he is accustomed to taking barley as one of the ingredients of the food and if he has strong power of digestion.

Alternatively, meat of animal inhabiting arid zone (jangala) should be boiled with the drugs belonging to the jivaniya group. The meat soup, thus prepared, should be sizzled with ghee, added with sugar and used as a said dish (vyanjana) for a patient suffering from kshatakshina.

Boiled barley should be given to a patient suffering from kshatakshina along with the milk of buffalo, mare, elephant and goat or with the meat soup or with vegetable soup or with phalamla sizzled with ghee.

The above mentioned recipes should be given to a patient having strong power of digestion. If the power of digestion is suppressed, then the patient should be given recipes which are stimulants of digestion and carminative. If there is diarrhea in a patient suffering from kshatakshina, then the bowel – binding recipes prescribed for the treatment of rajayakshma (chapter-8) should be used. [78-84]

Saindhavadi churna

पलिकं सैन्धवं शुण्ठी द्वे च सौवर्चलात् पले|
कुडवांशानि वृक्षाम्लं दाडिमं पत्रमर्जकात्||८५||

एकैकं मरिचाजाज्योर्धान्यकाद्द्वे चतुर्थिके|
शर्करायाः पलान्यत्र दश द्वे च प्रदापयेत्||८६||

कृत्वा चूर्णमतो मात्रामन्नपाने प्रयोजयेत्|
रोचनं दीपनं बल्यं पार्श्वार्तिश्वासकासनुत्||८७||

इति सैन्धवादिचूर्णम्|

palikaṁ saindhavaṁ śuṇṭhī dvē ca sauvarcalāt palē|
kuḍavāṁśāni vr̥kṣāmlaṁ dāḍimaṁ patramarjakāt||85||

ēkaikaṁ maricājājyōrdhānyakāddvē caturthikē|
śarkarāyāḥ palānyatra daśa dvē ca pradāpayēt||86||

kr̥tvā cūrṇamatō mātrāmannapānē prayōjayēt|
rōcanaṁ dīpanaṁ balyaṁ pārśvārtiśvāsakāsanut||87||

iti saindhavādicūrṇam

palikaM saindhavaM shuNThI dve ca sauvarcalAt pale|
kuDavAMshAni vRukShAmlaM dADimaM patramarjakAt||85||

ekaikaM maricAjAjyordhAnyakAddve caturthike|
sharkarAyAH palAnyatra dasha dve ca pradApayet||86||

kRutvA cUrNamato mAtrAmannapAne prayojayet|
rocanaM dIpanaM balyaM pArshvArtishvAsakAsanut||87||

iti saindhavAdicUrNam|

Saindhava (one pala), shunthi (one pala), sauvarchala (two palas), vrikshamla (one kudava), dadima (one kudava), leaf of arjaka (one kudava), maricha (one pala), ajaji (one pala), dhanyaka (two palas) and sugar (twelve palas) should be made in to powder and mixed together. In appropriate quantity, this powder should be added to food and drinks. It is appetizer, stimulant of digestion and promoter of strength. It cures parshvashula (pain in the sides of the chest), shvasa (respiratory disorders including asthma) and kasa (cough). [85-87]

Shadava recipe

एका षोडशिका धान्याद्द्वे द्वेऽजाज्यजमोदयोः|
ताभ्यां दाडिमवृक्षाम्लं द्विर्द्विः सौवर्चलात्पलम्||८८||

शुण्ठ्याः कर्षं दधित्थस्य मध्यात् पञ्च पलानि च|
तच्चूर्णं षोडशपले शर्कराया विमिश्रयेत्||८९||

षाडवोऽयं प्रदेयः स्यादन्नपानेषु पूर्ववत्|
मन्दानले शकृद्भेदे यक्ष्मिणामग्निवर्धनः||९०||

इति षाडवः|

ēkā ṣōḍaśikā dhānyāddvē dvē'jājyajamōdayōḥ|
tābhyāṁ dāḍimavr̥kṣāmlaṁ dvirdviḥ sauvarcalātpalam||88||

śuṇṭhyāḥ karṣaṁ dadhitthasya madhyāt pañca palāni ca|
taccūrṇaṁ ṣōḍaśapalē śarkarāyā vimiśrayēt||89||

ṣāḍavō'yaṁ pradēyaḥ syādannapānēṣu pūrvavat|
mandānalē śakr̥dbhēdē yakṣmiṇāmagnivardhanaḥ||90||

iti ṣāḍavaḥ

ekA ShoDashikA dhAnyAddve dve~ajAjyajamodayoH|
tAbhyAM dADimavRukShAmlaM dvirdviH sauvarcalAtpalam||88||

shuNThyAH karShaM dadhitthasya madhyAt pa~jca palAni ca|
taccUrNaM ShoDashapale sharkarAyA vimishrayet||89||

ShADavo~ayaM pradeyaH syAdannapAneShu pUrvavat|
mandAnale shakRudbhede yakShmiNAmagnivardhanaH||90||

iti ShADavaH|

Powders of dhanyaka (one pala), ajaji (two palas), ajamoda (two palas), dadima (four palas), vrikshamla (four palas), sauvarchala (one pala), shunthi (one karsa), pulp of kapittha (five palas) and sugar (sixteen palas) should be mixed together. Like the other recipe, the present shadava (delicious recipe having sweet and sour tastes) should be administered along with food and drinks for the treatment of mandanala (suppression of the power of digestion) and diarrhea. It promotes the digestive power of patients suffering from rajayakshma. [88-90]

Nagabala kalpa

पिबेन्नागबलामूलमर्धकर्षविवर्धितम्[ |
पलं क्षीरयुतं मासं क्षीरवृत्तिरनन्नभुक्||९१||

एष प्रयोगः पुष्ट्यायुर्बलारोग्यकरः परः|
मण्डूकपर्ण्याः कल्पोऽयं शुण्ठीमधुकयोस्तथा||९२||

pibēnnāgabalāmūlamardhakarṣavivardhitam [6] |
palaṁ kṣīrayutaṁ māsaṁ kṣīravr̥ttiranannabhuk||91||

ēṣa prayōgaḥ puṣṭyāyurbalārōgyakaraḥ paraḥ|
maṇḍūkaparṇyāḥ kalpō'yaṁ śuṇṭhīmadhukayōstathā||92||

pibennAgabalAmUlamardhakarShavivardhitam|
palaM kShIrayutaM mAsaM kShIravRuttiranannabhuk||91||

eSha prayogaH puShTyAyurbalArogyakaraH paraH|
maNDUkaparNyAH kalpo~ayaM shuNThImadhukayostathA||92||

Half karsha of the root (bark) of nagabala should be boiled with milk and given to the patient on the first day. Thereafter, the powder of nagabala root (bark) should be increased by half karsha every day, and given by boiling with milk. On eighth day, the quantity of nagabala- root will be one pala. Thereafter the patient should continue to take this drug in the dose of one pala for one month. While taking this drug boiled with milk, the patient should refrain from taking any cereals. Whenever he feels hungry, he should take only milk. The recipe is excellent for the promotion of nourishment, longevity, strength and immunity to diseases.

In the above mentioned manner, mandukaparni, sunthi and madhuka should be administered for therapeutic effects described above.[91-92]

Diet and Drinks

यद्यत् सन्तर्पणं शीतमविदाहि हितं लघु|
अन्नपानं निषेव्यं तत्क्षतक्षीणैः सुखार्थिभिः||९३||

यच्चोक्तं यक्ष्मिणां पथ्यं कासिनां रक्तपित्तिनाम्|
तच्च कुर्यादवेक्ष्याग्निं व्याधिं सात्म्यं बलं तथा||९४||

yadyat santarpaṇaṁ śītamavidāhi hitaṁ laghu|
annapānaṁ niṣēvyaṁ tatkṣatakṣīṇaiḥ sukhārthibhiḥ||93||

yaccōktaṁ yakṣmiṇāṁ pathyaṁ kāsināṁ raktapittinām|
tacca kuryādavēkṣyāgniṁ vyādhiṁ sātmyaṁ balaṁ tathā||94||

Yadyat santarpaNaM shItamavidAhi hitaM laghu|
annapAnaM niShevyaM tatkShatakShINaiH sukhArthibhiH||93||

yaccoktaM yakShmiNAM pathyaM kAsinAM raktapittinAm|
tacca kuryAdavekShyAgniM vyAdhiM sAtmyaM balaM tathA||94||

Food and drinks which are nourishing, cooling, avidahi (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from kshatakshina and who is desirous of regaining health. With due regard to the agni (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for rajayakshma, kasa and raktapitta.[93-94]

Need for prompt attention

उपेक्षिते भवेत्तस्मिन्ननुबन्धो हि यक्ष्मणः|
प्रागेवागमनात्तस्य तस्मात्तं त्वरया जयेत्||९५||

upēkṣitē bhavēttasminnanubandhō hi yakṣmaṇaḥ|
prāgēvāgamanāttasya tasmāttaṁ tvarayā jayēt||95||

upekShite bhavettasminnanubandho hi yakShmaNaH|
prAgevAgamanAttasya tasmAttaM tvarayA jayet||95||

If the patient suffering from kshatakshina is not given appropriate treatment on time, then this may lead to rajayakshma. Therefore well before the appearance of rajayakshma, the kshatakhsina should be treated, subdued (cured). [95]

Summary

तत्र श्लोकौ-

क्षतक्षयसमुत्थानं सामान्यपृथगाकृतिम्|
असाध्ययाप्यसाध्यत्वं साध्यानां सिद्धिमेव च||९६||

उक्तवाञ्ज्येष्ठशिष्याय क्षतक्षीणचिकित्सिते|
तत्त्वार्थविद्वीतरजस्तमोदोषः[१] पुनर्वसुः||९७||

tatra ślōkau-

kṣatakṣayasamutthānaṁ sāmānyapr̥thagākr̥tim|
asādhyayāpyasādhyatvaṁ sādhyānāṁ siddhimēva ca||96||

uktavāñjyēṣṭhaśiṣyāya kṣatakṣīṇacikitsitē|
tattvārthavidvītarajastamōdōṣaḥ [7] punarvasuḥ||97||

tatra shlokau-

kShatakShayasamutthAnaM sAmAnyapRuthagAkRutim|
asAdhyayApyasAdhyatvaM sAdhyAnAM siddhimeva ca||96||

uktavA~jjyeShThashiShyAya kShatakShINacikitsite|
tattvArthavidvItarajastamodoShaH punarvasuH||97||

To sum up:

In this chapter, on the treatment of kshatakshina, Lord Punarvasu who is conversant with truth and who is free from rajas (one of the three attributes representing fickle mindedness including passion) and [[[tamas]] (one of the three attributes representing slackness including ignorance) imparted instincts to the senior disciple on the following points:

  1. Etiology of kshatakshina;
  2. Signs and symptoms of kshatakshina in general and of each variety;
  3. Incurability, palliability and curability of kshatakshina; and
  4. Successful treatment of curable variety of kshatakshina. [96-97]

इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलपूरिते चिकित्सितस्थाने क्षतक्षीणचिकित्सितं नामैकादशोऽध्यायः||११||

ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalapūritē cikitsitasthānē kṣatakṣīṇacikitsitaṁ nāmaikādaśō'dhyāyaḥ||11||

ityagniveshakRute tantre~aprApte dRuDhabalapUrite cikitsitasthAne kShatakShINacikitsitaM nAmaikAdasho~adhyAyaH||11||

Thus, ends the eleventh chapter (on the treatment of Kshatakshina) of the Chikitsa Sthana; in the section on the therapeutics of Agnivesha’s work as redacted by Charak and not being available, restored by Dridhabala.

Tattva Vimarsha (Fundamental Principles)

  • In Kshatakshina, kshata (injury) is caused due to indulgence in various physical activities beyond one’s capacity. Kshina is a consequence of that injury with improper dietary habit and excess sexual intercourse.
  • The dhatu kshaya (depletion of tissues) is major pathological event in this disease. Hence brimhana(nourishment) and replenishment of depleted tissues is principle of management.
  • The onset is acute without appearance of any premonitory symptom.
  • If the manifestation of disease is mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. The disease is yapya (palliable), if the disease is chronic i.e. more than one year. If however, all the signs and symptoms of the disease are simultaneously manifested, then the condition is incurable.
  • Milk, meat, ghee and honey processed with jivaniya herbs have significant role in treatment of kshatakshina. Fresh blood of animals is also used in treatment of excess bleeding.
  • Food and drinks which are nourishing, cooling, avidahi (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from kshatakshina.
  • With due regard to the agni (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for rajayakshma, kasa and raktapitta.
  • Kshatakshina , if untreated, results in rajayakshma. Therefore, treatment at appropriate time is necessary to prevent rajayakshma.

Vidhi Vimarsha (Applied Inferences)

Kshatakshina is a disease characterized by depletion of body tissues due to chest injury. In present era, the condition occurs due to over exertion, strenuous work beyond one’s capacity, direct or indirect injury to the chest. The conditions like pneumothorax, pleural effusion and related respiratory conditions need to be addressed simultaneously by the surgical team to prevent progression of emaciation and complications of injury to vital lung tissues.

Etiopathology

The etiological factors can be divided into two categories viz. (1) Exogenous factors related to over-exertion/ strenuous physical activity that causes trauma to the lung tissues, excess weight lifting and excess sexual intercourse. Studies showed that strenuous athletic activities like vigorous swimming, heavy weight lifting, jolting, etc. can cause pneumothorax (PTX), pleural effusion and pneumomediastinum (PTM) etc. (2) Endogenous factors related to malnutrition that cause depletion of body tissues and excess intake of food having dry properties (less intake of unctuous dietary substances like ghee, oil, fats. Lipids leading to dryness in body) The etiological factors described for kshata are related to those that cause spontaneous lung injury.

Pathogenesis

The disease has acute onset without any premonitory signs. This shows sudden appearance of clinical features due to traumatic etiology. As disease progresses, it leads to depletion of body tissues causing emaciation.

The patient suffers from fever, pain, mental depression, diarrhea, anorexia, indigestion, cough with putrid sputum grayish in color, foul smelling, and yellow and knotty, in large quantities, with blood.

  • Subjective and objective parameters (scales with references)
  • Clinical examination: Chest auscultation for added sounds, decreased air entry, Body mass index. Lung function tests including spirometry
  • Pathological/radiological/ investigations: Sputum test for presence of Acid fast bacilli, RBCs, Chest X ray for fracture of ribs, opacity in lungs, pneumonia patch, pneumothorax, plural effusion etc.
  • Differential diagnosis:Pulmonary tuberculosis, Carcinoma of lungs, oesophageal varieces
  • Complications
    • Pulmonary tuberculosis
  • Prognosis: Curable if newly developed, and mildly emaciated, palliable in chronic stage, incurable in advanced stage and severely emaciated with multiple system involvement

Management of disease

  • Experience based clinical practices:
    • Applied principles in management of disease conditions
    • Styptic agents to stop bleeding
    • Binding agents for union of bones and injured tissues
    • Nourishing regimen for depletion of body tissues
    • Rejuvenation therapies

Shodhana chikitsa (body purification treatments) and procedures

Purification treatments are not indicated in this disease.

Therapeutic massage with kshirabala oil, Bala-ashwagandha lakshadi oil is done.

Chest physiotherapy for improving lung functions is advised.

Shamana chikitsa (pacification treatments) with list of formulations and medicines

S.No. Name of Medicine Dose Time of Administration Mode of Administration (Anupana)
1 Laksha Mixture 10-20 grams Frequently Vasavaleha
2 Amritaprasha ghee 10-20 grams After meals Milk
3 Suvarna malini vasanta 120-240 mg In between two meals Milk
4 Lakshmi Vilasa 60-120 mg In between two meals Milk
5 Vanga mishrana 250-500 mg In between two meals Milk
  • Pathya or recommended diet: Light to digest food like shali rice, wheat, green gram, pomegranate, dry grapes, mango, amalaka, goat milk and ghee prepared of it, medicated milk, meat juice of goat
  • Pathya or recommended activity: Total bed rest
  • Apathya or contraindicated diet: Excess hot, pungent, salty food causing burning sensation, heavy to digest food.
  • Apathya or contraindicated activity: Over exertion, strenuous exercise, weight lifting etc.

Parallel management of chest injury

Use of sandhaniya drugs like laksha (mainly indicated for the healing of fracture of bone) and madhuyashti clearly indicates that in kshatakshina there is external trauma (ribs fracture leading to pneumothorax) that should be managed with quick remedies. As only conservative management for the kshatakshina is described, it excludes the possibility of surgical interventions in kshatakshina in that era. However nowadays the surgical procedures like tube drainage with or without medical pleurodesis, vacuum-assisted thoracostomy (VATS) with pleurodesis and/or closure of leaks and bullectomy, and open surgical procedures such as thoracotomy for pleurectomy or pleurodesis) are conducted to decrease the chances of incurability of kshatakshina. At the present time, it is necessary to elaborate the management of acute dreaded complications like pneumothorax and hematuria in separate chapter.

Future Scope for Research

  • Exploring the clinical evidences for the immunomodulator and hemostatic properties of Sida Veronicaefolia Lam. (Nagabala).
  • In-vitro and in-vivo evaluation of hemostatic property of Boerhavia diffusa and clinical demonstration of its use in hemoptysis.
  • Exploring the role of auto-antibodies in the pathogenesis of tuberculosis and its relation with genetic suspectibility.
  • Evaluating the role of laksha (Laccifer lacca) and madhuyasti (Glycyrrhiza glabra) in rehabilitating pulmonary tissues in acute pulmonary injury.
  • Evaluating role of anti-oxidant drugs [like amalaki (Emblica officinalis)] and vitamin C in the management of chronic inflammatory as well as infectious pulmonary diseases.

Further reading

  1. Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
  2. Miles JW, Barrett GR. Rib fractures in athletes. Sports Med 1991;12:66 – 9.
  3. Garcia VF, Gotschall CS, Eichelberger MR, Bowman LM. Rib fractures in children: a marker of severe trauma. J Trauma 1990;30:695 – 700.
  4. Armstrong CP, Vanderspuy J. The fractured scapula: importance in management based on series of 62 patients. Injury 1984;15:324 – 9.
  5. Ferro RT, McKeag DB. Neck pain and dyspnea in a swimmer. Phys Sports Med 1999;27.
  6. Neer II CS. Fractures about the shoulder. In: Rockwood Jr CA, Green DP, editors. Fractures. Philadelphia: JD Lippincott; 1984. p. 713 – 21.
  7. Pfeiffer RP, Young TR. Case report: spontaneous pneumothorax in a jogger. Phys Sportsmed 1980;8:65 – 7.
  8. Marnejon T, Sarac S, Cropp AJ. Spontaneous pneumothorax in weightlifters. J Sports Med Phys Fitness 1995;35:124 – 6.
  9. Simoneaux SF, Murphy BJ, Tehranzadeh J. Spontaneous pneumothorax in a weightlifter. Am J Sports Med 1990;18:647 – 8.
  10. Harker CP, Neuman TS, Olson LK, et al. The roentgenographic findings associated with air embolism in sport scuba divers. J Emerg Med 1993;11:443 – 9.
  11. Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
  12. Partridge RA, Coley A, Bowie R, Woolard RH. Sports-related pneumothorax. Ann Emerg Med1997;30:539 – 41.
  13. Funk DA, McGanity PL, Hagemeier III KF, Schenck Jr RC. Pneumothorax in high school football. Tex Med 1998;94:72 – 4.
  14. Ziser A, Vaananen A, Melamed Y. Diving and chronic spontaneous pneumothorax. Chest 1985;87:264 – 5.
  15. Belham GJ, Adler M. Pneumothorax in a boxer. Br J Sports Med 1985;19:45.
  16. Sadat-Ali M, Al-Arfaj AL, Mohanna J. Pneumothorax due to soccer injury. Br J Sports Med 1986;20(2):91.
  17. Ciocca M. Pneumothorax in a weight lifter. Phys Sportsmed 2000;28.
  18. Harmer PA, Moriarty J, Walsh M, Bean M, Cramer J. Distant entry pneumothorax in a competitive fencer. Br J Sports Med 1996;30:265–6.
  19. Fischer RP, Flynn TC, Miller PW, Thompson DA. Scapular fractures and major ipsilateral upper torso injuries. Curr Concepts Trauma Care 1985;1:14– 6.
  20. Morgan EJ, Henderson DA. Pneumomediastinum as a complication of athletic competition. Thorax 1981;36:155–6.
  21. O’Kane J, O’Kane E, Marquet J. Delayed complication of a rib fracture. Phys Sports med 1998;26.
  22. Kizer KW, MacQuarrie MB. Pulmonary air leaks resulting from outdoor sports. A clinical series and literature review. Am J Sports Med 1999;27:517– 20.
  23. Volk CP, McFarland EG, Horsmon G. Pneumothorax: on field recognition. Phys Sportsmed 1995;23:43 – 6.
  24. Pasternak, M.S., & Rubin, R.H. (2001). Urinary tract tuberculosis. In R.W. Schrier (Ed.), Diseases of the kidney and urinary tract. (7th ed.) (pp. 1017-1037). Philadelphia: Lippincott Wil liams & Wilkins.
  25. Gibson, M.S., Puckett, M.L., & Shelly, M.E. (2004). Renal tuberculosis. RadioGraphics, 24, 251-256.
  26. Anwar, N., & Azher, A. (2002). Tuberculosis in a solitary kidney. Pakistan Journal of Medical Research, 41(4), 173-174.
  27. Soliman, M.S., Lessnau, K., & Hashmat, A. (2006). Tuberculosis of the genitourinary system. Retrieved March 11,2007, from http://www.emedicine.com/med/topic3073..htm.
  28. Centers for Disease Control and Prevention. (2005). Controlling tuberculosis in the United States. Mortality and Morbidity Weekly Reports (MMWR): Recommended Reports 54 (RR-12), 1-77.
  29. Khan, A.N., Chandramohan, M., & MacDonald, S. (2004, November 5). Tuberculosis, genitourinary tract. Retrieved March 11, 2007from http://www.emedicine.com/radio/topic721.ht
  30. Ahmed, M., & Murty, K. V. (2003). Isolated tuberculous pyonephrosis of a native kidney in a renal allograft recipient,an unusual manifestation of tuberculosis – A case report. Indian Journal of Nephrology, 13, 75-79.
  31. Kenney, P.J. (1990). Imaging of chronic renal infections. American Journal of Radiology, 155, 485-494.
  32. Christensen, W. (1974). Genitourinary tuberculosis: Review of 102 cases. Medicine (Baltimore), 53, 377-390.
  33. Kathuria, P; Sanghera, P; Stevenson, FT; Sharma, S; Lederer, E; Lohr, JW; Talavera, F; Verrelli, M (21 May 2013). "Goodpasture Syndrome Clinical Presentation". In Batuman, C. Medscape Reference. WebMD. Retrieved 14 March 2014.
  34. Schwarz, MI (November 2013). "Goodpasture Syndrome: Diffuse Alveolar Hemorrhage and Pulmonary-Renal Syndrome". Merck Manual Professional. Retrieved 14 March 2014.
  35. Seo P, Stone JH (July 2004). "The antineutrophil cytoplasmic antibody-associated vasculitides". Am. J. Med. 117 (1): 39–50.
  36. Berden, A; Göçeroglu, A; Jayne, D; Luqmani, R; Rasmussen, N; Bruijn, JA; Bajema, I (January 2012). "Diagnosis and management of ANCA associated vasculitis.". BMJ 344: e26.
  37. Pandey Manisha, Sonker Kanchan, Kanoujia Jovita, Koshy M. K., Saraf Shubhini A. Sida Veronicaefolia as a Source of Natural Antioxidant. International Journal of Pharmaceutical Sciences and Drug Research 2009; 1(3): 180-182.
  38. Bhattacharya A, Chatterjee A, Ghosal S, Bhattacharya SK. Antioxidant activity of active tannoid principles of Emblica officinalis (amla). Indian J Exp Biol. 1999 Jul;37(7):676-80.

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