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अथातस्त्रिमर्मीयचिकित्सितमध्यायंव्याख्यास्यामः||१||
अथातस्त्रिमर्मीयचिकित्सितमध्यायंव्याख्यास्यामः||१||
इतिहस्माहभगवानात्रेयः||२||
इतिहस्माहभगवानात्रेयः||२||
athātastrimarmīyacikitsitamadhyāyaṁ vyākhyāsyāmaḥ||1||
athātastrimarmīyacikitsitamadhyāyaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
iti ha smāha bhagavānātrēyaḥ||2||
athAtastrimarmIyacikitsitamadhyAyaM vyAkhyAsyAmaH ||1||
athAtastrimarmIyacikitsitamadhyAyaM vyAkhyAsyAmaH ||1||
iti ha smAha bhagavAnAtreyaH ||2||
iti ha smAha bhagavAnAtreyaH ||2||
Lord Atreya said, we shall now present the chapter on treatment pertaining to the disorders to the three marma (vital organs) [1-2]
Lord Atreya said, we shall now present the chapter on treatment pertaining to the disorders to the three marma (vital organs) [1-2]
सप्तोत्तरंमर्मशतंयदुक्तंशरीरसङ्ख्यामधिकृत्यतेभ्यः|
सप्तोत्तरंमर्मशतंयदुक्तंशरीरसङ्ख्यामधिकृत्यतेभ्यः|
मर्माणिबस्तिंहृदयंशिरश्चप्रधानभूतानिवदन्तितज्ज्ञाः||३||
मर्माणिबस्तिंहृदयंशिरश्चप्रधानभूतानिवदन्तितज्ज्ञाः||३||
प्राणाश्रयात्,तानिहिपीडयन्तोवातादयोऽसूनपिपीडयन्ति|
प्राणाश्रयात्,तानिहिपीडयन्तोवातादयोऽसूनपिपीडयन्ति|
तत्संश्रितानामनुपालनार्थंमहागदानांशृणुसौम्यरक्षाम्||४||
तत्संश्रितानामनुपालनार्थंमहागदानांशृणुसौम्यरक्षाम्||४||
saptōttaraṁ marmaśataṁ yaduktaṁ śarīrasaṅkhyāmadhikr̥tya tēbhyaḥ|
saptōttaraṁ marmaśataṁ yaduktaṁ śarīrasaṅkhyāmadhikr̥tya tēbhyaḥ|
marmāṇi bastiṁ hr̥dayaṁ śiraśca pradhānabhūtāni vadanti tajjñāḥ||3||
marmāṇi bastiṁ hr̥dayaṁ śiraśca pradhānabhūtāni vadanti tajjñāḥ||3||
prāṇāśrayāt, tāni hi pīḍayantō vātādayō'sūnapi pīḍayanti|
prāṇāśrayāt, tāni hi pīḍayantō vātādayō'sūnapi pīḍayanti|
tatsaṁśritānāmanupālanārthaṁ mahāgadānāṁ śr̥ṇu saumya rakṣām||4||
tatsaṁśritānāmanupālanārthaṁ mahāgadānāṁ śr̥ṇu saumya rakṣām||4||
saptottaraM marmashataM yaduktaM sharIrasa~gkhyAmadhikRutya tebhyaH |
saptottaraM marmashataM yaduktaM sharIrasa~gkhyAmadhikRutya tebhyaH |
marmANi bastiM hr̥dayaM shirashca pradhAnabhUtAni vadanti tajj~jAH ||3||
marmANi bastiM hr̥dayaM shirashca pradhAnabhUtAni vadanti tajj~jAH ||3||
prANAshrayAt, tAni hi pIDayanto vAtAdayo~asUnapi pIDayanti |
prANAshrayAt, tAni hi pIDayanto vAtAdayo~asUnapi pIDayanti |
tatsaMshritAnAmanupAlanArthaM mahAgadAnAM shRuNu saumya rakShAm ||4||
tatsaMshritAnAmanupAlanArthaM mahAgadAnAM shRuNu saumya rakShAm ||4||
The vital organs (marma) are mentioned as 107 in number while enumerating different body parts in śarīrasthāna (7th chapter). As per the specialists of the subjects, three vital organs, viz, basti (urinary bladder), hr̥dayaṁ (heart) and śira (head) are considered supreme among themselves, because they posess life (prāna) in them. Their suffering due to vāta etc also troubles/ endangers life (prāna). Hence to protect these vital organs, the method of protection from the attack of diseases, and their management will be discussed which you may listen (adressed to agnivesha) [3-4]
The vital organs (marma) are mentioned as 107 in number while enumerating different body parts in śarīrasthāna (7th chapter). As per the specialists of the subjects, three vital organs, viz, basti (urinary bladder), hr̥dayaṁ (heart) and śira (head) are considered supreme among themselves, because they posess life (prāna) in them. Their suffering due to vāta etc also troubles/ endangers life (prāna). Hence to protect these vital organs, the method of protection from the attack of diseases, and their management will be discussed which you may listen (adressed to agnivesha) [3-4]
Etiology and pathogenesis, signs and symptoms of udavarta (abnormal upward movement of vata)
==== Etiology and pathogenesis, signs and symptoms of udavarta (abnormal upward movement of vata) ====
कषायतिक्तोषणरूक्षभोज्यैः
कषायतिक्तोषणरूक्षभोज्यैः
पक्वाशयेकुप्यतिचेदपानःस्रोतांस्यधोगानिबलीसरुद्ध्वा||५||
पक्वाशयेकुप्यतिचेदपानःस्रोतांस्यधोगानिबलीसरुद्ध्वा||५||
anye ca rogA bahavo~anilotthA bhavantyudAvartakRutAH sughorAH |
anye ca rogA bahavo~anilotthA bhavantyudAvartakRutAH sughorAH |
cikitsitaM cAsya yathAvadUrdhvaM pravakShyate tacchRuNu cAgnivesha! ||10||
cikitsitaM cAsya yathAvadUrdhvaM pravakShyate tacchRuNu cAgnivesha! ||10||
Etiology and pathogenesis
Etiology and pathogenesis
Due to the indulgence of astringent, bitter, pungent, dry/ un unctuous food consumption and indulgence of sex without proper food intake, strongly aggravates apana vāta in colon which obstructs downward moving channels and gradually obstructs the movement of stool, urine and the flatus causing udāvarta, the serious trouble. [5]
Due to the indulgence of astringent, bitter, pungent, dry/ un unctuous food consumption and indulgence of sex without proper food intake, strongly aggravates apana vāta in colon which obstructs downward moving channels and gradually obstructs the movement of stool, urine and the flatus causing udāvarta, the serious trouble. [5]
Signs and symptoms of udavarta
Signs and symptoms of udavarta
Intense and frequent pain in urinary bladder, cardiac region, pelvis, abdomen, and also severe pain in back and sides of chest; flatulence, nausea, cutting pain, piercing pain, indigestion, inflammation of urinary bladder; retention of stool, appearance of nodules in the abdomen, abnormal upward movement of vāta, Delayed and difficulty in evacuation of dry stool; body becomes rough, un unctuous, and cold and consequently disorders such as fever, dysuria, pravahika (spurious feeling of the need to evacuate stools with straining), cardiac disorders, grahani disorder (malabsorption syndrome), vomiting, blindness, deafness, burning sensation in head, vātodara (affliction of abdomen due to vata), asthilā (stony hard tumours), psychological disorders, thirst, hemorrhagic disorders, anorexia, gulma (lump like feeling), cough, dyspnea, rhinitis, facial paralysis and chest pain arise. Many other severe vāta disorders are caused by udāvarta. Treatment of these ailments will be described hereafter you may listen Agnivesha.
Intense and frequent pain in urinary bladder, cardiac region, pelvis, abdomen, and also severe pain in back and sides of chest; flatulence, nausea, cutting pain, piercing pain, indigestion, inflammation of urinary bladder; retention of stool, appearance of nodules in the abdomen, abnormal upward movement of vāta, Delayed and difficulty in evacuation of dry stool; body becomes rough, un unctuous, and cold and consequently disorders such as fever, dysuria, pravahika (spurious feeling of the need to evacuate stools with straining), cardiac disorders, grahani disorder (malabsorption syndrome), vomiting, blindness, deafness, burning sensation in head, vātodara (affliction of abdomen due to vata), asthilā (stony hard tumours), psychological disorders, thirst, hemorrhagic disorders, anorexia, gulma (lump like feeling), cough, dyspnea, rhinitis, facial paralysis and chest pain arise. Many other severe vāta disorders are caused by udāvarta. Treatment of these ailments will be described hereafter you may listen Agnivesha.
Treatment of udāvarta:
==== Treatment of udāvarta ====
तंतैलशीतज्वरनाशनाकंस्वेदैर्यथोक्तैःप्रविलीनदोषम्|
तंतैलशीतज्वरनाशनाकंस्वेदैर्यथोक्तैःप्रविलीनदोषम्|
उपाचरेद्वर्तिनिरूहबस्तिस्नेहैर्विरेकैरनुलोमनान्नैः||११||
उपाचरेद्वर्तिनिरूहबस्तिस्नेहैर्विरेकैरनुलोमनान्नैः||११||
In Kapha predominance: The enema should be with urine.
In Kapha predominance: The enema should be with urine.
Benefits of this enema: Relievs retention of urine, stool and flatus, it strengthens the anal region as well as the connected blood vessels. [16]
Benefits of this enema: Relievs retention of urine, stool and flatus, it strengthens the anal region as well as the connected blood vessels. [16]
Diet in udāvarta:
==== Diet in udāvarta ====
त्रिवृत्सुधापत्रतिलादिशाकग्राम्यौदकानूपरसैर्यवान्नम्|
त्रिवृत्सुधापत्रतिलादिशाकग्राम्यौदकानूपरसैर्यवान्नम्|
अन्यैश्चसृष्टानिलमूत्रविङ्भिरद्यात्प्रसन्नागुडसीधुपायी||१८||
अन्यैश्चसृष्टानिलमूत्रविङ्भिरद्यात्प्रसन्नागुडसीधुपायी||१८||
3. Followed by drink of prasanna (clear wine/top portion of alcohol) or gudasidhu-wine prepared out of jaggery. [18]
3. Followed by drink of prasanna (clear wine/top portion of alcohol) or gudasidhu-wine prepared out of jaggery. [18]
Treatment of chronic udāvarta and other complications:
==== Treatment of chronic udāvarta and other complications ====
भूयोऽनुबन्धेतुभवेद्विरेच्योमूत्रप्रसन्नादधिमण्डशुक्तैः|
भूयोऽनुबन्धेतुभवेद्विरेच्योमूत्रप्रसन्नादधिमण्डशुक्तैः|
स्वस्थंतुपश्चादनुवासयेत्तंरौक्ष्याद्धिसङ्गोऽनिलवर्चसोश्चेत्||१९||
स्वस्थंतुपश्चादनुवासयेत्तंरौक्ष्याद्धिसङ्गोऽनिलवर्चसोश्चेत्||१९||
If the patient is normalized but there is retention of flatus and stool due to ununctuousness, then patient should be given anuvasana type of medicated enema (unctuous enema). [19]
If the patient is normalized but there is retention of flatus and stool due to ununctuousness, then patient should be given anuvasana type of medicated enema (unctuous enema). [19]
Churna preparations:
==== Churna preparations ====
द्विरुत्तरंहिङ्गुवचाग्निकुष्ठंसुवर्चिकाचैवविडङ्गचूर्णम्|
द्विरुत्तरंहिङ्गुवचाग्निकुष्ठंसुवर्चिकाचैवविडङ्गचूर्णम्|
सुखाम्बुनाऽऽनाहविसूचिकार्तिहृद्रोगगुल्मोर्ध्वसमीरणघ्नम्||२०||
सुखाम्बुनाऽऽनाहविसूचिकार्तिहृद्रोगगुल्मोर्ध्वसमीरणघ्नम्||२०||
8 parts- kustha- Saussurea lappa C.B Clarke
8 parts- kustha- Saussurea lappa C.B Clarke
Intake of this [powder] alleviates pleehodara (splenomegaly), indigestion and visucika (diarrhea with pricking pain in abdomen).[22]
Intake of this [powder] alleviates pleehodara (splenomegaly), indigestion and visucika (diarrhea with pricking pain in abdomen).[22]
Ghrita preparation:
==== Ghrita preparation ====
स्थिरादिवर्गस्यपुनर्नवायाःशम्पाकपूतीककरञ्जयोश्च|
स्थिरादिवर्गस्यपुनर्नवायाःशम्पाकपूतीककरञ्जयोश्च|
सिद्धःकषायेद्विपलांशिकानांप्रस्थोघृतात्स्यात्प्रतिरुद्धवाते||२३||
सिद्धःकषायेद्विपलांशिकानांप्रस्थोघृतात्स्यात्प्रतिरुद्धवाते||२३||
Decoction prepared out of two pala (80 grams) of each drugs of sthiradivarga (shalaparni-Desmodium gangeticum DC, Prisnaparni- Cyperus sp, brahati- Solanum indicum Linn./ anguivi Lam, kantakari- Garcinia morella Desr, gokshura- Tribulus terrestris Linn), Punarnava- Boerhaavia diffusa Linn, campak (aragvadha)-Cassia fistula Linn and putikarnja- Caesalpinia crista Linn cooked with one prasta (640 gms) of ghee.
Decoction prepared out of two pala (80 grams) of each drugs of sthiradivarga (shalaparni-Desmodium gangeticum DC, Prisnaparni- Cyperus sp, brahati- Solanum indicum Linn./ anguivi Lam, kantakari- Garcinia morella Desr, gokshura- Tribulus terrestris Linn), Punarnava- Boerhaavia diffusa Linn, campak (aragvadha)-Cassia fistula Linn and putikarnja- Caesalpinia crista Linn cooked with one prasta (640 gms) of ghee.
Intake of this medicated ghee cures pratiruddha vāta (obstructed flatus) [23]
Intake of this medicated ghee cures pratiruddha vāta (obstructed flatus) [23]
Condiment:
==== Condiment ====
फलंचमूलंचविरेचनोक्तंहिङ्ग्वर्कमूलंदशमूलमग्र्यम्|
फलंचमूलंचविरेचनोक्तंहिङ्ग्वर्कमूलंदशमूलमग्र्यम्|
स्नुक्चित्रकश्चैवपुनर्नवाचतुल्यानिसर्वैर्लवणानिपञ्च||२४||
स्नुक्चित्रकश्चैवपुनर्नवाचतुल्यानिसर्वैर्लवणानिपञ्च||२४||
Fruits and roots mentioned under purgatives (Sutra.1:77-85) alongwith hingu- Ferula asafetida (L), arka- Calotropis Gigantea (Linn) roots, dasamula (bilva, syonaka, gambhari, patala, ghanikarnika, salaparni, prishnaparni, brahati, kantakari, gokshura), snuhi, citraka and punarnava to be taken in equal quantity. To this five types of salt in equal quantity is to be added and made in to coarse powder, this mixture is further triturated with cows urine and fat and cooked within closed earthen saucer with well-closed joints with clay smeared cloth, and then placed over fire, when cooked, the salt should be powdered and there after used with food and drinks. This eliminates anaha (bloating in the upper abdomen) and pain (abdominal pain).[24-25]
Fruits and roots mentioned under purgatives (Sutra.1:77-85) alongwith hingu- Ferula asafetida (L), arka- Calotropis Gigantea (Linn) roots, dasamula (bilva, syonaka, gambhari, patala, ghanikarnika, salaparni, prishnaparni, brahati, kantakari, gokshura), snuhi, citraka and punarnava to be taken in equal quantity. To this five types of salt in equal quantity is to be added and made in to coarse powder, this mixture is further triturated with cows urine and fat and cooked within closed earthen saucer with well-closed joints with clay smeared cloth, and then placed over fire, when cooked, the salt should be powdered and there after used with food and drinks. This eliminates anaha (bloating in the upper abdomen) and pain (abdominal pain).[24-25]
Diagnosis associated symptoms and treatment of anaha (bloating in upper abdomen) and use of castor oil.
==== Diagnosis associated symptoms and treatment of anaha (bloating in upper abdomen) and use of castor oil ====
हृत्स्तम्भमूर्धामयगौरवाभ्यामुद्गारसङ्गेनसपीनसेन|
हृत्स्तम्भमूर्धामयगौरवाभ्यामुद्गारसङ्गेनसपीनसेन|
आनाहमामप्रभवंजयेत्तुप्रच्छर्दनैर्लङ्घनपाचनैश्च||२६||
आनाहमामप्रभवंजयेत्तुप्रच्छर्दनैर्लङ्घनपाचनैश्च||२६||
Castor oil should be administered up to the dose of five pala depending on the strength of the person, nature of disease, and the kosta. If the person is weak and is of mrudu kosta (laxed bowel) then, castor oil should be given along with food. [31]
Castor oil should be administered up to the dose of five pala depending on the strength of the person, nature of disease, and the kosta. If the person is weak and is of mrudu kosta (laxed bowel) then, castor oil should be given along with food. [31]
Thus ends the treatment of udāvarta[26-31]
Thus ends the treatment of udāvarta[26-31]
Etiology, types, pathogenesis, signs and symptoms of mutrakrcchra (dysuria)
==== Etiology, types, pathogenesis, signs and symptoms of mutrakrcchra (dysuria) ====
व्यायामतीक्ष्णौषधरूक्षमद्यप्रसङ्गनित्यद्रुतपृष्ठयानात्|
व्यायामतीक्ष्णौषधरूक्षमद्यप्रसङ्गनित्यद्रुतपृष्ठयानात्|
आनूपमत्स्याध्यशनादजीर्णात्स्युर्मूत्रकृच्छ्राणिनृणामिहाष्टौ||३२||
आनूपमत्स्याध्यशनादजीर्णात्स्युर्मूत्रकृच्छ्राणिनृणामिहाष्टौ||३२||
Signs of kaphaja dysuria: Heaviness and oedema in urinary bladder and phallus and the urine is associated with slimy materials
Signs of kaphaja dysuria: Heaviness and oedema in urinary bladder and phallus and the urine is associated with slimy materials
Signs of sannipata dysuria: All the signs and symptoms described above are manifested as all the doṣha are aggravated which is the cause for sannipatika type of dysuria which is most difficult type of dysuria for cure. [35]
Signs of sannipata dysuria: All the signs and symptoms described above are manifested as all the doṣha are aggravated which is the cause for sannipatika type of dysuria which is most difficult type of dysuria for cure. [35]
Dysuria caused by asmari (urinary calculus):
Dysuria caused by asmari (urinary calculus):
विशोषयेद्बस्तिगतंसशुक्रंमूत्रंसपित्तंपवनःकफंवा|
विशोषयेद्बस्तिगतंसशुक्रंमूत्रंसपित्तंपवनःकफंवा|