Sushruta Samhita Uttaratantra Chapter 47 Pānātyaya Pratiṣedha (Treatment of Alcoholism)


AIAPGET POINTS

        Qualities of MADYA are – Ushna, Tikshna, Sukshma, Vishada, Ruksha, Ashukari, Vyavayi and Vikasi.

        MADA is caused due to consuming MADYA on an empty stomach or in excess, when Madya gets mixed with AGNI in the stomach. MADA is said to be AGNI SAMAM – similar to fire in nature. (Su.Ut.47/9)

        Three Stages of MADA are – Purva, Madhya & Paschima.

        Features or Effects of PURVA MADA – Increase of Virya, Rati, Priti, Harsha, Bhashya etc.

        Features or Effects of MADHYA MADA – Pralapa, Moha, Yukta-Ayukta Kriya

        Features or Effects of PASCHIMA MADA – Visanjgna, Shete Nashta Karma Kriya Gunaha

        KAPHA Prakriti people are not troubled much by MADA.

        Recipe for Pana Vibhrama – syrup prepared from Amrataka and Kola added with more sugar and honey.

        MADYAJA TRSNA – MADYA has properties of AGNI & VAYU Bhutas. Therefore it would dry up AMBUVAHA SROTAS and give rise to TRSNA.

        In Raktaja Daha, Rohini Sira present in the extremities should be punctured according to the proper procedure. Su.Ut.47/9

        ASRJA PURNA KOSTHA JANYA DAHA / RaktaPurnaKostha Janya Daha is treated on the linens of SADYO VRANA CHIKITSA.

        Dhatu-Kshayaja Daha should be treated on the lines of RAKTAPITTA and SNIGDHA-ANILAPAHA Chikitsa.

        Application of paste of CHANDANA on the body regularly prevents affliction of mind by MADA according to Acharya Sushruta. Su.Ut.47/81

 

 

The 47th chapter of Uttaratantra of Sushruta Samhita is named as Pānātyaya Pratiṣedha Adhyaya. This chapter deals with the Treatment of Alcoholism.   

अथातः पानात्ययप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Pānātyaya pratiṣedha – treatment of Alcoholism; as revealed by the venerable Dhanvantari

Madya guna- karma- properties and actions of wines (alcoholic drinks)  

मद्यमुष्णं तथा तीक्ष्णं सूक्ष्मं विशदमेव च |
रूक्षमाशुकरं चैव व्यवायि च विकाशि च ||३||
औष्ण्याच्छीतोपचारं तत्तैक्ष्ण्याद्धन्ति मनोगतिम् |
विशत्यवयवान् सौक्ष्म्याद्वैशद्यात्कफशुक्रनुत् ||४||
मरुतं कोपयेद्रौक्ष्यादाशुत्वाच्चाशुकर्मकृत् |
हर्षदं च व्यवायित्वाद्विकाशित्वाद्विसर्पति ||५||
तदम्लं रसतः प्रोक्तं लघु रोचनदीपनम् |
केचिल्लवणवर्ज्यांस्तु रसानत्रादिशन्ति हि ||६||

Below mentioned are the properties of Madya (wine / alcoholic drinks) –

        hot in potency,

        penetrating,

        subtle / minute,

        non-slimy,

        dry,

        quick acting,

        quick spreading and

        (causes) loosening of joints

Property / quality of Madya Action
Hot potency wards off cold
Penetrating destroys functions of mind
Minuteness spreads to all organs
Non-slimy destroys kapha and semen
Dryness aggravates vata
Quick acting does actions quickly
Spreading to all parts pleasure
Loosening spreads to all parts of the body

Madya is –

        sour in taste,

        light in quality (easily digestible),

        increases appetite and

        kindles hunger

According to the opinion of some authorities, it has all tastes except salt (salty taste).

स्निग्धैस्तदन्नैर्मांसैश्च भक्ष्यैश्च सह सेवितम् |
भवेदायुःप्रकर्षाय बलायोपचयाय च ||७||

It bestows longevity, augments strength and growth when it is consumed along with unctuous foods, meat and snacks.

काम्यता मनसस्तुष्टिर्धैर्यं तेजोऽतिविक्रमः |
विधिवत् सेव्यमाने तु मद्ये सन्निहिता गुणाः ||८||

Below mentioned benefits are obtained by drinking wine in proper procedure –

        radiance,

        contentment of the mind,

        courage,

        valour and

        great bravery

Mada – intoxication

तदेवानन्नमज्ञेन सेव्यमानममात्रया |
कायाग्निना ह्यग्निसमं समेत्य कुरुते मदम् ||९||

If an ignorant person consumes wine on an empty stomach (without eating food), or if it is consumed in excess, it gets mixed with digestive fire in the stomach and gives rise to intoxication, being similar to fire in nature.

मदेन करणानां तु भावान्यत्वे कृते सति |
निगूढमपि भावं स्वं प्रकाशीकुरुतेऽवशः ||१०||

The functions of sense organs become deranged due to intoxication. When the person gets intoxicated, he reveals even all the secrets of his mind on his own accord, without any control.

Madaavasthā – stages of intoxication

त्र्यवस्थश्च मदो ज्ञेयः पूर्वो मध्योऽथ पश्चिमः |
पूर्वे वीर्यरतिप्रीतिहर्षभाष्यादिवर्धनम् ||११||
प्रलापो मध्यमे मोहो युक्तायुक्तक्रियास्तथा |१२|
विसञ्ज्ञः पश्चिमे शेते नष्टकर्मक्रियागुणः ||१२|| 

There are three avasthas i.e. stages of mada (intoxication). They are – Purva (earlier, first), Madhya (middle) and Paschima (last, later).

Avastha – stage of Mada (intoxication) Features / effects
Prathama Avastha – first stage Increase of valour, pleasure, desire, happiness, talking etc.
Madhya Avastha – middle stage Irrelevant talk, delusion and indiscriminate activities
Paschima Avastha – last stage Person lies unconscious, loses all activities and properties

श्लैष्मिकानल्पपित्तांश्च स्निग्धान्मात्रोपसेविनः |
पानं न बाधतेऽत्यर्थं विपरीतांस्तु बाधते ||१३||

Those belonging to Kapha Prakriti are not troubled much by intoxication. Intoxication will also not trouble people who have less pitta, those who are unctuous and those who consume wine in limited quantities.

The persons possessing opposite qualities are greatly troubled by intoxication.

Paramada

ऊष्माणमङ्गगुरुतां विरसाननत्वं श्लेष्माधिकत्वमरुचिं मलमूत्रसङ्गम् ||१९||
लिङ्गं परस्य तु मदस्य वदन्ति तज्ज्ञास्तृष्णां रुजां शिरसि सन्धिषु चापि भेदम् |२०|

Below mentioned are the symptoms of Paramada enumerated by the learned ones –

        increased body temperature,

        feeling of heaviness in the body,

        bad taste in the mouth,

        increase of kapha,

        loss of taste,

        non-elimination of urine and faeces,

        thirst and

        pain in the head (headache) and

        pain in the joints

Pānājirņa

आध्मानमुद्गिरणमम्लरसो विदाहोऽजीर्णस्य पानजनितस्य वदन्ति लिङ्गम् ||२०||
ज्ञेयानि तत्र भिषजा सुविनिश्चितानि पित्तप्रकोपजनितानि च कारणानि |२१|

Below mentioned are the definitive symptoms of Panajirna –

        flatulence,

        vomiting,

        feeling of sour taste in the mouth,

        burning sensation during digestion of food

The physician should understand that almost all symptoms of pitta aggravation will definitely manifest in this condition. 

Panavibharama

हृद्गात्रतोदवमथुज्वरकण्ठधूममूर्च्छाकफस्रवणमूर्धरुजो विदाहः ||२१||
द्वेषः सुरान्नविकृतेषु च तेषु तेषु तं पानविभ्रममुशन्त्यखिलेन धीराः |२२|

Below mentioned are the symptoms of Panavibhrama as documented by the scholars –

        pricking pain in the region of the heart and body,

        vomiting,

        fever,

        feeling of presence of smoke in the throat,

        fainting,

        excessive salivation,

        headache,

        burning sensation,

        aversion to madya (beer, wine) and

        aversion to food


हीनोत्तरौष्ठमतिशीतममन्ददाहं तैलप्रभास्यमति(पि)पानहतं विजह्यात् ||२२||
जिह्वौष्ठदन्तमसितं त्वथवाऽपि नीलं पीते च यस्य नयने रुधिरप्रभे च |
हिक्काज्वरौ वमथुवेपथुपार्श्वशूलाः कासभ्रमावपि च पानहतं भजन्ते ||२३||

The patient of alcoholic intoxication with below mentioned symptoms should be rejected –

        thinning of upper lips,

        feeling of excessive coldness in the body,

        severe burning sensation,

        oiliness of the face,

        lips, tongue and teeth becoming black and blue in colour,

        eyes become yellow or red in colour,

        hiccup,

        fever,

        vomiting,

        trembling,

        pain in the flanks,

        cough and

        giddiness

Madatyaya cikitsă – treatment of alcoholism

तेषां निवारणमिदं हि मयोच्यमानं व्यक्ताभिधानमखिलेन विधिं निबोध |२४|

Now, I will describe the methods of treatment for alcoholism (madatyaya). Listen attentively to the same.

Vātaja madātyaya 

मद्यं तु चुक्रमरिचार्द्रकदीप्यकुष्ठसौवर्चलायुतमलं पवनस्य शान्त्यै ||२४||
पृथ्वीकदीप्यकमहौषधहिङ्गुभिर्वा सौवर्चलेन च युतं वितरेत् सुखाय |
आम्रातकाम्रफलदाडिममातुलुङ्गैः कुर्याच्छुभान्यपि च षाडवपानकानि ||२५||
सेवेत वा फलरसोपहितान् रसादीनानूपवर्गपिशितान्यपि गन्धवन्ति |२६|

Madya – wine added with the below mentioned groups of herbs should be administered for controlling madatyaya produced by vata –

        arka (vinegar), marica, ardraka, dipyaka and kustha and sauvarcala

        prthvika, dipyaka, mahaushadha, hingu and sauvarcala

Below mentioned foods also need to be consumed –

        Sadava (condiments) and Panaka (syrups) prepared from fruits of amra, amrataka, dadima and matulunga or

        soup of meat or only meat of animals living in marshy regions added with fruit juices and made fragrant

Pittaja madatyaya

पित्तात्मके मधुरवर्गकषायमिश्रं मद्यं हितं समधुशर्करमिष्टगन्धम् ||२६||
पीत्वा च मद्यमपि चेक्षुरसप्रगाढं निःशेषतः क्षणमवस्थितमुल्लिखेच्च |
लावैणतित्तिरिरसांश्च पिबेदनम्लान् मौद्गान् सुखाय सघृतान् ससितांश्च यूषान् ||२७||

Recipe for those suffering from Pittaja Madatyaya (intoxication caused by pitta) – Wine mixed with decoction of herbs belonging to sweet group i.e. Kakolyadi Gana group, honey and sugar.

The patient should be made to consume more quantities of sugarcane juice first. Later it is brought out completely by administering vomiting immediately. Following this, the patient should drink soup of meat of lava and tittiri birds and deer without adding sour substances. Alternatively, he can drink green-gram soup with sugar and ghee.

Kaphaja madātyaya

पानात्यये कफकृते कफमुल्लिखेच्च मद्येन बिम्बिविदुलोदकसंयुतेन |
सेवेत तिक्तकटुकांश्च रसानुदारान् यूषांश्च तिक्तकटुकोपहितान् हिताय ||२८||
पथ्यं यवान्नविकृतानि च जाङ्गलानि श्लेष्मघ्नमन्यदपि यच्च निरत्ययं स्यात् |२९|

Treatment principles for Kaphaja Madatyaya (intoxication caused by kapha) – Wine mixed with decoction of Bimbi and Vidala (Vetasa) should be given to the patient to drink and the kapha should be expelled. Then, the patient should consume more quantities of meat-soup processed with herbs of bitter and pungent tastes. Alternatively, soup of pulses processed with bitter and pungent tasting herbs should be consumed. These are said to be beneficial. Foods prepared from yava – barley, meat of animals living in arid regions and other foods which mitigate kapha and are harmless should be consumed.

Tridoşaja madātyaya

कुर्याच्च सर्वमथ सर्वभवे विधानं द्वन्द्वोद्भवे द्वयमवेक्ष्य यथाप्रधानम् ||२९||
सामान्यमन्यदपि यच्च समग्रमग्र्यं वक्ष्यामि यच्च मनसो मदकृत् सुखं च |३०|

In Madatyaya – alcoholic intoxication caused by all three doshas together should be treated with treatments suitable for all the doshas.

In Madatyaya caused by any two doshas, treatments suitable for the two doshas involved or predominant doshas should be administered.

Further, other general treatments which are most important and bestow happiness to the mind shall be described by me.

Panatyaya cikitsă

त्वङ्गागपुष्पमगधैलमधूकधान्यैः श्लक्ष्णैरजाजिमरिचैश्च कृतं समांशैः ||३०||
पानं कपित्थरसवारिपरूषकाढ्यं पानात्ययेषु विधिवत्स्रुतमम्बरान्ते |
ह्रीवेरपद्मपरिपेलवसम्प्रयुक्तैः पुष्पैर्विलिप्य करवीरजलोद्भवैश्च ||३१||
पिष्टैः सपद्मकयुतैरपि सारिवाद्यैः सेकं जलैश्च वितरेदमलैः सुशीतैः |
त्वक्पत्रचोचमरिचैलभुजङ्गपुष्पश्लेष्मातकप्रसववल्कगुडैरुपेतम् ||३२||
द्राक्षायुतं हृतमलं मदिरामयार्तैस्तत्पानकं शुचि सुगन्धि नरैर्निषेव्यम् |
पिष्ट्वा पिबेच्च मधुकं कटुरोहिणीं च द्राक्षां च मूलमसकृत् त्रपुषीभवं यत् ||३३||
कार्पासिनीमथ च नागबलां च तुल्यां पीत्वा सुखी भवति साधु सुवर्चलां च |३४|

Nice powder of equal parts of the below mentioned ingredients should be prepared –

        Tvak,

        Nagapuspa,

        Magadha,

        Ela,

        Madhuka,

        Dhanyaka,

        Ajaji and

        Marica

This powder should be dissolved in a mixture of juice of kapittha and then filtered through a cloth. This should now be consumed with water and more quantity of Parusaka. This would cure Panatyaya.

Paste of the below mentioned herbs should be applied on the body –

        Hribera,

        Padma,

        Paripelava,

        Flowers of Karavira and

        Jaladodbhava (Padma)

Water boiled with Padmaka, herbs belonging to Sarivadi Gana group should be poured on the body in cold state only.

Panaka (syrup) should be used with below mentioned ingredients –

        Tvak,

        Patra,

        Coca,

        Marica,

        Ela,

        Bhujangapuspa (Nagakesara),

        Flowers and bark of Slesmataka and

        Guda (jaggery)

This syrup should be filtered, added with Draksa and made fragrant. A person suffering from Panatyaya should consume this recipe.

Pastes of the below mentioned groups of herbs should be consumed dissolved in water –

        Mmadhuka, Katurohini, Draksa and Root of Trapusa or

        Root of Karpasini and Nagabala added with Suvarcala

Paramada cikitsā

काश्मर्यदारुविडदाडिमपिप्पलीषु द्राक्षान्वितासु कृतमम्बुनि पानकं यत् ||३४||
तद्बीजपूरकरसायुतमाशु पीतं शान्तिं परां परमदे त्वचिरात् करोति |३५|

Syrup of the below mentioned ingredients should be done with water –

        Kasmarya,

        Devadaru,

        Bida,

        Dadima,

        Pippali and

        Draksa

Then, the syrup is added with juice of Bijapura and consumed. This recipe quickly mitigates the effect of Paramada.

द्राक्षासितामधुकजीरकधान्यकृष्णास्वेवं कृतं त्रिवृतया च पिबेत्तथैव ||३५||
सौवर्चलायुतमुदाररसं फलाम्लं भार्गीशृतेन च जलेन हितोऽवसेकः ||३६||

Syrup of the below mentioned ingredients should be consumed with Trivrt –

        Draksa,

        Sita,

        Madhuka,

        Jiraka,

        Dhanya and

        Krsna

Below mentioned should be used for pouring on the body of the patient –

        meat-soup added with sauvarcala,

        juice of sour fruits and

        decoction of Bharngi

Panajirna cikitsā

इक्ष्वाकुधामार्गववृक्षकाणि काकाह्वयोदुम्बरिकाश्च दुग्धे |
विपाच्य तस्याञ्जलिना वमेद्धि मद्यं पिबेच्चाह्नि गते त्वजीर्णे ||३७||
त्वक्पिप्पलीभुजगपुष्पविडैरुपेतं सेवेत हिङ्गुमरिचैलयुतं फलाम्लम् |
उष्णाम्बुसैन्धवयुतास्त्वथवा विडत्वक्चव्यैलहिङ्गुमगधाफलमूलशुण्ठीः ||३८||

The patient should consume one anjali (160ml) of milk boiled and processed with –

        Iksvaku,

        Dhamargava,

        Vrksaka,

        Kakahva and

        Udumbara

This recipe produces vomiting and mitigates the effects of Panajirna.

Below mentioned ingredients should be mixed in juice of sour fruits and consumed –

        Tvak,

        Pippali,

        Bhujaga Puspa (Nagakesara),

        Bida,

        Hingu and

        Marica

Alternatively, hot water added with powder of the below mentioned ingredients shall be consumed –

        Saindhava lavana,

        Bida lavana,

        Tvak,

        Cavya,

        Ela,

        Hingu,

        Magadhaphala Mula, (pippali and pippalimula) and

        Sunthi

Pānāvibhrama cikitsā

हृद्यैः खडैरपि  भोजनमत्र शस्तं द्राक्षाकपित्थफलदाडिमपानकं यत् |
तत् पानविभ्रमहरं मधुशर्कराढ्यमाम्रातकोलरसपानकमेव चापि ||३९||
खर्जूरवेत्रककरीरपरूषकेषु [१] द्राक्षात्रिवृत्सु च कृतं ससितं हिमं वा |
श्रीपर्णियुक्तमथवा तु पिबेदिमानि यष्ट्याह्वयोत्पलहिमाम्बुविमिश्रितानि ||४०||
क्षीरिप्रवालबिसजीरकनागपुष्पपत्रैलवालुसितसारिवपद्मकानि |
आम्रातभव्यकरमर्दकपित्थकोलवृक्षाम्लवेत्रफलजीरकदाडिमानि ||४१||
सेवेत वा मरिचजीरकनागपुष्पत्वक्पत्रविश्वचविकैलयुतान् रसांश्च |
सूक्ष्माम्बरस्रुतहिमांश्च सुगन्धिगन्धान् पानोद्भवान्नुदति सप्तगदानशेषान् ||४२||

The patient should consume pleasant khada i.e. cooked buttermilk which is beneficial for him. He should also drink syrup prepared from Draksa, Kapittha Phala and Dadima.

Pana Vibhrama will be cured by consumption of syrup prepared from Amrataka and Kola added with more quantity of sugar and honey.

He can also consume the below mentioned recipes –

        syrup prepared from kharjura, vetrakarira, parusaka, draksa and trivrt added with sugar or

        Sriparni, Yasti and Utpala mixed with cold water

Cold infusion prepared from the below mentioned ingredients shall be consumed –

        tender leaves of ksiri vrksas i.e. trees with milky sap (panca valkala etc),

        bisa,

        jiraka,

        nagapuspa,

        patra,

        elavaluka,

        sita sariva,

        padmaka,

        amrata,

        bhavya,

        karamarda,

        kapittha,

        kola,

        vrksamla,

        vetraphala,

        jiraka and

        dadima

Meat soup should be added with powder of –

        Marica,

        Jiraka,

        Nagapuspa,

        Tvak patra,

        Visva,

        Cavika and

        Ela

This should now be filtered through thin cloth and used cold. It would subside the effects of seven diseases caused by drinking wine in great quantities.

पञ्चेन्द्रियार्थविषया मृदुपानयोगा हृद्याः सुखाश्च मनसः सततं निषेव्याः [१] |
पानात्ययेषु विकटोरुनितम्बवत्यः पीनोन्नतस्तनभरानतमध्यदेशाः ||४३||
प्रौढाः स्त्रियोऽभिनवयौवनपीनगात्र्यः सेव्याश्च पञ्चविषयातिशयस्वभावाः ||४४||
Persons suffering from Panatyaya i.e. over-drinking of wine should indulge in –

        pleasures of five sense organs or

        consume soft drinks such as beer etc. which are always cordial and comfortable to the mind

Middle aged women (young) having the below mentioned features should keep the person suffering from panatyaya engaged (in sexual plays) –

        having curvy thighs and buttocks,

        fully elevated breasts,

        bent in thin abdomen,

        body adorned with fresh youthful mirth and

        equipped with stimulating objects of sense organs

पिबेद्रसं पुष्पफलोद्भवं वा सितामधूकत्रिसुगन्धियुक्तम् |
सञ्चूर्ण्य संयोज्य च नागपुष्पैरजाजिकृष्णामरिचैश्च तुल्यैः ||४५||

The person should drink juice of Puspa Phala (Kusmanda) added with powder of below mentioned ingredients taken in equal quantity –

        sita – sugar,

        madhuka,

        trisugandha,

        nagapuspa,

        ajaji,

        krishna and

        marica

वर्षाभूयष्ट्याह्वमधूकलाक्षात्वक्कर्बुदाराङ्कुरजीरकाणि |
द्राक्षां च कृष्णामथ केशरं च क्षीरे समालोड्य पिबेत् सुखेप्सुः ||४६||

Nice powder of the below mentioned ingredients should be prepared –

        Varsabhu,

        Yastyahva,

        Madhuka,

        Laksa,

        Tvak,

        Tender leaves of Karbudara,

        Jiraka,

        Draksa,

        Krishna and

        Kesara (Kumkuma)

This  powder is added to milk, mixed properly and consumed by the patient desirous of happiness.

भवेच्च मद्येन तु येन पातितः प्रकामपीतेन सुरासवादिना |
तदेव तस्मै विधिवत् प्रदापयेद्विपर्यये भ्रंशमवश्यमृच्छति ||४७||

The same wines such as sura, asava etc. due to excessive consumption of which the person has fallen sick should be administered to the person adhering to the regimen of drinking. Or else, the person would become a victim of many troubles.

यथा नरेन्द्रोपहतस्य कस्यचिद्भवेत् प्रसादस्तत एव नान्यतः |
ध्रुवं तथा मद्यहतस्य देहिनो भवेत् प्रसादस्तत एव नान्यतः ||४८||

The person who has been punished by the king would obtain relief by only the grace of the same king and definitely not due to the grace of others. Similarly, a person who has fallen sick by the effects of over-drinking will obtain relief only by drinking wine and not by any other thing.

विच्छिन्नमद्यः सहसा योऽतिमद्यं निषेवते |
तस्य पानात्ययोद्दिष्टा विकाराः सम्भवन्ति हि ||४९||

If a person who has discontinued drinking wine suddenly commences to drink again, then all the diseases arising from over-drinking of wine will definitely manifest.

Madyaja tṛṣṇā – alcoholic thirst

मद्यस्याग्नेयवायव्यौ गुणावम्बु(म्भो)वहानि तु |
स्रोतांसि शोषयेयातां तेन तृष्णोपजायते ||५०||

Madya has properties of Agni and Vayu bhutas. Hence it would dry up the Ambuvaha Srotas – channels of transportation of water in the body and give rise to trsna – thirst.

पाटलोत्पलकन्देषु मुद्गपर्ण्यां च साधितम् |
पिबेन्मागधिकोन्मिश्रं तत्राम्भो हिमशीतलम् ||५१||

For this, the patient should drink cold infusions prepared from Patala, Utpala Kanda and Mudgaparni. Magadhika powder should be added to this infusion.

सर्पिस्तैलवसामज्जदधिभृङ्गरसैर्युतम् |
क्वाथेन बिल्वयवयोः सर्वगन्धैश्च पेषितैः ||५२||
पक्वमभ्यञ्जने श्रेष्ठं सेके क्वाथश्च शीतलः |
रसवन्ति च भोज्यानि यथास्वमवचारयेत् ||५३||
पानकानि सुशीतानि हृद्यानि सुरभीणि च |५४|

Below mentioned group of ingredients should be cooked together and medicated fat should be prepared –

        ghee, oil, muscle-fat and bone marrow along with

        juice of bhrngaraja, decoction of bilva and yava and

        paste of sarvagandha (all fragrant herbs such as ela, karpura, jatipatra etc)

This fat is best for anointing. For pouring over the body, decoction prepared with herbs of cold potency will be useful.

Foods which are very tasty (predominantly prepared with sweet tasting ingredients) and sweet syrups made cold and fragrant shall be consumed by the patient.

Dāha – burning sensation

त्वचं प्राप्तस्तु पानोष्मा पित्तरक्ताभिमूर्च्छितः |
दाहं प्रकुरुते घोरं पित्तवत्तत्र भेषजम् ||५४||

Severe burning sensation is produced in the skin when the heat of the alcoholic drink combines with pitta and rakta on reaching the skin. The same treatments used for combating pitta aggravation should be adopted in this condition.

शीतं विधानमत ऊर्ध्वमहं प्रवक्ष्ये दाहप्रशान्तिकरमृद्धिमतां नराणाम् |
तत्रादितो मलयजेन हितः प्रदेहश्चन्द्रांशुहारतुहिनोदकशीतलेन ||५५||
शीताम्बुशीतलतरैश्च शयानमेनं [६] हारैर्मृणालवलयैरबलाः स्पृशेयुः |
भिन्नोत्पलोज्ज्वलहिमे शयने शयीत पत्रेषु वा सजलबिन्दुषु पद्मिनीनाम् ||५६||

Now, the methods of mitigating burning sensation as explained by intelligent persons shall be described by me.

Firstly, paste of Malayaja (candana) shall be anointed on the body of the patient. The paste should be made with water which has been cooled by moonlight and hailstones.

The patient should be made to lie down in a house made cool by cold water i.e. ponds, fountains etc.

The body of the patient should be touched by young women with garlands of flowers and lotus stalks.

The patient should be allowed to sleep at a place which is surrounded by cold water ponds. These ponds should contain lily flowers. He can also sleep on leaves of lotus, with bubbles of water floating on them.

आसादयन् पवनमाहृतमङ्गनाभिः कह्लारपद्मदलशैवलसञ्चयेषु |
कान्तैर्वनान्तपवनैः परिमृश्यमानः शक्तश्चरेद्भवनकाननदीर्घिकासु  ||५७||

Fans should be prepared from flowers of Kalhara, Padma and Saivala which have been woven by women. The person should get exposed to the air coming from these fans. Alternatively he should be exposed to the mild breeze of the garden. The patient should also move about in long lawns of houses or gardens.

दाहाभिभूतमथवा परिषेचयेत्तु  लामज्जकाम्बुरुहचन्दनतोयतोयैः |
विस्रावितां हृतमलां नववारिपूर्णां पद्मोत्पलाकुलजलामधिवासिताम्बुम् ||५८||
वापीं भजेत हरिचन्दनभूषिताङ्गः कान्ताकरस्पृशनकर्कशरोमकूपः |५९|

Water should be cooled by soaking Lamajjaka, Amburuha (Padma) and Candana in it. This medicated water may be poured in streams on the body of the person suffering from ‘burning sensation’.

Also, the patient may play in a pond containing fresh and clean water from which dirt is removed, and which contains Padma (lotus) and Utpala (lily). He should play in the pond after he gets his skin massaged by the hands of women, who have been applied with sandalwood paste all over her body.

तत्रैनमम्बुरुहपत्रसमैः स्पृशन्त्यः शीतैः करोरुवदनैः कठिनैः स्तनैश्च ||५९||
तोयावगाहकुशला मधुरस्वभावाः संहर्षयेयुरबलाः सुकलैः प्रलापैः |६०|

Those women should touch him with –

        petals of lotus flower,

        their hands, thighs, face and hard breasts

Women of sweet temperament who are well versed in water sports should make the person happy with pleasing manners and pleasant talk. 

धारागृहे प्रगलितोदकदुर्दिनाभे क्लान्तः शयीत सलिलानिलशीतकुक्षौ ||६०||
गन्धोदकैः सकुसुमैरुपसिक्तभूमौ पत्राम्बुचन्दनरसैरुपलिप्तकुड्ये |
जात्युत्पलप्रियककेशरपुण्डरीकपुन्नागनागकरवीरकृतोपचारे [१६] ||६१||
तस्मिन् गृहे कमलरेण्वरुणे शयीत यत्नाहृतानिलविकम्पितपुष्पदाम्नि |६२|

The patient who has been exhausted by drinking wine should stay in the interior chamber of a house. This chamber should be equipped with water fountains. This arrangement would make the space of the chamber appear like a cloudy day, with a cold breeze coming from all the sides.

The ground of the chamber should have been sprinkled with water with the sweet smell of flowers, especially of Jati, Padma and Candana. In the water used for this purpose (sprinkling) flowers of Utpala, Priyaka (Bijaka) Kesara, Pundarika, Punnaga, Nagakesara and Karavira should have been floating. The chamber should also be equipped with garlands of red lotus. These garlands should be made to swing by the current of air which is artificially made.

हेमन्तविन्ध्यहिमवन्मलयाचलानां शीताम्भसां सकदलीहरितद्रुमाणाम् ||६२||
उद्भिन्ननीलनलिनाम्बुरुहाकराणां चन्द्रोदयस्य च कथाः शृणुयान्मनोज्ञाः |
म्लानं प्रतान्तमनसं मनसोऽनुकूलाः पीनस्तनोरुजघना हरिचन्दनाङ्ग्यः ||६३||
ता एनमार्द्रवसनाः सह संविशेयुः श्लिष्ट्वाऽबलाः शिथिलमेखलहारयष्ट्यः ||६४||

Below mentioned (exposure to) things would mitigate the burning sensation –

        Hemanta Rtu – winter season,

        slopes of mountains like Vindya, Himavat and Malaya,

        banks of lakes of cold water,

        gardens of plantains and green trees,

        collections of blossoms of Nila, Nalina and Amburuha,

        moonlight,

        listening to stories which would please the mind

Woman with below mentioned features should engage the patient who is depressed and mentally exhausted –

        pleasing to mind,

        having well grown breasts, thighs and buttocks

        anointed with paste of hari candana,

        dressed in moist clothes,

        wearing waist belts and garlands loosely

हर्षयेयुर्नरं नार्यः स्वगुणै रहसि स्थिताः |
ताः शैत्याच्छमयेयुश्च पित्तपानात्ययान्तरम् [२१] ||६५||

With their behaviour in solitude, the women should make him happy. Burning sensation caused by pitta aggravated by consuming wine can be mitigated by these women.

तृड्दाहरक्तपित्तेषु [२२] कार्योऽयं भेषजक्रमः |
सामान्यतो
विशेषं तु शृणु दाहेष्वशेषतः ||६६||

These methods of treatments shall be adopted for generally combating thirst, burning sensation and bleeding diseases. Now, listen to the treatments of daha i.e. burning sensation specially.

Añyavidha daha – other kind of burning sensation

कृत्स्नदेहानुगं रक्तमुद्रिक्तं [२३] दहति ह्यति |
सञ्चूष्यते दह्यते च ताम्राभस्ताम्रलोचनः ||६७||
लोहगन्धाङ्गवदनो वह्निनेवावकीर्यते |
तं विलङ्घ्य विधानेन संसृष्टाहारमाचरेत् ||६८||
अप्रशाम्यति दाहे च रसैस्तृप्तस्य जाङ्गलैः |
शाखाश्रया यथान्यायं रोहिणीर्व्यधयेत् सिराः ||६९||

Rakta i.e. blood which is present all over the body, when aggravated would give rise to the below mentioned symptoms –

        severe burning sensation,

        sucking type of pain,

        coppery colour of the skin and eyes,

        odour of iron emanating from the body and mouth and

        feeling as if burning coal has been spread out on the body

The patient should be made to fast in this condition. Afterwards, the patient should be advised to follow a regimen of liquid food.

The patient should be given soup of meat of animals living in arid lands if the burning sensation does not subside.

Rohini Sira i.e. red coloured veins present in the extremities should be punctured according to the proper procedure.

Pittajadāha

पित्तज्वरसमः पित्तात् स चाप्यस्य विधिर्हितः |७०|

In a burning sensation produced by aggravated pitta, the symptoms will be similar to those of pittaja jvara – fever of pitta origin. Its treatment will also be on the lines of (same as) pittaja jvara.

Trṣṇanirodhaja daha

तृष्णानिरोधादब्धातौ क्षीणे तेजः समुद्धतम् ||७०||
सबाह्याभ्यन्तरं देहं दहेद्वै मन्दचेतसः |
संशुष्कगलताल्वोष्ठो जिह्वां निष्कृष्य चेष्टते ||७१||
तत्रोपशमयेत्तेजस्त्वब्धातुं च विवर्धयेत् |
पाययेत् काममम्भश्च शर्कराढ्यं पयोऽपि वा ||७२||
शीतमिक्षुरसं मन्थं वितरेच्चेरितं विधिम् |७३|

When a person controls his thirst (does not drink water), the water in the body becomes decreased and the heat in the body increases.

This leads to –

        manifestation of burning sensation, both inside and outside the body,

        dryness of the throat, palate and lips,

        tongue prolapse and

        abnormal movements of the body parts

The treatment principles in these conditions would be to reduce the heat of the body and to increase the water content in the body. For this, he should be made to drink water or milk with more sugar. The quantity shall be as much as he can drink. Also, sugarcane juice or mantha (solution of corn flour and sugar churned well) should be served cold (for consumption). After this, the treatment of pittaja jvara which has been mentioned earlier shall be adopted.

Raktapürnakoşthaja daha

असृजा पूर्णकोष्ठस्य दाहो भवति दुःसहः ||७३||
विधिः सद्योव्रणीयोक्तस्तस्य लक्षणमेव च |७४|

Severe burning sensation also develops when blood accumulates in the abdomen. The symptoms and treatment for the same has been described already in the context of Sadyo Vrana Chikitsa i.e. in Chikitsa Sthana section, chapter 2.

Dhātukşayaja daha

धातुक्षयोक्तो यो दाहस्तेन मूर्च्छातृषान्वितः ||७४||
क्षामस्वरः क्रियाहीनो भृशं [३२] सीदति पीडितः |
रक्तपित्तविधिस्तस्य हितः स्निग्धोऽनिलापहः ||७५||

Burning sensation develops even from Dhatu Ksaya i.e. decrease or loss of tissues, mainly blood. The other symptoms include fainting, thirst, feeble voice, inactivity and great debility.

Below mentioned treatments are beneficial in this condition –

        treatments prescribed for bleeding diseases,

        unctuous and vata mitigating therapies

Kşataja daha

क्षतजेनाश्नतश्चान्यः शोचतो वाऽप्यनेकधा |
तेनान्तर्दह्यतेऽत्यर्थं तृष्णामूर्च्छाप्रलापवान् ||७६||
तमिष्टविषयोपेतं सुहृद्भिरभिसंवृतम् |
क्षीरमांसरसाहारं विधिनोक्तेन साधयेत् ||७७||

There is another kind of burning sensation which develops when blood is consumed along with food or by different kinds of worries.

In this condition, the burning sensation will be more inside the body and the person will also have thirst, fainting and delirium.

While treating this condition, the below mentioned shall be provided to the patient –

        things he likes,

        company of friends,

        food with milk and meat soup and

        other comforts

Marmabhighätaja daha

मर्माभिघातजोऽप्यस्ति स चासाध्यतमः स्मृतः |
सर्व एव च वर्ज्याः स्युः शीतगात्रेषु देहिषु ||७८||
(एवंविधो भवेद्यस्तु मदिरामयपीडितः ||)

One more type of burning sensation is caused by injury / assault (disease) of the marmas (fatal / vital spots). This condition is considered as very difficult to cure.

When the body of the person has become cold, all kinds of burning sensation should be rejected.

प्रशान्तोपद्रवे चापि शोधनं प्राप्तमाचरेत् ||७९||

Purificatory therapies should be administered even after all the complications have subsided.

सजीरकाण्यार्द्रकशृङ्गवेरसौवर्चलान्यर्धजलप्लुतानि |
मद्यानि हृद्यान्यथ गन्धवन्ति पीतानि सद्यः शमयन्ति तृष्णाम् ||८०||

Wines or alcoholic drinks which are pleasing to the mind and fragrant should be added with the below mentioned –

        jiraka,

        ardraka,

        srngavera,

        sauvarcala and

        half quantity of water

When consumed, these wines would mitigate thirst.

जलप्लुतश्चन्दनभूषिताङ्गः स्रग्वी सभक्तां पिशितोपदंशाम् |
पिबन् सुरां नैव लभेत रोगान् मनोनुविघ्नं च मदं न याति ||८१||

A person who does the below mentioned things, he will not get intoxication which interferes with his mind –

        anoints his body with paste of candana – sandalwood made with water,

        wears garlands of flowers,

        consumes foods including meat and condiments and

        consumes sura – beer or other alcoholic drinks

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे मदात्ययप्रतिषेधो नाम (नवमोऽध्यायः, आदितः) सप्तचत्वारिंशत्तमोऽध्यायः ||४७||

Thus ends the forty seventh chapter by name Madatyaya Pratişedha in Uttara Sthana of Suśruta Samhita.

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