The 21st chapter of Uttaratantra of Sushruta Samhita is named as Karṇaroga Pratişedha Adhyaya. This chapter deals with the Treatment of Diseases of the Ear.
अथातः कर्णगतरोगप्रतिषेधं व्याख्यास्यामः ।। १ ।।
यथोवाच भगवान् धन्वन्तरिः ।। २ ।।
We will now expound Karnaroga pratişedha- treatment of diseases of the ear; as revealed by the venerable Dhañvañtari.
Samanya cikitsä- general treatment
सामान्यं कर्णरोगेषु घृतपानं रसायनम् ।।
अव्यायामोऽशिरः स्नानं ब्रह्मचर्यमकत्थनम् ।। ३ ।।
Below mentioned are the general treatments for ear diseases –
– Drinking ghee / medicated ghee,
– Rasayana,
– Avoidance of physical exercises and head bath,
– Maintaining celibacy and
– Not speaking too much
Vataja Karnasuladi cikitsa
कर्णशूले प्रणादे च बाधिर्यक्ष्वेडयोरपि ।।
चतुर्णामपि रोगाणां सामान्यं भेषजं विदुः ||४||
स्निग्धं वातहरैः स्वेदैर्नरं स्नेहविरेचितम् |
नाडीस्वेदैरुपचरेत्पिण्डस्वेदैस्तथैव च ||५||
The treatment is the same for the below mentioned four diseases –
– Karnasula,
– Pranada,
– Badhirya and
– Karnaksveda
The patient should firstly be administered with oily purgatives. Following this sudation should be given. It should be administered with vata mitigating herbs by either nadi sweda or pinda sweda methods.
बिल्वैरण्डार्कवर्षाभूदधित्थोन्मत्तशिग्रुभिः |
बस्तगन्धाश्वगन्धाभ्यां तर्कारीयववेणुभिः ||६||
आरनालशृतैरेभिर्नाडीस्वेदः प्रयोजितः |
कफवातसमुत्थानं कर्णशूलं निरस्यति ||७||
Below mentioned herbs are boiled in Aranala –
– Bilva,
– Eranda,
– Arka,
– Varsabhu,
– Dadhittha,
– Unmattha,
– Sigru,
– Bastagandha,
– Ashvagandha,
– Tarkari and
– Yavavenu
The fumes emanating from this are led through a pipe.
This Nadisveda relieves Karnasula – earache produced by aggravated kapha and vata.
मीनकुक्कुटलावानां मांसजैः पयसाऽपि वा |
पिण्डैः स्वेदं च कुर्वीत कर्णशूलनिवारणम् ||८||
Pinda sweda done using one of the blow mentioned things added with milk would relieve ear pain –
– Flesh of fish,
– Flesh of cock or
– Flesh of lava bird
अश्वत्थपत्रखल्लं वा विधाय बहुपत्रकम् |
तदङ्गारैः सुसम्पूर्णं निदध्याच्छ्रवणोपरि ||९||
यत्तैलं च्यवते तस्मात् खल्लादङ्गारतापितात् |
तत् प्राप्तं श्रवणस्रोतः सद्यो गृह्णाति वेदनाम् ||१०||
Leaves of Asvattha or Bahupatraka are heated on burning coal. The leaves are later kept on the ears, when they are warm enough for the ear to tolerate.
Also, oil should be expressed from these cooked leaves. This oil should be put into the ear. This oil immediately subsides the ear pain.
क्षौमगुग्गुल्वगुरुभिः सघृतैर्धूपयेच्च तम् |
भक्तोपरि हितं सर्पिर्बस्तिकर्म च पूजितम् ||११||
Kshauma, Guggulu and Aguru should be burnt in fire along with ghee. Ear should be exposed to the smoke coming from them.
Also, drinking ghee and enema after meals is highly praised.
निरन्नो निशि तत्सर्पिः पीत्वोपरि पिबेत् पयः |
मूर्धबस्तिषु नस्ये च मस्तिष्के परिषेचने ||१२||
शतपाकं बलातैलं प्रशस्तं चापि भोजने |
Ghee should be consumed by the patient on an empty stomach at night. After this, he needs to drink milk.
Satapaka Bala Taila is said to be best for usage and should be used in the below mentioned forms –
– Sirobasti,
– Nasya,
– Mastiska Parisecana (pouring medicated liquids on the head) and
– Along with food
कण्टकारीमजाक्षीरे पक्त्वा क्षीरेण तेन च ||१३||
विपचेत् कुक्कुटवसां कर्णयोस्तत्प्रपूरणम् |
Kantakari should be cooked in goat’s milk and muscle fat of cock boiled in this milk i.e. goat’s milk. This is used for ear-filling.
तण्डुलीयकमूलानि फलमङ्कोलजं तथा ||१४||
अहिंस्राकेन्दुकान्मूलं सरलं देवदारु च |
लशुनं शृङ्गवेरं च तथा वंशावलेखनम् ||१५||
कल्कैरेषां तम्लैश्च पचेत् स्नेहं चतुर्विधम् ।।
वेदनायाः प्रशान्त्यर्थं हितं तत्कर्णपूरणम् ।।१६।
Decoction and paste of the below mentioned are prepared –
– Roots of Tanduliyaka,
– Fruits of Ankola,
– Roots of Ahimsra and Kenduka,
– Sarala,
– Devadaru,
– Lasuna,
– Srngavera and
– Bark of Vamsa
Then, it is added with sour things (fermented gruels) and all four types of fats i.e. oil, ghee, muscle fat and bone marrow. They are all cooked together and medicated fat should be prepared. This should be filled into the ear for relief of pain.
लशुनार्द्रकशिग्रूणां मुरङ्गया मूलकस्य च ।।
कदल्याः स्वरसः श्रेष्ठः कदुष्णः कर्णपूरणे ।। १७ । ।
शृङ्गवेररसः क्षौद्रं सैन्धवं तैलमेव च ।।
कदुष्णं कर्णयोर्देयमेतद्वा वेदनापहम् ।।१८।।
Fresh juice of the below mentioned ingredients should be made lukewarm and filled in the ear –
– Lasuna,
– Ardraka,
– Sigru,
– Murangi,
– Mulaka and
– Kadali
Below mentioned ingredients should be made lukewarm and instilled into the ear relieves pain –
– Juice of Srngavera,
– Honey,
– Saindhava Lavana and
– Oil
वंशावलेखनायुक्ते मूत्रे चाजाविके भिषक् ।।
सर्पिः पचेत्तेन कर्णं पूरयेत् कर्णशूलिनः ।।१९।।
Below mentioned ingredients are cooked together –
– Urine of goat or sheep
– Bark of Vamsa and
– Ghee
This ghee shall be used for filling in the ear by the physician to cure ear pain.
Dīpikā taila
महतः पञ्चमूलस्य काण्डमष्टादशाङ्गुलम् ।।
क्षौमेणावेष्ट्य संसिच्य तैलेनादीपयेत्ततः ।।२०।।
यत्तैलं च्यवते तेभ्यो घृतेभ्यो भाजनोपरि ।।
ज्ञेयं तद्दीपिकातैलं सद्यो गृह्णाति वेदनाम् ।।२१।।
कुर्यादेवं भद्रकाष्ठे कुष्ठे काष्ठे च सारले ।।
मतिमान् दीपिकातैलं कर्णशूलनिबर्हणम् ।। २२।।
Shoots of herbs belonging to Mahat Pancamula should be cut to a length of eighteen angula – 36 cm. They are wrapped in cloth, soaked in oil and fire is set. The oil drops coming from burning it are collected in a vessel. This oil is known as Dipika Taila. When put into ears, it immediately cures earaches.
Similarly, oil should be prepared from Bhadrakastha, Kustha and Sarala should be prepared by an intelligent physician. This oil should be used for curing earache.
अर्काङ्कुरानम्लपिष्टांस्तैलाक्तान् लवणान्वितान् ।।
सन्निदध्यात् स्नुहीकाण्डे कोरिते तच्छदावृते ।।२३।।
पुटपाकक्रमस्विन्नान् पीडयेदारसागमात् ।।
सुखोष्णं तसं कर्णे दापयेच्छूलशान्तये ।।२४।।
कपित्थमातुलुङ्गलशृङ्गरः शुभैः ।।
सुखोष्णी: पूरयेत् कर्णं तच्दूलविनिवृत्तये ।। २५।।
कर्ण कोष्णोन चुक्रेण पूरयेत् कर्मशूलिनः ।।
समुद्रफेनचूर्णेन युक्त्या चाप्यवचूर्णयेत् ।।२६।।
Leaf buds of Arka are taken and added with sesame oil and rock salt. They are macerated in a sour liquid and made into a ball. This is kept inside a hollow made in the stem of Snuhi and covered by its bark itself. This is now cooked in the putapaka method. It is later removed and the contents are squeezed. The juice thus extracted should be put into the ear, comfortably warm. This cures earache.
Alternatively, juice of the below mentioned made comfortably warm should be put into the ear –
– Kapittha,
– Matulunga and
– Srngavera
Lukewarm Cukra – vinegar added with powder of Samudraphena should be filled in the ear for the cure of earache.
अष्टानामिह मूत्राणां मूत्रेणान्यतमेन तु ।।
कोष्णेन पूरयेत् कर्णं कर्णशूलोपशान्तये ।। २७।।
मूत्रेष्वप्लेषु वातघ्ने गणे कथिते भिषक् ।।
पचेच्चतुर्विधं स्नेहं पूरणं तच्च कर्णयोः ।। २८ ।।
For relief of pain, lukewarm urine of any one of the eight kinds of urine mentioned in chapter 45 of Sutra Sthana or any other urine shall be made use of (put into the ear for pain relief).
Herbs belonging to the Vata mitigating group, like Vidarigandhadi Gana should be boiled and processed in urine, any sour liquid and all four kinds of fats – oil, ghee, muscle-fat and bone marrow. This medicated fat should be used for filling into the ears.
Pittaja karna sula cikitsă
एता एव क्रियाः कुर्यात् पित्तघ्नैः पित्तसंयुते ।।
काकोल्यादौ दशक्षीरं तिक्तं चात्र हितं हविः ।। २९ ।।
क्षीरवृक्षप्रवालेषु मधुके चन्दने तथा ।।
कल्कक्काथे परं पक्कं शर्करामधुकैः सरैः ||३० ।।
In pittaja karnasula, the same methods explained above shall be done. Ghee, oil etc should be prepared with pitta mitigating drugs and instilled into the ears for the relief of pain. Also, paste of drugs of Kakolyadi gana should be processed with ten times (quantity) of milk or ghee shall be prepared (processed) with paste and decoction of tiktavarga group of drugs and the prepared medicines should be used as lukewarm drops into the ears.
Ghee prepared with decoction and paste of the below mentioned is said to be beneficial when used as ear drops –
– Tender leaves of ksiri vrksa,
– Two kinds of Madhuka,
– Two types of Candana,
– Sarkara,
– Madhuka and
– Laxative herbs
Kaphaja karnasula cikitsa
इङ्गुदीसर्षपस्नेहौ सकफे पूरणे हितौ ।।
तिक्तौषधानां यूषाश्च स्वेदाश्च कफनाशनाः ।। ३१ ।।
सुरसादौ कृतं तैलं पञ्चमूले महत्यपि ।।
मातुलुङ्गरसः शुक्तं लशुनाईकयो रसः || ३२ ||
एकैकः पूरणे पथ्यस्तैलं तेष्वपि वा कृतम् ||
तीक्ष्णा मूर्धविरेकाश्च कवलाश्चात्र पूजिताः ।।३३ ।।
In case of ear pain due to kapha origin, oil of Ingudi and Sarsapa is said to be the best for ear filling. Also, soup prepared from bitter tasting herbs should be given for drinking and sudation for mitigating kapha should also be done.
Oil should be prepared with the below mentioned ingredients either individually or all together –
– Surasadi Gana group of herbs or
– Mahat / Brhat Pancamula group of herbs,
– Juice of Matulunga,
– Sukta,
– Juice of Lasuna and
– Ardraka
This oil is beneficial for relieving pain. Strong purgatives to the head and mouth gargles are also advisable in this condition.
Raktaja karṇaśūla cikitsa
कर्णशूलविधिः कृत्स्नः पित्तघ्नः शोणितावृते ।।
In karna sula i.e. ear ache produced by rakta (vitiated blood), treatments indicated for pittaja karna sula should be done.
Bādhirya cikitsā – treatment of deafness
शूलप्रणादबाधिर्यक्ष्वेडानां तु प्रकीर्तितम् ।।३४ ।।
सामान्यतो , विशेषेण बाधियें पूरणं शृणु ।।
गवां मूत्रेण बिल्वानि पिष्ट्वा तैलं विपाचयेत् ।। ३५ ।।
सजलं च सदुग्धं च बाधिर्ये कर्णपूरणम् ।।
Until now, the general treatments for Karnasula, Pranada, Badhirya and Karna Ksveda were described. From here, the specific treatments for Badhirya shall be described, listen to the same.
All the parts of Bilva tree i.e. roots, bark, leaves and fruits are taken and are macerated in cow’s urine. Oil, water and milk are added to this and processed so as to prepare their medicated oil. This oil shall be put into the ear to cure deafness.
सितामधुकबिम्बीभिः सिद्धं वाऽऽजे पयस्यपि ।। ३६ ।।
बिम्बीक्काथे विमथ्योष्णं शीतीभूतं तदुद्धृतम् ।।
पुनः पचेद्दशक्षीरं सितामधुकचन्दनैः ।। ३७ ।।
बिल्वाम्बुगाढं तत्तैलं बाधिर्ये कर्णपूरणम् ।।
वक्ष्यते यः प्रतिश्याये विधिः सोऽप्यत्र पूजितः ।।३८ ।।
वातव्याधिषु यश्चोक्तो विधिः स च हितो भवेत् ।।
Alternatively, medicated oil is prepared with sugar, Madhuka and Bimbi and goat’s milk. This is churned with warm decoction of Bimbi. After the oil cools down, it is taken out separately and cooked once again by adding ten parts of milk and paste of Sita, Madhuka, Candana and decoction of Bilva. In conditions of deafness, this oil should be filled into the ear.
In this disease, treatments indicated for Pratisyaya are also beneficial. Similarly, the treatments indicated in Vata Vyadhi are also beneficial and hence should be adopted.
Karna srāvādi cikitsă
कर्णस्त्रावे पूतिकर्णे तथैव कृमिकर्णके ।। ३ ९ ।।
समानं कर्म कुर्वीत योगान् वैशेषिकानपि ।।
शिरोविरेचनं चैव धूपनं पूरणं तथा ।।४० ।।
प्रमार्जनं धावनं च वीक्ष्य वीक्ष्यावचारयेत् ।।
राजवृक्षादितोयेन सुरसादिगणेन वा ।। ४१ ।।
कर्णप्रक्षालनं कार्यं चूर्णैरेषां च पूरणम् ।।
Both general and specific treatments should be done in Karnasrava, Putikarna and Krimikarna diseases.
Considering the condition of the dosha, the below mentioned treatments should be done –
– Sirovirecana – purgation to the head,
– Dhupana – fumigation to the ear,
– Purana – filling the ear with medicines,
– Pramarjana – washing and
– Dhavana – cleaning
This should be done using the decoction of herbs belonging to either Rajavrksadi Gana or Surasadi Gana herbs.
Ear filling should be done using the powders of the same herbs.
Karna srāva cikitsa
क्वाथं पञ्चकषायं तु कपित्थरसयोजितम् ।।४२ ।।
कर्णस्त्रावे प्रशंसन्ति पूरणं मधुना सह ।।
सर्जत्वक्चूर्णसंयुक्तः कार्पासीफलजो रसः ।। ४३ ।।
योजितो मधुना वाऽपि कर्णस्त्रावे प्रशस्यते ।।
लाक्षा रसाञ्जनं सर्जश्चूर्णितं कर्णपूरणम् ।।४४ ।।
सशैवलं महावृक्षजम्ब्वाम्रप्रसवायुतम् ।।
कुलीरक्षौद्रमण्डूकीसिद्धं तैलं च पूजितम् ।। ४५ ।।
Decoction of five herbs is prepared as enumerated in 46th verse. It is added with Kapittha juice and honey. This recipe is used for filling the ear in Karna Srava disease.
Recipe prepared by combining the below mentioned ingredients is used for fillingn the ears in Karna Srava disease –
– Juice of Karpasa fruits,
– Powder of bark of Sarja and
– Honey
Powder of the below mentioned should be filled into the ear –
– Laksa,
– Rasanjana and
– Bark of Sarja
Another recipe – Decoction of Saivala, Mahavrksa, Jambu, Amra pallava (leaf buds of amra) is prepared. It is added with pastes of Kulira (Karkatasrngi), Ksaudra (honey) and Manduki (Madhukaparni). Oil is prepared from this and this recipe is considered to be the best one to be filled in the ear.
तिन्दुकान्यभया रोध्रं समङ्गाऽऽमलकं मधु |पूरणं चात्र पथ्यं स्यात्कपित्थरसयोजितम् ||४६||
Decoction should be prepared with the below mentioned ingredients –
– Tinduka,
– Abhaya,
– Rodhra,
– Samanga and
– Amalaka
This decoction is mixed with honey and Kapittha juice.
This preparation is beneficial for filling into the ear.
रसमाम्रकपित्थानां मधूकधवशालजम् |
पूरणार्थं प्रशंसन्ति तैलं वा तैर्विपाचितम् ||४७||
प्रियङ्गुमधुकाम्बष्ठाधातकीशिलपर्णिभिः |
मञ्जिष्ठालोध्रलाक्षाभिः कपित्थस्य रसेन वा ||४८||
पचेत्तैलं तदास्रावमवगृह्णाति पूरणात् |
Juice of tender leaves of the below mentioned herbs, either individually or all together is used for filling the ears –
– Amyangera,
– Kapittha,
– Madhuka,
– Dhava and
– Sala
It is praised as a best recipe in this condition. Also, oil boiled and prepared with the same ingredients shall be used for ear filling and is also beneficial.
Medicated oil is prepared with the decoction of below mentioned ingredients added with juice of tender leaves of Kapittha –
– Priyangu,
– Madhuka,
– Ambastha,
– Dhataki,
– Manassila,
– Salaparni,
– Manjistha,
– Lodhra and
– Laksa
This oil cures Karna Srava when used for ear filling.
Putikarna Cikitsa
घृतं रसाञ्जनं नार्याः क्षीरेण मधुसंयुतम् ||४९||
तत्प्रशस्तं चिरोत्थेऽपि सास्रावे पूतिकर्णके |
निर्गुण्डीस्वरसस्तैलं सिन्धुर्धूमरजो गुडः ||५०||
पूरणः पूतिकर्णस्य शमनो मधुसंयुतः |५१|
In putikarna with exudation, rasanjana macerated with woman’s milk and added with honey should be filled in the ear. It is said to be a highly praised recipe in this condition. It can also be used in chronic conditions of putikarna.
Recipe prepared with below mentioned ingredients relieves Putikarna when it is filled in the affected ear –
– Fresh juice of leaves of Nirgundi,
– Tila,
– Saindhava Lavana,
– Powder of dhuma (grha dhuma – kitchen soot),
– Jaggery and
– Honey
Krimikarna cikitsa
कृमिकर्णकनाशार्थं कृमिघ्नं योजयेद्विधिम् ||५१||
वार्ताकुधूमश्च हितः सार्षपस्नेह एव च |५२|
Treatments which would kill the krimis (worms, bacteria, microorganisms etc) should be administered for the cure of Krimikarna disease. Below mentioned recipes are also beneficial –
– Fumigation to the ear with smoke of Vartaka,
– Filling the ear with Sarsapa Taila
Karna daurgandhya cikitsa
कृमिघ्नं हरितालेन गवां मूत्रयुतेन च ||५२||
गुग्गुलोः कर्णदौर्गन्ध्ये धूपनं श्रेष्ठमुच्यते |
छर्दनं धूमपानं च कवलस्य च धारणम् ||५३||
Treatment principles for Karna Daurgandhya –
– For filling in the ear- the powder of Vidanga and Haritala added with Gomutra should be used.
– Fumigation with smoke of guggulu is considered as best for karna daurgandhya.
– Apart from these, emesis (initiation of vomiting), inhalation of smoke and mouth gargles are also to be done.
Karna Ksveda and Karna Vidradhi Cikitsa
कर्णक्ष्वेडे हितं तैलं सार्षपं चैव पूरणम् |
विद्रधौ चापि कुर्वीत विद्रध्युक्तं चिकित्सितम् ||५४||
In karnaksveda, it is beneficial to fill the ears with lukewarm Sarsapa taila.
In karna Vidradhi, treatments prescribed for vidradhi (abscess) should be adopted.
Karnavit Cikitsa
प्रक्लेद्य धीमांस्तैलेन स्वेदेन प्रविलाय्य च |
शोधयेत्कर्णविट्कं तु भिषक् सम्यक् शलाकया ||५५||
The intelligent physician should lubricate the ear with oil, then give fomentation and remove the ear-wax with the help of a rod shaped instrument.
Karnakandu cikitsa
नाडीस्वेदोऽथ वमनं धूमो मूर्धविरेचनम् |
विधिश्च कफहृत्सर्वः कर्णकण्डूमपोहति ||५६||
Karna Kandu should be treated with the below mentioned measures –
– Nadi Sweda – tubular sudation,
– Emesis,
– Medicated smoke inhalation,
– Purgation to the head and
– All kinds of Kapha mitigating treatments
Karna pratinaha cikitsa
अथ कर्णप्रतीनाहे स्नेहस्वेदौ प्रयोजयेत् |
ततो विरिक्तशिरसः क्रियां प्राप्तां समाचरेत् ||५७||
Principles of treating Karna Pratinaha – Karna Pratinaha should be treated with the below mentioned measures –
– Oleation,
– Sudation,
– Purgation to the head
– Other measures and medicines useful and indicated in the treatment of headaches
Karnapaka cikitsa
कर्णपाकस्य भैषज्यं कुर्यात्पित्तविसर्पवत् |
Karnapaka should be treated on the lines of treating Pittaja Visarpa (Chikitsa Sthana, Chapter 17).
Karnakita
कर्णच्छिद्रे वर्तमानं कीटं क्लेदमलादि वा ||५८||
शृङ्गेणापहरेद्धीमानथवाऽपि शलाकया |
शेषाणां तु विकाराणां प्राक् चिकित्सितमीरितम् ||५९||
An intelligent physician should use either a horn (sucking horn) or rod like instrument to remove the insects, fluids, wax etc present in the ear orifices.
The treatment for other ear diseases has been described earlier in the concerned chapters of Cikitsa Sthana section of the treatise.
इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे कर्णगतरोगप्रतिषेधो नामैकविंशोऽध्यायः ।।२१।।
Thus ends the twenty-first chapter by name Karnaroga Pratisedha in Uttara Sthana of Susruta Samhita.
