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Sushruta Samhita Uttaratantra Chapter 43 Hrdroga Pratiṣedha (Therapy of Coronary heart Ailments)

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AIAPGET Factors

        Ajirna Ahara-Adhyashana, Asatmya Bhojana, Viruddha Ashana and Ushna Ruksha Anna – are the essential Nidanas of Hrdroga in line with Acharya Sushruta. (Su.Ut.43/3-4)

        Nirmathyate, Diryate, Sphotyate, Patyate – are the forms of pains in VATAJA HRDROGA (Su.Ut.43/6)

        Hridaya Klama is a symptom of Pittaja Hrdroga (Su.Ut.43/7)

        Tamaha and Shyava Netrata are signs of Krimija Hrdroga (Su.Ut.43/9)

        Snehana and Vamana are indicated by Sushruta in Vataja Hrdroga (Su.Ut.43/11)

        Decoctions that are useful for and talked about within the context of Pittaja Jwara (fevers induced as a consequence of predominant aggravation of pitta) needs to be administered in Pittaja Hrdroga additionally. (Su.Ut.43/15)

        Sneha Vasti utilizing Madhuka Taila blended with honey is run in Pittaja Hrdroga (Su.Ut.43/16)

        Bala Taila Basti is indicated in Kaphaja Hrdroga (Su.Ut.43/19)

        Pippalyadi Churna is run following Vamana in each Vataja and Kaphaja Hrdroga (Su.Ut.43)

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The forty third chapter of Uttaratantra of Sushruta Samhita is called as Hrdroga Pratiṣedha Adhyaya. This chapter offers with the Therapy of Coronary heart Ailments.   

अथातो हृद्रोगप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We are going to now expound Hrdroga pratiședha – therapy of ailments of the

coronary heart; as revealed by the venerable Dhañvañtari.

Nidāna-samprāpti – causes and pathogenesis

वेगाघातोष्णरूक्षान्नैरतिमात्रोपसेवितैः |
विरुद्धाध्यशनाजीर्णैरसात्म्यैश्चापि(ति) भोजनैः ||३||
दूषयित्वा रसं दोषा विगुणा हृदयं गताः |
कुर्वन्ति हृदये बाधां हृद्रोगं तं प्रचक्षते ||४||

Causes –

      Vegaghata – Suppression of the urges,

      Ushna ruksha anna – extreme consumption of meals which is scorching in efficiency and dry in high quality

      Viruddha ashana – extreme use of mutually reverse and incompatible meals,

      Adhyashana – consumption of meals in additional amount than what is required,

      Ajirna ahara – extreme consumption of raw or unprocessed meals or taking meals when one has indigestion,

      Asatmya bhojana – extreme consumption of meals that are unaccustomed,

Pathogenesis –

Because of the above stated etiological causes, the doshas get aggravated. These aggravated doshas vitiate the rasa current within the coronary heart. Attributable to this, the particular person experiences ache within the coronary heart. This situation is called Hrdroga.

Signs –

Because of the vitiation of rasa current within the coronary heart, the particular person experiences ache within the coronary heart.

Kinds of Hrdroga

चतुर्विधः स दोषैः स्यात् कृमिभिश्च पृथक् पृथक् |
लक्षणं तस्य वक्ष्यामि चिकित्सितमनन्तरम् ||५||

There are 4 forms of Hrdroga.

Amongst them, three forms of Hrdroga are brought on by the vitiated doshas, one from every dosha individually. They’re additionally named after these doshas i.e. Vataja Hrdroga, Pittaja Hrdroga and Kaphaja Hrdroga.

The fourth kind is brought on by krimi – worms.

Now, the options and therapy of those Hrdrogas will likely be described.

Vātaja Hrdroga

आयम्यते मारुतजे हृदयं तुद्यते [१] तथा |
निर्मथ्यते दीर्यते च स्फोट्यते पाट्यतेऽपि च ||६||

Within the Hrdroga brought on by aggravated vata, the particular person feels the beneath talked about sorts of ache within the coronary heart / cardiac area –

      Ayama – increasing / stretching kind of ache

      Toda – pricking ache

      Mathanavat – twisting / churning kind of ache

      Deerana – tearing kind of ache

      Sphotana – blasting or exploding kind of ache

      Patyate – splitting kind of ache

Pittaja Hrdroga

तृष्णोषादाहचोषाः स्युः पैत्तिके हृदयक्लमः |
धूमायनं मूर्च्छा च स्वेदः शोषो मुखस्य च ||७||

Within the Hrdroga brought on by aggravated pitta, the particular person experiences the beneath talked about signs –

      Trshna – thirst

      Daha – burning sensation

      Chosha – sucking ache

      Hrdaya klama – exhaustion or debility of the guts,

      Dhumayana – feeling as if scorching fumes are popping out of the area of the guts / chest

      Murcha – fainting

      Sweda – extreme sweating

      Mukha Sosha – dryness of the mouth

Kaphaja Hrdroga 

गौरवं कफसंस्रावोऽरुचिः स्तम्भोऽग्निमार्दवम् |
माधुर्यमपि चाऽऽस्यस्य बलासावतते हृदि ||८||

Within the Hrdroga brought on by aggravated Kapha, the beneath talked about signs are discovered –

      Gaurava – heaviness of the physique or heaviness within the chest / area of the guts,

      Kapha samsrava – extreme circulation of kapha from the mouth and nostril

      Aruchi – tastelessness, anorexia,

      Stambha – stiffness of the physique components,

      Agni mardavam – sluggish digestive hearth / weak digestion capability,

      Madhurya – manifestation of candy style within the mouth

Krimija Hrdroga

उत्क्लेशः ष्ठीवनं तोदः शूलो हृल्लासकस्तमः |
अरुचिः श्यावनेत्रत्वं शोषश्च कृमिजे भवेत् ||९||

Within the Hrdroga brought on by Krimi, the beneath talked about signs might be seen –

      Utklesha – extreme watering within the mouth,

      Shteevana – extreme spitting

      Toda – choosing ache

      Shula – ache or oppression within the area of coronary heart / chest

      Hrllasa – nausea, vomiting sensation

      Tama – look of darkness in entrance of eyes / extreme drowsiness or tendency to sleep

      Aruchi – tastelessness, anorexia

      Shyava netrata – bluish black colouration within the eyes

      Shosha – emaciation

Upadrava – problems

भ्रमक्लमौ सादशोषौ ज्ञेयास्तेषामुपद्रवाः |
कृमिजे कृमिजातीनां श्लैष्मिकाणां च ये मताः ||१०||

Under talked about are the problems of Hrdroga –

      Bhrama – giddiness

      Klama – exhaustion

      Sada – debility

      Shosha – emaciation

The problems talked about below Shlesmika Krimi – worms produced as a consequence of kapha may also be current in Krimija Hrdroga.

Cikitsā – therapy

Therapy ideas of Vataja Hrdroga –

वातोपसृष्टे हृदये वामयेत् स्निग्धमातुरम् |
द्विपञ्चमूलक्वाथेन सस्नेहलवणेन तु ||११||
पिप्पल्येलावचाहिङ्गुयवभस्मानि सैन्धवम् |
सौवर्चलमथो शुण्ठीमजमोदां च चूर्णितम् ||१२||
फलधान्याम्लकौलत्थदधिमद्यासवादिभिः |
पाययेत विशुद्धं च स्नेहेनान्यतमेन वा ||१३||

Snehana – Firstly, snehana – oleation remedy needs to be administered.

Vamana – Subsequent, the affected person needs to be administered Vamana – vomiting. For inducing vamana, decoction ready with each Mahat Pancamula and Laghu Pancamula (i.e. Dasamula) needs to be given after including fat and salts, for consuming.

Pippalyadi Churna – After correct cleaning i.e. after confirming that the emesis has taken place correctly, the powder of the beneath talked about herbs needs to be given –

      Pippali

      Ela

      Vacha

      Hingu

      Yava Bhasma / yava kshara

      Saindhava

      Sauvarchala

      Sunthi and

      Ajamoda

The above-mentioned powder needs to be consumed with one among the many juice of bitter fruits, dhanyamla – fermented liquid, horse-gram soup, curds, Madhvasava and many others. It can be given blended with any one of many fat i.e. oil, ghee, fats or bone-marrow.

भोजयेज्जीर्णशाल्यन्नं जाङ्गलैः सघृतै रसैः |
वातघ्नसिद्धं तैलं च दद्याद्बस्तिं प्रमाणतः ||१४||

Bhojana – meals ready from outdated rice is right for these sufferers. It needs to be served together with soup of meat of animals and birds residing in desert-like / arid areas after including ghee to it.

Vasti – Enema shall be administered with oil ready from Vataghna dravyas – vata mitigating medication.

Therapy Rules for Pittaja Hrdroga 

श्रीपर्णीमधुकक्षौद्रसितोत्पलजलैर्वमेत् |
पित्तोपसृष्टे हृदये सेवेत मधुरैः शृतम् ||१५||
घृतं कषायांश्चोद्दिष्टान् पित्तज्वरविनाशनान् |१६|

Vamana – Firstly, vamana – emesis needs to be given to the affected person affected by Pittaja Hrdroga. Emesis needs to be given by administering water boiled with the beneath talked about herbs –

      Sriparni

      Madhuka

      Kshaudra – honey

      Sita – sugar and

      Utpala

Ghrta / Kashaya – After Vamana, the affected person needs to be given ghee or decoction ready with herbs belonging to Madhura gana – herbs having candy style. Decoctions that are useful for and talked about within the context of Pittaja Jwara (fevers induced as a consequence of predominant aggravation of pitta) needs to be administered in Pittaja Hrdroga additionally.

तृप्तस्य च रसैर्मुख्यैर्मधुरैः सघृतैर्भिषक् ||१६||
सक्षौद्रं वितरेद्बस्तौ तैलं मधुकसाधितम् |१७|

Bhojana – The doctor ought to give meat soup for consuming and ask the affected person to drink it to the extent of competition. The meat soup needs to be added with candy substances like sugar, honey and many others and in addition ghee.

Vasti – Then, the affected person is run an unctuous enema utilizing Madhuka Taila blended with honey.

Therapy Rules for Kaphaja Hrdroga

वचानिम्बकषायाभ्यां वान्तं हृदि कफात्मके ||१७||
चूर्णं तु पाययेतोक्तं वातजे भोजयेच्च तम् |
फलादिमथ मुस्तादिं त्रिफलां वा पिबेन्नरः ||१८||
श्यामात्रिवृत्कल्कयुतं घृतं वाऽपि विरेचनम् |
बलातैलैर्विदध्याच्च बस्तिं बस्तिविशारदः ||१९||

Vamana – Vamana needs to be administered to the affected person affected by Kaphaja Hrdroga. For this, the decoction of Nimba and Vaca needs to be used.

Pippalyadi Churna – After vamana has been carried out correctly, the affected person needs to be given with Pippalyadi Churna which has been defined within the context of therapy of Vataja Hrdroga.

Virechana – Subsequent, the affected person needs to be given purgation remedy. Under talked about recipes shall be used for conducting Virecana –

      Decoction of herbs of Madanaphaladi Gana

      Decoction of herbs of Mustadi Gana

      Decoction of Triphala or

      Ghee boiled with Shyama and Trivrit

Vasti – The doctor who’s specialised in administering enema remedy ought to give enema with Bala Taila.

For krimija hrdroga

कृमिहृद्रोगिणं स्निग्धं भोजयेत् पिशितौदनम् |
दध्ना च पललोपेतं त्र्यहं, पश्चाद्विरेचयेत् ||२०||
सुगन्धिभिः सलवणैर्योगैः साजाजिशर्करैः |
विडङ्गगाढं धान्याम्लं पाययेताप्यनन्तरम् ||२१||
हृदयस्थाः पतन्त्येवमधस्तात् क्रिमयो नृणाम् |
यवान्नं वितरेच्चास्य सविडङ्गमतः परम् ||२२||

Snehana – Oleation needs to be first administered to the affected person affected by Krimija Hrdroga.

Bhojana – After snehana, the affected person needs to be given meals with meat together with curds and fried sesame seeds for 3 days.

Virecana – Subsequent, the affected person needs to be administered purgatives added with sugandhi dravyas i.e. sweet-smelling medication, salt, ajaji and sugar.

Dhanyamla – As soon as the virechana has been carried out in a correct manner, the affected person needs to be given dhanyamla – fermented liquid / gruel added with a very good amount of Vidanga.

With these therapies and medicines, the krimis current within the coronary heart (area of the guts) are eradicated by a downward route (anus). After this, the affected person needs to be given meals ready with Yava, blended with Vidanga.

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे हृद्रोग प्रतिषेधो नाम (पञ्चमोऽध्यायः, आदितः) त्रिचत्वारिंशोऽध्यायः।।४३।।

Thus ends the forty third chapter by title Hydroga pratiṣedha in Uttara Sthana of Suśrutasamhita.

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