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Sushruta Samhita Uttaratantra Chapter 56 Udavarta Pratişedha(Remedy of Gastroenteritis)

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AIAPGET Factors

        Amajirna results in Visuchika. Visthabdhajirna results in Alasaka. Vidagdhajirna causes Vilambika.

        Vilambika is a illness during which the meals vitiated by kapha and vata doesn’t come out both from upward (mouth) or downward (anus) routes. It is going to keep within the stomach for lengthy durations of time and bother the individual. Ref – Su.Ut.56/9

        In remedy of Visuchika, Dahana or Agnikarma has been indicated to be performed to the HEEL with heated iron. (Su.Ut.56/12)

        Kshara Agada has been prescribed within the remedy of Visuchika.

        Kalyanaka Lavana described within the Remedy of Vata Roga has additionally been indicated within the remedy of Visuchika.

        Vyoshadi Anjana has been prescribed within the remedy of Visuchika. Su.Ut.56/18

        Purisha-Mutra Stambha and Shakrd-Vamana are the signs of Purishaja Anaha.

 

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The 56th chapter of Uttaratantra of Sushruta Samhita is known as as Pratişedha Pratiședha. This chapter offers with Remedy of Gastroenteritis.

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

We’ll now expound Visciuka pratiṣedha- remedy of Gastroenteritis as revealed by the venerable Dhanvantari.

अजीर्णमामं विष्टब्धं विदग्धं च यदीरितम् |
विसूच्यलसकौ तस्माद्भवेच्चापि विलम्बिका ||३||

Visucika, Alaska and Vilambika come up from the three sorts of ajirna – indigestion specifically – Amajirna, Visthabdhajirna and Vidagdhajirna.

Causes and pathogenesis of Visucika

सूचीभिरिव गात्राणि तुदन् सन्तिष्ठतेऽनिलः |
यस्याजीर्णेन सा वैद्यैरुच्यते ति विसूचिका ||४||
न तां परिमिताहारा लभन्ते विदितागमाः |
मूढास्तामजितात्मानो लभन्ते कलुषाशयाः ||५||

Consequent to ajirna, vata will get aggravated and offers rise to pricking ache within the physique. Physicians name this situation Visucika.

This illness won’t have an effect on the individuals who devour meals in correct portions as permitted by the texts and cling to the right regimens of meals. Alternatively, it can have an effect on these individuals who shouldn’t have management over themselves and in addition vitiate their abdomen with unhealthy meals.

Lakşana – medical options

मूर्च्छातिसारौ वमथुः पिपासा शूलं भ्रमोद्वेष्टनजृम्भदाहाः |
वैवर्ण्यकम्पौ हृदये रुजश्च भवन्ति तस्यां शिरसश्च भेदः ||६||

Beneath talked about are the signs of Visucika –

        fainting,

        diarrhoea,

        vomiting,

        thirst,

        stomach ache,

        giddiness,

        rigidity of extremities,

        extreme yawning,

        feeling of burning sensation,

        discolouration,

        shivering,

        ache within the area of the center and

        headache

Alasaka

कुक्षिरानह्यतेऽत्यर्थं प्रताम्यति विकूजति |
निरुद्धो मारुतश्चापि कुक्षौ विपरिधावति ||७||
वातवर्चोनिरोधश्च कुक्षौ यस्य भृशं भवेत् |
तस्यालसकमाचष्टे तृष्णोद्गारावरोधकौ ||८||

Alasaka – The illness characterised with the under talked about options known as Alasaka –

        extreme distension of the stomach,

        unconsciousness and moaning,

        vata which is obstructed strikes upwards within the abdomen and

        there’s obstruction to flatus and faeces and

        their accumulation in extra contained in the stomach, accompanied by

        thirst and

        extreme belching

Vilambikā

दुष्टं तु भुक्तं कफमारुताभ्यां प्रवर्तते नोर्ध्वमधश्च यस्य |
विलम्बिकां तां भृशदुश्चिकित्स्यामाचक्षते शास्त्रविदः पुराणाः ||९||

The traditional physicians have documented a situation / illness which is tough to remedy and have named it as Vilambika. On this situation, the meals we devour will get vitiated by kapha and vata. Such vitiated meals won’t come out both from upward (mouth) or downward (anus) paths. It is going to keep contained in the stomach for an extended time period and bother the individual.

यत्रस्थमामं विरुजेत्तमेव देशं विशेषेण विकारजातैः |
दोषेण येनावततं स्वलिङ्गैस्तं लक्षयेदामसमुद्भवैश्च ||१०||

The place during which āma is current offers rise to ache i.e. in whichever place of the physique ama is situated, that place would develop ache. The place of the physique during which ama is current and offers rise to ache ought to be thought-about (that place) because the origin of ailments brought on by the doshas. That additional ought to be decided by the presence of personal (particular to it) signs of ama in that place.

यः श्यावदन्तौष्ठनखोऽल्पसञ्ज्ञश्छर्द्यर्दितोऽभ्यन्तरयातनेत्रः |
क्षामस्वरः सर्वविमुक्तसन्धिर्यायान्नरः सोऽपुनरागमाय ||११||

The individual presenting with the under talked about options is alleged to stroll away by no means to return (would die) –

        tooth (gums), lips and nails turning blue,

        very much less actions of physique elements,

        vomiting,

        eyes gone deep inside (the attention socket),

        very feeble voice and

        looseness of all of the joints

Cikitsā – remedy

साध्यासु पार्ष्ण्योर्दहनं प्रशस्तमग्निप्रतापो वमनं च तीक्ष्णम् |
पक्वे ततोऽन्ने तु विलङ्घनं स्यात् सम्पाचनं चापि विरेचनं च ||१२||
विशुद्धदेहस्य हि सद्य एव मूर्च्छातिसारादिरुपैति शान्तिम् |
आस्थापनं चापि वदन्ति पथ्यं सर्वासु योगानपरान्निबोध ||१३||

Curable types of Visucika ought to be handled. In these circumstances, it’s supreme to do the under talked about remedies –

        burn the heel of the affected person i.e. branding ought to be performed with heated iron,

        digestive hearth ought to be augmented and

        sturdy emetics shall be administered in order to provide vomiting

As soon as the meals will get digested, the affected person ought to be made to quick. Digestive herbs ought to be used and purgatives ought to be administered.

The signs similar to fainting, diarrhoea and many others. instantly subside in individuals who’re purified by present process vomiting and purgation therapies. It’s stated that the decoction enema can also be useful on this illness. Now, I shall describe the opposite medicinal formulae, hearken to the identical.

पथ्यावचाहिङ्गुकलिङ्गगृञ्जसौवर्चलैः सातिविषैश्च चूर्णम् |
सुखाम्बुपीतं विनिहन्त्यजीर्णं शूलं विसूचीमरुचिं च सद्यः ||१४||

Powder of the under talked about elements ought to be ready –

        Pathya,

        Vaca,

        Hingu,

        Kalingaka,

        Grnjanaka,

        Sauvarcala and

        Ativisa

This powder ought to be consumed combined in comfortably heat water. It instantly cures indigestion, stomach ache, visucika and lack of style.

क्षारागदं वा लवणं विडं वा गुडप्रगाढानथ सर्षपान् वा |
अम्लेन वा सैन्धवहिङ्गुयुक्तौ सबीजपूर्णौ सघृतौ त्रिवर्गौ ||१५||
कटुत्रिकं वा लवणैरुपेतं पिबेत् स्नुहीक्षीरविमिश्रितं तु |
कल्याणकं वा लवणं पिबेतु यदुक्तमादावनिलामयेषु ||१६||

Beneath talked about are additionally useful and therefore ought to be consumed –

        Ksara Agada – described in kalpa sthana part, chapter 6,

        Bida Lavana or Sarsapa added with extra amount of jaggery or

        Saindhava Lavana and Hingu combined with bitter gruel, or

        Juice of Bijapura combined with trivarga (trikatu), added with saindhava lavana and combined with snuhi ksira or

        Kalyanaka Lavana – described within the remedy of vata roga (cikitsa sthana, chapter 4)

कृष्णाजमोदक्षवकाणि वाऽपि तुल्यौ पिबेद्वा मगधानिकुम्भौ |
दन्तीयुतं वा मगधोद्भवानां कल्कं पिबेत् कोषवतीरसेन ||१७||
उष्णाभिरद्भिर्मगधोद्भवानां कल्कं पिबेन्नागरकल्कयुक्तम् |१८|

Equal elements of the under talked about elements ought to be taken and their powder is ready –

        Krishna,

        Ajamoda and

        Ksavaka

This powder could also be consumed with bitter liquids.

The opposite useful formulae are –

        Powder of Magadha and Nikumbha or

        Paste of Magadha and Danti could also be consumed with juice of Kosavati (combined on this juice or

        Paste of Magadodbhava (Pippali) added with paste of Nagara ought to be consumed together with heat water

व्योषं करञ्जस्य फलं हरिद्रे मूलं समं चाप्यथ मातुलुङ्ग्याः ||१८||
छायाविशुष्का गुटिकाः कृतास्ता हन्युर्विसूचीं नयनाञ्जनेन |१९|

Equal elements of Vyosa, fruits (seeds) of Karanja and roots of Haridra are taken. They’re macerated with Matulunga juice and made into tablets. These tablets are dried in shade. They’re later used for utility to the eyes within the type of collyrium. This drugs would remedy Visucika.

सुवामितं साधुविरेचितं वा सुलङ्घितं मनुजं विदित्वा ||१९||
पेयादिभिर्दीपनपाचनीयैः सम्यक्क्षुधार्तं समुपक्रमेत |२०|

The affected person ought to be handled with peya i.e. skinny gruel and many others. processed with carminative and digestive herbs after figuring out the under stated issues –

        that the affected person has had passable vomiting and purgation (the therapies have been applied correctly and the indicators of correct administration of those therapies have been documented),

        that the affected person has fasted properly and

        that he has obtained starvation correctly

Anāha – flatulence

आमं शकृद्वा निचितं क्रमेण भूयो विबद्धं विगुणानिलेन ||२०||
प्रवर्तमानं न यथास्वमेनं विकारमानाहमुदाहरन्ति |२१|

Anaha is a situation which is marked by the under talked about occasions / options –

        ama i.e. undigested meals or sakrt – faeces steadily accumulates contained in the alimentary canal and

        they get obstructed from going out by the aggravated vata and therefore,

        they don’t come out in their very own routes i.e. ama doesn’t come out in upward (mouth) course and purisa – faeces doesn’t come out within the downward (anus) route

तस्मिन् भवन्त्यामसमुद्भवे तु तृष्णाप्रतिश्यायशिरोविदाहाः ||२१||
आमाशये शूलमथो गुरुत्वं हृल्लास उद्गारविघातनं च |२२|

Beneath talked about are the signs of anaha produced by ama – the undigested meals –

        thirst,

        working nostril,

        burning sensation within the head,

        ache and heaviness within the abdomen,

        nausea and

        obstruction to belching

स्तम्भः कटीपृष्ठपुरीषमूत्रे शूलोऽथ मूर्च्छा स [१] शकृद्वमेच्च ||२२||
श्वासश्च पक्वाशयजे भवन्ति लिङ्गानि चात्रालसकोद्भवानि |२३|

Beneath talked about are the signs of anaha brought on by purisa – faeces –

        stiffness (lack of motion) of the waist and again,

        non-elimination of faeces and urine,

        ache within the stomach,

        fainting,

        faecal vomiting,

        dyspnoea and

        signs of alasaka

Cikitsā – remedy

आमोद्भवे वान्तमुपक्रमेत संसर्गभक्तक्रमदीपनीयैः ||२३||
अथेतरं यो न शकृद्वमेत्तमामं जयेत् स्वेदनपाचनैश्च |२४|

Vomiting ought to be administered in anaha brought on by ama. Following this, routine of liquid food regimen (peya, vilepi and many others) ought to be applied together with administration of herbs which improve starvation.

Within the different sort of anaha i.e. that brought on by faeces, ama ought to be handled by administering sudation and digestives, if there isn’t any faecal vomiting.

विसूचिकायां परिकीर्तितानि द्रव्याणि वैरेचनिकानि यानि ||२४||
तान्येव वर्तीर्विरचेद्विचूर्ण्य महिष्यजावीभगवां तु मूत्रैः |
स्विन्नस्य पायौ विनिवेश्य ताश्च चूर्णानि चैषां प्रधमेत्तु नाड्या ||२५||

The herbs that are described as purgatives (virecana dravyas) ought to be macerated with urine of buffalo, goat, sheep, elephant or cow and made into recta wicks / suppositories. These wicks ought to be launched into the rectum (anus) of the individual affected by Visucika. Alternatively, powder of the purgative herbs could also be blown into the rectum by means of a tube.

मूत्रेषु संसाध्य यथाविधानं द्रव्याणि यान्यूर्ध्वमधश्च यान्ति |
क्वाथेन तेनाशु निरुहयेच्च मूत्रार्धयुक्तेन समाक्षिकेण ||२६||
त्रिभण्डियुक्तं लवणप्रकुञ्चं दत्त्वा विरिक्तक्रममाचरेच्च |
एष्वेव तैलेन च साधितेन प्राप्तं यदि स्यादनुवासयेच्च ||२७||

The herbs which produce upward motion (emetics) and people which produce downward motion (purgatives) ought to be boiled in urines within the traditional method. Then, half the amount of the paste of tribhandi, one prakunca (40 gm) amount of saindhava lavana and honey are added to this and combined totally. The resultant liquid is run as decoction enema. Afterwards, the routine of post-purgation remedy ought to be adopted. For giving Anuvasana Basti i.e. oil enema, the oil boiled and processed with the identical herbs could also be used.

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे विसूचिकाप्रतिषेधो नाम
(अष्टादशोऽध्यायः, आदितः ) षट्पञ्चाशत्तमोऽध्यायः ||५६||

Thus ends the fifty-sixth chapter by title Visucikā pratiṣedha in Uttarasthana of Suśruta samhita.

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