Sushruta Samhita Uttaratantra Chapter 24 Pratiśāyaya Pratiṣedha (Therapy of Nasal Catarrh / Rhinitis/ Frequent Chilly)

The twenty fourth chapter of Uttaratantra of Sushruta Samhita is known as as Pratiśāyaya Pratiṣedha Adhyaya. This chapter offers with the Therapy of Nasal Catarrh / Rhinitis/ Frequent Chilly.

अथातः प्रतिश्यायप्रतिषेधं व्याख्यास्यामः ।। १ ।।
यथोवाच भगवान् धन्वन्तरिः ||२||

We are going to now expound pratiśyāya pratişedha – remedy of nasal catarrh / widespread chilly; as revealed by the venerable Dhanvantari.

Pratiśyāya nidāna – causes

नारीप्रसङ्गः शिरसोऽभितापो धूमो रजः शीतमतिप्रतायः ।।
संधारणं मूत्रपुरीषयोश्च सद्यः प्रतिश्यायनिदानमुक्तम् ।। ३ ।।

Beneath talked about are the quick causes for Pratisyaya –

–        Indulgence in copulation,

–        Head damage,

–        Being stricken by publicity to smoke, daylight, mud and so on.

–        Affected by an excessive amount of chilly attributable to publicity to mist, fog, rain, breeze and so on.

–        Suppression of urges of urine and faeces

Samprāpti – pathogenesis

चयं गता मूर्धनि मारुतादयः पृथक् समस्ताश्च तथैव शोणितम् ||
प्रकोप्यमाणा विविधैः प्रकोपणैर्नृणां प्रतिश्यायकरा भवन्ति हि ।।४।।

On account of publicity to thrilling / causative components talked about above, vata and different doshas get aggravated, both individually or together and likewise would get related to rakta – blood. These doshas accumulate within the head and produce Pratisyaya – nasal catarrh.

Pūrvarūpa – premonitory signs

शिरोगुरुत्वं क्षवथोः प्रवर्तनं तथाऽङ्गमर्दः परिहृष्टरोमता ।।
उपद्रवाश्चाप्यपरे पृथग्विधा नृणां प्रतिश्यायपुरःसराः स्मृताः ||५||

Beneath talked about are the premonitory signs of pratisyaya –

–        Feeling of heaviness of the hed,

–        Extra sneezes,

–        Physique aches,

–        Horripilations and

–        Many issues comparable to fever, lack of style and so on.

Pratilyaya laksana

Vataja Pratisyaya

आनद्धा पिहिता नासा तनुस्रावप्रवर्तिनी |
गलताल्वोष्ठशोषश्च निस्तोदः शङ्खयोस्तथा ||६||
स्वरोपघातश्च भवेत् प्रतिश्यायेऽनिलात्मके |

Signs of Pratisyaya produced by aggravated vata –

–        Bloating and obstruction of nostril,

–        Circulate of skinny (watery) fluid out of nostril,

–        Dryness of throat and lips,

–        Fixed ache within the temples,

–        Voice problems

Pittaja Pratisyaya

उष्णः सपीतकः स्रावो घ्राणात् स्रवति पैत्तिके ||७||
कृशोऽतिपाण्डुः सन्तप्तो भवत्तृष्णानि(भि)पीडितः |
सधूमं सहसा वह्निं वमतीव च मानवः ||८||

Signs of Pratisyaya produced by aggravated Pitta –

–        Circulate of heat, yellow fluid from the nostril,

–        Emaciation,

–        Extreme anaemia,

–        Extreme thirst,

–        Feeling of sizzling smoke popping out from the nostril

Kaphaja Pratisyaya

कफ: कफकृते प्राणाः शीत: वेमुहुः ॥
शुक्लावभासः शूनाक्षो भवेरुशरोमुखः ॥९॥
शिरोगलौष्ठतालूनां कण्डूयनमतीव च

Signs of Pratisyaya produced by aggravated kapha –

–        Circulate of white or yellow and chilly fluid from the nostril,

–        Whitish colouration of pores and skin and so on.

–        Swelling of eyes,

–        Feeling of heaviness of head and face,

–        Extreme itching within the head, throat, lips and palate

Sarvabhava (Sannipataja) Pratisyaya

भूत्वा भूत्वा प्रतिश्यायो योऽकस्माद्भिनिवर्तते ।।१०।।
संपको वाऽप्यपको वा स सर्वप्रभवः स्मृतः ॥
लिङ्गानि चैव सर्वेशं पीनसानां च सर्वजे ।।११।।

Signs of Pratisyaya produced by all doshas –

–        Look and disappearance of signs with none trigger,

–        Indicators of ripe or unripe doshas could also be produced

Raktaja Pratisyaya

रक्तजे तु प्रतिश्याये रक्तास्त्रायः प्रवर्तते ।।
ताम्राक्षश्च भवेम्जन्तुरुरोपातप्रपीडितः ॥१२॥
दुर्गन्योच्यासवदनस्तथा गन्यत्र येति ॥
मूर्च्छन्ति चात्र कृमयः घेता: स्निग्धास्तावः ||१३||
कृमिमूर्धविकारेण समानं चास्य लक्षणम् ।।

Signs of Pratisyaya produced by aggravated Rakta – blood,

–        Bleeding from nostril,

–        Reddish eyes,

–        Chest ache,

–        Foul smelling breath,

–        Unable to know or differentiate between totally different odours,

–        Krimis (worms, micro organism) – that are white, unctuous and minute are shaped within the nostril and likewise come out of the nostril and

–        Options much like krimija sirasula – complications attributable to worms and micro organism

Duşta pratisyāya

प्रक्लिद्यति पुनर्नासा पुनश्च परिशुष्यति ।।१४।।
मुहुरानहाते चापि मुहुर्विवियते तथा ।।
निःश्वासोच्छ्रासदौर्गन्ध्यं तथा गन्यान्न वेत्ति च ।। १५ ।।
एवं दुष्टप्रतिश्यायं जानीयात् कृच्छ्रसाधनम् ।।

Signs of Dusta Pratisyaya – continual rhinitis –

–        Moistness or dryness of the nostril time and again,

–        Bloating / swelling generally and widening generally (of the nostril),

–        Unhealthy odor throughout inspiration and expiration

–        Unable to acknowledge and admire odor

This situation is tough to treatment.

Pratiśyāya pariņāma

सर्व एव प्रतिश्याया नरस्याप्रतिकारिणः ।। १६ ।।
कालेन रोगजनना जायन्ते दुष्टपीनसाः ।।
बाधिर्यमान्ध्यमघ्राणं घोरांच नयनामयान् ॥
कासाग्निसादशोफांश्च वृद्धाः कुर्वन्ति पीनसाः ।।१७।।

Every kind of Pratisyaya give rise to many ailments in the end of time when not handled at acceptable time. Beneath talked about are a few of these circumstances –

–        Persistent rhinitis,

–        Deafness,

–        Blindness,

–        Lack of sensation of odor,

–        Dreaded ailments of the eyes,

–        Cough,

–        Weak digestive capability (weak digestive hearth) and

–        Dropsy

Pratiśyāya cikitsä – remedy of nasal catarrh

नवं प्रतिश्यायमपास्य सर्व मुपाचरेत् सर्पिष एव पानैः ।।
स्वेदैर्विचित्रैर्वमनैश्च युक्तैः कालोपपन्नैरवपीडनैश्च ।।१८।।

Therapy rules of every kind of Pratisyaya apart from nascent (of latest origin) sort of the illness –

–        Consuming of ghee solely adopted by

–        Sudation of various varieties,

–        Emesis and

–        Nasal medicine

These therapies are useful when finished at acceptable occasions.

अपच्यमानस्य हि पाचनार्थं स्वेदो हितोऽप्लैरहिमं च भोज्यम् ।।
निषेव्यमाणं पयसाऽऽर्द्रकं वा संपाचयेदिक्षुविकारयोगैः ।।१९।।

Sudation is useful to ripen the unripe state of doshas. Meals that are bitter in style and sizzling in efficiency must be used. Milk boiled with ardraka must be eaten. Likewise, merchandise of sugarcane juice like jaggery, sugarcandy, sugar and so on too must be consumed.

पक्वं घनं चाप्यवलम्बमानं शिरोविरेकैरपकर्षयेत्तम् |
विरेचनास्थापनधूमपानैरवेक्ष्य दोषान् कवलग्रहैश्च ||२०||

The exudate has grow to be stable (jelly like) and hangs out of the nostril within the ripe state of the illness. This must be eliminated by the beneath talked about measures after contemplating the situation of doshas –

–        Purgation to the pinnacle,

–        Purgation,

–        Decoction enema,

–        Inhalation of medicated smoke and

–        Mouth gargles

निवातशय्यासनचेष्टनानि मूर्ध्नो गुरूष्णं च तथैव वासः |
तीक्ष्णा विरेकाः शिरसः सधूमा रूक्षं यवान्नं विजया च सेव्या ||२१||

The affected person ought to do the beneath talked about issues –

–        Ought to sleep, sit and contain in different actions in a home devoid of breeze,

–        Put on heavy clothes on the pinnacle,

–        Ought to bear robust purgation to the pinnacle and inhalation of medicated smoke,

–        Eat meals ready with boiled barley and haritaki with out addition of fat

शीताम्बुयोषिच्छिशिरावगाहचिन्तातिरूक्षाशनवेगरोधान् |
शोकं च मद्यानि नवानि चैव विवर्जयेत् पीनसरोगजुष्टः ||२२||

The affected person of pinasa / pratisyaya ought to keep away from the beneath talked about –

–        Consuming chilly water,

–        Copulation,

–        Immersion in chilly water,

–        Fear,

–        Very dry meals,

–        Suppression of physique urges,

–        Grief and

–        Consuming contemporary wines

छर्द्यङ्गसादज्वरगौरवार्तमरोचकारत्यतिसारयुक्तम् |
विलङ्घनैः पाचनदीपनीयैरुपाचरेत् पीनसिनं यथावत् ||२३||

The affected person with beneath talked about circumstances must be handled with fasting and use of appetizer and carminative herbs –

–        Vomiting,

–        Debility,

–        Fever,

–        Feeling of heaviness of the physique,

–        Lack of style,

–        Restlessness and

–        Diarrhea

बहुद्रवैर्वातकफोपसृष्टं प्रच्छर्दयेत् पीनसिनं वयःस्थम् |
उपद्रवांश्चापि यथोपदेशं स्वैर्भेषजैर्भोजनसंविधानैः |
जयेद्विदित्वा मृदुतां गतेषु प्राग्लक्षणेषूक्तमथादिशेच्च ||२४||

Vomiting must be administered with liquid emetics to sufferers of Pinasa of appropriate (center) age and having predominance of vata and kapha.

Appropriate medicines and eating regimen (meals) in keeping with the dosha aggravated must be used to deal with the issues. Appropriate meals and actions must be suggested after figuring out the mitigation of illness from the signs described earlier.

वातिके तु प्रतिश्याये पिबेत् सर्पिर्यथाक्रमम् |
पञ्चभिर्लवणैः सिद्धं प्रथमेन गणेन च ||२५||
नस्यादिषु विधिं कृत्स्नमवेक्षेतार्दितेरितम् |

Therapy of Vataja Pratisyaya – Beneath talked about recipes could also be administered –

–        Ghee boiled with 5 salts for consuming and

–        Herbs belonging to Vidarigandhadi Gana group,

–        Nasal medicine – as indicated within the remedy of ardita (Chikitsa Sthana, chapter 5)

पित्तरक्तोत्थयोः पेयं सर्पिर्मधुरकैः शृतम् ||२६||
परिषेकान् प्रदेहांश्च कुर्यादपि च शीतलान् |
श्रीसर्जरसपत्तङ्गप्रियङ्गुमधुशर्कराः ||२७||
द्राक्षामधूलिकागोजीश्रीपर्णीमधुकैस्तथा |
युज्यन्ते कवलाश्चात्र विरेको मधुरैरपि ||२८||

Therapy of Pittaja and Raktaja Pratisyaya – Beneath talked about recipes could also be administered –

–        Ghee boiled and ready with herbs which predominantly have candy style

–        Liquids for pouring must be used chilly and

–        Poultices too must be used chilly,

–        Mouth gargle could also be finished with – Srivestaka, Sarjarasa, Pattanga, Priyangu, Madhu and Sarkara

–        Mouth gargle could also be finished with – Draksa, Madhulika, Gojihva, Sriparni and Madhuka

–        Purgation – must be induced through the use of herbs predominantly having candy style

धवत्वक्त्रिफलाश्यामातिल्वकैर्मधुकेन च |
श्रीपर्णीरजनीमिश्रैः क्षीरे दशगुणे पचेत् ||२९||
तैलं कालोपपन्नं तन्नस्यं स्यादनयोर्हितम् |

Decoction is ready by boiling the beneath talked about herbs in water –

–        Bark of Dhava,

–        Triphala, Syama,

–        Tilvaka,

–        Madhuka,

–        Sriparni and

–        Rajani

Ten elements of milk and one a part of oil are added to this, cooked and medicated oil is ready. This oil must be used as nasal drops with profit, in each these ailments.

कफजे सर्पिषा स्निग्धं तिलमाषविपक्वया ||३०||
यवाग्वा वामयेद्वान्तः कफघ्नं क्रममाचरेत् |
उभे बले बृहत्यौ च विडङ्गं सत्रिकण्टकम् ||३१||
श्वेतामूलं सदाभद्रां वर्षाभूं चात्र संहरेत् |
तैलमेभिर्विपक्वं तु नस्यमस्योपकल्पयेत् ||३२||
सरलाकिणिहीदारुनिकुम्भेङ्गुदिभिः कृताः |
वर्तयश्चोपयोज्याः स्युर्धूमपाने यथाविधि ||३३||

Therapy of Kaphaja Pratisyaya – This situation could also be handled as defined beneath –

–        Emesis – Ghee or thick gruel boiled with tila and masa must be used to provide vomiting.

–        Kapha mitigating therapies – must be administered after administering vomiting.

Additionally,

Nasal drops must be instilled with medicated oil ready utilizing the beneath talked about herbs –

–        Two sorts of Bala,

–        Two styles of Brhati,

–        Vidanga,

–        Trikantaka,

–        Roots of Sveta,

–        Sadabhadra (Kasmari) and

–        Varsabhu

A smoke wick (cigar) must be ready with the beneath talked about herbs –

–        Sarala,

–        Kinihi,

–        Devadaru,

–        Nikumbha and

–        Ingudi

The smoke from this must be inhaled in keeping with the process.

सर्पींषि कटुतिक्तानि तीक्ष्णधूमाः कटूनि च |
भेषजान्युपयुक्तानि हन्युः सर्वप्रकोपजम् ||३४||
रसाञ्जने सातिविषे मुस्तायां भद्रदारुणि |
तैलं विपक्वं नस्यार्थे विदध्याच्चात्र बुद्धिमान् ||३५||

Therapy of Pratisyaya produced by all of the three doshas – This situation shall be handled as beneath talked about –

–        Ghee boiled with pungent and bitter herbs shall be given for consuming,

–        Smoke inhalation – with robust and pungent herbs (alt – smoke inhalation with robust medicine and consumption of powders or medicines ready utilizing pungent medicine)

–        For nasal drops – Oil ready by boiling with rasanjana, ativisa, musta and bhadradaru must be used

मुस्ता तेजोवती पाठा कट्फलं कटुका वचा |
सर्षपाः पिप्पलीमूलं पिप्पल्यः सैन्धवाग्निकौ ||३६||
तुत्थं करञ्जबीजं च लवणं भद्रदारु च |
एतैः कृतं कषायं तु कवले सम्प्रयोजयेत् ||३७||
हितं मूर्धविरेके च तैलमेभिर्विपाचितम् |३८|

Decoction is ready with the beneath talked about herbs –

–        Musta,

–        Tejovati,

–        Patha,

–        Katphala,

–        Katuka,

–        Vaca,

–        Sarsapa,

–        Pippalimula,

–        Pippali,

–        Saindhava,

–        Agnika,

–        Tuttha,

–        Karanja Bija,

–        Lavana and

–        Bhadradaru

This decoction must be used as mouth gargles.

For purgation to the pinnacle – oil ready with the identical herbs (above talked about) must be used.

Dasaksira ghrta

क्षीरमर्धजले क्वाथ्यं जाङ्गलैर्मृगपक्षिभिः ||३८||
पुष्पैर्विमिश्रं जलजैर्वातघ्नैरौषधैरपि |
हिमे क्षीरावशिष्टेऽस्मिन् घृतमुत्पाद्य यत्नतः ||३९||
सर्वगन्धसितानन्तामधुकं चन्दनं तथा |
आवाप्य विपयेद्भूयो दशक्षीरं तु तद्घृतम् ||४०||
नस्ये प्रयुक्तमुद्रिक्तान् प्रतिश्यायान् व्यपोहति |
यथास्वं दोषशमनैस्तैलं कुर्याच्च यत्नतः ||४१||

Milk is added with the beneath talked about and boiled collectively –

–        Half its amount of water,

–        Meat of animals and birds residing in arid areas,

–        Flowers of crops rising in water and

–        Vata mitigating herbs

All these are cooked till solely milk stays.

This could now be churned, its butter obtained and made into ghee later.

That is added with the beneath talked about substances and cooked to type medicated ghee –

–        Paste of Sarvagandha – aromatic herbs like ela, karpura and so on.

–        Sita – sugar,

–        Ananta – sariva,

–        Madhuka and

–        Chandana and

–        Ten elements of milk

This ghee must be used as nasal drops. It mitigates the elevated nasal catarrh.

In the identical manner, medicated oil could also be ready with dosha mitigating herbs and used as nasal drops.

समूत्रपित्ताश्चोद्दिष्टाः क्रियाः कृमिषु योजयेत् |
यापनार्थं कृमिघ्नानि भेषजानि च बुद्धिमान् ||४२||

Herbs that are krimighna – ‘worm destroying’ in motion must be blended with urine and bile of animals and administered in pratisyaya produced by krimi – worms (micro organism, virus and so on.).

The therapies which destroy worms must be continued till the illness persists.

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे प्रतिश्यायप्रतिषेधो नाम चतुर्विंशतितमोऽध्यायः ||२४||

Thus ends the twenty fourth chapter by identify Pratiśyāya Pratişedha in Uttara Sthana of Susruta Samhita.