The twelfth chapter of Chikitsasthana of Sushruta Samhita is known as as Pramehapidaka Cikitsitam Adhyaya. This chapter offers with Therapy of Diabetic Ulcers / Carbuncles.
अथातःप्रमेहपिडकाचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।
We are going to now expound Prameha pidaka chikitsa – therapy of diabetic eruptions; as revealed by the venerable Dhañvañtari.
शराविकाद्यानवपिडकाःप्रागुक्ताः;ताःप्राणवतोऽल्पास्त्वङ्मांसप्राप्तामृदयोऽल्परुजःक्षिप्रपाकभेदिन्यश्चसाध्याःताभिरुपद्भुतंप्रमेहिणमुपचरेत्।।३।।
In Nidana Sthana Part of the Samhita (Sushruta Nidana Chapter 6), Sarāvika and different 9 sorts of Prameha Pidakas i.e. eruptions occurring in individuals affected by prameha have already been described.
Curability of Prameha Pidakas –
Prameha Pidakas are curable within the under talked about circumstances –
– Manifested in sturdy sufferers
– Of delicate nature,
– Localized solely within the pores and skin and muscle groups and never gone deeper into the tissues,
– They’re tender and related to much less ache,
– They ripen and burst open rapidly
Sufferers presenting with such eruptions having indicators of curability shall be handled by the physicians.
Cikitsā: Methodology of therapy
तत्रपूर्वरूपेष्वपतर्पणंवनस्पतिकषायंबस्तमूत्रंचोपदिशेत्;एवमकुर्वतस्तस्यमधुराहारस्यमूत्रंस्वेदःश्लेष्माचमधुरीभवतिप्रमेहश्चाभिव्यक्तोभवति.तत्रोभयतःसंशोधनमासेवेत;एवमकुर्वतस्तस्यदोषाःप्रवृद्धामांसशोणितेप्रदूष्यशोर्फजनयन्त्युपद्रवान्वाकांश्चित्.तत्रोक्तःप्रतीकारःसिरामोक्षश्चएवमकुर्वतस्तस्यशोफोवद्धोऽतिमात्रंरुजोविदाहमापद्यते.शस्त्रप्रणिधानमुक्तंव्रणक्रियोपसेवाच;एवमकुर्वतस्तस्यपूयोऽभ्यन्तरमवदार्योत्सङ्गंमहान्तमवकाशंकृत्वाप्रवृद्धोभवत्यसाध्यः;तस्मादादितएवप्रमेहिणमुपक्रमेत्।।४।।
- Therapy in purvarupa stage solely –
The affected person is prescribed the under talked about interventions within the premonitory stage itself –
– Apatarpana – fasting
– Vanaspati Kashaya – decoction of medicinal herbs,
– Basta mutra – goat’s urine for ingesting
- Shodhana –
If the sufferers proceed utilization of candy meals not adhering to the above-mentioned types of interventions, their urine, sweat and kapha would develop sweetness. Because of this, Prameha turns into nicely manifested in these sufferers.
In these sufferers purificatory therapies ought to be administered within the type of emesis and purgation, inflicting cleaning in each instructions.
- What occurs if these therapies aren’t achieved?
The doshas would get excessively aggravated if these therapies aren’t achieved. In flip, these doshas would vitiate the blood and muscle groups and produce swelling and different issues.
What to do in such circumstances?
In such circumstances, remedies talked about in chapter 1 of Chikitsasthana for shotha ought to be achieved. Siravedha i.e. venepuncture too ought to be achieved.
- What occurs if therapy is just not achieved on this situation?
If these remedies aren’t achieved on this stage, it results in a rise of swelling. The elevated swelling is related to ache and burning sensation.
What ought to be achieved then?
In such circumstances, surgical procedure will probably be a very good choice. It ought to be handled by utilizing sharp surgical devices. Following that, therapy for the injuries ought to be administered.
- What occurs if therapy is just not achieved on this situation?
If these interventions aren’t adopted, pus will get elevated in nice portions inside. This creates a giant cavity and therefore turns into incurable. Subsequently, the affected person of prameha ought to be correctly handled from the early stage of its manifestation itself.
Dhāñvañtara Ghrta
भल्लातकबिल्वाम्बुपिप्पलीमूलोदकीर्यावर्षाभूपुनर्नवाचित्रकशटीस्नुहीवरुणकपुष्करदन्तीपथ्यादशपलोन्मितायवकोलकुलत्यांश्चप्रास्थिकान्सलिलद्रोणेनिष्क्वाथ्यचतुर्भागावशिष्टेऽवतार्यवचात्रिवृत्कम्पिल्लकभार्गीनिचुलशुण्ठीगजपिप्पलीविडङ्गरोधशिरीषाणांभागैरर्धपलिकैतप्रस्थंविपाचयेन्मेहश्वयथुकुष्ठगुल्मोदरार्श:प्लीहविद्रधिपिडकानांनाशनंनाम्नाधान्वन्तरम्।।५।।
Elements –
10 pala – 480 grams every of –
– Bhallataka
– Bilva
– Ambu
– Pippalimula
– Udakirya
– Varsabhu
– Punarnava
– Citraka
– Sati
– Snuhi
– Varunaka
– Puskaramula
– Danti and
– Pathya
1 prastha – 640 grams every of –
– Yava
– Kola
– Kulattha –
Methodology of preparation
All of the above stated elements ought to be boiled in 1 drona grams of water and decreased to at least one fourth of the amount in order to organize their decoction.
To this decoction, ½ pala – 20 grams every of –
– Vacha
– Trivrit
– Kampillaka
– Bharangi
– Nicula
– Sunthi
– Gajapippali
– Vidanga
– Rodhra
– Sirisa
To this, 1 prastha of ghee is added, boiled and ghee is cooked.
This medicated ghee thus ready known as Dhanwantara Ghrta.
Advantages – Dhanwantara Ghrta successfully helps in curing the under talked about illnesses –
– Diabetes
– Swelling / dropsy
– Pores and skin issues together with leprosy
– Belly tumours
– Belly enlargement
– Haemorrhoids
– Spleen issues
– Abscess
– Eruptions
Madhumeha: Diabetes mellitus
दुर्विरेच्याहिमधुमेहिनोभवन्तिमेदोऽभिव्याप्तशरीरत्वात्.तस्मात्तीक्ष्णमेतेषांशोधनकुर्वीत।पिडकापीडिताःसोपद्रवाःसर्वएवप्रमेहामूत्रादिमाधुर्येमधुगन्धसामान्यात्पारिभाषिकीमधुमेहाख्यांलभन्ते।।६।।
It is vitally troublesome to manage virechana – purgation remedy for sufferers of madhumeha since purging doesn’t happen simply in them, since their physique is stuffed with fats. That is the explanation why they need to be administered with Tikshna shodhana i.e. sturdy cleaning therapies, primarily purgation.
Why the identify Madhumeha?
All sufferers of prameha who’ve developed eruptions on their our bodies and different issues together with sweetness of their urine and so on. and likewise scent of their physique resembling honey can be thought-about to have developed a situation known as as Madhumeha. She or he will technically derive the identify as madhumehi i.e. the one who has developed madhumeha. This identify is given when the above stated options are manifested.
Contraindication of Swedana
नचैतान्कथंचिदपिस्वेदयेत्.मेदोबहुत्वादेतेषांविशीर्यतेदेहःस्वेदेन।।७।।
Swedana – sudation ought to by no means be administered to the sufferers affected by Madhumeha. It’s because the big amount of fats current of their physique turns into drastically troubled by swedana.
These sufferers (of madhumeha) ought to by no means be given sudation remedy as a result of these individuals can have an abundance of fats of their physique and subsequently the swedana, when administered, would bother the particular person drastically.
Causes for diabetic eruptions growing within the decrease elements of the physique
रसायनीनांचदौर्बल्यान्नेर्ध्वमुत्तिष्ठन्तिप्रमेहिणांदॊषाः.ततॊमधुमेहिनामधःकायेपिडकाःप्रादुर्भवन्ति॥८॥
In individuals affected by prameha, there may be weaknenss of Rasayanis i.e. channels of rasa. Resulting from this weak spot, the doshas don’t transfer in upward course and therefore don’t accumulate within the higher elements of the physique. Therefore, the eruptions of madhumeha develop solely within the decrease elements of the physique.
अपक्वानांतुपिडकानाशोफवत्प्रतीकारः.पक्वानांव्रणवदिति;तैलंतुव्रणारॊपणमेवादौकुर्वीत.आरग्वधादिकषायमुत्सादनार्थ.शालसारादिकषायपरिषेचने.पिप्पल्यादिकाषायंपारभोजनेषुपाठाचिन्नकशार्ङ्गेष्टाक्षुद्राबृहतीसारिवासॊमवल्कसप्तर्णारग्व्धकुटजमूलचूर्णनि मधुमिश्राणिप्राश्रीणियात्॥९॥
Unripe eruptions i.e. eruptions which haven’t undergone suppuration ought to be handled on the traces of treating sopha. The eruptions which have ripened ought to be handled on the traces of treating a wound.
Useful recipes for various functions –
- For vrana ropana – Vrana ropana taila i.e. medicated oils ready for the aim of therapeutic the injuries ought to be ready and saved beforehand,
- For utsadana i.e. massaging – decoction of Aragvadhadi Gana group of herbs ought to be ready and saved prepared.
- For parisechana – decoction of herbs of Salasaradi Gana group of herbs ought to be ready and saved prepared for bathing or irrigating the wound.
- For pana and bhojana – decoction of herbs of Pippalyadi gana group of herbs ought to be used for ingesting functions and likewise ought to be used together with meals or for getting ready meals.
- For consumption within the morning – the powder of the under talked about ought to be used blended with honey, day-after-day –
– Patha
– Citraka
– Sarngesta
– Kshudra
– Brhati
– Sariva
– Smoavalka
– Saptaparna
– Aragvadha and
– Root of Kutaja
Salasaradi Leha
शालसारादिवर्णकशायंचतुर्भागावशिष्टमवतार्यपरित्राव्यपुनरुपनीयसाधयेत्.सिध्यतिचामलकोप्रप्रियाङ्दन्तीकृष्णाचस्तानचूर्णान्यावपेत्.एतदनुपदग्धंलेहीभूतमवतार्यानुगुजनिदम्यान.ततॊयथायोगमुपयुशीत.एषलेहःसर्वमेहानांहन्ता॥१०॥
Salasäradigana group of herbs ought to be boiled in water. It ought to be decreased to at least one fourth and filtered. It ought to be boiled once more after filtering. Whereas re-boiling, powder of the under stated is added –
– Amalaka
– Rodhra
– Priyangu
– Danti
– Krshna Ayas
– Tamra
We must always wait till the liquid positive aspects confection like consistency. It’s now faraway from the contact of fireplace and saved in a vessel. The vessel ought to be hid. This drugs known as Salasaradi Leha and ought to be utilized in appropriate doses as and when required. This confection is claimed to treatment all types of prameha.
Navayasa Loha
त्रिफलाचित्रविककटुकविडङमुस्तानांनवभागास्तावन्तएवकृष्णायचूर्णस्य.सत्सर्वमैकण्यंकृत्वायथायोगमात्रांसर्पिर्मधुभ्यांसंसृज्योपयुञ्जीत.एतन्नवायसम्एतेनजाठर्यभजाति.समोऽग्निराप्यायते,दुर्नामशोफपाण्डुकुष्ठरोगाविपाककासश्वासप्रमेहाचनभवन्ति॥१॥
Under talked about ought to be taken in equal proportions, every ingredient one half, which sums as much as 9 elements –
– Triphala – Haritaki, Bibhitaki and Amalaki – one half every – 3 elements
– Chitraka – 1 half
– Trikatu – Pippali, Maricha and Shunti – 1 half every – 3 elements,
– Vidanga – 1 half
– Musta – 1 half
Krsna Ayas i.e. iron fillings or ash of pure iron ought to be taken in the same amount i.e. 9 elements (equal to the blended amount of the above stated elements).and blended totally with the powder of the above stated herbs. That is known as Navayasa Churna.
This powder ought to be consumed in appropriate doses blended with honey and ghee.
This churna (Navayasa Churna) prevents (cures) the under talked about circumstances –
– Belly enlargement
– Weak digestion
– Dropsy
– Anaemia
– Leprosy
– Dyspepsia
– Indigestion
– Cough
– Dyspnoea
– Diabetes
Loharista
शालसारादिनियूहचतुर्थाशावशेषिते।।
परिनुतेततःशीतेमधुमाक्षिकमावपेत्।।१२।।
फाणितीभावमापन्नंगुडशोधितमेवच।।
लक्ष्णपिष्टानिचूर्णानिपिप्पल्यादिगणस्यच।।१३।।
ऐकध्यमावपेत्कुम्भेसंस्कृतेपतभाविते।।
पिप्पलीचूर्णमधुभिःप्रलिप्तेऽन्तःशुचौदृढे।।१४।।
श्लक्ष्णानितीक्ष्णलोहस्यतत्रपत्राणिबुद्धिमान्।।
खदिराङ्गारतप्तानिबहुशःसन्निपातयेत्।।१५।।
सुपिधानंतुतंकृत्वायवपल्लेनिधापयेत्।।
मासास्त्रींश्चतुरोवाऽपियावदालोहसंक्षयात्।।१६।।
ततोजातरसंतंतुप्रातःप्रातर्यथाबलम्।।
निषेवेतयथायोगमाहारंचास्यकल्पयेत्।।१७।।
कार्यकद्वलिनामेषसन्नस्याग्नेःप्रसाधकः।।
शोफनुदगुल्महत्कुष्ठमेहपाण्ड्वामयापहः।।१८।।
प्लीहोदरहरःशीघ्रंविषमज्वरनाशनः।।
अभिष्यन्दापहरणोलोहारिष्टोमहागुणः।।१९।।
Salasaradi Gana group of herbs is taken. Its decoction is ready by boiling the elements in water, lowering it to at least one fourth amount and filtering it.
As soon as the decoction will get cooled, honey and maksika (iron pyrites) ought to be added and boiled once more.
Boiling is sustained till the liquid assumes the consistency of molasses. Now, refined jaggery and tremendous powder of Pippalyadi Gana group of herbs is added to it. The contents are actually poured into a giant pot whose inside has been smeared with ghee.
Then, the under talked about are put into the liquid –
– Powder of Pippali
– Honey
– Skinny sheets of Tiksna Loha which has been made crimson scorching many instances on the burning coal of wooden of Khadira
Now, the pot during which the drugs is there may be lined with a lid and sealed with mud plaster. The pot is now saved hid in a heap of barley husk for a time interval of 3-4 months, till all of the steel sheets put into it get dissolved.
As soon as the drugs has attained fermentation, it’s taken out of the pot. Now it’s prepared for use and known as Loharishta. It shall be administered in appropriate doses together with appropriate meals.
Advantages –
This Loharishta has many advantages –
– It makes the overweight individuals skinny,
– It enhances the weakened digestive fireplace,
It additionally cures the under talked about circumstances –
– Dropsy,
– Belly tumours,
– Leprosy,
– Diabetes,
– Anaemia,
– Issues of spleen
– Enlargement of stomach,
– Intermittent fever and
– Conjunctivitis
Prameha mukta lakṣaṇa: Indicators of treatment of diabetes
प्रमेहिणोयदामूत्रमपिच्छिलमनाविलम्।।
विशदंतिक्तकटुकंतदाऽऽरोग्यंप्रचक्षते।।२०।।
The affected person of Prameha is taken into account to be wholesome when the urine of the affected person turns into –
– Non-slimy
– Non-turbid,
– Viscid and
– Bitter or pungent in style
इतिश्रीसुश्रुतसंहितायांचिकित्सास्थानेप्रमेहपिडकाचिकित्सितंनामद्वादशोऽध्यायः।।१२।।
Thus ends the twelfth chapter by identify Pramehapidaka Cikitsita in Cikitsā Sthāna of Suśruta Samhita.
