Ashtangasamgraha 21

English (machine translation) 21

Language: English

21.1

Now we shall expound the chapter on the treatment of the doṣas (Doṣopakramaṇīya); thus said Ātreya and the great rṣis:
The treatment for vāta consists of oleation; sudation; mild, unctuous, warm, sweet, sour, and salty purifying agents and food substances; after anointing, poultices, bandaging, kneading, pouring libations, tub-baths, gentle rubbing, and pressing; startling, alarming, and causing to forget; preparations of surā and āsava wines; and fats from diverse sources processed with substances that kindle digestion, digest toxins, relieve vāta, and induce purgation, as well as those boiled a hundred or a thousand times, to be used in every way; enemas; regulation of enemas; especially [sesame] oil, meat broth, unctuous enemas [anuvāsana], comfortable living, and the winter regimen with the avoidance of sexual intercourse.
Thus said Ātreya and the other great rṣis.
Thus said Ātreya and the other great rṣis.

21.2

For pitta: drinking ghee, oleation with ghee, downward elimination of doṣas [purgation], use of medicines and foods that are sweet, bitter, and astringent, enjoyment of mild, fragrant, cool, and heart-pleasing scents, immersion in extremely cool and fragrant water;

wearing on the chest garlands strung with pearl gems, beryl, emerald, conch shell, stone, ruby, and moonstone that are exquisite and delightfully radiant, which are pleasant and agreeable to the touch of the mind, and fashioned from diverse colored blossoms such as lotus flowers frightened by bees, blue water lilies, plantain leaves, fresh jasmine, kunda, and mallikā;

sprinkling at every moment the floor surfaces, doors, windows, and palace walls with fragrant, cool, clear scented water perfumed with superior sandalwood, priyaṅgu, kāleyaka, lotus stalk, and camphor, along with blue water lilies, white water lilies, and night-blooming water lilies;

listening to singing, musical instruments, and recitations of prosperity that are pleasing to the ear, soft, sweet, and congenial to the mind;

sitting together with uninhibited friends whose interests, dress, and conduct are identical, whose mutual sight is an ever greater festive delight;

affectionately embracing beloved little children whose bud-like mouths are naturally ever-fragrant from the absence of untruthful speech, who speak not too distinctly, and whose tender babbling is unsophisticated and sweet;

and passionately embracing wanton women who wear extremely fine, soft, and fragrant garments; whose ornaments consist mostly of pearls resembling jasmine buds; whose charms are accompanied by the sweet, innocent, affectionate, and gentle speech called forth by the jingling of their anklets and girdle-bands echoing the soft calls of swans stirred to longing by the chattering cries of their female companions; whose waists tremble with the heavy sighs of fatigue from bearing the burden of their wide hips, pair of tight breasts, and ornaments; whose lotus-eyes are half-closed; who have slightly passed their fresh youth; whose garments slip loose at the supreme delight of physical contact alone; whose cool bodily unguent is melted by the sweat loosened all over their limbs due to shame, confusion, boldness, distress, joy, dejection, wonder, smiles, anger, grace, and trepidation arising all at once; who bring delight to the entire body and heart; and who, though having slender limbs, carry as it were the entire fourfold army of the god of love;

palace terraces and river sands made exceedingly cool by being bathed in the abundant beams of the full moon;

a shower house whose floor is strewn with very white sand and from which streams of clear water flow through the operation of various mechanical contrivances;

a pavilion that rivals the cool of the Himālaya mountains and mimics the playful charm of the rainy season—covered by the dense shade of many flowering, wide, tall, and varied trees growing on the banks and firmly planted beside reservoirs resembling the ocean; constructed on a spacious, sandy ground whose entire water is suffused with the pollen of white, red, and blue lotuses; a portion of whose ground is imbued with the sweet fragrance of earth caused by flowing streams of water trickling from water-jars, pots, and numerous large leather bags swaying back and forth; whose cloth canopies are stitched with hanging sprays of mango, rose-apple, kadamba, vidula, nicula, and other sprouts, buds, and clusters of blossoms; which, through the forceful efforts of men, has droplets of water resembling pearls caught and falling from the mouths of constantly pouring jars infused with uśīra and sandalwood; whose height and breadth do not obstruct the distant, expansive entrance of cool breezes; and which dispels torment, burning sensation, confusion, fatigue, exhaustion, and thirst by the ceaseless, cool spray of abundant water, possessing extraordinary loveliness;

pleasure ponds made charming by the indistinct chirping of flocks of aquatic birds colored by the pollen of fully blown lotuses, blue water lilies, white water lilies, fragrant water lilies, red lotuses, and hundred-petaled lotuses; and pleasure groves where gentle breezes are busy preparing beds composed of collections of diverse flowers fallen from swaying creepers when swarms of bees settle in greed to drink their nectar;

and especially ghee, milk, purgations, all mild and cool measures, and the regimen for the hot season, excluding sleeping by day.

There [in pitta], when vāta is predominant, one should prescribe oil or ghee cooked with meṣaśṛṅgī, śārṅgeṣṭā, castor plant, guḍūcī, and the two pañcamūlas for drinking and for massage.

[The ear disease] provoked by the improper use of sound and by other aggravating factors—

21.3

For śleṣman, moreover: sharp purifications administered according to rule; mostly dry foods; foods mixed with pungent, bitter, and astringent substances; sharp, long-aged, heart-pleasing alcoholic beverages; running, jumping, swimming, staying awake at night, fighting, wrestling, sexual intercourse, physical exercise, dry massage, bathing, and dry unguents;

especially honey, legume soup, emetics, fasting entirely, gargles with medicated smoke, avoidance of ease, and the regimen of the spring season entirely for the sake of well-being.

And here are [verses]:

Alternatively, one should boil one pala each of paṭola, picumanda, dārvī, durālabhā, tiktarohiṇī, pāṭhā, parpaṭaka, and trāyamāṇā in two āḍhakas of water down to one-eighth portion remaining.

With that [decoction] and with pastes of one karṣa each of sandalwood, upakulyā, mustā, trāyantī, indrayava, and bhūnimba, one should prepare twelve palas of ghee.

This Tiktaka ghee cures kuṣṭha, erysipelas, blisters, boil-like swellings, cervical adenitis, swelling, eruptions, bleeding disorders, piles, vātarakta, jaundice, anemia, madness, burning sensation, thirst, dizziness, itching, skin diseases, sinus tracts, abdominal swelling, intoxication, cataract, dark facial spots, vitiligo, epilepsy, fistula-in-ano, abdominal disease, menorrhagia, fever, poisoning from artificial poison, abscess, disorders of the duodenum, and heart disease;

hemicrania, stiffness, and aversion to cold.

21.4

This course of treatment which has been declared for each single doṣa separately
should be combined appropriately according to each doṣa in dual combinations and in the combination of all three.

Or one should drink Guggulupañcatikta.

And the ear may become suddenly empty, as if with movement and wandering.

21.5

The summer regimen is generally for vāta combined with pitta; the spring regimen is for kapha combined with vāta;
and because vāta is catalytic, the autumn regimen is for kapha combined with pitta.

Or ghee cooked with the decoction of the two bṛhatīs, kākamācī, and śukanāsā, along with a paste of black pepper, viḍaṅga, śigru, jasmine, devadāru, kṣavaka, turmeric, and abhayā, and with horse urine.

It matures quickly, is fully suppurated, and oozes yellowish lymph;
and whatever that lymph touches, that too undergoes suppuration.

21.6

When vāta is enraged, the salty, sour, and sweet tastes should be employed in that order;
when pitta is enraged, the sweet and astringent tastes are beneficial, and then the bitter taste.

Or ghee cooked with bhallātaka, pathyā, and kṛmighna.

Itching, swelling, desire for heat, and from suppuration a thick white discharge.

21.7

In a disorder of kapha, [the tastes to be used are] pungent first, then bitter, and astringent at the end.

Taking into account the strength [of the patient], one should puncture one, two, three, four, or five veins.

And from time to time, one should repeatedly drink unctuous substance.

For vāta overcomes a weak person suffering from kuṣṭha whose abdominal cavity is empty.

For his emesis, however, one should administer madhuka, kuṭaja seeds, nimba, and leaves of paṭola;

and for purgation, kumbha, nikumbha, triphalā, and Māṇibhadra pills.

Blood [disease] has pain similar to [that of] pitta, or with slightly greater symptoms.

21.8

Accumulation, aggravation, and pacification of vāta occur in the three [seasons] beginning with summer;
but of pitta, in [those] beginning with the rainy season; and of śleṣman, in [those] beginning with late winter.

Having been purged upwards and downwards, when [the medicine] is digested, he should eat with the soup of wild animals.

Thus, after administration for six nights, this effectively destroys pitta, kapha, swelling, kuṣṭha, foul sinus ulcers, piles, anal fistula, impaired digestion, anemia, halīmaka, jaundice, irregular fever, and pain in the heart and bladder.

Alternately, a desire for heat and cold arises, accompanied by dulled hearing;
when ripe, it discharges thick pus that is white, dark, and red.

21.9

Vāta accumulates due to herbs that are light and dry;
being of such nature, in a body of such nature, it does not become aggravated because of the heat of the season.

Having boiled one tulā of āvartakī in an armaṇa of water reduced to one-eighth, with that decoction and its roots one should prepare a prastha of ghee.

Then he should drink a dose every other day.

Being purged upwards and downwards, feeling thirsty,
he should drink cold, salted sour gruel, and once the unctuous substance is digested, he should eat cooked kodrava grain with the very same.

By this, kuṣṭha, śvitra, cervical lymphadenitis, anal fistula, sinus ulcers, and rat poisons are cured.

This also improves intellect and promotes the birth of a male child.

They call that sudden production of various sounds 'ringing in the ears' (karṇanāda).

21.10

Pitta undergoes accumulation due to waters and herbs
of sour post-digestive effect, but does not aggravate because of the coolness of the season.

Cooked with these very [drugs], unctuous substance serves as an unctuous enema for one fit for an unctuous enema.

With dantī, marica, phaṇijjaka, fresh ginger, karañja seeds, pippalī, viḍaṅga, and rock salt, head-evacuation [is performed] in kuṣṭha situated above the clavicles and in worms;
and also the purgative smoke mentioned in the Sūtrasthāna.

It causes hearing [only] with difficulty when loud, and gradually leads to deafness.

21.11

Kapha accumulates due to unctuous and cold waters and herbs;
though the season and the body correspond, it does not aggravate because of its coagulated state.

Pain, heaviness, and obstruction—that is named pratīnāha.

21.12

Such is the nature of the season; but due to diet and the like,
the doṣas undergo accumulation and so forth even immediately, or not even in their proper season.

Having taken down the decoction remaining at one-eighth and strained it, one should cook three hundred palas of ghee in it; and when a little decoction remains, having added three thousand split marking nuts, one should cook it again. Having discarded the marking nuts whose juice is exhausted, into that unctuous substance one should throw well-powdered:
vyādhighāta, vyoṣa, nākulī, mārkava, arka, kākādanī, tagara, kaṭukā, kuṣṭha, bilva, hiṅgu, viḍaṅga, citraka, ativiṣā, mustā, indrayava, indravāruṇī, silver slag, iron powder, magnetite, rasāñjana, mica, śukanāsā, devadālī, triphalā, lāṅgalikī, viśālā, kumbha, nikumbha, vacā, vārāhī, mahādruma, kośātakī, prapunnāṭa, somaparṇī, the two kinds of nalikā, paṭolī, shoots of jātī, copper pyrite, kāravellī, kūlikā, kandaka, saptacchada, śārṅgeṣṭā, utpala, sārivā, guggulu, śilājatu, mūrvā, kustumbarī, the two kinds of jīvaka, pāṭhā, indrurekhā, vajrakanda, the two kinds of haridrā, and the five salts—each three palas—and one pala of śṛṅgī poison. Then, having stirred it all around with a ladle, one should bury it well concealed in the ground or in grain for a month.

21.13

It pervades the body suddenly from head to foot;
but an aggravated mala recedes little by little, like a flood of water.

And when it is digested, [he may take] food as desired. By it, at first his limbs are pierced, torn, swollen, twitching, and cracked;
then, after seven nights, they become healthy again.
Moreover:
It produces thick, foul-smelling, abundant discharge: [this is] pūtikarṇaka.

21.14

One should conquer the doṣa in accumulation alone; but when aggravated, without opposing [the others];
when all are aggravated, [one should conquer] the stronger one, without opposing the remaining doṣas.

It completely destroys kuṣṭha even when the limbs have fallen away and only a web of ligaments remains.

Worms biting cause severe [pain]: that is kṛmikarṇaka.

21.15

In order: vāta, pitta, and kapha, when their strength is equal in all respects;
for the natural strength of vāta and the others is according to their preceding order.

This foremost rejuvenative remedies swelling, worms, anemia, and fevers.

An abscess is as described before, and other swellings, piles, and tumors have been spoken of.

21.16

Parāśara too stated this very meaning, confirming it
as the physician's cure for doṣas initially obtained according to their presentation:

21.17

"For when the leader falls, the defeat of the entire army is seen."
Then, having made roasted barley flour from those [grains], mixed with a fourth part of powder of bhallātaka, prapunnāṭa, avalguja, citraka, viḍaṅga, and mustā, one should have [him] drink it with a decoction of the asana group.

21.18

Some desire the destruction of śleṣman first because of its location:
when the head, chest, and throat are coated, whence can there be appetite for food?
This is the procedure for all mantha beverages.
And one should make foods of barley, such as apūpa, pūrṇakośa, śaṣkulī, and the like;
and similarly with wheat as with barley.
Vidārikā [is the size of] a pippalī berry, due to the combination of all three doṣas.

21.19

In its absence, how could there be the administration of foods and drinks?
And when there is no eating, whence can there be suppression of doṣas?
Then, one should give it, endowed with fragrance and taste, to the patient of kuṣṭha to drink.

21.20

Therefore, kapha is to be destroyed first, for it is the bolt to the body's door;
while pitta, situated in the middle, is regarded as quick-acting.
With that decoction one should steep the rice grains;
and one should steam the ground paste,
and ferment it as before.
And when healed, it surely contracts the ear-lobe.

21.21

Therefore, one should next effect the subjugation of this [pitta], the friend of vāta. / For this very reason, the order beginning with pitta and ending with kapha is taught by others.
When it is ready, one should add:
one part of pippalī powder, two [parts] of honey, and the same amount of ghee. Then, when a quarter remains and it is removed [from the fire], one should again cast a red-hot iron ball into it, and when cool, place it well-secured in an iron vessel. / This iron preparation cures even stubborn leprosy or urinary disorder; / it reduces the obese, removes swelling, and rekindles a weak digestive fire. / It is specifically prescribed for those with consumption; / and a man, having used it, attains a lifespan of a hundred years.

21.22

Suśruta, however, says that this view does not apply everywhere: / 'In fever and in diarrhea, one should conquer pitta, kapha, and vāta in succession.'

21.23

In fever, due to its hot nature, fire is generally prominent; / and the passage of feces as well as soft bowels are due to pitta.
One prastha of a decoction of khadira and devadāru, one prastha of honey, one prastha of candy sugar, and half a prastha of iron powder, having added one karṣa each of triphalā, caturjātaka, and black pepper, kept in an iron vessel for a month, one should use it.
A swelling in the ear, painful on the lobe, reddish, and cracking.

21.24

Its attendant force is śleṣman, which causes heaviness, indigestion, and sluggishness; / and vāyu inevitably increases in the days that follow, upon the decrease of those two.

21.25

Therefore, in fever and diarrhea, this is the order for conquering the doṣas.
In vitiligo, leprosy, sprue, urinary disorder, obesity, hemorrhoids, fistula-in-ano, / anemia, edema, and kapha diseases, the wise one should administer formulations such as churning-beverages.
A swelling accompanied by blisters, eruptions, redness, burning, and exudation.

21.26

Others say the order in both of those is kapha, pitta, and vāta, / because their arising is mostly from the agitation of the stomach.
Mung beans, lentils, pigeon peas, bitter vegetables, and meat from arid tracts.
Stiff, of the same color, itchy, an unmantha and a gallira.

21.27

Even there, according to the first order, [one treats them when] exacerbated, dwelling in their own seat; / for the rapid action of those vitiated in their own seats is indeed certain.
Water with dhātrī, khadira, and neem; soup of mung beans and paṭola.
A swelling arising from a combination of all three doṣas; by name, it is duḥkhavardhana.

21.28

Having recognized the aggravation of the doṣas by their respective actions according to strength, / one should apply the appropriate medicine, but one should not make the sequence an absolute rule.
Wholesome food and drink in leprosy, but not sour, salty, or pungent; / one should strictly avoid curds, milk, jaggery, meat of marshy animals, sesame, and black gram.
For those eruptions called lihyā, if neglected, would eat away the earlobe.

21.29

A treatment that pacifies one disease but excites another / is not pure; pure is that which pacifies without aggravating [another].
One tulā of chebulic myrobalan rind, ten tulās of marking nut.
Among these, one is incurable, one is manageable; one should cure the other forms of tantrikā.

21.30

Neither doṣa is able to conquer an enraged waste product owing to their own slightness; / nor, since they are of doṣic nature, can they conquer one another, even when equal.
Having strained that decoction, one should place it in a copper vessel.
Treatment of ear diseases.

21.31

Similarity in qualities such as cold, liquid, sour, salty, and pungent / is observed mutually among the doṣas; therefore, they do not conquer one another.
Known as nimbāriṣṭa, this was formulated by Varuṇa.

21.32

Just as the triad of qualities, even though mutually opposed, is seen to initiate the universe simultaneously, / so is the triad of doṣas seen to initiate disease.
And twelve [parts] of jaggery; used for a month by one who has self-control, it destroys [these diseases].

21.33

Vāyu associated with āma causes pain, abdominal distension, and is non-moving; / pitta [with āma] is foul-smelling, dark, pungent, thick, and heavy.
The Yakṣa Māṇibhadra, wishing to save the life of a monk, declared this proven formulation.

21.34

Kapha [with āma] is turbid, thread-like, dense, coating, and slimy; / in the opposite case, it is digested; so copper is like collyrium.
Habitually used, the decoction destroys skin diseases characterized by an excess of śleṣman and pitta.

21.35

[Pure] pitta is yellow and clear; [pure] śleṣman is clear or consolidated, / non-slimy, frothy, white, and sweet in taste.
One should prepare khadirāriṣṭa, guḍūcī, devadāru, and dāruharidrā separately in this way.

21.36

Owing to the weakness of the digestive fire, the first bodily tissue, undigested, / vitiated, and located in the stomach, is called āma rasa.
[It destroys] skin diseases, throat diseases, adenitis, abdominal swelling, and urinary disorders, as a fierce wind dispels clouds.

21.37

Others say that the arising of āma is from the doṣas themselves, excessively vitiated, / by their mutual commingling, like poison from kodrava grains.
The decoction of khadira destroys leprosy, as virtue residing in the mind [destroys] an astringent passion.

21.38

The doṣas mixed with that āma, and the tissues vitiated by it, / are taught as sāma, as are the diseases arising from them.
Having cut beneath, one should place an iron pot to collect the resin.

21.39

One should not eliminate sāma doṣas spread throughout the entire body, / which are clinging to the tissues and not excited, just as [one cannot extract] juice from an unripened fruit.
The juice that flows from that, taken with honey, ghee, and āmalakī juice, / cures leprosy, fistula-in-ano, ulcers, adenitis, urinary disorders, bleeding disorders, and anemia; / a prastha of it also wards off old age; but the food here should be taken and avoided as with the marking nut.

21.40

For they would cause destruction of the body because they are difficult to eliminate; / having prepared them by means of digestives, appetite stimulants, oleations, and sudations,
Rohītaka and surāhva for those who drink curd-water.

21.41

one should purify them with purification therapies at the proper time, according to the nearest route and according to strength. / A substance administered through the mouth quickly destroys the wastes from the stomach.
Or chebulic myrobalan taken for a month with the three pungents, jaggery, and sesame oil,

21.42

[wastes] arising above the collarbones through the nose, but from the colon through the rectum. / The doṣas which are excited, whether upwards or downwards, and flowing on their own, not mixed with āma,
drunk, they cure hemorrhoids, abdominal enlargements, abdominal swelling, leprosy, wind in the bowels, deep-seated rheumatic conditions, sprue, and urinary disorders.

Commentaries (1)

Śaśilekhā — Indu, Sanskrit

Linked texts (1)

Aṣṭāṅgasaṃgraha — Vāgbhaṭa, Sanskrit