The Compendium of Caraka 6.10: daśamo 'adhyāyaḥ/

Now we shall explain the treatment of epilepsy.

Thus spoke the venerable Ātreya.

The expert physicians call epilepsy the departure of memory, / an entering into darkness, with grotesque behavior, due to the perturbation of intellect and mind.

In people whose many doṣas are disturbed, from the eating of unwholesome and impure food, / and similarly when the mind is struck down by worry, passion, fear, anger, grief, agitation, and the like, / epilepsy sets in.

For the doṣas, having resorted to the dhamanīs, afflict the heart; / severely oppressed, bewildered, he suffers with a wandering mind.

He sees non-existent forms, falls, and twitches; / his tongue, eyes, and brows [are distorted], drooling saliva, and thrashing his hands and feet.

And when the paroxysm of doṣas has passed, he awakens like one asleep. / It is declared to be of four kinds: by the doṣas individually, and all together.

He trembles, gnashes his teeth, vomits foam, pants, / and sees rough, reddish, or black forms from vāta.

One with paittika [epilepsy] has yellow foam, limbs, face, and eyes, sees yellow and blood-colored forms, / has thirst and heat, and sees the world engulfed in fire.

One with ślaiṣmika [epilepsy] has white foam, limbs, face, and eyes, is cold, has horripilated limbs, is heavy, / sees white forms, and is released after a long time.

Born of all three doṣas is to be recognized by all these symptoms combined; / that epilepsy is incurable, as is that which occurs in an emaciated patient or is chronic.

Every fortnight, or every twelve days, or every month, the provoked malas / produce a paroxysm for epilepsy, or at slightly different intervals.

The awakening of their heart, channels, and mind that are covered by them, / the physician should first perform with sharp measures such as emesis and the like.

One should treat vātika epilepsy predominantly with bastis, paitta mostly with purgatives, / and ślaiṣmika epilepsy mostly with emetics.

For him who is well purified on all sides and properly comforted, / listen to the pacifying formulations for release from epilepsy:

Ghee prepared with equal parts of cow's dung juice, sour curds, milk, and urine, / one should drink; it destroys epilepsy, jaundice, and fever. / Thus Pañcagavya Ghṛta. / The two pañcamūlas, the triphalā, the two rajanīs, the bark of kuṭaja, / saptaparṇa, apāmārga, nīlinī, kaṭarohiṇī,

Śampāka, phalgu root, puṣkara, along with durālabhā, / two palas each, boiled in a droṇa of water until reduced to a fourth—

Bhārgī, pāṭhā, trikaṭu, trivṛt, and viculā, / śreyasī, āḍhakī, mūrvā, dantī, bhūnimba, and citraka,

The two sārivās, rohiṣa, bhūtīka, and madayantikā— / grinding [these], one should add one akṣa of each, and with that boil one prastha of ghee

Along with equal parts of cow's dung juice, sour curds, milk, and urine; / it is known as Mahāpañcagavya, comparable to nectar.

In epilepsy, and likewise in insanity, in edema, in abdominal enlargements, / in gulma, piles, pāṇḍu disease, in jaundice, and in halīmaka,

This ghee is praised, and it should be administered day after day; / it destroys inauspiciousness and seizure-diseases, and destroys quartan fevers. / Thus Mahāpañcagavya Ghṛta. / Aged ghee [cooked] with brāhmī juice, vacā, kuṣṭha, and śaṅkhapuṣpī / removes insanity, inauspiciousness, epilepsy, and evil.

Ghee cooked with rock salt and asafoetida in four times as much ram's / urine destroys epilepsy and the disease of cardiac constriction.

Ghee prepared with vacā, śampāka, kaiṭarya, vayaḥsthā, asafoetida, and coraka, / combined with palaṅkaṣā, [is efficacious] in that caused by vāta and kapha.

One prastha of oil and one prastha of ghee, boiled with one pala each of the jīvanīya [drugs] / in a droṇa of milk, when prepared, destroys epilepsy.

In a kaṃsa each of milk and sugarcane juice, and eight times as much kāśmarya juice, / one should boil one prastha of ghee with one karṣa each of the jīvanīya [drugs];

It quickly checks epilepsy arising from vāta and pitta; / likewise ghee cooked with a decoction of kāśa, vidārī, sugarcane, and kuśa.

Similarly, one prastha of ghee prepared with a paste of two palas of madhuka / and a droṇa of āmalakī juice is a medicine for pitta-epilepsy.

For anointing, mustard oil prepared in four times as much goat's urine / should be used, and bathing and unction with cow dung and cow urine.

Oil prepared in the decoction of barks of kaṭabhī, nimba, kaṭvaṅga, and madhuśigru, / along with an equal part of [goat's] urine, is praised for the purpose of anointing.

With palaṅkaṣā, vacā, pathyā, vṛścikālī, arka, and mustard, / jaṭilā, pūtanā, keśī, nākulī, asafoetida, and coraka,

Garlic, atirasā, citrā, kuṣṭha, and the feces of carnivorous / birds, as available, [prepared] in four times as much ram's urine,

The medicated oil prepared for anointing destroys epilepsy; / and with these very drugs, fumigation along with plastering should be performed.

Pippalī, rock salt, citrā, asafoetida, hiṅguśivāṭikā, / kākolī, mustard seeds, kākanāsā, kaiṭarya, and sandalwood,

Shoulder bone, claws, and ribs of a dog should be ground / with goat's urine under the Puṣya constellation; this makes a poultice together with fumigation.

Rubbing the body [is performed] with apetarākṣasī, kuṣṭha, pūtanā, keśī, and coraka, / ground with urine, and sprinkling [should be done] with that very urine.

Likewise with leech feces, or burnt goat hair, / donkey bones, elephant claws, and cow tail hair.

Urine of tawny cows is highly beneficial as an errhine; / that of dogs, jackals, cats, lions, and the like is also recommended.

Bhārgī, vacā, nāgadantī; śvetā, śvetā, and viṣāṇikā; / jyotiṣmatī and nāgadantī—these, stated as quarter-parts, ground with urine,

Form three formulations. From these, the physician should instill five or six drops as an errhine. / With triphalā, vyoṣa, pītadru, barley-ash, phaṇijjha,

Śyāmā, apāmārga, and fruits of karañja, in goat's urine, / medicated oil prepared as an errhine destroys epilepsy.

Pippalī, vṛścikālī, kuṣṭha, the salts, / and bhārgī, powdered, should be used as an excellent insufflation.

Having ground kāyasthā, autumnal mudga beans, musta, uśīra, and barley, / along with vyoṣa, using goat's urine, one should prepare wicks [for collyrium].

In epilepsy, likewise in insanity, snakebite, affliction by artificial poison, / ingestion of poison, and in the drowned, these act like nectar.

Musta, vayaḥsthā, triphalā, kāyasthā, asafoetida, śādvala, / vyoṣa, māṣa beans, and barley—with the three urines: of goat, sheep, and bull—

Having ground [these] and made that wick, one should apply it in epilepsy, / in kilāsa, likewise in insanity, and in irregular fevers.

Dog's bile extracted under Puṣya is an epilepsy-destroying collyrium; / the very same mixed with ghee is considered an excellent fumigation.

With the beaks, feathers, and feces of mongoose, owl, cat, / vulture, insects, snake, and crow, the physician should perform fumigation.

By these proven therapies, the heart is re-awakened / and the channels are purified; then he regains consciousness.

If a secondary exogenous condition is observed, presenting symptoms exceeding those of the doṣas, / for him the treatment for exogenous insanity should be administered.

Immediately after, Agniveśa spoke this with palms joined in reverence: / 'O Blessed One! Previously in the Sūtrasthāna, the great disease was mentioned—

Namely, atattvābhiniveśa; but its etiology, symptoms, and treatment / were not stated there. Therefore I wish to hear it; let that be declared here.'

Hearing the words of the pupil eager to learn, Punarvasu said: / 'O gentle one! Listen to the great disease along with its etiology, symptoms, and treatment.

In one habituated to impure food, who suppresses manifested natural urges, / and through excessive indulgence in causes such as cold, hot, unctuous, and dry,

The doṣas, taking recourse in the heart and vitiating the vessels / that carry the mind and intellect, abide in a person whose self is covered by rajas and delusion.

When intellect and mind are covered by increased rajas and tamas, / and the heart is agitated by the doṣas, then, confounded and feeble-minded,

He forms perverted judgments regarding the eternal and non-eternal, the beneficial and unbeneficial; / authoritative teachers call that great disease atattvābhiniveśa.

Having prepared him with oleation and sudation, purified him with emesis and the like, / and given him the restorative regimen of diet, one should treat him with intellect-promoting food and drinks.

The pañcagavya prescribed with the fresh juice of brāhmī / should be used, along with śaṅkhapuṣpī and whatever rasāyana is intellect-promoting.

Well-disposed friends, dependable relatives, and teachers of dharma and artha / should unite him with discernment, fortitude, memory, and concentration.

One should administer oil with garlic, or śatāvarī with milk, / or the juice of brāhmī, the juice of kuṣṭha, or vacā combined with honey.

For epilepsy is difficult to cure, chronic, and deeply rooted; / therefore, one should treat it mostly with rasāyanas.

One should always protect him, as well as an insane patient, / from water, fire, trees, cliffs, and uneven places, for these bring immediate loss of life.'

Here are two verses summarizing the content:

How the aggravated doṣas produce epilepsy, / their symptoms generally and specifically, and their treatment,

As well as the origin, symptoms, and medication of the great disease— / the sage declared in detail and in brief in [this chapter on] the treatment of epilepsy.

Thus ends the tenth chapter, titled 'Treatment of Epilepsy', in the Cikitsāsthāna of the compendium composed by Agniveśa, redacted by Caraka, and, where missing, completed by Dṛḍhabala. //10