13. madhumēhacikitsitam

Meaning of the śloka

The chapter on the treatment of madhumeha is now explained, as taught by Bhagavān Dhanvantari. The passage says that a discerning physician may treat, by the regimen described here, a person with prameha who has progressed to madhumeha and has been given up by physicians. In the months called Śukra and Śuci, mountains heated by the sun's rays exude from their rocks a resin-like substance known as śilājatu, which the text traditionally describes as destroying all diseases.

Key terms

madhumeha

The advanced condition named in the chapter and addressed by the regimen introduced here.

prameha

The broader classical disorder from which the person is described as having progressed to madhumeha.

śilājatu

A resin-like substance described as exuding from sun-heated mountain rocks.

jatuprakāśa

Resembling resin; the commentary specifies an appearance like lac.

Meaning of the śloka

Śilājatu should be understood as associated with one of the six metals beginning with trapu. Its particular source is recognized from its own characteristic smell, and it is therefore known in the world as having six possible origins.

Key terms

ṣaḍyoni

Having six possible metallic sources or causes in this account.

trapu

The first of the six metals listed as possible sources of śilājatu.

kṛṣṇalauha

Black iron, listed as one of the six possible metallic sources.

svagandha

The characteristic smell by which the particular source is said to be recognized.

Meaning of the śloka

Because this lac-like śilājatu arises from a metal, it bears the vīrya and rasa of that particular metal.

Key terms

vīrya

The potency attributed here to the metal from which a type of śilājatu arises.

rasa

The taste or characteristic property said here to be inherited from the source metal.

jatuprabha

Having an appearance like lac or resin.

aupacārika

A figurative or extended use of a term, as the commentary explains the naming here.

Meaning of the śloka

The varieties arising from trapu, sīsa, and the succeeding metals are considered progressively more important in the stated order. Accordingly, when the source substance is superior, superior qualities are also traditionally attributed to the preparation.

Key terms

pradhāna

Relative importance or superiority assigned progressively across the listed varieties.

uttarottara

Successively or progressively, indicating the order of ranking.

śreṣṭhaguṇa

Superior qualities attributed to a variety arising from a superior source substance.

loha

The broad metal category discussed in the commentary, whose application to trapu and sīsa is said to be less familiar.

Meaning of the śloka

All of the substances under discussion are described as bitter and pungent, with an astringent secondary taste, and as sara. They have a pungent post-digestive effect and hot potency, and are said to produce drying and separating or breaking-up actions.

Key terms

kaṣāyānurasa

An astringent secondary or accompanying taste.

sara

A mobile or flow-promoting quality attributed to the substances in this passage.

kaṭupāka

A pungent post-digestive effect.

uṣṇavīrya

Possessing hot potency.

śoṣaṇa

A drying or reducing action, explained here with reference to vitiated blood and similar material.

chedana

A separating or breaking-up action, illustrated by the commentary with kapha-related nodules.

Meaning of the śloka

Among them, the best is said to be that which is black, is not heavy, is smooth or unctuous, contains no gritty or crystalline particles, and has an odor resembling cow's urine.

Key terms

kṛṣṇa

Black in color, one of the stated selection characteristics.

alaghu

Not light, or weighty; the compact reading should be verified in context.

snigdha

Smooth or unctuous in character.

niḥśarkara

Free from gritty, stony, or crystalline particles.

gomūtragandhi (gomūtragandhin)

Having an odor compared in the source to cow's urine.

Meaning of the śloka

The passage directs that, after prior purification, the finely powdered mountain-derived śilājatu, processed with substances of the sāra group, be taken at daybreak with water prepared from that group, in a quantity suited to the person's strength. When it has been digested, food with broth from animals of arid regions is prescribed. The text traditionally attributes long life, freedom from aging, improved bodily condition, complexion and strength, and freedom from madhumeha to completing the stated course. It gives numerical proportions according to the total quantity used and says that the precautions follow the procedure prescribed for bhallātaka. It further makes broad traditional claims for śilājatu in conditions named meha, kuṣṭha, apasmāra, unmāda, ślīpada, gara, śoṣa, śopha, arśas, gulma, pāṇḍutā, and viṣamajvara, and says that it breaks up long-established śarkarā and aśmarī. Suitable medicinal substances are also to be used when processing and stirring it.

Key terms

śilājatu

The mountain-derived mineral substance whose historical processing and use are described.

sāragaṇa

A classical group of substances, exemplified by śālasāra in the commentary.

hṛtadoṣa

A person whose body has undergone the prior purification understood by the commentator.

jāṅgala rasa

Broth from animals associated with arid regions, prescribed here with food.

tulā

A classical unit defined by the commentary as one hundred palas.

aśmarī

A classical disorder cited in connection with the broad claim and with surgical management in the commentary.

bhāvanā

Repeated processing or impregnation with a prescribed liquid or medicinal substance.

Meaning of the śloka

The passage extends the preceding method to tāpīja mākṣika dhātu, which it compares to amṛta. It describes one variety as sweet and gold-like in appearance, and another as sour and silver-like. Taken according to that method, it is traditionally said to remove aging and conditions named kuṣṭha, meha, pāṇḍu, āmaya, and kṣaya. A person whose body has been treated with it is instructed to avoid pigeon meat and kulattha.

Key terms

mākṣika dhātu

A mineral substance whose historical use is extended from the preceding śilājatu procedure.

tāpīja

Originating from the Tāpī River, according to the commentary.

suvarṇamākṣika

The gold-like variety of mākṣika included by the commentator.

rajatamākṣika

The silver-like variety of mākṣika included by the commentator.

kulattha

A food substance that the passage instructs the treated person to avoid.

tadbhāvita

Described by the commentator as having the body pervaded or conditioned by the relevant mineral preparation.

Meaning of the śloka

The text states that a thoughtful physician may use this formulation even for a person with kuṣṭha whose condition has gone beyond the benefits of the five measures, provided that the person has faith and wishes to live.

Key terms

pañcakarmaguṇātīta

A disputed expression explained through several interpretations concerning failure to obtain the benefits of prior measures.

asthigata kuṣṭha

Kuṣṭha understood by the commentator as situated in asthi, the fifth tissue in the stated sequence.

jijīviṣu

A person who wishes to live.

prameha

The classical disease category for which the formulation is first said to be applicable.

Meaning of the śloka

The passage presents a tuvaraka rasāyana regimen. It describes collecting ripe fruits from tuvaraka trees growing near the western sea at the beginning of the rainy season, extracting and processing their kernels and oil, and keeping the oil in a heap of dung for a fortnight. After prior oleation, sudation, and elimination, a person is directed to take a strength-appropriate measure of ritually consecrated oil on an auspicious day and at a specified interval from meals. A mantra asks the potent kernel essence to purify all the dhātus under the command of Acyuta. The text says that doṣas then pass repeatedly upward and downward, followed in the evening by cooled yavāgū with little unctuous substance and salt. It describes repeating the oil for five days, observing restrictions for a fortnight, and eating rice with mudga broth. Further variants include processing the oil in a threefold quantity of khadira decoction and taking it for a month, external application, combining it with ghee, honey, and khadira water with a diet of bird-meat broth, use as nasya for fifty days, and taking the kernels in a measured amount. The passage traditionally attributes purification, relief of kuṣṭha and meha, improvement in severe manifestations of kuṣṭha, bodily excellence, strong memory, and exceptionally long life to these uses.

Key terms

tuvaraka

The plant whose fruit kernels and oil form the basis of the regimen.

rasāyana

The classical restorative or longevity-oriented regimen described in this passage.

hṛtamala

Having had feces and doṣas such as kapha removed, according to the commentary.

caturthabhaktāntarita

Separated by the specified interval of four meal occasions, explained through a detailed fasting and dosing schedule.

yavāgū

A thin gruel directed for the evening after the purificatory response.

nasya

Nasal administration, presented as one variant use of the oil.

Meaning of the śloka

The passage describes an eye application prepared from tuvaraka kernel material burned without allowing smoke to escape, placed in tuvaraka oil together with saindhava and añjana. It traditionally claims that this application relieves conditions named paillya, arma, night blindness, kāca, nīlīroga, and timira.

Key terms

sāntardhūma

Burned while the smoke is retained or enclosed.

saindhava

Salt included in the eye preparation.

añjana

An ophthalmic application; the commentary identifies the substance here as srotoñjana.

timira

One of the classical eye conditions for which the application is claimed.

tuvaraka

The plant providing the kernel material and oil used in the preparation.

Meaning of the śloka

Thus ends the thirteenth chapter of the Cikitsāsthāna in the Suśruta Saṃhitā, entitled ‘Treatment of Madhumeha.’

Key terms

Cikitsāsthāna

The section of the Suśruta Saṃhitā concerned with treatment.

madhumehacikitsita

The chapter entitled ‘Treatment of Madhumeha.’

Nibandhasaṅgraha

The name of Dalhaṇa’s commentary on the Suśruta Saṃhitā.