௨௫. மிஶ்ரகசிகித்ஸிதம்

Meaning of the śloka

Now the chapter on the treatment of miscellaneous disorders is explained, as taught by Bhagavān Dhanvantari. The disorders of the earlobe, previously said to require drainage, are paripoṭa, utpāta, unmantha, duḥkhavardhana and parilehī. Paripoṭa is described as a painful, cracked, stiff, dark-red swelling caused by vāta when a delicate earlobe, left unstretched for a long time, is suddenly enlarged. Utpāta is a dusky or red swelling with burning, suppuration and pain, arising from heavy ornaments, striking or friction and attributed to rakta and pitta. When the ear is forcibly enlarged, aggravated vāyu together with kapha produces a swollen, discoloured and painful earlobe; this itching kapha-vāta disorder is unmanthaka. Duḥkhavardhana is a superficial swelling and suppuration accompanied by itching, burning and pain while the ear is being enlarged. In parilehī, kapha, blood and kṛmi produce changing, discharging, mustard-seed-like eruptions of the earlobe with itching, burning and pain; the disorder spreads and, as it were, consumes the lobe together with the outer ear. These grave earlobe diseases can damage the lobe when neglected in a person following unsuitable diet and conduct.

Key terms

paripoTaka (paripoṭaka)

A vāta-attributed painful, cracked and stiff swelling of the earlobe.

utpAta (utpāta)

An earlobe swelling associated here with trauma, burning, suppuration, pain, rakta and pitta.

unmanthaka

An itching earlobe disorder attributed to kapha and vāta after forced enlargement.

duHkhavardhana (duḥkhavardhana)

A superficial swelling and suppuration arising during enlargement of the ear, with itching, burning and pain.

parilehI (parilehī)

A spreading earlobe disorder with discharging eruptions, itching, burning and pain, attributed to kapha, blood and kṛmi.

shaShkulI (śaṣkulī)

The outer ear structure adjoining the earlobe, according to the commentary.

Meaning of the śloka

The physician should treat these disorders promptly with a sequence beginning with oleation and with massage, pouring of liquids, applications and removal of blood, as appropriate. General and specific external applications are then described. For paripoṭaka, a milk-containing preparation of finely ground apāmārga, yaṣṭyāhva, rock salt, devadāru, aśvagandhā, radish and bākucī fruit is cooked with ghee, oil, animal fat, marrow and beeswax and applied to the earlobe. An oil prepared with mañjiṣṭhā, sesame, yaṣṭyāhva, sārivā, utpala, padmaka, rodhra, kadamba, balā, and tender jambu and mango leaves, together with dhānyāmla, is prescribed for utpāta. For unmantha, oil is cooked with tālapatrī, aśvagandhā, arka, bākucī fruit, rock salt, crab and monitor-lizard fat, sarala and lāṅgalī; pouring a decoction of aśmantaka, jambu and mango leaves is also advised. A lobe anointed with oil is rubbed and dusted with powders of prapauṇḍarīka, madhuka, mañjiṣṭhā and the two rajanīs. For parilehī, the text prescribes oil cooked with lac and viḍaṅga paste and an application after fomentation with a lump of cow dung. Other applications use ground viḍaṅga combined with trivṛt, śyāmā and arka, or karañja and iṅgudī seeds with kuṭaja and āragvadha. Mustard oil prepared with these substances, pepper, neem leaves and beeswax is also described. For diseased, thin or hard earlobes, a nourishing and softening oil is prepared from the marrow and fat of lopāka and marsh-dwelling animals, fresh oil and ghee, ten times the quantity of milk, the madhura group, apāmārga, aśvagandhā and lac juice. It is filtered, carefully stored and repeatedly applied to a well-fomented and thoroughly massaged lobe; the text says that this makes the lobes enlarged, painless, free from complications, soft, nourished, even, unctuous and able to bear ornaments.

Key terms

snehAdikrama (snehādikrama)

A therapeutic sequence beginning with oleation, understood by the commentary to include procedures such as emesis.

asRugvimokShaNa (asṛgvimokṣaṇa)

The historical procedure of removing blood.

catuHsneha (catuḥsneha)

The four fatty substances used together in the preparation: ghee, oil, animal fat and marrow.

kharama~jjarI (kharamañjarī)

A plant identified by the commentary as apāmārga.

avalgujA (avalgujā)

A plant identified by the commentary as bākucī.

madhuragaNa (madhuragaṇa)

The sweet-substance group, identified here with the kākolyādi group.

Meaning of the śloka

Leaves of nīlī, bhṛṅgarāja, arjuna bark, dark piṇḍītaka, iron rust, and flowers of bījaka and sahacara are powdered together with pathyā, akṣa and dhātrī. After measuring, all are combined with an equal amount of mud from a lotus pond, placed in a covered iron vessel and kept indoors for a fortnight. Oil is then cooked with this material and with the juices of bhṛṅgarāja and triphalā. Near completion, a crane feather is added as a test. When it becomes dark blue like the body of a bee, the preparation is considered cooked; it is placed in a black-iron vessel for a month. The text states that applying this oil removes grey hair.

Key terms

nIlI (nīlī)

A colouring plant identified in the commentary as nīlāñjanikā or śāradaphalā.

bhRu~ggarAja (bhṛṅgarāja)

A plant identified by the commentary as mārkava and used in the oil and its liquid component.

nalinIbhava pa~gka (nalinībhava paṅka)

Mud taken from the bed of a lotus pond.

balAkApatra (balākāpatra)

A crane feather used as the stated indicator of completion when it turns blue.

palita

Greying or whiteness of the hair addressed by this preparation.

triphalA (triphalā)

The three fruits represented here by pathyā, akṣa and dhātrī.

Meaning of the śloka

Flowers of sairīyaka, jambū, arjuna, and kāśmarī; sesame; seeds of mārkava and cūta; the two varieties of punarnavā; kardama and kaṇṭakārī; kāsīsa, piṇḍītaka, and bījasāra; triphalā, iron powder, añjana, yaṣṭyāhva, nīraja, and sārivā are ground together with modayantī in an extract prepared from bījaka heartwood. After mixing this with seven prasthas of that extract and keeping it protected for ten days in a suitable iron vessel, akṣodbhava oil is carefully cooked with it. The prepared oil is then placed in a new iron vessel. After bodily purification, it is prescribed as a nasal application and for massage, while the person eats māṣa or kṛśarā. The text states that after a month the hair becomes dense, curled at the ends, and dark like a bee or collyrium; hair may also grow where there is baldness, premature ageing does not quickly approach, the senses gain exceptional strength, and the face becomes free of wrinkles. It says this oil should not be given to one who lacks desire for it, seeks no benefit, is ungrateful, or is hostile.

Key terms

akShodbhava taila (akṣodbhava taila)

Oil identified by the commentary as bibhītaka oil.

bIjasAra (bījasāra)

Heartwood, here explained as the heartwood of asana or bījaka.

palita

Premature greying of the hair in the stated application of the formulation.

khalati

Baldness or loss of hair in the stated application of the formulation.

nasya

Administration through the nose, prescribed here for the prepared oil.

Meaning of the śloka

Lākṣā, rodhra, the two kinds of haridrā, śilāla, kuṣṭha, nāga, gairika, and varṇaka; mañjiṣṭhā, ugrā, the substance originating in Surāṣṭra, pattaṅga, rocanā, and añjana; the bark of hemāṅga, the pale leaf of the banyan, kālīya, padmaka, the central part of the lotus, red and white sandalwood, pārada, and the group beginning with kākolī are ground with milk. Fat, marrow, beeswax, cow ghee, milk, and a decoction of latex-bearing trees are then cooked together with these. The resulting medicated ghee is described as foremost for application to the face. The text states that it removes vyaṅga, pronounced nīlikā, and certain eruptions arising on the face, and makes the face lotus-like, free of wrinkles, full-cheeked, and pleasing. It says a physician should apply it regularly for kings, women, and comparable men. The ghee is also described as foremost against kuṣṭha and for those having vaipādikā on the feet.

Key terms

vaktrAbhya~gga (vaktrābhyaṅga)

Application or anointing of the prepared substance on the face.

vya~gga (vyaṅga)

A facial discoloration named by the passage.

nIlikA (nīlikā)

A pronounced dark or bluish facial discoloration named separately in the passage.

vali

A wrinkle, explained by the commentary as contraction of the skin.

vaipAdikA (vaipādikā)

A disorder located on the feet, named as an application of the preparation.

Meaning of the śloka

The powders or plant materials named are haritaki, arishta leaves, mango bark, the stalk of a pomegranate flower, and leaves of madayantika. The passage describes their paste as a cosmetic application suitable for a king.

Key terms

harItakI (harītakī)

Haritaki, one of the plant materials named for the paste.

ariShTapatra (ariṣṭa-patra)

Arishta leaves, interpreted as neem leaves or, alternatively, leaves of the phenila tree.

cUtatvak (cūta-tvak)

Mango bark.

madayantikA (madayantikā)

The plant called mendi in the commentary, whose ground leaves are used to colour the nails.

a~ggarAga (aṅgarāga)

A cosmetic paste or application for the body.

Meaning of the śloka

Thus ends the twenty-fifth chapter of the Cikitsasthana in the Sushruta Samhita, entitled Mishraka-cikitsita, the chapter on mixed treatments.

Key terms

mishrakacikitsita (miśraka-cikitsita)

The chapter title, concerning mixed or miscellaneous treatments.

cikitsAsthAna (Cikitsāsthāna)

The section of the Sushruta Samhita devoted to treatment.

nibandhasa~ggraha (Nibandhasaṅgraha)

Dalhana's commentary on the Sushruta Samhita.