The chapter is called Mishraka because it describes in combined form eight principal measures among the sixty procedures: softening or resolving swelling, maturation, splitting, pressure, cleansing, healing, elevation and depression. Others say the title refers to mixed formulations for both swelling and wounds.
Key terms
mishraka
Mixed or combined, referring either to eight principal procedures or to formulations for swelling and wounds.
मातुलुङ्ग्यग्निमन्थौ च भद्रदारु महौषधम् |
अहिंस्रा चैव रास्ना च प्रलेपो वातशोफजित् ||३||
दूर्वा च नलमूलं च मधुकं चन्दनं तथा |
शीतलाश्च गणाः सर्वे प्रलेपः पित्तशोफहृत् ||४||
आगन्तुजे रक्तजे च ह्येष एव विधिः स्मृतः |
विधिर्विषघ्नो विषजे पित्तघ्नोऽपि हितस्तथा ||५||
अजगन्धाऽश्वगन्धा च काला सरलया सह |
एकैषिकाजशृङ्गी च प्रलेपः श्लेष्मशोफहृत् ||६||
एते वर्गास्त्रयो लोध्रं पथ्या पिण्डीतकानि च |
अनन्ता चेति लेपोऽयं सान्निपातिकशोफहृत् ||७||
Meaning of the śloka
A pralepa of matulungi, agnimantha, bhadradaru, mahaushadha, ahimsra and rasna is said to relieve vata swelling. Durva, nala root, madhuka, candana and all cooling groups form a pralepa for pitta swelling. The same cooling method is prescribed for traumatic and blood-origin swelling; poison-origin swelling receives an antipoison method as well as a pitta-calming method. Ajagandha, ashvagandha, kala, sarala, ekaishika and ajashringi form a pralepa for kapha swelling. These three groups combined with lodhra, pathya, pinditaka and ananta form an application for swelling caused by all doshas.
This begins with vimlapana formulations opposed in sequence to vata and the other causes of swelling. Matulungi is bijapuraka, agnimantha arani, bhadradaru devadaru, mahaushadha dried ginger, ahimsra the large ahimsra, and rasna surabhi. The cooling groups include Kakolyadi, Utpaladi and Nyagrodhadi. Cooling treatment in traumatic swelling is intended to prevent maturation. Poison-related treatment is the antipoison method described in Kalpasthana. Ajagandha is bothayika; some call it a climbing herb and others yavani. Kala is ahimsra. Sarala is the red-rooted variety of trivrit and ekaishika the white-rooted variety. Ajashringi is karkatashringi; others identify it as chagalavishanika, uttamarani, locally called medhika. For combined-dosha swelling, the three preceding groups are joined with lodhra, haritaki as pathya, madana as pinditaka, and duralabha as ananta. Some read three pinditakas in place of the transmitted phrase.
Key terms
vimlApana (vimlapana)
A resolving or softening measure intended to reduce swelling.
pralepa
A topical paste formulated here according to the cause of swelling.
For vata, the application is unctuous, sour, salty and lukewarm. For pitta, it is cold and mixed with milk. For kapha, it is warm and rich in alkali and urine. These preparations are intended to calm the respective conditions.
The passage specifies how the application is processed or compounded according to dosha. Adhya means abundant, so the kapha preparation contains abundant alkali and urine.
Key terms
saMskAravisheSha (samskaravishesha)
A particular method of preparing or modifying an application according to dosha.
Roots and fruits of shana and shigru, sesame, mustard, saktu, kinva, flaxseed, and substances of hot potency are described as maturing applications for swelling.
The word fruit applies separately to shana, mulaka, shigru and mustard in the compound. Shana has a sounding pod when mature, shigru is shobhanjana, kinva is the fermenting starter placed into sura, and atasi is locally called alasi. Hot-potency substances include kushtha, aguru and others, thereby including unlisted maturing drugs. The ingredients may be used separately or together. Although saktu is considered cooling, it is assigned a maturing action through a special effect or through its particular combination.
Key terms
pAcana (pacana)
A measure intended to mature or bring a swelling toward suppuration.
kiNva (kinva)
A fermenting starter used in the preparation of sura.
Adhikarana ৫ (১০) · Śloka ১০
চিরবিল্বোঽগ্নিকো দন্তী চিত্রকো হযমারকঃ |
কপোতকঙ্কগৃধ্রাণাং পুরীষাণি চ দারণম্ |
ক্ষারদ্রব্যাণি বা যানি ক্ষারো বা দারণং পরম্ ||১০||
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चिरबिल्वोऽग्निको दन्ती चित्रको हयमारकः |
कपोतकङ्कगृध्राणां पुरीषाणि च दारणम् |
क्षारद्रव्याणि वा यानि क्षारो वा दारणं परम् ||१०||
Meaning of the śloka
Cirabilva, agnika, danti, citraka, hayamaraka, and the feces of pigeon, kanka and vulture are described as splitting agents. Plants used to prepare alkali, or the alkali made from them, are considered especially strong splitting agents.
Cirabilva is old karanja, locally called cirihili. Agnika is kalikarika; others identify it as bhallataka. Danti is dantini, and hayamara is karavira. Feces applies separately to each bird. Kapota is a pale wild pigeon, kanka is kankamalla rather than crow, and gridhra is a flesh-eating bird. Darana means splitting a ripe swelling. Alkali-source plants include mushkaka, kutaja, palasha, ashvakarna and paribhadra. Pratisaraniya alkali is prepared from them. Parama here means severe or harsh splitting and is not intended for children, older people and similar vulnerable groups. Splitting is divided into gentle and harsh: bird feces and similar agents are gentle, while alkali is harsh.
Key terms
dAraNa (darana)
Splitting or opening a ripe swelling, classified as gentle or harsh.
pratisAraNIya kShAra (pratisaraniya kshara)
A caustic alkali preparation applied locally and classed as a harsh splitting agent.
Slimy substances include shalmali, shelu, vataparna and others. Prapidana is pressure applied to a narrow-mouthed wound near a vital point or similar location. The wound opening is kept exposed while paste is applied around it. The application is allowed to dry, and in its dried state it exerts pressure.
Key terms
prapIDana (prapidana)
A compressive application around a narrow wound opening, especially near a vital region.
Shankhini is a large-leaved, milky variety of yavatikta. Ankotha is an astringent small-leaved plant locally called ankolla. Sumanas is jati, and suvarcala is suryavarta, locally called sauncali according to the transmitted gloss. Decoctions of these and the Aragvadhadi group cleanse through washing and related use. Cleansing is eightfold: decoction, wick, paste, ghee, oil, concentrated extract, powder and fumigation. These will be explained in sequence. Decoction itself is fourfold: boiled decoction, cold infusion, hot infusion and fresh juice. Paste is later discussed separately as a fifth category in that context.
Key terms
shodhana
Cleansing of a wound through one of eight formulation forms.
kaShAya (kashaya)
A liquid plant preparation, here divided into boiled decoction, cold infusion, hot infusion and fresh juice.
Ingredients prescribed for cleansing wicks include ajagandha, ajashringi, gavakshi, langalahvaya, putika, citraka, patha, vidanga, ela, harenu, the three pungents, yavakshara, the salts, manahshila, kasisa, trivrit, danti, haritala and saurashtraja.
Gavakshi is indravaruni and langalahvaya kalikarika. Putika is cirabilva; some identify it as the thorny vitapa-karanja. Harenu means renuka. The five salts are saindhava, sauvarcala, bida, gada and samudra salt. Others substitute kala salt for gada to maintain the count of five; kala salt is described as an odourless variety of sauvarcala. Saurashtraja is tumburu earth, locally called turi; others take it generally as black earth. Some remaining substances were explained earlier and others are treated as well known. A thread wick is coated with these substances and placed in the wound.
Key terms
saMshodhanI varti (samshodhani varti)
A medicated thread wick placed in a wound for cleansing.
lavaNapa~jcaka (lavanapancaka)
A group of five salts whose membership has a variant between gada and kala salt.
Adhikarana ৯ (১৫) · Śloka ১৫
এতৈরেবৌষধৈঃ কুর্যাত্কল্কানপি চ শোধনান্ ||১৫||
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एतैरेवौषधैः कुर्यात्कल्कानपि च शोधनान् ||१५||
Meaning of the śloka
Cleansing pastes may also be prepared from these same medicinal substances.
After describing cleansing wicks, the text turns to paste preparations. 'These same substances' refers to the preceding group beginning with ajagandha and ending with the substance from Saurashtra.
A cleansing ghee should be prepared by grinding arka and uttama, snuhi latex, foremost alkaline substances, jasmine root, the two haridras, kasisa, katurohini and the other ingredients specified earlier.
The commentary separates arka and uttama, identifying the former as arka root and the latter as triphala; others read arkottama as one word and identify it as mandarika. Snuhi-kshira is the latex of sehunda. The foremost alkaline substances include mushkaka, kutaja, palasha and ashvakarna. Jati-mula is explained as jasmine root, while another reading has jatukanda, identified as guggulu known in the northern region. The previously specified ingredients are those listed for the cleansing wick.
Key terms
shodhana ghRuta (shodhana ghrita)
A ghee preparation classified here as cleansing.
arkottama
Read either as arka plus uttama, identified as arka root and triphala, or as one term identified as mandarika.
jAtImUla (jatimula)
Jasmine root; a variant reads jatukanda and identifies it as guggulu.
मयूरको राजवृक्षो निम्बः कोशातकी तिलाः ||१७||
बृहती कण्टकारी च हरितालं मनःशिला |
शोधनानि च योज्यानि तैले द्रव्याणि शोधने ||१८||
Meaning of the śloka
Mayuraka, rajavriksha, nimba, koshataki, sesame, brihati, kantakari, haritala, manahshila and other cleansing substances should be combined in an oil intended for cleansing.
Mayuraka is identified as apamarga, rajavriksha as kiramalaka, and koshataki as ghoshaka, locally called ghusundi. One interpretation takes the additional cleansing substances from the preceding cleansing-wick list; another takes them from the substances prescribed for emesis and purgation.
Key terms
shodhana taila
An oil preparation classified in this passage as cleansing.
mayUraka (mayuraka)
Identified by the commentary as apamarga.
koshAtakI (koshataki)
Identified as ghoshaka and said to be locally known as ghusundi.
The additional ingredients are explained as those specified for cleansing wicks together with substances used as components of emetic and purgative preparations. Some of these were explained earlier and others were regarded as well known by the commentator.
Key terms
shodhana cUrNa (shodhana churna)
A powder preparation classified here as cleansing.
सालसारादिसारेषु पटोलत्रिफलासु च |
रसक्रिया विधातव्या शोधनी शोधनेषु च ||२०||
Meaning of the śloka
A cleansing rasakriya should be prepared from the heartwoods beginning with salasara, from patola and triphala, and from the other cleansing substances.
Rasakriya is described as having the consistency of phanita and as locally called kakavi. 'Other cleansing substances' may mean those listed for cleansing wicks, or alternatively the emetic and purgative substances used for upward and downward cleansing. The preparation method given is to add eight or sixteen parts water relative to the ingredients, decoct until one-eighth or one-sixteenth remains respectively, strain it, and cook again until it reaches phanita consistency.
Key terms
rasakriyA (rasakriya)
A concentrated extract cooked to a phanita-like consistency.
This is presented as the eighth and remaining form, fumigation. Shriveshtaka is described as sarala resin resembling a lump of butter and locally known as gugguli; sarjarasa is locally called rala; sarala here means the bark of the sarala tree. The heartwoods are the unlisted ones belonging to the salasara group. Some recensions place after the earlier paste verse an additional instruction to make oils and ghees from kasisa, katurohini, jatikanda and haridra together with previously stated groups. There, kanda is said to exclude daruharidra; another reading, jatukanda, denotes guggulu. Those earlier groups include the shankhini and ajagandha groups. The commentator assigns the decoctions and related preparations to wound washing and the other uses stated in the chapter on two kinds of wounds.
Key terms
vraNadhUpana (vranadhupana)
Wound fumigation in the historical classification.
shrIveShTaka (shriveshtaka)
Sarala resin described as butter-like and locally called gugguli.
कषायाणामनुष्णानां वृक्षाणां त्वक्षु साधितः |
शृतः शीतकषायो वा रोपणार्थं प्रशस्यते ||२२||
सोमामृताश्वगन्धासु काकोल्यादौ गणे तथा |
क्षीरिप्ररोहेष्वपि च वर्तयो रोपणाः स्मृताः ||२३||
Meaning of the śloka
A cooked preparation or a cold infusion made from the bark of non-heating, astringent trees is praised for wound closure. Wound-closing wicks are described from soma, amrita, ashvagandha, the kakolyadi group and sprouts of latex-bearing trees.
Wound-closing preparations, like cleansing preparations but excluding fumigation, are said to have seven forms beginning with decoctions. The non-heating, astringent trees include nyagrodha, udumbara, ashvattha and plaksha. Cooked preparation and cold infusion also stand by implication for phanta and fresh juice. A cold infusion is defined here as a substance left overnight in warm water. Ropana means promoting closure. Soma is taken by the commentator as soma itself; others read somavalkala, while still others identify soma as brahmi. Amrita is guduchi, and the latex-bearing sprouts are shoots of trees such as nyagrodha and udumbara.
Key terms
ropaNa (ropana)
Promoting wound closure in the historical classification.
shItakaShAya (shitakashaya)
A cold infusion defined as material left overnight in warm water.
soma
Read as soma itself, alternatively somavalkala, or identified by some as brahmi.
Samanga is identified as anjalikarika, locally called lajjaluki, while others identify it as varahakranta. Soma is treated as soma itself. Sarala is identified as the sarala plant, though others take it as vishamsika. Somavalka is identified as katphala.
Key terms
ropaNa kalka (ropana kalka)
A paste classified here as promoting wound closure.
sama~ggA (samanga)
Identified as anjalikarika or lajjaluki, with varahakranta given as an alternative.
saralA (sarala)
Identified as sarala, with vishamsika offered by others.
A healing powder is prepared from kanguka, triphala, rodhra, kasisa, shravanahvaya, and bark of dhava and ashvakarna. Another praised healing powder contains priyanguka, sarjarasa, pushpakasisa and dhava bark powder.
Kanguka means kangava, though others call it a kind of grain; some read kimshuka instead. Shravanahvaya is munditika. Dhava is the tree also called shakata. Ashvakarna is described in the eastern region as gandhamunda, a tree resembling ashvattha.
The cool root of apamarga is used rather than its hot-potency fruit. Talapatri is mushali. Suvarchala is suryavarta; its root, not its hot-potency fruit, is used. Utsadana means increasing flesh by application of a paste.
Key terms
utsAdana (utsadana)
A paste-based measure intended in the source to raise or increase deficient flesh.
कासीसं सैन्धवं किण्वं कुरुविन्दो मनःशिला |
कुक्कुटाण्डकपालानि सुमनोमुकुलानि च ||३१||
फले शैरीषकारञ्जे धातुचूर्णानि यानि च |
व्रणेषूत्सन्नमांसेषु प्रशस्तान्यवसादने ||३२||
Meaning of the śloka
Kasisa, saindhava, kinva, kuruvinda, manahshila, eggshell, jasmine buds, fruits of shirisha and karanja, and mineral powders are praised for avasadana where flesh is excessively raised in a wound.
Kuruvinda is the red jewel called padmaraga. Sumanas buds are jati buds. Mineral powders include haritala, pushpakasisa and rasanjana. Utsanna flesh means elevated flesh; avasadana is intended to reduce or break it down.
Key terms
avasAdana (avasadana)
A measure intended to reduce excessively elevated wound flesh.
Adhikarana ২৩ (৩৩) · Śloka ৩৩
সমস্তং বর্গমর্ধং বা যথালাভমথাপি বা |
প্রযুঞ্জীত ভিষক্ প্রাজ্ঞো যথোদ্দিষ্টেষু কর্মসু ||৩৩||
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समस्तं वर्गमर्धं वा यथालाभमथापि वा |
प्रयुञ्जीत भिषक् प्राज्ञो यथोद्दिष्टेषु कर्मसु ||३३||
Meaning of the śloka
For the stated procedures, a discerning physician may use the entire group, half of it, or whatever members are available.
If every substance in the cleansing, healing and related groups is unavailable, combinations of three, four, five, six or another number may be used. This rule applies only to groups in this chapter and the two related chapters, not throughout the treatise. Others assign the full group to a strong disease, half to moderate disease and available items to mild disease, but Gayadasa rejects that interpretation. Yathalabha means using whichever substances are obtained.
Adhikarana পুষ্পিকা · Śloka ৩৭
ইতি সুশ্রুতসংহিতাযাং সূত্রস্থানে মিশ্রকাধ্যাযো নাম সপ্তত্রিংশত্তমোঽধ্যাযঃ ||৩৭||
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इति सुश्रुतसंहितायां सूत्रस्थाने मिश्रकाध्यायो नाम सप्तत्रिंशत्तमोऽध्यायः ||३७||
Meaning of the śloka
Thus ends the thirty-seventh chapter, called Mishraka, in the Sutrasthana of the Sushruta Samhita.