क्षीणस्य बहुदोषस्य विरुद्धाहारसेविनः |
वेगाघातादभीघाताद्धीनसत्त्वस्य वा पुनः ||३||
करणायतनेषूग्रा बाह्येष्वाभ्यन्तरेषु च |
निविशन्ते यदा दोषास्तदा मूर्च्छन्ति मानवाः ||४||
हृत्पीडा जृम्भणं ग्लानिः सञ्ज्ञानाशो बलस्य च |
सर्वासां पूर्वरूपाणि, यथास्वं ता विभावयेत् ||५||
Meaning of the śloka
In a person who is depleted, has many doṣas, eats incompatible food, has suppressed urges or suffered a blow, or has little sattva (mental strength), when fierce doṣas lodge in the external and internal seats of the senses (karaṇāyatana), people faint. Pain in the heart, yawning, fatigue, loss of consciousness and of strength are the premonitory signs of all (the kinds of mūrcchā); one should recognise them according to each.
The commentary gives cause and pathogenesis of doṣa-caused mūrcchā. Karaṇāyatana means the seats of the sense-organs, action-organs, mind, intellect and ego. 'External' seats are the action-organs; 'internal' are the mind, intellect and ego. An objection: the heart is one, so why plural? Answer: the channels carrying inner consciousness are also counted as internal seats. 'Lodge' means settle. Others say karaṇāyatana means the karaṇas (instruments) themselves by figurative use, so doṣas settling in the external and internal instruments cause fainting. Still others explain it differently, that doṣas lodge in the seats and also in the external and internal instruments. The cause runs from depletion to blow; the pathogenesis begins with the lodging of doṣas.
Key terms
karaṇāyatana
Seat of the sense and action organs and mental faculties.
When the channels that carry consciousness are blocked by vāta and the other doṣas, darkness suddenly overtakes, taking away pleasure and pain; and, from the removal of pleasure and pain, the person falls down like a log. They call this delusion (moha) mūrcchā... (the verse is cut off).
The commentary explains the process by which a person faints. Removal of pleasure and pain follows loss of awareness, which results from blockage of the consciousness-carrying channels. Others explain 'pleasure and pain' as sattva and rajas, with the removal meaning their loss, the state being dominated by tamas.
Key terms
saṃjñāvahā nāḍī
Channels carrying consciousness.
tamas
Darkness or inertia; here the veiling of awareness.
moha
Delusion or unconsciousness.
Adhikarana 4 (7-8) · Śloka 8
... ṣaḍvidhā sā prakīrtitā ||7||
vātādibhiḥ śōṇitēna madyēna ca viṣēṇa ca |
ṣaṭsvapyētāsu pittaṁ hi prabhutvēnāvatiṣṭhatē ||8||
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... षड्विधा सा प्रकीर्तिता ||७||
वातादिभिः शोणितेन मद्येन च विषेण च |
षट्स्वप्येतासु पित्तं हि प्रभुत्वेनावतिष्ठते ||८||
Meaning of the śloka
... it is described as sixfold: by vāta and the other doṣas, by blood, by wine, and by poison. In all six, pitta stays as the dominating factor.
The commentary states the number. Those in another tantra who accept four kinds (by the doṣas and blood) hold that wine and poison are stated separately, like pāṇḍuroga described after; so in this text there are six kinds. In all types pitta is the chief agent, prevailing over the other doṣas. The cause runs from suppression of urges; the pathogenesis begins with the seats of the senses.
Key terms
ṣaḍvidhā mūrcchā
Fainting of six kinds.
madyaja
Arising from alcohol.
viṣaja
Arising from poison.
Adhikarana 5 (9) · Śloka 9
apasmārōktaliṅgāni tāsāmuktāni tattvataḥ |9|
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अपस्मारोक्तलिङ्गानि तासामुक्तानि तत्त्वतः |९|
Meaning of the śloka
Their signs are stated in truth as those told in apasmāra (epileptic-type seizure disorder).
The commentary extends the signs for the three types from vāta and the others: each should know the signs as stated for apasmāra, according to its own kind. Some read 'apasmāreṇa liṅgāni' and explain: the signs are like those of apasmāra but without biting the teeth and nails, distorted eyes and drooling. It quotes another tantra: 'from sannipāta, of all forms, he falls suddenly as if in apasmāra; but he throws a person down quickly without disgusting movements'.
Key terms
apasmāra
A classical disorder of seizure-like loss of awareness.
The commentary gives the pathogenesis and sign of blood-caused mūrcchā. Earth and water are both tamas-dominated, as an earlier statement says: 'earth is rich in tamas, water is rich in sattva and tamas'; blood (a five-element product) has earth and water predominating, and so the smell of blood arises from these. The commentary answers several objections: the smell is earthy, so how does it arise from earth and water? By mutual support. If the smell of blood causes fainting, why not in all? Only in the weak-minded. It records another way of reading 'made of that', and another reading of the whole verse ('the form of earth, water and tamas is blood; by the smell of blood it is a triad'), with the argument that smell is a specific quality which is composed of the three guṇas but with tamas predominant. So people faint from the smell of blood, tamas being aggravated in the heart, by the rule that 'sameness is the cause of increase of all things'.
The commentary says that after stating its own view, the author states another's: some hold that fainting from blood is by the nature of the substance itself.
Key terms
dravyasvabhāva
Nature of the substance.
eke
Some (other teachers).
Adhikarana 8 (11) · Śloka 11
guṇāstīvrataratvēna sthitāstu viṣamadyayōḥ |
ta ēva tasmājjāyēta mōhastābhyāṁ yathēritaḥ ||11||
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गुणास्तीव्रतरत्वेन स्थितास्तु विषमद्ययोः |
त एव तस्माज्जायेत मोहस्ताभ्यां यथेरितः ||११||
Meaning of the śloka
Their (dry and other) qualities remain more intense in poison and wine; from those same qualities, delusion (mūrcchā) arises from them, as described.
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viṣamadyōtthē āha- guṇā ityādi| ta ēva guṇā rūkṣādayaḥ| mōhō mūrcchā| tābhyāṁ viṣamadyābhyām| yathēritō yathākathita ityarthaḥ| atha viṣamadyavikārayōḥ sāmānyēnaiva mūrcchāpraṇayanāt kathamatra viśiṣṭamabhidhānam? ucyatē- tatra itaralakṣaṇaiḥ saha tadgrahaṇārtham| nanu, yadi viṣamadyayōstulyā guṇāḥ sthitāḥ, tat kimiti viṣavanmadyaṁ māraṇātmakaṁ na syāt? satyaṁ, madyē tēṣāṁ guṇānāmanatitīvratvēnāvasthānāt| yadyēvaṁ tarhi ‘guṇāstīvrataratvēna sthitāstu viṣamadyayōḥ’ iti kathaṁ na vyāhanyatē? satyaṁ, tīvrataraśabdādagrē tīvraśabdō madhyē luptō draṣṭavyaḥ| tēna viṣē tīvrataratvēna tē guṇāḥ sthitāḥ, madyē tīvratvēnētyarthaḥ| tathā ca tantrāntaram,- “viṣasya yē guṇā dr̥ṣṭāḥ sannipātaprakōpaṇāḥ| ta ēva madyē dr̥śyantē viṣē tu balavattarāḥ|| ta ēva tasmāttābhyāṁ tu mōhau syātāṁ yathēritau” (ca. ci. 24)- iti||11||
Meaning of the commentary
The commentary explains the fainting due to poison or wine. The same qualities (dryness and so on) are meant. An objection: fainting from wine and poison was already stated in general, so why state it separately? Answer: to include it along with the other signs. Another objection: if poison and wine have equal qualities, why is wine not deadly like poison? Answer: in wine the qualities are less intense. But then the verse says the qualities are more intense in both poison and wine, which would contradict; the answer is that a word is understood to be omitted in the middle: in poison the qualities are more intense, in wine they are intense. It quotes another tantra (Caraka Cikitsā 24): 'the qualities of poison that aggravate sannipāta are seen in wine too, but are stronger in poison; therefore the two swoons arise as described'.
The commentary gives the signs of alcohol-caused mūrcchā. 'Raving' means uttering delirious speech. 'Lost, confused mind' means one who has lost his mind (like apasmāra) and is confused-minded, with scattered thought. 'Until it is digested' is jarā (pāka).
In one who has fainted from poison, there are trembling, sleep, thirst and stiffness; the more intense signs are to be known by the signs of the particular poison.
The commentary gives the signs of poison-caused mūrcchā. Vepathu is trembling; stambha is stiffness. The person's particular poison, whether from root to bulb kinds, is to be known by the signs given for each.
Pouring (seka), immersion baths, gems worn with necklaces, cool pastes, fans and breezes, and cool, fragrant drinks are unforbidden in all kinds of mūrcchā.
The commentary gives the treatment. Maṇayas are pearls, crystal and similar gems, worn strung in necklaces. Vyajanānilāḥ are the breezes of fans. Cool pastes are those made of sandal, blue lotus and similar. 'Cool, fragrant drinks' are cool and scented drinks. 'Unforbidden' means recommended.
Key terms
seka
Pouring or sprinkling.
avagāha
Immersion bath.
anivārita
Not forbidden, approved.
Adhikarana 13 (15) · Śloka 15
sitāpriyālēkṣurasaplutāni drākṣāmadhūkasvarasānvitāni |
kharjūrakāśmaryarasaiḥ śr̥tāni pānāni sarpīṁṣi ca jīvanāni ||15||
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सिताप्रियालेक्षुरसप्लुतानि द्राक्षामधूकस्वरसान्वितानि |
खर्जूरकाश्मर्यरसैः शृतानि पानानि सर्पींषि च जीवनानि ||१५||
Meaning of the śloka
Drinks steeped in sugar, priyāla and sugarcane juice, mixed with grape and madhūka juices, cooked with the juices of dates and kāśmarī; and life-giving ghṛtas.
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tānyēva śītāni gandhavanti ca pānānyāha- sitāpriyālēkṣurasaplutānītyādi| kharjūrakāśmaryarasaiḥ śr̥tāni sitāpriyālādiyutāni pānāni pānakāni sarvāsvanivāritāni| na kēvalaṁ pānānyēvānivāritāni sarpīṁṣi ca jīvanānīti kākōlyādisiddhānītyarthaḥ| kēcit pānānītyatra siddhānīti paṭhanti, tē ca ghr̥taviśēṣaṇaṁ manyantē||15||
Meaning of the commentary
The commentary says these are the same cool, fragrant drinks. Drinks cooked in the juices of dates and kāśmarī, with sugar and priyāla and the rest, are not forbidden in all the mūrcchās. Not only drinks, but also jīvana (life-giving) ghṛtas, meaning those cooked with kākolī and similar, are not forbidden. Some read 'siddhāni' for 'pānāni', which they take as an adjective of ghṛta.
Key terms
pāna
Drink.
jīvana ghṛta (jīvanāni sarpīṃṣi)
Ghṛtas cooked with life-promoting drugs (kākolī group).
सिद्धानि वर्गे मधुरे पयांसि सदाडिमा जाङ्गलजा रसाश्च |
तथा यवा लोहितशालयश्च मूर्च्छासु पथ्याश्च सदा सतीनाः ||१६||
Meaning of the śloka
Milks cooked with the sweet group, with pomegranate, and jāṅgala meat juices; likewise barley, red śāli rice, and always tīna (round pulse) are wholesome in mūrcchā.
The commentary asks whether only these are beneficial in all mūrcchās or others too. 'In the sweet group' means kākolī and others. All milks, since all milks remove mūrcchā. 'With pomegranate' means prepared with pomegranate; jāṅgala juices are of dry-land animals. Foods beneficial in mūrcchā: 'beneficial' is 'in food'. Tīna is round kalāya.
Key terms
madhura varga (madhuravarga)
The sweet group, kākolī and others.
lohitaśāli
Red śāli rice.
satīna
Round pulse (vartula kalāya).
Adhikarana 15 (17) · Śloka 17
bhujaṅgapuṣpaṁ maricānyuśīraṁ kōlasya madhyaṁ ca pibēt samāni |
śītēna tōyēna bisaṁ mr̥ṇālaṁ kṣaudrēṇa kr̥ṣṇāṁ sitayā ca pathyām ||17||
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भुजङ्गपुष्पं मरिचान्युशीरं कोलस्य मध्यं च पिबेत् समानि |
शीतेन तोयेन बिसं मृणालं क्षौद्रेण कृष्णां सितया च पथ्याम् ||१७||
Meaning of the śloka
Bhujaṅgapuṣpa, pepper, uśīra and the kernel of kola, in equal parts, should be drunk with cold water; bisa and mṛṇāla (lotus stalk) with cold water; kṛṣṇā (pippalī) with honey; and pathyā with sugar.
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bhujaṅgapuṣpamityādi| bhujaṅgapuṣpaṁ nāgakēśaram| kōlasya madhyaṁ badaramajjā| ētāni bhujaṅgapuṣpādīni samāni tulyāni śītatōyēna saha pibēt| na kēvalamētānyēva śītatōyēna saha pibēt bisaṁ mr̥ṇālaṁ cāpi śītatōyēna pibēt; bisaṁ bisēndrakaṁ, mr̥ṇālaṁ padmanālam| kṣaudrēṇa kr̥ṣṇāmiti madhunā saha pippalīṁ pibēdityarthaḥ; anyē lihēditi manyantē| sitayā ca pathyāmiti harītakīṁ śarkarayā saha pibēdityarthaḥ||17||
Meaning of the commentary
The commentary says bhujaṅgapuṣpa is nāgakesara; the kernel of kola is jujube marrow. These, in equal parts, are drunk with cold water. Bisa is bisendraka and mṛṇāla is lotus stalk, also with cold water. Pippalī is drunk (or licked, per others) with honey; harītakī with sugar.
One should also block the nose and mouth (nāsāvadanāvarodha), or give human (women's) milk to drink. In persistent mūrcchā, one should repeatedly overcome it by śirovirecana (nasal cleansing) and by sharp emetics.
The commentary says that, by blocking the nose and mouth, the vāta turning back inside, opening the blocked channels, removes the fainting; women's milk is very cool. 'Persistent' means recurring again and again. Śirovirecana means nasyas. 'Repeatedly' means again and again. Although pitta is the main agent in all mūrcchā, and sharp nasyas and emetics are not appropriate for it, still, because they relieve the obstruction of the consciousness-carrying channels and oppose the disease, they are beneficial. Some read 'pathyaiḥ' (wholesome) for 'tīkṣṇaiḥ' (sharp), explaining it as pitta- and kapha-relieving.
हरीतकीक्वाथशृतं घृतं वा धात्रीफलानां स्वरसैः कृतं वा |
द्राक्षासितादाडिमलाजवन्ति शीतानि नीलोत्पलपद्मवन्ति ||१९||
पिबेत् कषायाणि च गन्धवन्ति पित्तज्वरं यानि शमं नयन्ति |२०|
Meaning of the śloka
Ghṛta cooked in harītakī decoction, or made with āmalaka fruit juices; or cool decoctions, rich in grapes, sugar, pomegranate and parched rice, blue lotus and lotus, and fragrant, that pacify pitta fever, may be drunk.
The commentary says ghṛta is cooked in harītakī decoction, or with the juices of āmalaka fruit. The decoctions that pacify pitta fever, made of śrīparṇī and similar, may be drunk when rich in drākṣā, sugar, pomegranate and parched rice, blue lotus and lotus, and fragrant drugs. The qualifiers 'rich in blue lotus and lotus' and the like describe the pittajvara-relieving decoctions.
One who has abundant doṣa, who from an excess of tamas has fainted and does not wake, and is 'renounced of consciousness' (sannyasta-saṃjña), is to be known by the wise as extremely hard to treat.
The commentary states another named state of mūrcchā. The person with abundant doṣa, who, having fainted from an excess of tamas, does not regain awareness, is hard to treat and called sannyastasaṃjña by the wise physician. 'Sannyasta-saṃjña' means one at the mouth of death, as if 'renounced'.
Key terms
sannyastasaṃjña
One whose consciousness is 'renounced'; a deep, hard-to-treat unconscious state.
As one would quickly take out an unbaked clay lump placed in water, so the physician should treat quickly the one who is without sweat and has come under the control of death.
The commentary gives an example for quick remedy for a sannyasta person: a raw clay lump dissolves in water, so must it be taken out at once; likewise this person is treated swiftly. 'Without sweating' means without perspiration.
By sharp añjana (collyrium), sharp anointing, smoke inhalation, likewise needle-pricks in the nails, by playing of instruments and singing, comforting words, unusual shakings, and rubbing with gupta-phala.
The commentary says 'sharp' attaches to collyrium and the rest. Totras are needle-like tools; vāditra is a lute and similar; anunaya is conciliatory speech. Vighaṭṭana is moving in various ways. Guptaphalāvagharṣaṇa is rubbing with kapikacchū fruit; others say guptaphala is the testis and it means pressing it. Some read 'vismāpanaiḥ' (astonishing means) for 'vighaṭṭanaiḥ'. With these measures the physician should treat until consciousness returns.
Key terms
tīkṣṇāñjana
Sharp collyrium.
dhūmayoga
Smoke inhalation.
totra
Needle-like tool.
guptaphala
Kapikacchū fruit, or testis per others.
Adhikarana 21 (23) · Śloka 23
ābhiḥ kriyābhiśca na labdhasañjñaḥ sānāhalālāśvasanaśca varjyaḥ ||23||
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आभिः क्रियाभिश्च न लब्धसञ्ज्ञः सानाहलालाश्वसनश्च वर्ज्यः ||२३||
Meaning of the śloka
One who does not regain consciousness by these measures, and who has distension, drooling and gasping breath, is to be avoided (abandoned).
The commentary says 'these measures' means the sharp collyrium and others just described. Sānāha means with distension; lālā is drooling; śvasana is breathing (gasping).
After the person has regained consciousness, purified by sharp emetics and purgatives, and having eaten light wholesome food, he should be treated for a month with preparations of phalatrika, citraka and nāgara, and with śilājatu, with sugar; especially old ghṛta should be given to him to drink.
The commentary says the aftercare of the fainter who has regained consciousness is described. With sharp collyrium and so on he is brought back; then purged upward and downward with sharp emetics and purgatives, and after the graded diet, is given for a month preparations of triphalā, citraka and ginger, and śilājatu prepared in the manner of a vajraka-vaṭaka, with sugar, to pacify the remaining doṣas. Old ghṛta of ten years is to be drunk.
Key terms
śilājatu
Mineral pitch.
jīrṇaghṛta
Old (aged) ghṛta.
prabuddhasaṃjña
One who has regained consciousness.
Adhikarana 23 (25) · Śloka 25
yathāsvaṁ ca jvaraghnāni kaṣāyāṇyupayōjayēt |
sarvamūrcchāparītānāṁ viṣajāyāṁ viṣāpaham ||25||
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यथास्वं च ज्वरघ्नानि कषायाण्युपयोजयेत् |
सर्वमूर्च्छापरीतानां विषजायां विषापहम् ||२५||
Meaning of the śloka
According to each, fever-relieving decoctions should be used; and in the poison-caused kind, poison-relieving (measures) in all who are overcome by mūrcchā.
The commentary says that the decoctions stated for fevers according to doṣa are also to be used in mūrcchās arising from those doṣas. 'Poison-relieving' means the nasya, collyrium and other measures described in the Kalpasthāna that remove poison-induced unconsciousness.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे मूर्च्छाप्रतिषेधो नाम (अष्टमोऽध्यायः, आदितः) षट्चत्वारिंशत्तमोऽध्यायः ||४६||
Meaning of the śloka
Thus ends the chapter named Mūrcchāpratiṣedha, the forty-sixth chapter (the eighth from the beginning of this section), in the Kāyacikitsā-tantra within the Uttaratantra of the Suśruta Saṃhitā.