23. nāsāgatarōgapratiṣēdhādhyāyaḥ

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Adhikarana 1 (1-2) · Śloka 2

athātō nāsāgatarōgapratiṣēdhaṁ vyākhyāsyāmaḥ ||1|| yathōvāca bhagavān dhanvantariḥ ||2||

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अथातो नासागतरोगप्रतिषेधं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now we shall explain the treatment of diseases situated in the nose, as declared by the venerable Dhanvantari.

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athāta ityādi||1-2||

Meaning of the commentary

The commentary identifies these as the customary introductory statements beginning with 'Now, therefore.'

Key terms

nAsAgatarogapratiShedha (nasagata-roga-pratishedha): The treatment or counteraction of diseases situated in the nose.
dhanvantari (Dhanvantari): The revered authority to whom the teaching is attributed.

Adhikarana 2 (3) · Śloka 3

pūrvōddiṣṭē pūtinasyē ca jantōḥ snēhasvēdau chardanaṁ sraṁsanaṁ ca | yuktaṁ bhaktaṁ tīkṣṇamalpaṁ laghu syāduṣṇaṁ tōyaṁ dhūmapānaṁ ca kālē ||3||

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पूर्वोद्दिष्टे पूतिनस्ये च जन्तोः स्नेहस्वेदौ छर्दनं स्रंसनं च | युक्तं भक्तं तीक्ष्णमल्पं लघु स्यादुष्णं तोयं धूमपानं च काले ||३||

Meaning of the śloka

For the previously described disorder and for putinasa, the text prescribes oleation, fomentation, emesis, and purgation. Food should be suitable, pungent, small in quantity, and light; warm water and smoking are also prescribed at the appropriate time.

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apīnasapūtinasyayōścikitsāmāha- pūrvōddiṣṭē ityādi| pūrvōddiṣṭē apīnasē ityarthaḥ| chardanaṁ vamanaṁ, sraṁsanaṁ virēkaḥ| kr̥taśuddhērantaḥsaṁsargaṁ niyamayannāha- yuktamityādi| tōyasya pānaṁ niyamayannāha- uṣṇaṁ tōyamityādi| kālē dhūmapānakālē||3||

Meaning of the commentary

The commentary states that the 'previously described' disorder is apinasa, so this treatment concerns both apinasa and putinasa. Chardana means therapeutic emesis, and sramsana means purgation. After purification, the text regulates what is taken internally by prescribing suitable food, warm water for drinking, and smoking at its proper time.

Key terms

apInasa (apinasa): The disorder intended by the phrase 'previously described,' according to the commentary.
pUtinAsya (putinasa): The nasal disorder treated together with apinasa in this passage.
chardana: Therapeutic emesis, as explained by the commentary.
sraMsana (sramsana): Purgation, as explained by the commentary.
dhUmapAna (dhumapana): A historical therapeutic smoking procedure prescribed at its proper time.

Adhikarana 3 (4) · Śloka 4

hiṅgu vyōṣaṁ vatsakākhyaṁ śivāṭī lākṣā bījaṁ saurabhaṁ kaṭphalaṁ ca | ugrā kuṣṭhaṁ tīkṣṇagandhā viḍaṅgaṁ śrēṣṭhaṁ nityaṁ cāvapīḍē karañjam ||4||

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हिङ्गु व्योषं वत्सकाख्यं शिवाटी लाक्षा बीजं सौरभं कट्फलं च | उग्रा कुष्ठं तीक्ष्णगन्धा विडङ्गं श्रेष्ठं नित्यं चावपीडे करञ्जम् ||४||

Meaning of the śloka

For regular use as an avapida nasal preparation, the text lists hingu, vyosha, vatsaka, shivati, laksha, bija, saurabha, katphala, ugra, kushtha, tikshnagandha, vidanga, and superior karanja.

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tayōrēvāvapīḍamuddiśannāha- hiṅgu vyōṣamityādi| vyōṣaṁ trikaṭukam| śivāṭī śvētapunarnavā, śēphālikētyanyē| ugrā vacā, tīkṣṇagandhā śōbhāñjanakaḥ| avapīḍya dīyata ityāvapīḍaḥ| kēcidamumēva pāṭhamanyathā paṭhanti, sa cādarśanānna likhitaḥ||4||

Meaning of the commentary

The commentary presents this as an avapida preparation for the same two disorders. It identifies vyosha as trikatu; shivati as white punarnava, while others identify it as shephalika; ugra as vacha; and tikshnagandha as shobhanjana. Avapida is so called because the substance is pressed and administered. Some authorities read this passage differently, but the commentator does not record that variant because he had not seen it.

Key terms

avapIDa (avapida): A historical nasal preparation administered after pressing or expressing the substance.
vyoSha (vyosha): Identified by the commentary as trikatu.
shivATI (shivati): Identified as white punarnava, with shephalika preserved as an alternative identification.
ugrA (ugra): Identified by the commentary as vacha.
tIkShNagandhA (tikshnagandha): Identified by the commentary as shobhanjana.

Adhikarana 4 (5) · Śloka 5

ētairdravyaiḥ sārṣapaṁ mūtrayuktaṁ tailaṁ dhīmānnasyahētōḥ pacēta |5|

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एतैर्द्रव्यैः सार्षपं मूत्रयुक्तं तैलं धीमान्नस्यहेतोः पचेत |५|

Meaning of the śloka

A knowledgeable person should prepare mustard oil with these substances and with urine for use as a nasya preparation.

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apīnasapūtinasyayōrētairēvāvapīḍanadravyairnasyārthaṁ tailasādhanamāha- ētairdravyairityādi| kēcit ‘asmin tailē yuktitaḥ sampacēta mañjiṣṭhāṁ vai srōtasi mrakṣaṇārthaṁ, iti paṭhanti, sa cācāryairanārṣīkr̥taḥ|5|-

Meaning of the commentary

The commentary says that, for apinasa and putinasa, the same substances just prescribed for avapida are used to prepare an oil intended for nasya. It also cites another reading that adds manjishtha to this oil in a suitable manner for application to the channels, but states that the teachers regarded this reading as non-authoritative.

Key terms

sArShapa taila (sarshapa taila): Mustard oil used as the base of the historical preparation.
mUtrayukta (mutrayukta): Combined with urine in the formulation described by the source.
nasya: A historical mode of administering a substance through the nose.
ma~jjiShThA (manjishtha): A substance added in the cited alternative reading, which the commentary reports as non-authoritative.

Adhikarana 5 (5) · Śloka 6

nāsāpākē pittahr̥tsaṁvidhānaṁ kāryaṁ sarvaṁ bāhmamābhyantaraṁ ca ||5|| hr̥tvā raktaṁ kṣīravr̥kṣatvacaśca sājyāḥ sēkā yōjanīyāśca lēpāḥ |6|

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नासापाके पित्तहृत्संविधानं कार्यं सर्वं बाह्ममाभ्यन्तरं च ||५|| हृत्वा रक्तं क्षीरवृक्षत्वचश्च साज्याः सेका योजनीयाश्च लेपाः |६|

Meaning of the śloka

In nasapaka, all measures that alleviate pitta should be employed, both externally and internally. After removing blood, irrigation and pastes prepared with the bark of milk-exuding trees and combined with ghee are to be applied.

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nāsāpākē bhēṣajamāha- nāsāpākē ityādi| bāhmaṁ lēpābhyaṅgapariṣēkādi, ābhyantaraṁ punarāhārasnēhapānavirēcanādi| sājyāḥ saghr̥tāḥ||5||-

Meaning of the commentary

The commentary explains treatment for nasapaka. External measures include pastes, anointing, and irrigation, while internal measures include diet, drinking unctuous preparations, and purgation. Sajya means combined with ghee.

Key terms

nAsApAka (nasapaka): The nasal disorder for which the treatment is stated.
pittahRut (pittahrit): A measure intended in the source to alleviate pitta.
bAhma (bahya): External treatment, explained as including pastes, anointing, and irrigation.
Abhyantara (abhyantara): Internal treatment, explained as including diet, unctuous drinks, and purgation.
kShIravRukShatvac (kshiravriksha-tvach): Bark of milk-exuding trees used in the stated irrigation and paste.
sAjya (sajya): Combined with ghee, according to the commentary.

Adhikarana 6 (6) · Śloka 6

vakṣyāmyūrdhvaṁ raktapittōpaśāntiṁ... |6|

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वक्ष्याम्यूर्ध्वं रक्तपित्तोपशान्तिं... |६|

Meaning of the śloka

The means of calming raktapitta will be explained later.

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raktapittasyānāgatāvēkṣaṇēna saṅkṣēpārthaṁ cikitsitamāha- vakṣyāmyūrdhvamityādi| ūrdhvaṁ raktapittapratiṣēdhē| upaśāntiṁ cikitsitaṁ ‘nāsāpravr̥ttē jalamāśu dēyaṁ saśarkaraṁ nāsikayā payō vā’ ityādikam|6|-

Meaning of the commentary

Anticipating the later discussion of raktapitta, the commentator says that its treatment is mentioned here only briefly. ‘Later’ refers to the chapter on the treatment of raktapitta. As an example of the measures for calming it, the commentary cites the instruction that when bleeding occurs from the nose, water with sugar, or milk, is to be given promptly through the nasal route.

Key terms

raktapitta: The disorder whose pacification is deferred to a later treatment chapter.
upashAnti (upaśānti): Pacification or treatment intended to calm the disorder.
nAsApravRutte (nāsāpravṛtte): When bleeding or discharge has begun from the nose, as understood in the cited instruction.

Adhikarana 7 (6) · Śloka 6

... nāḍīvatsyāt pūyaraktē cikitsā ||6||

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... नाडीवत्स्यात् पूयरक्ते चिकित्सा ||६||

Meaning of the śloka

In pūyarakta, treatment should be carried out in the same manner as for a nāḍī.

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pūyaraktasya vidhānamāha- nāḍīvadityādi| pūyaraktē nāḍīvat nāḍītulyā cikitsā, yā visarpanāḍīstanarōgacikitsitē vyākhyātā||6||

Meaning of the commentary

The passage states the therapeutic rule for pūyarakta: its treatment is to follow that used for a nāḍī, meaning the nāḍī-like condition whose management was explained in the treatment section concerning visarpa, nāḍī, and disorders of the breast.

Key terms

pUyarakta (pūyarakta): The nasal disorder being treated in this passage, designated by the source as pūyarakta.
nADIvat (nāḍīvat): In the manner of the treatment prescribed for a nāḍī.
cikitsA (cikitsā): Treatment or therapeutic management.

Adhikarana 8 (7) · Śloka 7

vāntē samyak cāvapīḍaṁ vadanti tīkṣṇaṁ ghūmaṁ śōdhanaṁ cātra nasyam |7|

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वान्ते सम्यक् चावपीडं वदन्ति तीक्ष्णं घूमं शोधनं चात्र नस्यम् |७|

Meaning of the śloka

After proper emesis, the authorities prescribe a strong avapīḍa preparation, medicated smoke, and cleansing nasya in this condition.

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pūyaraktē sāmānyāṁ cikitsāmabhidhāya viśēṣacikitsāmāha- vāntē ityādi| atra pūyaraktē; anyē tu ‘atrēti nāsāpākē’ iti vyākhyānayanti| kēcit ‘vāntē samyak’ ityādikaṁ kṣavathau bhraṁśathau ca yōjayanti|7|-

Meaning of the commentary

After first stating the general treatment of pūyarakta, the text gives a specific treatment. The commentator takes ‘in this condition’ to refer to pūyarakta. Other interpreters understand it as referring to nāsāpāka, while some apply the statement beginning ‘after proper emesis’ to kṣavathu and bhraṃśathu. These alternative applications are preserved without choosing among them.

Key terms

avapIDa (avapīḍa): A nasal preparation or procedure named by the source.
ghUma (dhūma): Medicated smoke used as a historical therapeutic measure.
shodhana nasya (śodhana nasya): A cleansing form of nasal therapy.
nAsApAka (nāsāpāka): An alternative condition to which some commentators apply the instruction.
kShavathu (kṣavathu): One of the conditions to which some interpreters apply the passage.
bhraMshathu (bhraṃśathu): Another condition to which some interpreters apply the passage.

Adhikarana 9 (7) · Śloka 8

kṣēpyaṁ nasyaṁ mūrdhavairēcanīyairnāḍyā cūrṇaṁ kṣavathau bhraṁśathau ca ||7|| kuryāt svēdān mūrdhni vātāmayaghnān snigdhān dhūmān yadyadanyadvitaṁ ca |8|

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क्षेप्यं नस्यं मूर्धवैरेचनीयैर्नाड्या चूर्णं क्षवथौ भ्रंशथौ च ||७|| कुर्यात् स्वेदान् मूर्ध्नि वातामयघ्नान् स्निग्धान् धूमान् यद्यदन्यद्वितं च |८|

Meaning of the śloka

For kṣavathu and bhraṃśathu, powder made from substances used for cleansing the head is to be administered through a tube as nasya. Thereafter, warming measures are prescribed for the head, together with unctuous medicated smoke and whatever other measures are beneficial for disorders attributed to vāta.

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kṣavathau bhraṁśathau ca cikitsāmāha- kṣēpyamityādi| nasyamiti pradhamanamityarthaḥ, pañcavidhatvānnasyasya| mūrdhavairēcanīyaiḥ śirōvirēcanadravyaiḥ| pradhamanēna kṣīṇē kaphē vātē ca vr̥ddhē sati anilaghnān snigdhānityarthaḥ| anyaditi śirōbastimastiṣkādikam||7||-

Meaning of the commentary

The passage gives treatment for kṣavathu and bhraṃśathu. Here nasya is explained specifically as pradhmana, the insufflation of powder, because nasya is classified into five kinds. The substances termed mūrdhavirecanīya are those used for cleansing the head. The commentator explains that after insufflation has reduced kapha and vāta has consequently increased, the smoke should be unctuous and directed against anila. ‘Other measures’ includes śirobasti and mastishka and similar procedures.

Key terms

kShavathu (kṣavathu): A nasal condition for which the passage prescribes treatment.
bhraMshathu (bhraṃśathu): A second nasal condition treated by the stated measures.
pradhamana: A type of nasya involving the insufflation of powder.
mUrdhavairecanIya (mūrdhavirecanīya): Substances described as cleansing or evacuating the head.
shirobasti (śirobasti): One of the additional head procedures included by the commentator.
mastiShka (mastiṣka): Another head procedure included among the commentator's additional measures.

Adhikarana 10 (8) · Śloka 8

dīptē rōgē paittikaṁ saṁvidhānaṁ kuryāt sarvaṁ svādu yacchītalaṁ ca ||8||

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दीप्ते रोगे पैत्तिकं संविधानं कुर्यात् सर्वं स्वादु यच्छीतलं च ||८||

Meaning of the śloka

In dīptaroga, the complete regimen appropriate to a pitta disorder should be employed, using measures that are sweet and cooling.

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dīptarōgasya cikitsāmāha- dīptē ityādi| saṁvidhānaṁ karmētyarthaḥ, sarvaṁ bāhmābhyantaram||8||

Meaning of the commentary

This states the treatment of dīptaroga. The word saṃvidhāna means therapeutic procedure or regimen, and ‘complete’ includes both external and internal measures.

Key terms

dIptaroga (dīptaroga): The nasal disorder addressed by this treatment statement.
paittika: Pertaining to pitta and guiding the regimen described here.
saMvidhAna (saṃvidhāna): The therapeutic procedure or complete regimen.
svAdu (svādu): Sweet in quality or taste.
shItala (śītala): Cooling in quality.

Adhikarana 11 (9) · Śloka 9

nāsānāhē snēhapānaṁ pradhānaṁ snigdhā dhūmā mūrdhabastiśca nityam | balātailaṁ sarvathaivōpayōjyaṁ vātavyādhāvanyaduktaṁ ca yadyat ||9||

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नासानाहे स्नेहपानं प्रधानं स्निग्धा धूमा मूर्धबस्तिश्च नित्यम् | बलातैलं सर्वथैवोपयोज्यं वातव्याधावन्यदुक्तं च यद्यत् ||९||

Meaning of the śloka

In nāsānāha (nasal obstruction), drinking an unctuous substance is considered foremost. Unctuous medicinal smoke and mūrdhabasti are to be used regularly. Balā Taila should be employed in every appropriate manner, together with whatever other measures have been prescribed for vāta disorders.

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nāsānāhacikitsāmāha- nāsānāhē snēhapānamityādi| snēhapānam uttarabhaktakam| mūrdhabastiścēti cakārāt sālvaṇōpanāhādayō gr̥hyantē| sarvathaivēti pānābhyaṅgānuvāsanaśirōbastimastiṣkādibhiḥ sarvairēva prakāraiḥ| anyat aṇutailādikam||9||

Meaning of the commentary

The commentary explains the treatment of nāsānāha. Snehapāna here means taking the unctuous preparation after food. The word ‘and’ following mūrdhabasti also includes measures such as sālavaṇa-upanāha. ‘In every manner’ refers to the various uses of Balā Taila, including drinking, massage, anuvasana, śirobasti, and mastiska applications. Other measures include Aṇu Taila and related preparations.

Key terms

nAsAnAha (nāsānāha): The nasal obstruction being treated in this passage.
snehapAna (snehapāna): Oral intake of an unctuous preparation; the commentary specifies its use after food here.
mUrdhabasti (mūrdhabasti): A historical procedure retaining an unctuous preparation on the head.
balAtaila (Balā Taila): A medicated oil recommended through several modes of use.

Adhikarana 12 (10) · Śloka 10

nāsāsrāvē ghrāṇataścūrṇamuktaṁ nāḍyā dēyaṁ yō'vapīḍaśca tīkṣṇaḥ | tīkṣṇaṁ dhūmaṁ dēvadārvagnikābhyāṁ māṁsaṁ vā''jaṁ yuktamatrādiśanti ||10||

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नासास्रावे घ्राणतश्चूर्णमुक्तं नाड्या देयं योऽवपीडश्च तीक्ष्णः | तीक्ष्णं धूमं देवदार्वग्निकाभ्यां मांसं वाऽऽजं युक्तमत्रादिशन्ति ||१०||

Meaning of the śloka

For nāsāsrāva (nasal discharge), the previously described powder should be introduced through the nose with a tube, together with a strong avapīḍa nasal preparation. Strong medicinal smoke prepared with devadāru and agnika is also prescribed, and goat meat is regarded as suitable here.

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nāsāsrāvacikitsāmāha- nāsasrāvē ityādi| uktaṁ cūrṇaṁ śirōvirēcanadravyakr̥tam| tīkṣṇō'vapīḍō ‘hiṅgu vyōṣaṁ vatsakākhyaṁ’ ityādinā ihaivādhyāyē prōktaḥ| agnikaḥ citrakaḥ, ajamōdāmanyē| ājaṁ māṁsaṁ ‘bhōjanē’ iti śēṣaḥ||10||

Meaning of the commentary

The commentary identifies the powder as one made from substances used for śirovirecana. The strong avapīḍa is the formulation beginning with hiṅgu, vyoṣa, and vatsaka that was stated earlier in this chapter. Agnika is interpreted as citraka, although some authorities understand it as ajamodā. Goat meat is to be supplied with the understood qualification ‘as food.’

Key terms

nAsAsrAva (nāsāsrāva): Nasal discharge in the terminology of this passage.
avapIDa (avapīḍa): A historical nasal administration of expressed medicinal liquid.
shirovirecana (śirovirecana): A head-cleansing category of substances from which the cited powder is prepared.
agnika: Interpreted as citraka by the commentator, while some authorities interpret it as ajamodā.

Adhikarana 13 (11) · Śloka 11

nāsāśōṣē kṣīrasarpiḥ pradhānaṁ siddhaṁ tailaṁ cāṇukalpēna nasyam | sarpiḥpānaṁ bhōjanaṁ jāṅgalaiśca snēhaḥ svēdaḥ snaihikaścāpi dhūmaḥ ||11||

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नासाशोषे क्षीरसर्पिः प्रधानं सिद्धं तैलं चाणुकल्पेन नस्यम् | सर्पिःपानं भोजनं जाङ्गलैश्च स्नेहः स्वेदः स्नैहिकश्चापि धूमः ||११||

Meaning of the śloka

For nāsāśoṣa (dryness of the nose), milk-ghee is considered foremost, and oil prepared according to the method of Aṇu Taila is prescribed as nasya. The passage also recommends drinking ghee, food with the meat of jāṅgala animals, uncting, sudation, and unctuous medicinal smoke.

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nāsāśōṣē cikitsāmāha- nāsāśōṣē kṣīrasarpirityādi| kṣīrasarpiḥ ādita uktam| pradhānaṁ śrēṣṭham| nasyē nasyaviṣayē| aṇukalpēna aṇutailavidhānēna vātavyādhyuktēna| sarpiḥpānam antarbhaktakam| jāṅgalaiḥ ēṇādimāṁsaiḥ, snēhaḥ svēda ityarthaḥ| snaihikō dhūmō madhūcchiṣṭādibhiḥ||11||

Meaning of the commentary

The commentary says that the milk-ghee intended here is the preparation described at the beginning and that ‘foremost’ means best. The oil is for nasal administration and is prepared by the Aṇu Taila method stated under vāta disorders. Ghee is to be taken during the meal. Jāṅgala refers to meats such as that of the eṇa antelope. The wording concerning sneha and sveda is understood as uncting and sudation. The unctuous smoke is prepared with substances such as beeswax.

Key terms

nAsAshoSha (nāsāśoṣa): Dryness of the nose in the terminology of this passage.
kShIrasarpiH (kṣīrasarpiḥ): A milk-and-ghee preparation identified by the commentary as one described earlier.
nasya: Nasal administration of a medicinal preparation.
snaihika dhUma (snaihika dhūma): Unctuous medicinal smoke, here said to use substances such as beeswax.

Adhikarana 14 (12) · Śloka 12

śēṣān rōgān ghrāṇajān sanniyacchēduktaṁ tēṣāṁ yadyathā saṁvidhānam ||12||

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शेषान् रोगान् घ्राणजान् सन्नियच्छेदुक्तं तेषां यद्यथा संविधानम् ||१२||

Meaning of the śloka

The remaining disorders arising in the nose should be managed according to the respective procedures already prescribed for each of them.

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arśaḥprabhr̥tīnāṁ cikitsāmāha- śēṣānityādi| śēṣān rōgānarśaḥśōphādīn, sanniyacchēt cikitsēt| uktaṁ saṁvidhānaṁ svē svē cikitsitē||12||

Meaning of the commentary

The commentary states that ‘remaining disorders’ means conditions such as arśas and śopha. ‘Should be controlled’ means should be treated, and the prescribed procedure is the management stated in the respective treatment section for each condition.

Key terms

ghrANajAn rogAn (ghrāṇajān rogān): Disorders arising in the nose.
arshaH (arśas): One example of the remaining disorders referenced by the commentary.
shopha (śopha): Swelling, given as another example by the commentary.
saMvidhAna (saṃvidhāna): The respective therapeutic arrangement already stated for a condition.

Adhikarana puṣpikā · Śloka 23

iti suśrutasaṁhitāyāmuttaratantrāntargatē śālākyatantrē nāsāgatarōgapratiṣēdhō nāma trayōviṁśō'dhyāyaḥ ||23||

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इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे नासागतरोगप्रतिषेधो नाम त्रयोविंशोऽध्यायः ||२३||

Meaning of the śloka

Thus ends the twenty-third chapter, entitled ‘Prevention and Treatment of Diseases of the Nose,’ in the Śālākya-tantra section of the Uttara-tantra of the Suśruta-saṃhitā.

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iti śrīḍalha(hla)ṇaviracitāyāṁ nibandhasaṅgrahākhyāyāṁ suśrutavyākhyāyāmuttaratantrāntargatē śālākyatantrē trayōviṁśō'dhyāyaḥ||23||

Meaning of the commentary

Thus ends the twenty-third chapter in the Śālākya-tantra section of the Uttara-tantra in Dalhaṇa’s commentary on the Suśruta-saṃhitā, entitled Nibandhasaṅgraha.

Key terms

nAsAgatarogapratiShedha (nāsāgatarogapratiṣedha): The chapter title concerning prevention and treatment of diseases situated in the nose.
shAlAkyatantra (Śālākya-tantra): The textual section in which this chapter is placed.
uttaratantra (Uttara-tantra): The division of the Suśruta-saṃhitā containing this chapter.
nibandhasa~ggraha (Nibandhasaṅgraha): The title of Dalhaṇa’s commentary named in the colophon.

← 22. nāsāgatarōgavijñānīyādhyāyaḥ 24. pratiśyāyapratiṣēdhādhyāyaḥ →