अथातः स्वरभेदप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
Meaning of the śloka
Now, therefore, we shall explain the chapter on the treatment (pratiṣedha) of svarabheda (impairment of voice). Thus spoke Lord Dhanvantari.
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শ্বাসকাসপ্রতিষেধানন্তরমূর্ধ্বগতত্বসামান্যাত্ শ্বাসকাসচিকিত্সিতসাধ্যত্বাচ্চ স্বরভেদপ্রতিষেধারম্ভো যুক্ত ইত্যত আহ- অথাত ইত্যাদি| স্বরভেদঃ স্বরোপঘাতঃ||১-২||
Meaning of the commentary
The commentary says that after the chapter on śvāsa and kāsa, beginning svarabheda is fitting because of similarity of upward movement and because it is curable by the śvāsa and kāsa treatments. Svarabheda means injury to the voice.
अत्युच्चभाषणविषाध्ययनातिगीतशीतादिभिः प्रकुपिताः पवनादयस्तु |
स्रोतःसु ते स्वरवहेषु गताः प्रतिष्ठां हन्युः स्वरं भवति चापि हि षड्विधः सः ||३||
Meaning of the śloka
From talking too loudly, poison, excessive study, excessive singing, cold and similar factors, the aggravated vāta and other doṣas go into the channels that carry voice and obstruct its foundation and damage the voice. It is sixfold.
The commentary gives cause, pathogenesis and number. Adhyayana is continuous recitation of the Veda and the like; atigīta is unceasing singing; 'cold etc.' includes causes of pitta and kapha aggravation. The verse names mainly vāta-aggravating causes to show that vāta is chief in injuring the voice. Others take 'etc.' as heavy, light, unctuous and dry qualities. The voice-carrying channels are the sound-carrying vessels. The six kinds: three by the doṣas separately, one by sannipāta, and two from meda (fat) and depletion. An objection: Caraka lists six as vāta, pitta, kapha, cough, blood-flow, and running nose, so how do the two agree? The reply: cough-born and running-nose-born are counted as vāta-type; blood-born is counted under kapha since blood with kapha causes it. So the count is not exceeded.
The commentary gives the signs of vātaja svarabheda. 'Dark' applies to eyes, face, urine and stool. 'Broken' means unsteady. Another tantra says: 'from vāta, the voice becomes rough, weak and unsteady'. Some read 'gardabhavat' (like a donkey) for 'gadgadavat' (stammering-like).
The commentary gives the signs of pittaja svarabheda. 'Yellow' attaches to face, eyes, stool and urine. Some read 'with burning' as attached to the speaker, the person with voice impairment.
From kapha: with difficulty and constantly, his throat blocked by kapha, he speaks slowly and softly, and there is a special improvement in the daytime.
The commentary gives the signs of kaphaja svarabheda. 'Constantly' means without break; 'throat blocked by kapha' means enveloped in phlegm; 'softly, slowly' means very slowly. The improvement in the day is from reduced kapha. Some read 'from improvement by day', explaining that at night, the throat being blocked by kapha, he cannot speak at all, but by day, kapha diminishing, he speaks a little.
The commentary gives the signs of sānnipātika svarabheda: all the signs of vāta and the others appear, and speech is unclear. That sannipāta voice impairment is called incurable.
One with voice loss from depletion, when speaking, seems to emit smoke from the mouth, and his voice reaches destruction; such a person, one who has lost his voice, is to be avoided.
The commentary gives the signs of kṣayaja svarabheda. 'Seems to emit smoke' means as though smoke leaves the mouth while he speaks. 'Reaches destruction of speech' is completed with 'from vāta'.
अन्तर्गलं स्वरमलक्ष्यपदं चिरेण मेदश्चयाद्वदति दिग्धगलौष्ठतालुः ||६||
क्षीणस्य वृद्धस्य कृशस्य चापि चिरोत्थितो यश्च सहोपजातः |
मेदस्विनः सर्वसमुद्भवश्च स्वरामयो यो न स सिद्धिमेति ||७||
Meaning of the śloka
From accumulation of meda (fat), one speaks with the voice inside the throat, with indistinct words and after a delay, with the throat, lips and palate smeared as if with grease. In one who is depleted, aged or emaciated; in one where it has long been present or has arisen with (another illness); in the fat person; and the type from all (doṣas): the voice disorder does not reach cure.
The commentary gives the signs of the fat-caused voice impairment. Antargala means in the interior of the throat; 'says the voice' means makes sound; digdha means smeared with fat. Some read 'antargataṃ' with the same sense, and 'medo'nvayāt' for 'medaścayāt'.
Those afflicted in voice, oleated and with doṣas drawn out by emesis, purgation and enemas in the right manner, should be treated with various nasal drops, avapīḍa, mouth-cleansing, smokes, licks and gargles.
The commentary gives general treatment. Although oleation is not proper in kapha- and fat-caused voice impairment (they need depletion), oleation with sneha opposed to the doṣa, or cooked with drugs opposing it, is fitting; or since vāta is present even in the kapha and fat types, oleation is advised. 'Doṣas drawn out' means by emesis, purgation and enemas, each done properly. Avapīḍa is a kind of nasya given by pressing; mukhadhāvana is gargling and the like. The two types of gargle are distinguished: kavala when it cannot be moved freely, gaṇḍūṣa when it can be moved comfortably.
In voice injury from vāta, after a meal, ghṛta cooked in the juices of kāsamarda, vārtāka or mārkava (bhṛṅgarāja) may be drunk; ghṛta cooked in the juice of ārtagala (kakubha) destroys vāta.
The commentary gives the special regimen. 'After the meal' means on top of food; mārkava is bhṛṅgarāja; 'cooked' means boiled. 'Destroys vāta' is figurative for vātaja voice impairment; ārtagala is kakubha (arjuna).
Key terms
kāsamarda
Cassia occidentalis type plant.
ārtagala
Kakubha (arjuna).
Adhikarana ১৩ (১১) · Śloka ১২
যবক্ষারাজমোদাভ্যাং চিত্রকামলকেষু বা ||১১||
দেবদার্বগ্নিকাভ্যাং বা সিদ্ধমাজং সমাক্ষিকম্ |১২|
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यवक्षाराजमोदाभ्यां चित्रकामलकेषु वा ||११||
देवदार्वग्निकाभ्यां वा सिद्धमाजं समाक्षिकम् |१२|
Meaning of the śloka
Ghṛta cooked with yavakṣāra and ajamodā; or with citraka and āmalaka; or with devadāru and agnika, and goat's ghṛta with honey (may be drunk).
The commentary lists three ghṛtas for the vāta type. Agnika is ajamodā. 'Goat's' is supplied for ghṛta; 'with honey' means mixed with honey; 'drunk' is supplied.
Key terms
yavakṣāra
Barley alkali.
ājaṃ ghṛtam
Goat's ghṛta.
Adhikarana ১৪ (১২) · Śloka ১২
সুখোদকানুপানো বা সসর্পিষ্কো গুডৌদনঃ ||১২||
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सुखोदकानुपानो वा ससर्पिष्को गुडौदनः ||१२||
Meaning of the śloka
Or rice cooked with jaggery and ghṛta, taken with lukewarm water as after-drink.
The commentary says lukewarm water is slightly warm water. Some take this for pitta type; the commentators reject that since in similar tantras it is used only for vātaja voice impairment.
The commentary gives the treatment of pittaja voice impairment. Atandrita means not lazy.
Key terms
kṣīrānupāna
Milk as an after-drink.
Adhikarana ১৬ (১৩) · Śloka ১৩
অশ্নীযাচ্চ সসর্পিষ্কং যষ্টীমধুকপাযসম্ ||১৩||
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अश्नीयाच्च ससर्पिष्कं यष्टीमधुकपायसम् ||१३||
Meaning of the śloka
He may eat yaṣṭīmadhu pāyasa with ghṛta.
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পৈত্তিকে পথ্যযোগমাহ- অশ্নীযাদিত্যাদি| যষ্টীমধুকপাযসমিতি যষ্টীমধুকসাধিতক্ষীরসিদ্ধাংস্তণ্ডুলান্; অথবা যষ্টীমধুকান্বিতং পাযসং যষ্টীমধুকপাযসম্||১৩||
Meaning of the commentary
The commentary gives a wholesome food for the pitta type. Yaṣṭīmadhu-pāyasa is rice cooked in milk cooked with yaṣṭīmadhu, or pāyasa mixed with yaṣṭīmadhu.
Key terms
pāyasa
Rice cooked in milk.
yaṣṭīmadhu
Liquorice.
Adhikarana ১৭ (১৪) · Śloka ১৪
লিহ্যান্মধুরকাণাং বা চূর্ণং মধুঘৃতাপ্লুতম্ |
শতাবরীচূর্ণযোগং বলাচূর্ণমথাপি বা ||১৪||
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लिह्यान्मधुरकाणां वा चूर्णं मधुघृताप्लुतम् |
शतावरीचूर्णयोगं बलाचूर्णमथापि वा ||१४||
Meaning of the śloka
He may lick the powder of the sweet drugs mixed with honey and ghṛta; or śatāvarī powder, or balā powder.
In kapha-caused loss of voice, he may drink pungent things with (cow's) urine; or lick pungent things with honey and oil; or eat them after a meal.
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কফজস্বরভেদচিকিত্সামাহ- পিবেদিত্যাদি| কটূনি ত্রিকটুকাদীনি| মূত্রেণ গোমূত্রেণ প্রাধান্যাত্| স্বরসঙ্ক্ষযে স্বরভেদে| লিহ্যাদ্বা মধুতৈলাভ্যামিত্যাদি মধুতৈলাভ্যাং বা কটূনি ত্রিকটুকপ্রভৃতীনি লিহ্যাত্, ভুক্ত্বা বা তানি খাদেত্||১৫||
Meaning of the commentary
The commentary says pungent things are trikaṭu and the like; urine is chiefly cow's urine. 'Loss of voice' means voice impairment. He may lick them with honey and oil, or eat them after eating.
Key terms
kaṭu (kaṭūni)
Pungent substances such as trikaṭu.
gomūtra (mūtra)
Cow's urine.
Adhikarana ১৯ (১৬) · Śloka ১৬
স্বরোপঘাতে মেদোজে কফবদ্বিধিরিষ্যতে |১৬|
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स्वरोपघाते मेदोजे कफवद्विधिरिष्यते |१६|
Meaning of the śloka
In voice injury from fat, the regimen is as for kapha.
The commentary says that even for the incurable sannipātaja and kṣayaja types, treatment is to be done. 'After declaring incurable' means having ruled it out as incurable. 'Treatment' means all the treatments of vāta and the other doṣa types in sannipāta, and the depletion regimen in kṣayaja; others say the general treatment in both.
Key terms
pratyākhyāya
Having declared it incurable (informing the patient/family).
sarvaja / kṣayaja (sarvaja, kṣayaja)
From all doṣas / from depletion.
Adhikarana ২১ (১৭) · Śloka ১৭
শর্করামধুমিশ্রাণি শৃতানি মধুরৈঃ সহ |
পিবেত্ পযাংসি যস্যোচ্চৈর্বদতোঽভিহতঃ স্বরঃ ||১৭||
The commentary says that although voice impairment from loud speaking is of vāta nature, a special treatment is given by reason of its cause. Milks cooked with kākolī and similar drugs, mixed with sugar and honey, are drunk. The plural 'milks' includes cow, buffalo and goat milk.
Key terms
atyuccabhāṣaṇa
Excessive loud speaking.
madhura
Sweet drugs such as kākolī.
Adhikarana পুষ্পিকা · Śloka ৫৩
ইতি সুশ্রুতসংহিতাযামুত্তরতন্ত্রান্তর্গতে কাযচিকিত্সাতন্ত্রে ছর্দিপ্রতিষেধো নাম (পঞ্চদশোঽধ্যাযঃ, আদিতঃ) ত্রিপঞ্চাশত্তমোঽধ্যাযঃ ||৫৩||
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इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे छर्दिप्रतिषेधो नाम (पञ्चदशोऽध्यायः, आदितः) त्रिपञ्चाशत्तमोऽध्यायः ||५३||
Meaning of the śloka
Thus ends the fifty-third chapter (the fifteenth from the beginning of this section) in the Kāyacikitsā-tantra within the Uttaratantra of the Suśruta Saṃhitā. (The sloka source names it 'Chardipratiṣedha'.)
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ইতি শ্রীডল্হ(হ্ল)ণবিরচিতাযাং নিবন্ধসঙ্গ্রহাখ্যাযাং সুশ্রুতব্যাখ্যাযামুত্তরতন্ত্রান্তর্গতে কাযচিকিত্সাতন্ত্রে স্বরভেদপ্রতিষেধো নাম ত্রিপঞ্চাশত্তমোঽধ্যাযঃ||৫৩||
Meaning of the commentary
Thus ends the fifty-third chapter, named Svarabhedapratiṣedha, in the Kāyacikitsā of the Uttaratantra, in the Suśruta commentary called Nibandhasaṅgraha composed by Śrī Ḍalhaṇa.