Sushruta Samhita Uttaratantra Chapter 26 Siroroga Pratisedha (Treatment of Headaches)
The 26th chapter of Uttaratantra of Sushruta Samhita is named as Siroroga Pratisedha Adhyaya. This chapter deals with the Treatment of Headaches.
अथातः शिरोरोगप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound Siroroga pratisedha – treatment of headaches; as revealed by the venerable Dhanvantari.
Vataja Siroroga Cikitsa – treatment of headache of vata origin:-
वातव्याधिविधिः कार्यः शिरोरोगेऽनिलात्मके |
पयोनुपानं सेवेत घृतं तैलमथापि वा ||३||
मुद्गान् कुलत्थान्माषांश्च खादेच्च निशि केवलान् |
कटूष्णांश्च ससर्पिष्कानुष्णं चानु पयः पिबेत् ||४||
पिबेद्वा पयसा तैलं तत्कल्कं वाऽपि मानवः |
वातघ्नसिद्धैः क्षीरैश्च सुखोष्णैः सेकमाचरेत् ||५||
तत्सिद्धैः पायसैर्वाऽपि सुखोष्णैर्लेपयेच्छिरः |
स्विन्नैर्वा मत्स्यपिशितैः कृशरैर्वा ससैन्धवैः ||६||
चन्दनोत्पलकुष्ठैर्वा सुश्लक्ष्णैर्मगधायुतैः |
स्निग्धस्य तैलं नस्यं स्यात् कुलीररससाधितम् ||७||
वरुणादौ गणे क्षुण्णे क्षीरमर्धोदकं पचेत् |
क्षीरशेषं च तन्मथ्यं शीतं सारमुपाहरेत् ||८||
ततो मधुरकैः सिद्धं नस्ये तत् पूजितं हविः |
तस्मिन् विपक्वे क्षीरे तु पेयं सर्पिः सशर्करम् ||९||
धूमं चास्य यथाकालं स्नैहिकं योजयेद्भिषक् |
पानाभ्यञ्जननस्येषु बस्तिकर्मणि सेचने ||१०||
विदध्यात्त्रैवृतं धीमान् बलातैलमथापि वा |
भोजयेच्च रसैः स्निग्धैः पयोभिर्वा सुसंस्कृतैः ||११||
The treatments prescribed for Vata Vyadhis should be done in headaches caused by aggravated vata.
As after-drink – milk, ghee or oil should be used.
Food – Mudga, Kulattha or Masa alone should be consumed by the person suffering from vataja headache. They should be added with pungent herbs and herbs having hot potency and ghee made hot. Following this, he should drink milk.
The milk used for consumption may be added with oil or paste of these pulses.
Seka (pouring medicated liquids) – Warm milk boiled and prepared with vata mitigating herbs should be used for this purpose.
Alternatively, payasa i.e. milk pudding made comfortably warm should be applied / coated over the head.
Fomentation should be given with fish meat. Alternatively, Krsara (rice cooked with green-gram or black gram) added with saindhava lavana should be used for the same purpose.
Nice paste of the the below mentioned ingredients should be applied on the head –
– Candana,
– utpala ,
– Kustha and
– Magadha
Oil boiled with soup of crab meat should be used as nasal drops after administering oleation.
Herbs belonging to the Varunadi Gana group should be collected and should be cut into pieces. They should be put in one part of milk and added with half part of water. It should be boiled until only milk remains. Then it is churned and its butter is extracted. The butter is boiled again with herbs predominantly having a sweet taste so as to obtain the ghee. This ghee is ideal for usage as nasal drops.
Similarly milk boiled (processed) with drugs of Varunadi Gana should be added with ghee and sugar and given for drinking.
Also, the physician should also administer snaihika dhuma i.e. lubricating smoke at appropriate time.
The intelligent physician should administer Trivrta Taila or Bala Taila in the below mentioned forms –
– Drinking,
– Anointing,
– Nasal medication,
– Enema and
– Pouring on the body
The patient should be advised to take food along with meat soup added with fats (oil or ghee) or with milk which has been suitably processed.
Pittaja and Raktaja Siroroga cikitsa
पित्तरक्तसमुत्थानौ शिरोरोगौ निवारयेत् |
शिरोलेपैः ससर्पिष्कैः परिषेकैश्च शीतलैः ||१२||
क्षीरेक्षुरसधान्याम्लमस्तुक्षौद्रसिताजलैः |
नलवञ्जुलकह्लारचन्दनोत्पलपद्मकैः ||१३||
वंशशैवलयष्ट्याह्वमुस्ताम्भोरुहसंयुतैः |
शिरःप्रलेपैः सघृतैर्वैसर्पैश्च तथाविधैः ||१४||
मधुरैश्च मुखालैपैर्नस्यकर्मभिरेव च |
आस्थापनैर्विरेकैश्च पथ्यैश्च स्नेहबस्तिभिः ||१५||
क्षीरसर्पिर्हितं नस्यं वसा वा जाङ्गला शुभा |१६|
उत्पलादिविपक्वेन क्षीरेणास्थापनं हितम् ||१६||
भोजनं जाङ्गलरसैः सर्पिषा चानुवासनम् |
मधुरैः क्षीरसर्पिस्तु स्नेहने च सशर्करम् ||१७||
पित्तरक्तघ्नमुद्दिष्टं यच्चान्यदपि तद्धितम् | Therapies mentioned below should be
used to treat headache produced by pitta and rakta –
– Application of paste of herbs added and mixed with ghee,
– Pouring liquids like milk, sugarcane juice, fermented rice-wash, whey, honey or sugar water in cold state
Paste of the below mentioned herbs added with ghee should be smeared on the head –
– Nala,
– Vanjula,
– Kalhara,
– candana ,
– Utpala,
– Padmaka,
– Vamsa,
– Saivala,
– Yastyahva,
– Musta and
– Amboruha (Padma)
Treatments indicated for Visarpa may also be done in these conditions according to the procedure. For facial application – paste of herbs having sweet taste may be used. The juice of the same herbs shall be instilled into the nose.
Below mentioned therapies should be administered as and when suitable –
– Decoction enema,
– Purgation and
– Oil enema
Nasal drops – Ghee obtained from milk or muscle-fat of animals living in arid regions is ideal for usage as nasal drops.
For Enema – Milk boiled with herbs belonging to Utpaladi Gana group is used for enema. Food – should be taken along with soup of meat of animals living in arid regions.
Lubricating enema – ghee is the best one for this purpose.
Milk is boiled with herbs predominantly having a sweet taste and added with sugar. Ghee is obtained from this milk and is used for oleation i.e. for the purpose of drinking and anointing.
Any other suitable pitta mitigating treatments may also be administered.
Kaphaja siroroga cikitsa
कफोत्थितं शिरोरोगं जयेत् कफनिवारणैः ||१८||
शिरोविरेकैर्वमनैस्तीक्ष्णैर्गण्डूषधारणैः |
अच्छं च पाययेत्सर्पिः स्वेदयेच्चाप्यभीक्ष्णशः ||१९||
शिरो मधूकसारेण स्निग्धं चापि विरेचयेत् |
इङ्गुदस्य त्वचा वाऽपि मेषशृङ्गस्य वा भिषक् ||२०||
आभ्यामेव कृतां वर्तिं धूमपाने प्रयोजयेत् |
घ्रेयं कट्फलचूर्णं च कवलाश्च कफापहाः ||२१||
सरलाकुष्ठशार्ङ्गेष्टादेवकाष्ठैः सरोहिषैः |
क्षारपिष्टैः सलवणैः सुखोष्णैर्लेपयेच्छिरः ||२२||
यवषष्टिकयोश्चान्नं व्योषक्षारसमायुतम् |
पटोलमुद्गकौलत्थैर्मात्रावद्भोजयेद्रसैः ||२३||
Treatment for headache produced by kapha includes kapha mitigating therapies like purgation to the head, emesis, holding strong medicinal liquids in the mouth etc.
For achchapana i.e. drinking fats alone in more quantity, ghee should be used.
Sudation therapy should be conducted frequently.
Below mentioned herbs may be used by the physician for providing purgation to the head –
– Madhuka sara – gum resin of Madhuka or
– Inguda or
– Mesasrngi
For smoke inhalation, a smoke wick or cigar made from the same (above mentioned) herbs should be used.
Snuff – powder of Katphala may be inhaled.
Gargles – liquids prepared from kapha mitigating herbs shall be used for this purpose.
The below mentioned herbs should be macerated in solution of ksara (alkali, ash) and their paste be prepared –
– Sarala,
– Kustha,
– Srngesta,
– Devakastha,
– Rohisa and
– Saindhava Lavana
This paste is applied comfortably warm on the head.
Food should be prepared from Yava or Sastika. It should be added with Vyosa and Yavaksara. This food should be consumed in little quantities along with the soup prepared from patola, mudga and kulattha.
Tridosaja Siroroga cikitsa
शिरोरोगे त्रिदोषोत्थे त्रिदोषघ्नो विधिर्हितः |
सर्पिःपानं विशेषेण पुराणं वा दिशन्ति हि ||२४||
Therapies mitigating the three doshas should be used to treat headaches produced by combination of all the three doshas. Mainly, old ghee is indicated for drinking.
Ksayaja Siroroga Cikitsa
क्षयजे क्षयमासाद्य कर्तव्यो बृंहणो विधिः |
पाने नस्ये च सर्पिः स्याद्वातघ्नमधुरैः शृतम् ||२५||
क्षयकासापहं चात्र सर्पिः पथ्यतमं विदुः |
Following the description of Ksayaroga Chikitsa explained in Uttara Tantra, Chapter 41, the headaches caused by Ksaya (depletion of blood and other tissues) should be treated with stoutening therapies.
For drinking and nasal medication – ghee boiled and processed with vata mitigating and sweet tasting herbs should be used.
Medicated ghee which cures depletion of tissues and cough or cough caused by depletion of tissues is also said to be beneficial in treating Ksayaja Siroroga.
Krimija siroroga cikitsa
क्षयजे क्षयमासाद्य कर्तव्यो बृंहणो विधिः |
पाने नस्ये च सर्पिः स्याद्वातघ्नमधुरैः शृतम् ||२५||
क्षयकासापहं चात्र सर्पिः पथ्यतमं विदुः |
कृमिभिर्भक्ष्यमाणस्य वक्ष्यते शिरसः क्रिया ||२६||
नस्ये हि शोणितं दद्यात्तेन मूर्च्छन्ति जन्तवः |
मत्ताः शोणितगन्धेन समायान्ति यतस्ततः ||२७||
तेषां निर्हरणं कार्यं ततो मूर्धविरेचनैः |
ह्रस्वशिग्रुकबीजैर्वा कांस्यनीलीसमायुतैः ||२८||
कृमिघ्नैरवपीडैश्च मूत्रपिष्टैरुपाचरेत् |
पूतिमत्स्ययुतान् धूमान् कृमिघ्नांश्च प्रयोजयेत् ||२९||
Now, the treatment of headache caused by krimi – worms will be described –
Nasal drops – blood of animals should be used as nasal drops.
Affected by the odor of blood, the krimis become fainted and come out through the nose.
Purgation of the head should be administered to expel these worms. This should be done by using seeds of hrsva sigru along with powder of kamsyanili.
Herbs having the property of destroying the worms should be macerated with cow’s urine and should be used for avapida – nasal drops.
Similarly, the herbs which kill worms should be added with foul smelling fish. This should be used for smoke inhalation.
Also, foods and drinks which destroy worms should be used by the patient.
Suryavarta cikitsa
भोजनानि कृमिघ्नानि पानानि विविधानि च |
सूर्यावर्ते विधातव्यं नस्यकर्मादिभेषजम् ||३०||
Therapies such as nasal medication etc should be administered in the treatment of Suryavarta. The patient should also predominantly consume meat of animals living in arid regions as food.
Various kinds of preparations of rice with milk and added with ghee should be given (or milk mixed with ghee should be given for drinking).
Ardhavabheda Cikitsa
भोजनं जाङ्गलप्रायं क्षीरान्नविकृतिर्घृतम् |
तथाऽर्धभेदके व्याधौ प्राप्तमन्यच्च यद्भवेत् ||३१||
शिरीषमूलकफलैरवपीडोऽनयोर्हितः |
वंशमूलककर्पूरैरवपीडं प्रयोजयेत् ||३२||
अवपीडो हितश्चात्र वचामागधिकायुतः |
मधुकेनावपीडो वा मधुना सह संयुतः ||३३||
मनःशिलावपीडो वा मधुना चन्दनेन वा |
Avapida i.e. nasal drops should be done with one of the below mentioned recipes in Ardhavabhedaka and such other diseases –
– Sirisa, Mulaka and Madana Phala,
– Root of Vamsa, Mulaka and Karpura,
– Vaca and Magadhika or
– Madhu mixed with honey or
– Manassila with honey and Candana
Ghee prepared from the sweet tasting herbs is the best for use as nasal drops at the end of Avapida.
Sariva, Utpala, Kustha and Madhuka should be macerated in sour liquid. It should be added with ghee and oil and applied over the head. This recipe bestows comfort in Suryavarta and Ardhavabhedaka types of headaches.
Even in headaches produced by Kapha, the same treatments may be administered.
Anantavata Cikitsa
सारिवोत्पलकुष्ठानि मधुकं चाम्लपेषितम् |
सर्पिस्तैलयुतो लेपो द्वयोरपि सुखावहः ||३५||
एष एव प्रयोक्तव्यः शिरोरोगे कफात्मके |
अनन्तवाते कर्तव्यः सूर्यावर्तहरो विधिः ||३६||
सिराव्यधश्च कर्तव्योऽनन्तवातप्रशान्तये |
आहारश्च विधातव्यो वातपित्तविनाशनः ||३७||
मधुमस्तकसंयावघृतपूरैश्च भोजनम् |
Treatments indicated for Suryavarta should be adopted in treatment of Anantavata also. Additionally, venepuncture should also be done. Madhumastaka, Samyava, Ghrtapura etc sweet dishes which are also the foods which mitigate vata and pitta should be consumed by the patient.
Sankhaka Cikitsa
अनन्तवाते कर्तव्यः सूर्यावर्तहरो विधिः ||३६||
सिराव्यधश्च कर्तव्योऽनन्तवातप्रशान्तये |
आहारश्च विधातव्यो वातपित्तविनाशनः ||३७||
मधुमस्तकसंयावघृतपूरैश्च भोजनम् |
क्षीरसर्पिः प्रशंसन्ति नस्ये पाने च शङ्खके ||३८||
जाङ्गलानां रसैः स्निग्धैराहारश्चात्र शस्यते |
शतावरीं तिलान् कृष्णान् मधुकं नीलमुत्पलम् ||३९||
दूर्वां पुनर्नवां चैव लेपे साध्ववचारयेत् |
महासुगन्धामथवा पालिन्दीं चाम्लपेषिताम् ||४०||
शीतांश्चात्र परीषेकान् प्रदेहांश्च प्रयोजयेत् |
अवपीडश्च देयोऽत्र सूर्यावर्तनिवारणः ||४१||
कृमिक्षयकृतौ हित्वा शिरोरोगेषु बुद्धिमान् |
मधुतैलसमायुक्तैः शिरांस्यतिविरेचयेत् ||४२||
पश्चात्सर्षपतैलेन ततो नस्यं प्रयोजयेत् |
न चेच्छान्तिं व्रजन्त्येवं स्निग्धस्विन्नांस्ततो भिषक् ||४३||
पश्चादुपाचरेत्सम्यक् सिराणामथ मोक्षणैः |
For nasal drops and drinking, Ksirasarpi i.e. ghee obtained from butter obtained by churning milk is praised and considered to be the best one in the treatment of Sankhaka.
Foods should be consumed along with soup of meat of animals living in arid regions added with fats.
Paste prepared from the below mentioned herbs should be applied on the head –
– Satavari,
– Krsnatila,
– Madhuka,
– Nilotpala,
– Durva and
– Punarnava
Alternatively, paste of Mahasugandha (Utpala, Sariva or Sarpagandha) and Palindi macerated in any sour juice should be applied on the head for treating Sankhaka.
Pariseka i.e. pouring medicated liquids on the body and Pradeha i.e. poultice should be done cold.
Avapida i.e. nasal drops used in the treatment of Suryavarta may also be used in this disease.
Intelligent physicians should administer purgation to the head many times, added with honey and oil, in all headaches with exception of those caused by Krimi and Ksaya. Afterwards, Sarsapa Taila is used for nasal medication.
The physician should administer oleation and sudation and also venepuncture if the disease does not subside by these treatments. After this, it should be treated with appropriate therapies.
षट्सप्ततिर्नेत्ररोगा दशाष्टादश कर्णजाः ||४४||
एकत्रिंशद् घ्राणगताः शिरस्येकादशैव तु |
इति विस्तरतो दृ(दि)ष्टाः सलक्षणचिकित्सिताः ||४५||
संहितायामभिहिताः सप्तषष्टिर्मुखामयाः |
एतावन्तो यथास्थूलमुत्तमाङ्गगता गदाः |
अस्मिञ्छास्त्रे निगदिताः सङ्ख्यारूपचिकित्सितैः ||४६||
Thus, seventy six eye diseases, twenty eight ear diseases, thirty one nasal diseases, eleven diseases of the head / headaches and sixty seven oral (mouth) diseases have been described along with their features and treatments. They have been described as described by other authorities in their treatises. Thus, all the diseases of the head and all its parts are described in brief along with their numbers, features and treatments in this treatise also.
इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गत शालाक्यतन्त्रे शिरोरोगप्रतिषेधो नाम षड्विंशोऽध्यायः ।। २६ ।।
Thus ends the twenty-sixth chapter by name siroroga pratisedha in Uttara sthana of Susruta samhita.
इति श्रीभगवता धन्वन्तरिणोपदिष्टायां महर्षिणा सुश्रुताचार्येण विरचितायां सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गतं शालाक्यतन्त्रं समाप्तम् ।।
Thus ends the Salakya Tantra-section on diseases of the organs above the shoulders in Susruta Samhita.
