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Sushruta Samhita Uttaratantra Chapter 54 Krimiroga Pratiședha (Therapy of Helmenthiasis)

AIAPGET Factors

 –    There are 20 varieties of Krimi.

    Krimis are born from three sources – Purisha, Kapha and Rakta.

    Pandu, Hrdroga and Vidbheda are brought on by Purishaja Krimi.

    Raktaja Krimi are purple or black in color, unctuous (slimy) and thick in measurement and produce ailments affecting the organs of blood.

    Consumption of Masha, Pishtanna, Vidala and Parna Shakha results in manufacturing of Purishaja Krimi.

    Amongst 20 Krimis – 7 purishaja and 6 kaphaja Krimis are DRSHYA KRIMI (Seen). The 7 raktaja krimis are ADRSHYA KRIMIS (invisible).

    Amashaya is the seat of Kaphaja Krimis. Pakvashaya is the seat of Purishaja Krimis. Dhamanis are the seats of Raktaja Krimis.

    Surasadi Gana Siddha Ghrta must be administered for VAMANA within the remedy of Krimis. (Su.Ut.54/21)

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The 54th chapter of Uttaratantra of Sushruta Samhita is called as Krimiroga Pratiședha. This chapter offers with Therapy of Helmenthiasis.

अथातः कृमिरोगप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We’ll now expound Krimiroga pratisedha – remedy of illness produced by worms (helmenthiasis); as revealed by the venerable Dhanvantari.

Nidāna samprāpti – causes and pathogenesis

अजीर्णाध्यशनासात्म्यविरुद्धमलिनाशनैः |
अव्यायामदिवास्वप्नगुर्वतिस्निग्धशीतलैः ||३||
माषपिष्टान्नविदलबिसशालूकसेरुकैः |
पर्णशाकसुराशुक्तदधिक्षीरगुडेक्षुभिः ||४||
पललानूपपिशितपिण्याकपृथुकादिभिः |
स्वाद्वम्लद्रवपानैश्च श्लेष्मा पित्तं च कुप्यति ||५||
कृमीन् बहुविधाकारान् करोति विविधाश्रयान् |
आमपक्वाशये तेषां कफविड्जन्मनां पुनः |
धमन्यां रक्तजानां च प्रसवः प्रायशः स्मृतः ||६||

Beneath talked about are the etiological elements of krimiroga –

      consuming meals that are raw,

      consuming meals extra in amount,

      consuming unaccustomed,incompatible and soiled (contaminated) meals

      sedentary life – not doing any bodily exercise,

      habitually sleeping throughout daytime,

      consuming meals that are tough to digest, very unctuous (fatty) and chilly,

      consuming in extra, the meals ready from māsa, corn flour, pulses, bisa, loka and kaseruka and leafy greens,

      extreme ingesting of surā, Sukta, dadhi and ksira,

      consuming snacks ready from jaggery and sugarcane juice,

      extreme consumption of paste of tila, meat of animals of marshy lands, pinyāka (paste of sesame added with jaggery), prthuka (paddy fried and flattened),

      ingesting drinks that are candy and bitter

Pathogenesis – By the above mentioned causes, kapha and pitta turn into aggravated. These aggravated doshas produce worms of various shapes by getting localized in numerous seats of the physique.

Amasaya – abdomen is the seat of krimis – worms produced by kapha and Pakvashaya – colon is the seat of krimis produced by Purisha / vit (faeces). Equally, dhamanis – blood vessels are the seats of the krimis produced by rakta – blood.

Classes and sources of krimi

विंशतेः कृमिजातीनां त्रिविधः सम्भवः स्मृतः |
पुरीषकफरक्तानि, तासां वक्ष्यामि विस्तरम् ||७||

There are twenty classes of krimi – worms. They’re born from three sources i.e.

        purisa – faeces,

        kapha and

        rakta – blood

The main points of the identical shall be given by me now.

Purişaja krimi – worms born from faeces

अजवा विजवाः किप्याश्चिप्या गण्डूपदास्तथा |
चूरवो द्विमुखाश्चैव ज्ञेयाः सप्त पुरीषजाः ||८||
श्वेताः सूक्ष्मास्तुदन्त्येते गुदं प्रतिसरन्ति च |
तेषामेवापरे पुच्छैः पृथवश्च भवन्ति हि ||९||
शूलाग्निमान्द्यपाण्डुत्वविष्टम्भबलसङ्क्षयाः |
प्रसेकारुचिहृद्रोगविड्भेदास्तु पुरीषजैः ||१०||
रक्ता गण्डूपदा दीर्घा गुदकण्डूनिपातिनः |
शूलाटोपशकृद्भेदपक्तिनाशकराश्च ते ||११||

The beneath talked about seven sorts of krimi are born from faeces –

        Ajava,

        Vijava,

        Kipya,

        Cipya,

        Gandupada,

        Curava and

        Dvimukha

Options –

        they’re white in color and small in measurement,

        they prick (irritate) the anus and comes out of the anus,

A few of them are huge of their tail portion. These krimis give rise to the beneath talked about signs –

        ache within the stomach,

        dyspepsia,

        anaemia,

        constipation,

        lack of power,

        nausea,

        lack of style,

        coronary heart illness and

        diarrhoea

Gandupada Krimi are –

        purple in color,

        lengthy

        trigger itching of the anus, stomach ache, gurgling sounds within the gut, diarrhoea and lack of digestive fireplace

Kaphaja krimi – worms born from kapha

दर्भपुष्पा महापुष्पाः प्रलूनाश्चिपिटास्तथा |
पिपीलिका दारुणाश्च कफकोपसमुद्भवाः ||१२||
रोमशा रोममूर्धानः सपुच्छाः श्यावमण्डलाः |
रूढधान्याङ्कुराकाराः शुक्लास्ते तनवस्तथा ||१३||
मज्जादा नेत्रलेढारस्तालुश्रोत्रभुजस्तथा |
शिरोहृद्रोगवमथुप्रतिश्यायकराश्च ते ||१४||

Beneath talked about are the six sorts of krimi born from kapha –

        Darbhapuspa,

        Mahapuspa,

        Praluna,

        Cipita,

        Pipilika and

        Daruna

Options –

        These krimis have hairs on their physique and head.

        In addition they have blue patches on their physique.

        They’ve tails.

        They resemble sprouted grain in form, are white in color and skinny (flat).

        They devour bone marrow.

        They lick the eyes, palate, ears and shoulders.

        They offer rise to complications, coronary heart illness, vomiting and nasal catarrh.

Raktaja krimi – worms born from blood 

केशरोमनखादाश्च दन्तादाः किक्किशास्तथा |
कुष्ठजाः सपरीसर्पा ज्ञेयाः शोणितसम्भवाः ||१५||
ते सरक्ताश्च कृष्णाश्च स्निग्धाश्च पृथवस्तथा |
रक्ताधिष्ठानजान् प्रायो विकारान् जनयन्ति ते ||१६||

Beneath talked about are the seven sorts of krimi produced by sonita (rakta) –

        Kesada,

        Romada,

        Nakhada,

        Dantada,

        Kikkisa,

        Kusthaja and

        Parisarpa

Options – These krimi are –

        purple or black in color,

        unctuous (slimy) and

        thick in measurement and

        produce ailments affecting the organs / seats of blood

माषपिष्टान्नविदलपर्णशाकैः पुरीषजाः |
मांसमाषगुडक्षीरदधितैलैः कफोद्भवाः ||१७||
विरुद्धाजीर्णशाकाद्यैः शोणितोत्था भवन्ति हि |

Sorts of meals consumed Kind of krimi Produced
Meals ready from Masa, Pistanna (meals ready with corn flour), pulses and leafy greens Purisaja Krimi – worms produced by faeces
Consuming meat, masa (black gram), guda (jaggery), milk, curds and oils Kaphaja Krimi – worms produced by kapha
Consuming incompatible meals, raw greens Raktaja Krimi – worms produced by blood

Krimiroga Laksana

ज्वरो विवर्णता शूलं हृद्रोगः सदनं भ्रमः ||१८||
भक्तद्वेषोऽतिसारश्च सञ्जातकृमिलक्षणम् |१९|

Beneath talked about are the signs indicating the presence of worms within the physique –

        fever,

        discolouration of the physique,

        ache within the stomach,

        coronary heart ailments,

        debility,

        giddiness,

        aversion to meals and

        diarrhoea

दृश्यास्त्रयोदशाद्यास्तु कृमीणां परिकीर्तिताः ||१९||
केशादाद्यास्त्वदृश्यास्ते द्वावाद्यौ परिवर्जयेत् |२०|

Amongst these 13 sorts of seen worms i.e. seven purisaja and 6 kaphaja krimis, the krimis commencing from kesada are invisible.

The primary two sorts amongst these i.e. kesada and romada must be rejected i.e. they shouldn’t be handled.

 Krimiroga cikitsā – remedy of worm an infection

एषामन्यतमं ज्ञात्वा जिघांसुः स्निग्धमातुरम् ||२०||
सुरसादिविपक्वेन सर्पिषा वान्तमादितः |
विरेचयेत्तीक्ष्णतरैर्योगै
रास्थापयेच्च तम् ||२१||
यवकोलकुलत्थानां सुरसादेर्गणस्य च |
विडङ्गस्नेहयुक्तेन क्वाथेन लवणेन च ||२२||

In the beginning, the doctor ought to decide which worms must be handled. After doing so, the doctor ought to firstly administer oleation remedy. Subsequent, ghee ready with herbs belonging to the Surasadi Gana group must be administered for the aim of manufacturing vomiting. Following this, the affected person must be given robust purgative recipes or must be administered decoction enema with decoction of yava, kola, kulattha, herbs belonging to surasadi gana group and vidanga added with oil and saindhava lavana.

प्रत्यागते निरूहे तु नरं स्नातं सुखाम्बुना |
युञ्ज्यात् कृमिघ्नैरशनैस्ततः शीघ्रं भिषग्वरः ||२३||
स्नेहेनोक्तेन चैनं तु योजयेत् स्नेहबस्तिना |२४|

The affected person must be requested to take a shower in comfy heat water after the consequences of decoction enema are famous. Following this, meals which have been ready with herbs which destroy the krimis must be served. The affected person ought to then be administered oil enema with the oil talked about earlier, within the earlier verse.

ततः शिरीषकिणिहीरसं क्षौद्रयुतं पिबेत् ||२४||
केवूकस्वरसं वाऽपि पूर्ववत्तीक्ष्णभोजनः |
पलाशबीजस्वरसं कल्कं वा तण्डुलाम्बुना ||२५||

Subsequent, the affected person must be given juice (decoction) of sirisa and kinihi, added with honey, for ingesting.

Contemporary juice of kebuka must be given combined with honey, as mentioned beforehand. Later, meals processed with herbs having penetrating properties must be given for consuming.

Juice or paste of seeds of Palasa must be consumed with rice-wash.

पारिभद्रकपत्राणां क्षौद्रेण स्वरसं पिबेत् |
पत्तूरस्वरसं वाऽपि पिबेद्वा सुरसादिजम् ||२६||

Beneath talked about may additionally be consumed –

        juice of leaves of paribhadraka must be added with honey and consumed,

        juice of leaves of pattura or of

        herbs of surasadi gana group

लिह्यादश्वशकृच्चूर्णं वैडङ्गं वा समाक्षिकम् |
पत्रैर्मूषिकपर्ण्या वा सुपिष्टैः पिष्टमिश्रितैः ||२७||
खादेत् पूपलिकाः पक्वा धान्याम्लं च पिबेदनु |२८|

Powder of horse dung or vidanga added with honey must be consumed. Pupalika (puri) must be ready with leaves of musakaparni added with corn flour. This must be consumed by the affected person. After this, he ought to drink dhanyamla (fermented gruel).

सुरसादिगणे पक्वं तैलं वा पानमिष्यते ||२८||
विडङ्गचूर्णयुक्तैर्वा पिष्टैर्भक्ष्यांस्तु कारयेत् |
तत्कषायप्रपीतानां तिलानां स्नेहमेव वा ||२९||

Taila – oil is cooked with herbs belonging to Surasadi Gana. It’s used for ingesting. Eatables must be ready from corn flour and used, added with vidanga powder.

Oil ready from tila soaked within the decoction of vidanga used for ingesting can be helpful.

श्वाविधः शकृतश्चूर्णं सप्तकृत्वः सुभावितम् |
विडङ्गानां कषायेण त्रैफलेन तथैव च ||३०||
क्षौद्रेण लीढ्वाऽनुपिबेद्रसमामलकोद्भवम् |
अक्षाभयारसं वाऽपि विधिरेषोऽयसामपि ||३१||

Porcupine excreta is powdered. This powder is soaked in decoction of vidanga or triphala for seven instances and is later consumed.

Alternatively, it could be licked with honey. After this, one ought to drink amalaka or aksa or abhaya juice.

Ayas – iron may additionally be utilized in the identical process.

पूतीकस्वरसं वाऽपि पिबेद्वा मधुना सह |
पिबेद्वा पिप्पलीमूलमजामूत्रेण संयुतम् ||३२||
सप्तरात्रं पिबेद्धृष्टं त्रपु वा दधिमस्तुना |३३|

The beneath talked about recipes are additionally helpful when consumed –

        recent juice of putika taken with honey or

        powder of pippalimula taken with goat’s urine or

        trapu – tin macerated with whey of curds for seven instances

पुरीषजान् कफोत्थांश्च हन्यादेवं कृमीन् भिषक् ||३३||

The worms born from faeces and kapha might be destroyed by the doctor on this method.

शिरोहृद्घ्राणकर्णाक्षिसंश्रितांश्च पृथग्विधान् |
विशेषेणाञ्जनैर्नस्यैरवपीडैश्च साधयेत् ||३४||

Collyriums, nasal (oil) drops and nasal drops carried out utilizing recent juices of herbs (avapida) could also be used to destroy the worms residing particularly within the head, coronary heart, nostril, ears and eyes.

शकृद्रसं तुरङ्गस्य सुशुष्कं भावयेदति |
निष्क्वाथेन विडङ्गानां चूर्णं प्रधमनं तु तत् ||३५||
अयश्चूर्णान्यनेनैव विधिना योजयेद्भिषक् |
सकांस्यनीलं तैलं च नस्यं स्यात्सुरसादिके ||३६||

Horse dung powder must be soaked in decoction of vidanga. Later it’s dried properly and could also be blown into the nostril.

Equally, the beneath talked about may additionally be used as nasal drops –

        powder of ayas (iron) or

        oil ready with kamsya (bronze) and

        decoction of herbs belonging to surasadi gana group

इन्द्रलुप्तविधिश्चापि विधेयो रोमभोजिषु |
दन्तादानां समुद्दिष्टं विधानं मुखरोगिकम् ||३७||

The identical remedies indicated for indralupta must also be administered to destroy the worms which eat away the physique hairs.

The identical remedies prescribed for ailments of the mouth must also be administered to destroy the worms which eat away the tooth.

रक्तजानां प्रतीकारं कुर्यात् कुष्ठचिकित्सिते |
सुरसादिं तु सर्वेषु सर्वथैवोपयोजयेत् ||३८||
प्रव्यक्ततिक्तकटुकं भोजनं च हितं भवेत् |
कुलत्थक्षारसंसृष्टं क्षारपानं च पूजितम् ||३९||

The remedy of Kustha must be prescribed to deal with the worms born in Rakta – blood.

Herbs belonging to the Surasadi Gana group of herbs must be utilized in every kind of worms. They need to be utilized in all modes like decoctions, combined with meals, processing ingesting water and for boiling water used for bathing.

Additionally shall be useful are the meals that are predominantly bitter and astringent tastes.

Yavakshara must be consumed with the ash of kulattha. This recipe is very praised.

क्षीराणि मांसानि घृतानि चैव दधीनि शाकानि च पर्णवन्ति |
समासतोऽम्लान्मधुरान् हिमांश्च कृमीन् जिघांसुः परिवर्जयेत्तु ||४०||

Usually, individuals desirous of eliminating worms ought to keep away from the beneath talked about –

        milk,

        meats,

        ghee,

        curds,

        leafy greens,

        meals that are bitter, candy and chilly

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे कृमिप्रतिषेधो नाम (षोडशोऽध्यायः, आदितः) चतुःपञ्चाशत्तमोऽध्यायः ||५४||

Thus ends the fifty-fourth chapter by identify Krimiroga pratişedha in Uttara sthana of Suśruta Samhita.

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