The thirteenth chapter of Chikitsasthana of Sushruta Samhita is known as as Madhumeha Cikitsitam Adhyaya. This chapter offers with Remedy of Diabetes Mellitus.

अथातोमधुमेहचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।१२।।

We are going to now expound Madhumeha Chikitsa – remedy of diabetes mellitus; as revealed by the venerable Dhanvantari.

मधुमेहित्वमापन्नभिषग्भिःपरिवर्जितम्।।
योगेनानेनमतिमान्प्रमेहिणमुपाचरेत्।।३।।

The doctor ought to reject (usually) the affected person in whom Prameha has attained the stage of Madhumeha. A clever doctor shall deal with the sufferers of Prameha by the formulations which will likely be described henceforth.

Silājatu utpatti and guna – Origin and properties of bitumen

मासेशुक्रेशुचौचैवशैलाःसूर्यांशुतापिताः।।
जतुप्रकाशंस्वरसंशिलाभ्यःप्रस्रवन्तिहि।।४।।
शिलाजत्वितिविख्यातंसर्वव्याधिविनाशनम्।।

Throughout the summer time months of sukra (Jyestha) and suci (asadha), a lac like juice flows from the rocks of the mountains that are heated up by the robust rays of sum. These exudates are known as Silajatu. It has a fame of destroying all ailments.

न्नप्वादीनांतुलोहानांषण्णामन्यतमान्वयम्।।५।।
ज्ञेयंस्वगन्धतश्चापिषड्योनिप्रथितंक्षितौ।।
लोहाद्भवतितद्यस्माच्छिलाजतुजतुप्रभम्।।६।।
तस्यलोहस्यतद्वीर्यरसंचापिबिभर्तितत्।।
न्नपुसीसायसादीनिप्रधानान्युत्तरोत्तरम्।।७।।
यथातथाप्रयोगेऽपिश्रेष्ठेश्रेष्ठगुणाःस्मृताः।।
तत्सर्वतिक्तकदुकंकषायानुरसंसरम्।।८।।
कटुपाक्युष्णवीचशोषणंछेदनंतथा।।

Shilajatu consists of the essence of six metals like trapu i.e. tin and others, like lead, copper, silver, gold and iron. Subsequently, it may be mentioned that Shilajatu has six sources. Every type of Shilajatu needs to be distinguished by its particular odour.

The Shilajatuobtained from iron containing rocks resembles shellac. It additionally possesses the efficiency and style of iron.

Shilajatu obtained from the rocks containing the under talked about metals are thought of to be glorious in successive (given under) order and are additionally greatest in medicinal properties –

–        Tin

–        Lead

–        Iron

Normal properties of all types of Shilajatu –

–        Major style – Bitter and pungent

–        Secondary style – Astringent

–        Virya – sizzling in efficiency

–        Vipaka – Katu, pungent style after digestion,

–        Karma – actions – Sara – laxative, Sosana – causes dryness, Chedana – chopping or tearing of the tissues

तेषुयत्कृष्णमलघुस्निग्धंनिःशर्करंचयत्।।९।।
गोमूत्रगन्धियच्चापितत्प्रधानंप्रचक्षते।।

Under talked about are the qualities of the most effective number of Shilajatu –

–        Black in color

–        Heavy

–        Unctuous

–        Devoid of sand

–        Emitting the scent of urine of cow

Śilājatu yoga – recipes of bitumen

तद्भावितंसारगणैर्हतदोषोदिनोदये।।१०।।
पिबेत्सारोदकेनैवश्लक्ष्णपिष्टंयथाबलम्।।
जाङ्गलेनरसेनान्नंतस्मिञ्जीर्णेतुभोजयेत्।।११।।
उपयुज्यतुलामेवंगिरिजादमृतोपमात्।।
वपुर्वर्णबलोपेतोमधुमेहविवर्जितः।।१२।।
जीवेद्वर्षशतंपूर्णमजरोऽमरसन्निमः।।
शतंशतंतुलायांतुसहस्रंदशतौलिके।।१३।।
भल्लातकविधानेनपरिहारविधिःस्मृतः।।
मेहंकुष्ठमपस्मारमुन्मादंश्लीपदंगरम्।।१४।।
शोषंशोफार्शसीगुल्मंपाण्डुतांविषमज्वरम्।।
अपोहत्यचिरात्कालाच्छिलाजतुनिषेवितम्।।१५।।
नसोऽस्तिरोगोयंचापिनिहन्यान्नशिलाजतु।।
शार्करांचिरसंभूतांभिनत्तिचतथाऽश्मरीम्।।१६।।
भावनालोडनेचास्यकर्तव्येभेषजैर्हितैः।।

Śilājatu needs to be stored soaked within the Salasaradi Gana Kashaya i.e. decoction ready from the Salasaradi group of herbs.

Subsequent morning, it needs to be made into a pleasant paste by grinding it with decoction of the identical herbs. They shall be consumed in doses as appropriate to at least one’s physique energy.

One ought to wait until the shilajatu is digested. As soon as it’s digested, boiled rice needs to be eaten together with soup of the meat of animals of arid lands.

Under talked about advantages are bestowed on the one that consumes one tula i.e. 4 kg of shilajatu possessing nectar like qualities on this method –

–        Freedom from diabetes

–        Good bodily energy

–        Good complexion

–        Longevity of full 100 years with out senility, like Gods

Dose – Every day dose of Shilajatu could be elevated by ten instances i.e. ten pala or 400 grams dose. Equally, the whole amount of Shilajatu could be elevated to at least one hundred tula i.e. 400 kg.

The strategy of aid of untoward signs by use of Shilajatu needs to be thought of as the identical as prescribed to be used in Bhallataka Yogas (as defined in Chapter 6, verse 17).

Advantages – Shilajatu consumed within the above-described methods cures the under talked about ailments shortly –

–        Diabetes

–        Pores and skin ailments / leprosy

–        Epilepsy,

–        Madness,

–        Homicidal poisoning,

–        Consumption,

–        Swelling / dropsy,

–        Haemorrhoids,

–        Stomach tumour,

–        Anaemia

–        Irregular fevers

All ailments are cured by Shilajatu and there’s no such illness on this planet which can’t be cured by Shilajatu. It breaks the urinary stone. It additionally removes the lengthy standing and cussed urinary gravel.

Shilajatu needs to be soaked in and consumed with decoction of applicable herbs.

Māksikadhātu yoga – use of Iron pyrites

एवंचमाक्षिकंघातुंतापीजममृतोपमम्।।१७।।
मधुरंकाञ्चनाभासमम्लंवारजतप्रभम्।।
पिबन्हन्तिजराकुष्ठमेहपाण्ड्वामयक्षयान्।।१८।।
तद्भावितःकपोतांश्चकुलत्थांश्चविवर्जयेत्।।

Equally,Maksika Dhatu needs to be used. It needs to be born in Tapi river which can have properties much like nectar.

Maksika Dhatu which is shining like gold or silver and bitter in style is consumed, it cures the under talked about situations –

–        Leprosy

–        Diabetes

–        Anaemia

–        Consumption and in addition

–        Wards of previous age (anti-ageing)

Meat of kapota i.e. dove and kulattha – horse gram needs to be averted whereas utilizing Maksika Dhatu.

Tuvarakataila yoga – recipe of Chalmogra oil / hydnocarpus oil

पञ्चकर्मगुणातीतंश्रद्धावन्तंजिजीविषुम्।।१९।।
योगेनानेनमतिमान्साधयेदपिकुष्ठिनम्।।

The affected person affected by kustha – pores and skin ailments, leprosy – needs to be handled by the under talked about recipe when –

–        The illness is past the attain of Panchakarma i.e. it can’t be cured despite administering PanchaKarma therapies – 5 purificatory therapies that are thought of as greatest cures for Kustha,

–        In affected person who’s devoted

–        In affected person who wishes to dwell lengthy

वृक्षास्तुवरकायेस्युःपश्चिमार्णवभूमिषु।।२०।।
बीचीतरङ्गविक्षेपमारुतोद्भूतपल्लवाः।।
तेषांफलानिगृह्णीयात्सुपक्वान्यम्बुदागमे।।२१।।
मज्जंतेभ्योऽपिसंहृत्यशोषयित्वाविचूर्ण्यच।।
तिलवत्पीडयेद्बोण्यास्त्रावयद्वाकुसुम्भवत्।।२२।।
तत्तैलंसंहृतंभूयःपचेदातोयसंक्षयात्।।
अवतार्यकरीषेचपक्षमात्रंनिधापयेत्।।२३।।
स्निग्धःस्विन्नोहृतमल :पक्षादूर्ध्वप्रयत्नवान्।।
चतुर्थभक्तान्तरितःशुक्लादौदिवसेशुभे।।२४।।
मन्त्रपूतस्यतैलस्यपिबेन्मात्रांयथानम।।
तत्रमन्त्रंप्रवक्ष्यामियेनेदमभिमन्यते।।२५।। ‘
मज्जंसारमहावीर्यसर्वान्धातून्विशोधय।।
शङ्खचक्रगदापाणिस्त्वामाज्ञापयतेऽच्युतः ‘ ।।२६।।
तेनास्योर्ध्वमधश्चापिदोषायान्त्यसकृत्ततः।।
अस्नेहलवणांसायंयवागूशीतलांपिबेत्।।२७।।
पञ्चाहंप्रपिबेत्तैलमनेनविधिनानरः।।
पक्षंपरिहरेच्चापिमुद्गयूषौदनाशनः।।२८।।
पञ्चभिर्दिवसैरेवंसर्वकुष्ठर्विमुच्यते।।
तदेवखदिरक्वाथेत्रिगुणेसाधुसाधितम्।।२९।।
निहितंपूर्ववत्पक्षात्पिबेन्मासमतन्द्रितः।।
तेनाभ्यक्तशरीरश्चकुर्वीताहारमीरितम्।।३०।।
भिन्नस्वरंरक्तनेत्रंविशीर्णंकृमिभक्षितम्।।
अनेनाशुप्रयोगेणसाधयेत्कुष्ठिनंनरम्।।३१।।
सर्पिर्मधुयुतंपीतंतदेवखदिराम्बुना।।
पक्षिमांसरसाहारंकरोतिद्विशतायुषम्।।३२।।
तदेवनस्येपञ्चाशदिवसानुपयोजितम्।।
वपुष्मन्तंश्रुतिधरंकरोतित्रिशतायुषम्।।३३।।
शोधयन्तिनरंपीतामज्जानस्तस्यमात्रया।।
महावीर्यस्तुवरकःकुष्ठमेहापहःपरः।।३४।।

Fruits of Tuvaraka bushes needs to be collected –

–        In cloudy season

–        From the bushes that develop within the west ocean coast (Arabian sea)

–        Whose leaves are shaken by the wind coming from the ocean waves

–        Whose fruits are nicely ripened

After gathering the fruits, the marrow (pulp) inside them is taken out. It’s dried in daylight and later powdered.

Subsequent, this powder of Tuvaraka fruits shall be pressed similar to urgent the sesame seeds in an oil mill and its oil extracted. Alternatively, it may be boiled in a cauldron like Kusumbha – Carthamus seeds are performed and its oil extracted.

In no matter technique the oil is extracted, it shall be collected individually and boiled till all of the water evaporates. The oil which is devoid of water molecules is now put right into a pot. This pot is stored inside a heap of ash for fifteen days.

The affected person needs to be administered with shodhana i.e. purificatory therapies after having administered snehana – oleation and swedana – sudation. With this, all of the wastes are faraway from the physique of the affected person.

Now the affected person is made to drink Tuvaraka Taila on a pre-selected auspicious day, throughout vibrant fortnight, in between 4 meal instances, in a dose which fits the energy of the physique of the particular person.

Earlier than administration, the oil shall be sanctified with the under point out hymn –

‘You, the essence of the marrow, who may be very a lot highly effective, please cleanse all of the tissues. Lord Acyuta (Vishnu) who bears a conch, disc and mace in his arms, orders you to take action.’

The doshas are expelled from the physique by consuming this recipe. The doshas utterly come out by means of each, upward and downward routes i.e. by means of vomiting and purgation.

The affected person needs to be given cooled Yavagu i.e. thick gruel within the night. Fat and salt shouldn’t be added to the yavagu. On this method, the oil shall be consumed for 5 days repeatedly. Later it needs to be discontinued and never consumed for the following fifteen days. He ought to eat solely boiled rice together with inexperienced gram soup throughout this era. The affected person would get cured of kustha – pores and skin ailments together with leprosy inside 5 days itself, if he follows the above defined routine.

Tuvaraka Taila needs to be boiled with decoction of Khadira, thrice its amount. The contents shall be stored hid as defined earlier than, for fifteen days. Later, it needs to be consumed for a interval of 1 month, with out laxity. After anointing the physique of the affected person with oil, he’s given good meals to eat. On this means, the affected person of kustha needs to be handled, particularly when he has developed a damaged voice, purple colored eyes, and physique elements which have been eaten by worms and have been mutilated.

The particular person lives for a span of 200 years when he drinks Tuvaraka Taila combined with ghee and honey adopted by decoction ready from Khadira and consuming soup ready from meat of birds.

Under talked about are the advantages of utilizing the above mentioned oil within the type of nasal drops for a interval of fifty days –

–        Good and wholesome physique free from kustha

–        Good reminiscence

–        Lifespan of 300 years

The fruit marrow purifies the particular person when it’s consumed in applicable doses.

Thus Tuvarka,is essentially the most highly effective one and is taken into account to be the most effective to treatment kustha and prameha.

सान्तधूमस्तस्यमज्जातुदग्धःक्षिप्तस्तैलेसैन्धवंचाञ्जनंच।।
पैल्ल्यंहन्यादर्मनक्तान्ध्यकाचान्नीलीरोगंतैमिरंचाञ्जनेन।।३५।।

The fruit marrow is burnt by the interior technique. Herein, the marrow and burning coal, each are put in a pot and the mouth / opening of the pot is roofed with a lid. After the marrow is completely burnt, the pot is opened, and the oil of the marrow is taken out. The oil is then combined with Saindhava and Anjana (Sroto Anjana). When that is utilized as collyrium to the eyes, it cures the under talked about situations –

–        Pilla roga

–        Arma

–        Naktandhya

–        Kaca

–        Niliroga and

–        Timira

इतिश्रीसुश्रुतसंहितायांचिकित्सास्थानेमधुमेहचिकित्सितंनाम त्रयोदशोऽध्यायः।।१३।।

Thus ends the thirteenth chapter by identify Madhumeha Cikitsita in Chikitsa Sthāna of Suśruta Samhita.