Sushruta Samhita Uttaratantra Chapter 59 Uritkrichcha Pratishtha (Treatment of Dysuria)

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– There are eight types of urinary disorders – Vaataja, Pittaja, Kaphaja, Tridoshaja, Abhighaja, Shakruja, Ashmarija and Sharkraj.

– In vataj mutrakrachhra – there is a tearing pain, in pittaja mutrakrachhra – there is a burning sensation and in kaphaj mutrakrachhra – there is heaviness in the scrotum, penis and bladder.

– The symptoms of traumatic enuresis are similar to the symptoms of Vata Basti (enuresis).

– Symptoms of Shakrut Vighatja (Pratighatja) Mutrakrachchhra are – Adhamana, Shashula Mutra Pravritti and Mutrasanga.

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The name of the 59th chapter of Uttaratantra of Sushruta Samhita is ‘Uritrikchha Pratisedha’. This chapter deals with the treatment of dysuria.

अथातो वृत्रकृछ्छ्प्रतिषेधाम्ध्याम् विक्षास्यामः ||1||
Yathovach Lord Dhanvantarih ||2||

Now we will describe Mutrakrichchha Pratisedha – treatment of Uritrichchha, strangulation; As revealed by respected Dhanvantari.

bheda – type

वातेन पितेन कफेन सर्वास्ताथाऽभिघाताः शक्रदस्मारिभ्याम |
Tathāparah sarkarāya sukṣato uriopaghataḥ saṃśiṣṭamastu ||3||

There are eight types of urinary tract infection or urinary tract infection. they are –

– One from each dosha – Vaataja, Pittaja and Kaphaja,

– One of the three doshas – Tridoshaja,

– A stroke by trauma,

– One by Sakrat – Mal,

– One by Asmari – urinary stones and

– One by Sarkara – Urine Gravel

These conditions are very difficult to treat.

Symptoms – Clinical Features

Alpalpam Samutpadya Mushkamehanbastibhih |
फालद्भिरिव कृच्छेन वाताघातेन महती ||4||
Haridramushnam raktam va mushkamehanbastibhih.
अग्निना दह्यामानभैः पित्घाटेन महती ||5||
Snigdham Shuklamanushnam Cha Mushkamehanbastibhih.
संहृष्टरोमा गुरुभिः मुक्सचाघातेन महती ||6||
Dahshitarujavishto naanavarnam mahurmuhuh.
Tamyamānastu kṛchchreṇa sannipaaten mehti ||7||

युर्तुवाहिषु शल्येन क्षतेश्वभिहेतेषु च |
Source: Su Uritaghatastu Jayate Bhrishvedanah ||8||
Vatabastestu tulyani tasya lingani laksayet |

Traumatic Urinary Tract –

Dysuria occurs when the urinary tract is injured by foreign bodies.

Its symptoms are –

– It hurts a lot to urinate,

– Presence of other symptoms similar to Vatabasti (described in the previous chapter)

शक्रितस्तु प्रतिघाताद्वायुर्विगुन्तां गातः ||9||
अधमानमं च सशुलं च वृत्संगं करोती ही |
अशमरीहेतुकः पुर्वम युरिगाट उदाहृतः ||10||

Sukritjanya urinary retention – When a person restrains stool for a long time, Vata is aggravated.

Symptoms include –

– Abdominal distension,

– painful urination and

– urinary obstruction

Asmari-induced urinary stones – Asmari – Urinary stones or urinary stones have been described in the first place of diagnosis – Chapter 3.

Possible symptoms of Ashra Glucose Chavea:
शक्राया विशेषं तु श्रुनु कीर्तयतो मम ||11||
pacchyamanasya pitten bhidyamanasya vauna |
श्लेसमनोऽवाविवा भिन्नाह ग्लूकोस इती संज्ञिताह ||12||
Heartache Vepathuha Shulaan Kukshau Vahanih Sudurbalah.
ताभीर्भवती मूर्चा च उृत्रघातश्च दारुनः ||13||
युरुवेगनिर्स्तासु तासु शाम्यति वेदाना |
Yavadanya Punarnaiti Gudikasrotso Mukham ||14||
ग्लूकोससम्भावस्यातनमुत्रघातस्य लक्षनाम |15|

In terms of causes and symptoms, Asmari – urinary stones and Sarkara – urinary gravel are similar. Now I will explain the special symptoms of Sarkara (urinorrhea due to gravel) and listen to him.

Sarkara i.e. urinary particles are formed when Asmari-Calculus is cooked by Pitta, broken into pieces by Vata and separated into parts by Kapha.

The following symptoms are caused by Sarkara –

– pain in the heart area,

– to tremble,

– stomach ache,

– weakening of digestive fire,

– unconsciousness and

– severe dysuria

The pain subsides when the urge to urinate subsides and when the urethra is not blocked by another lump or gravel.

These are the symptoms of dysuria caused by Asmari and Sarkara.

medical treatment

चिकित्सित्मथाटेशाम्षतानामपी वक्ष्यते ||15||

Now the treatment of these eight types of urinary tract infections will be described.

Ashmrin cha Samashritya Yaduktam Prasamikshya Tat |
Yathadosham prayunjit snehadimpi cha kramam ||16||

In these diseases, first of all the treatments like applying oil etc. as described in chapter 7 should also be done. Treatment should be done according to the defects.

emetic enuresis therapy

स्दंस्त्रस्माभिदौ कुम्भीं हपुषं कंतकारिकाम |
Balam Shatavari Rasnam Varunam Girikarnikam ||17||
And Vidarigandhadin Samhrtya Traivrutam Pachet.
तैलां घृतं वा तत् पेयं तेन वायप्यनुवासनम् ||18||
डड्यादुत्तरबस्तिं च वातक्रिच्छोपशांतये |19|

A decoction is prepared from the following ingredients –

– Swadmastra,

– Asmabeda,

– watercress,

– Hapusa,

– Kantkarika,

– Bala,

– Satavari,

– Rasna,

– Varuna,

– Girikarnika and

– Other herbs of Vidarigandhadi group

With this decoction three types of fats i.e. oil, ghee and muscle fat are processed together to prepare their Trivarta Sneh.

Alternatively, only oil – tel or ghee – ghee can be cooked with this decoction and their affection is prepared.

It is used for drinking, oil enema or urethral enema. This recipe cures dysuria caused by Vata.

शादंस्त्रस्वरसे तैलं सगुडक्षीरनाग्रम ||19||
Paktva tat purvavadyojyam tatranilrujapaham |20|

The oil is boiled and processed with fresh juice of Swadamastra, Jaggery, Ksheera and Nagar. This oil can be used as described earlier. This cures the problem of urination caused due to vata.

pittaja mutrakracha treatment

त्रिनोतपलादिकाकोलिन्याग्रोधादिगानैः क्र(श्री)तम ||20||
पीतं घृतं पितकृच्छ्छ्रं नाशेयत क्षीरेमेव वा |
डड्यादुत्तरबस्तिं च पित्तकृच्च्छरोपशांतये ||21||

The decoction is prepared from herbs belonging to the following groups –

– Trna Panchmula,

– Utpaladi Gana,

– Kakolyadi Gana and

– Nygrodhadi Gana

Ghee is cooked in this decoction to prepare medicinal ghee. Alternatively, medicinal milk can be prepared by boiling milk with these herbs.

When these remedies are taken, they cure burning sensation during urination. It may also be administered as a urethral enema. It cures dysuria caused by bile.

Abhirev Kritah Snehastrividheshvapi Bastishu.
हितं विरेचनाम चेक्षुक्षीरद्रक्षारसैर्युतम् ||22||

Oil or ghee prepared from the same herbs should be used for all three types of enemas i.e. Niruh (decoction), Anuvasana (astringent) and Uttara (urethral) Basti. Similarly, laxative remedies will also be given along with sugarcane juice, milk or grape juice. These remedies are ideal for inducing purgation.

Kaphaja Urethritis

सुरसोशमुस्तदौ वरुनादौ च यत क्रतम् |
Tailan and Yavagwadi Kafghaate Prashasyate ||3||

The decoction should be prepared from the following groups of herbs –

– sursadi gana

– Usakadi Gana,

– Mustadi Gana and

– Varunadi Gana

Medicinal oil is prepared from this decoction.

This oil is beneficial in the treatment of dysuria caused by cough.

Yavagu etc. made from these herbs are also beneficial in this condition.

typhoid fever treatment

यताधोशोच्छ्यं कुर्यादेतनेव च सर्वजे |
Falguvrischidarbhasmasarachurnam cha varina ||24||
Surekshurasdarbhambupitam krichchrujapaham |25|

The same herbs will be used appropriately in the treatment of dysuria caused by all three doshas.

Powder of Phalgu, Vrishira, Darbha and Asmasar (Shilajatu) should be prepared. This powder should be consumed by mixing it in water, beer, sugarcane juice or Darbha decoction. It cures urination problems caused by all three doshas together.

traumatic plastic surgery

ताथऽभिघात्जे कुर्यात् सद्योव्रांचिकित्सितम् ||25||

In the treatment of dysuria due to injury, the same treatments as for accidental wounds should be followed.

active plastic surgery

Urukchhre Shakrajate Karya Vathari Kriya.
स्वेदगाहावभ्यंग्बस्तिचूर्नक्रियास्था ||26||

In the treatment of dysuria caused by stool, the following remedies will be given to reduce Vata –

– Sudhashan,

– tub-bath,

– Abhishek or massage with oil,

– enema and

– Consuming herbal powders to reduce vata

Asmari-Sarkraja Krachra Chikitsa

Ye tvanye tu tatha krichhe tayo proktah kriyavidhih

The treatments which have already been described in Medical Places, Chapter 7, will be followed in the treatment of the other two types of dysuria i.e. dysuria caused by Asmari and Sarkara.

59.

In this way, the forty-ninth chapter named Mutrakrechra Pratisedha ends in the northern part of Sushruta Samhita.