जलौकावचारणीयाध्यायः
अथातो जलौकावचारणीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
"Now, we shall expound the chapter on the application of leeches."
"Thus said the venerable Dhanvantari."
This introduction sets the stage for discussing the methods and techniques for using leeches in medical treatments, following the teachings of the revered Dhanvantari.
नृपाढ्यबालस्थविरभीरुदुर्बलनारीसुकुमाराणामनुग्रहार्थं परमसुकुमारोऽयं शोणितावसेचनोपायोऽभिहितो जलौकसः ||३||
"For the benefit of kings, the wealthy, children, the elderly, the fearful, the weak, women, and delicate individuals, this very gentle method of bloodletting using leeches has been recommended."
This shloka highlights the gentle and beneficial method of using leeches for bloodletting, specifically recommended for individuals who are particularly delicate or vulnerable, including kings, the wealthy, children, the elderly, the fearful, the weak, and women.
तत्र वातपित्तकफदुष्टशोणितं यथासङ्ख्यं शृङ्गजलौकालाबुभिरवसेचयेत्, सर्वाणि सर्वैर्वा (विशेषस्तु विस्राव्यं शृङ्गजलौकालाबुभिर्गृह्णीयात्) ||४||
"For blood vitiated by Vata, Pitta, and Kapha, it should be let out using horn, leeches, and Alabu (gourd). Alternatively, all types of vitiated blood can be let out using any of these methods, but specifically, horn, leeches, and Alabu are recommended."
This shloka provides guidelines for bloodletting based on the type of dosha vitiation, recommending specific methods such as using a horn, leeches, or a gourd for letting out vitiated blood.
भवन्ति चात्र श्लोकाः-
उष्णं समधुरं स्निग्धं गवां शृङ्गं प्रकीर्तितम् |
तस्माद्वातोपसृष्टे तु हितं तदवसेचने ||५||
शीताधिवासा मधुरा जलौका वारिसम्भवा |
तस्मात् पित्तोपसृष्टे तु हिता सा त्ववसेचने ||६||
अलाबु कटुकं रूक्षं तीक्ष्णं च परिकीर्तितम् |
तस्माच्छ्लेष्मोपसृष्टे तु हितं तदवसेचने ||७||
"A cow's horn is considered warm, slightly sweet, and oily; therefore, it is beneficial for bloodletting in conditions involving Vata. Leeches, which inhabit cool water and are sweet, are beneficial for conditions involving Pitta. Alabu (gourd) is pungent, dry, and sharp; hence, it is beneficial for conditions involving Kapha."
These shlokas explain the specific properties and uses of different bloodletting tools, highlighting their suitability for treating different dosha imbalances. Cow horns are used for Vata conditions, leeches for Pitta, and Alabu for Kapha.
तत्र प्रच्छिते तनुबस्तिपटलावनद्धेन शृङ्गेण शोणितमवसेचयेदाचूषणात्, सान्तर्दीपयाऽलाब्वा (जलायुका वक्ष्यन्ते) ||८||
"In the case of superficial incisions, bloodletting should be performed using a horn covered with a thin bladder membrane to facilitate suction. For deeper incisions, an Alabu (gourd) should be used, and for leeches, their application will be discussed next."
This shloka provides guidelines for different methods of bloodletting based on the depth of the incision, recommending the use of a horn for superficial incisions and a gourd for deeper ones, with leech application to be discussed subsequently.
जलमासामायुरिति जलायुकाः, जलमासामोक इति जलौकसः ||९||
"The term 'Jalayuka' means 'one whose life is water,' and 'Jalauka' means 'one who lives in water.'"
This shloka explains the etymology of the terms "Jalayuka" and "Jalauka," both referring to leeches and emphasizing their close relationship with water.
ता द्वादश; तासां सविषाः षट्, तावत्य एव निर्विषाः ||१०||
"There are twelve types of leeches; six of them are poisonous, and the other six are non-poisonous."
This shloka categorizes leeches into two groups, specifying that out of twelve types, six are poisonous and six are non-poisonous.
तत्र सविषाः- कृष्णा, कर्बुरा, अलगर्दा, इन्द्रायुधा, सामुद्रिका, गोचन्दना चेति |
तासु, अञ्जनचूर्णवर्णा पृथुशिराः कृष्णा; वर्मिमत्स्यवदायता छिन्नोन्नतकुक्षिः कर्बुरा; रोमशा महापार्श्वा कृष्णमुखी अलगर्दा; इन्द्रायुधवदूर्ध्वराजिभिश्चित्रा इन्द्रायुधा; ईषदसितपीतिका विचित्रपुष्पाकृतिचित्रा सामुद्रिकाः; गोवृषणवदधोभागे द्विधाभूताकृतिरणुमुखी गोचन्दनेति |
ताभिर्दष्टे पुरुषे दंशे श्वयथुरतिमात्रं कण्डूर्मूर्च्छा ज्वरो दाहश्छर्दिर्मदः सदनमिति लिङ्गानि भवन्ति |
तत्र महागदः पानालेपननस्यकर्मादिषूपयोज्यः |
इन्द्रायुधादष्टमसाध्यम् |
इत्येताः सविषाः सचिकित्सिता व्याख्याताः ||११||
"The poisonous leeches are: Krishna, Karbura, Alagarda, Indrayudha, Samudrika, and Gochandana. Among them,
The Krishna leech is black like collyrium powder with broad heads;
Karbura resembles the Varmi fish with a sunken abdomen;
Alagarda is hairy with broad sides and a black face;
Indrayudha is colorful like a rainbow with stripes;
Samudrika is slightly blackish-yellow and has varied colors like flowers;
Gochandana resembles the scrotum of a bull and has a small mouth.
When a person is bitten by these leeches, they experience excessive swelling, itching, fainting, fever, burning sensation, vomiting, intoxication, and weakness. The treatment involves using Mahagada internally, externally, and through nasal administration. Bites from the Indrayudha leech are considered incurable. These poisonous leeches and their treatments have been described."
These shlokas provide detailed descriptions of the various types of poisonous leeches, their characteristics, the symptoms caused by their bites, and the treatments required for such bites. The classification helps in identifying the specific leech and administering appropriate treatment.
अथ निर्विषाः- कपिला, पिङ्गला, शङ्कुमुखी, मूषिका, पुण्डरीकमुखी, सावरिका चेति |
तत्र, मनःशिलारञ्जिताभ्यामिव पार्श्वाभ्यां पृष्ठे स्निग्धा मुद्गवर्णा कपिला; किञ्चिद्रक्ता वृत्तकाया पिङ्गाऽऽशुगा च पिङ्गला; यकृद्वर्णा शीघ्रपायिनी दीर्घतीक्ष्णमुखी शङ्कुमुखी; मूषिकाकृतिवर्णाऽनिष्टगन्धा च मूषिका; मुद्गवर्णा पुण्डरीकतुल्यवक्त्रा पुण्डरीकमुखी; स्निग्धा पद्मपत्रवर्णाऽष्टादशाङ्गुलप्रमाणा सावरिका, सा च पश्वर्थे; इत्येता अविषा व् याख्याताः ||१२||
"The non-poisonous leeches are: Kapila, Pingala, Shankumukhi, Mushika, Pundarikamukhi, and Savarika. Among them,
The Kapila leech is smooth and yellowish, with sides resembling cinnabar;
Pingala is slightly red, round-bodied, and quick-moving;
Shankumukhi is liver-colored, moves quickly, and has a long, sharp mouth;
Mushika resembles a mouse in shape and color and has an unpleasant odor;
Pundarikamukhi is yellowish-green and has a face like a lotus flower;
Savarika is smooth, has the color of lotus leaves, is eighteen fingers long, and is used for animals. These are the non-poisonous leeches."
This shloka describes the various types of non-poisonous leeches, detailing their characteristics and specific uses.
तासां यवनपाण्ड्यसह्यपौतनादीनि क्षेत्राणि; तेषु महाशरीरा बलवत्यः शीघ्रपायिन्यो महाशना निर्विषाश्च विशेषेण भवन्ति ||१३||
"The regions of Yavana, Pandya, Sahya, and Pautana are known for their leeches; in these regions, the leeches are large-bodied, strong, quick-moving, voracious eaters, and especially non-poisonous."
This shloka describes the specific regions known for their non-poisonous leeches, highlighting their characteristics such as being large, strong, quick-moving, and voracious eaters.
तत्र, सविषमत्स्यकीटदर्दुरमूत्रपुरीषकोथजाताः कलुषेष्वम्भसु च सविषाः; पद्मोत्पलनलिनकुमुदसौगन्धिककुवलयपुण्डरीकशैवलकोथजाता विमलेष्वम्भःसु च निर्विषाः ||१४||
भवति चात्र-
क्षेत्रेषु विचरन्त्येताः सलिलाढ्यसुगन्धिषु |
न च सङ्कीर्णचारिण्यो न च पङ्केशयाः सुखाः ||१५||
"Leeches that are born in dirty water contaminated with poisonous fish, insects, frogs' urine, and feces are poisonous. Those born in clean water with lotuses, water lilies, kumud, saugandhika, kuvala, pundarika, and algae are non-poisonous.
Therefore, leeches living in clear, fragrant waters are healthy, and those living in dirty, muddy places are unhealthy."
These shlokas explain that the habitat of leeches determines their toxicity. Leeches from contaminated and dirty water sources are poisonous, while those from clean and fragrant waters are non-poisonous.
तासां ग्रहणमार्द्रचर्मणा, अन्यैर्वा प्रयोगैर्गृह्णीयात् ||१६||
"Leeches can be collected using moist leather or other methods."
This shloka provides simple guidance on how to collect leeches, suggesting the use of moist leather or other appropriate methods for gathering them.
अथैनां नवे महति घटे सरस्तडागोदकपङ्कमावाप्य निदध्यात्; भक्ष्यार्थे चासामुपहरेच्छैवलं वल्लूरमौदकांश्च कन्दांश्चूर्णीकृत्य; शय्यार्थं तृणमौदकानि च पत्राणि; त्र्यहात्त्र्यहाच्चाभ्योऽन्यज्जलं भक्ष्यं च दद्यात्; सप्तरात्रात् सप्तरात्राच्च घटमन्यं सङ्क्रामयेत् ||१७||
"Then, place the leeches in a new large pot filled with water from a lake or pond mixed with mud. For feeding them, provide algae, Vallura (a type of aquatic plant), and powdered water roots. For bedding, use aquatic grass and leaves. Change their water and food every three days. Every seven days, transfer them to a different pot."
This shloka describes the proper care and maintenance of leeches, including their habitat, feeding, and regular transfer to ensure their health and effectiveness for medical use.
भवति चात्र-
स्थूलमध्याः परिक्लिष्टाः पृथ्व्यो मन्दविचेष्टिताः |
अग्राहिण्योऽल्पपायिन्यः सविषाश्च न पूजिताः ||१८||
"Here, those with thick bodies, dirty appearance, and slow movements; those that do not attach or drink little, and those that are poisonous should not be used."
This shloka explains the characteristics of leeches that are not suitable for medical use, emphasizing that leeches with thick bodies, dirty appearance, slow movements, poor attachment, little blood intake, or poisonous nature should be avoided.
अथ जलौकोवसेकसाध्यव्याधितमुपवेश्य संवेश्य वा, विरूक्ष्य चास्य तमवकाशं मृद्गोमयचूर्णैर्यद्यरुजः स्यात् |
गृहीताश्च ताः सर्षपरजनीकल्कोदकप्रदिग्धगात्रीः सलिलसरकमध्ये मुहूर्तस्थिता विगतक्लमा ज्ञात्वा ताभी रोगं ग्राहयेत् |
श्लणशुक्लार्द्रपिचुप्रोतावच्छन्नां कृत्वा मुखमपावृणुयात्; अगृह्णन्त्यै क्षीरबिन्दुं शोणितबिन्दुं वा दद्यात्, शस्त्रपदानि वा कुर्वीत; यद्येवमपि न गृह्णीयात्तदाऽन्यां ग्राहयेत् ||१९||
"Next, the patient suitable for leech therapy should be seated or laid down, and the area to be treated should be dried and sprinkled with fine mud and cow dung powder if there is no pain. The collected leeches should be coated with a paste of mustard and turmeric water, and left in a pot of water for a moment to refresh them. Then, leeches should be applied to the affected area.
Cover the leeches with a soft, white, moist cloth, exposing only their heads. If the leeches do not attach, apply a drop of milk or blood, or make small incisions. If this still does not work, try a different leech."
This shloka describes the preparation and application of leeches for therapeutic purposes, including the preparation of the patient, the leeches, and the steps to ensure the leeches attach properly.
यदा च निविशतेऽश्वखुरवदाननं कृत्वोन्नम्य च स्कन्धं तदा जानीयाद्गृह्णातीति; गृह्णन्तीं चार्द्रवस्त्रावच्छन्नां कृत्वा धारयेत् ||२०||
"When the leech attaches firmly, resembling the raising of a horse's hoof and lifting its body, it indicates that the leech is feeding. At this stage, cover it with a moist cloth and let it continue."
This shloka describes the signs that indicate a leech has successfully attached and is feeding, comparing it to the movement of a horse's hoof. It also advises covering the feeding leech with a moist cloth to let it continue its work effectively.
दंशे तोदकण्डुप्रादुर्भावैर्जानीयाच्छुद्धमियमादत्त इति; शुद्धमाददानामपनयेतः अथ शोणितगन्धेन न मुञ्चेन्मुखमस्याः सैन्धवचूर्णेनावकिरेत् ||२१||
"One can know that the leech is feeding effectively when there is a feeling of pricking pain and itching at the bite site. Remove the leech when it is full. If the leech does not release its grip due to the smell of blood, sprinkle Saindhava (rock salt) powder on its mouth."
This shloka describes how to identify that a leech is feeding effectively by the sensation of pricking pain and itching at the bite site. It also provides instructions on removing the leech, including the use of rock salt to help it release its grip if needed.
अथ पतितां तण्डुलकण्डनप्रदिग्धगात्रीं तैललवणाभ्यक्तमुखीं वामहस्ताङ्गुष्ठाङ्गुलीभ्यां गृहीतपुच्छां दक्षिणहस्ताङ्गुष्ठाङ्गुलिभ्यां शनैः शनैरनुलोममनुमार्जयेदामुखात्, वामयेत् तावद्यावत् सम्यग्वान्तलिङ्गानीति |
सम्यग्वान्ता सलिलसरके न्यस्ता भोक्तुकामा सती चरेत् |
या सीदती न चेष्टते सा दुर्वान्ता, तां पुनः सम्यग्वामयेत् |
दुर्वान्ताया व्याधिरसाध्य इन्द्रमदो नाम भवति |
अथ सुवान्तां पूर्ववत् सन्निदध्यात् ||२२||
"Then, after the leech falls off, smear its body with rice flour paste, and its mouth with oil and salt. Hold its tail with the thumb and forefinger of the left hand, and gently stroke it from tail to mouth with the thumb and forefinger of the right hand, making it vomit until it shows signs of proper vomiting. A properly vomited leech will move actively in the water container and show eagerness to feed again. If a leech is inactive and sluggish, it has not vomited properly and should be made to vomit again. An improperly vomited leech develops an incurable condition called 'Indramada.' Once properly vomited, the leech should be kept as before."
These shlokas describe the process of handling leeches after they fall off the patient's body, including ensuring they vomit properly to prevent them from becoming sick and ensuring their readiness for future use.
शोणितस्य योगायोगानवेक्ष्य शतधौतघृताभ्यङ्गः, तत्पिचुधारणं वा;
जलौकोव्रणान् मधुनाऽवघट्टयेत्, शीताभिरद्भिः परिषेचयेद्बध्नीत वा, कषायमधुरस्निग्धशीतैश्च प्रदेहैः प्रदिह्यादिति ||२३||
"After observing the suitability and unsuitability of the bloodletting, apply Shatadhauta Ghrita (ghee washed a hundred times) as an ointment, or apply a plaster. Clean the leech bites with honey, sprinkle with cold water, and bandage. Use astringent, sweet, oily, and cooling ointments to cover the area."
This shloka provides post-treatment care guidelines after leech therapy, recommending the application of Shatadhauta Ghrita or a plaster, cleaning the leech bites with honey, using cold water to rinse, and applying astringent, sweet, oily, and cooling ointments to promote healing.
भवति चात्र-
क्षेत्राणि ग्रहणं जातीः पोषणं सावचारणम् |
जलौकसां च यो वेत्ति तत्साध्यान् स जयेद्गदान् ||२४||
"One who understands the habitats, collection, species, care, and proper application of leeches can conquer the diseases treatable by them."
This shloka emphasizes the importance of comprehensive knowledge about leeches, including their habitats, collection methods, species, care, and application, for effectively treating diseases.
इति सुश्रुतसंहितायां सूत्रस्थाने जलौकावचारणीयो नाम त्रयोदशोऽध्यायः ||१३||
"Thus ends the thirteenth chapter named 'Jalaukaavacharaniya' in the Sutra Sthana section of the Sushruta Samhita."
This verse signifies the conclusion of the thirteenth chapter called 'Jalaukaavacharaniya' in the Sutra Sthana section of the Sushruta Samhita, which discusses the application and therapeutic use of leeches.