AYURVEDA FOR ALL

अथात ऊरुस्तम्भचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||

 Now, we shall expound the chapter on the “treatment of Urustambha (Spasticity of the thigh)” Thus, said Lord Atreya [1-2]

PROLOGUE / introduction
 
श्रिया परमया ब्राह्मया परया च तपःश्रिया|
अहीनं चन्द्रसूर्याभ्यां सुमेरुमिव पर्वतम्||३||
धीधृतिस्मृतिविज्ञानज्ञानकीर्तिक्षमालयम्|
अग्निवेशो गुरुं काले संशयं परिपृष्टवान्||४||

 Once, Agnivesha asked Lord Punarvasu, who was endowed with both of brahminic knowledge as well as elegance, who was like the Mt. Sumeru flanked by the sun and the moon, and who also the above of wisdom, memory, mundane knowledge, spiritual knowledge, frame and forgiveness, the following questions. [3-4]


Agnivesa’s question: What is the disease contra indicated for Panchakarma?
 
भगवन् पञ्च कर्माणि समस्तानि पृथक् तथा|
निर्दिष्टान्यामयनां हि सर्वेषामेव भेषजम्||५||
दोषजोऽस्त्यामयः कश्चिद्यस्य तानि भिषग्वर!|
न स्युः शक्तानि शमने साध्यस्य क्रियया सतः||६||
 

• Oh! Lord, all the 5 purification therapies (Pancha Karma) are described in many instances of disease treatment.  
• Is there any curable disease caused by doshas for the alleviation of which these 5 elimination therapies (Pancha- Karma) are contra- indicated. [5-6]

means that is there any disease caused by doshas that cannot be alleviated by pancha karma or these 5 elimination therapies are contraindicated ?

अस्त्यूरुस्तम्भ इत्युक्ते गुरुणा तस्य कारणम्|
सलिङ्गभेषजं भूयः पृष्टस्तेनाब्रवीद्गुरुः||७||

Atreya replied, “there is such a disease for which PanchaKarma is contra-indicated and it is called Urustambha (spasticity of the thighs)”.

Agnivesha again enquired about the karanam / etiology, lingam / symptomatology and bheshajam / treatment of this aliment. 


The preceptor again replied as follows. [7] 


Urustambha nidana and Samprapti:

स्निग्धोष्णलघुशीतानि जीर्णाजीर्णे समश्नतः|
द्रवशुष्कदधिक्षीरग्राम्यानूपौदकामिषैः||८||
पिष्टव्यापन्नमद्यातिदिवास्वप्नप्रजागरैः|
लङ्घनाध्यशनायासभयवेगविधारणैः||९||

Urustambha (spasticity of the thighs) is caused by the following factors: 

1. Intake of 

• Snigdha (unctuous), 
• Ushna (hot),
• Laghu(light) and 
• Shita (cold) ingredients,  when the ingested food is partially digested and partially undigested  

2. Intake of 

• Drava(liquid) and 
• Sushka(dry) ingredients 

3. Intake of 

• Dadhi(yoghurt), 
• Kshira (milk) and 
• meat of animals who are 

                 - Gramya (domesticated animals),
                 -  Anupa (animals inhabiting marshy land)                                - Audaka (aquatic animals)


4. Intake of 

• Pistanna(pastries) and 
• Madya(alcohol)

5.  Divaswapna – Excessive sleep during the day time and


6. Prajagraih – dreaming awake at night for a long time

7. Langhana (Fasting) or Adhyashana (taking food while the previous meal is not digested) 

8. Aayasa (Overexertion) and Bhaya – exposure to fearful situations; and

9. Vega vidharana – Suppression of the manifested natural urges. 

 Pathology of Urusthambha:

स्नेहाच्चामं चितं कोष्ठे वातादीन्मेदसा सह| 
रुद्ध्वाऽऽशु गौरवादूरू यात्यधोगैः सिरादिभिः||१०||
पूरयन् सक्थिजङ्घोरु दोषो मेदोबलोत्कटः|
अविधेयपरिस्पन्दं जनयत्यल्पविक्रमम्||११||


Because of unctuousness / sneha, 
   
- the Ama (a product of altered digestion and metabolism) located in the gastro-intestinal tract, along with fat 
                                                              ↓
causes obstruction to the movement of Vata, etc. 
                                  ↓
Because of heaviness, it immediately reaches the thighs through the downward moving vessels. Etc and 
                                         ↓
being provoked by the powerful fat, these Doshas (morbid material) fill up the lower limbs including the thighs and calf regions to cause involuntary spasms and immobility in these parts. [10-11]

Simile of Pond:
 
महासरसि गम्भीरे पूर्णेऽम्बु स्तिमितं यथा|
तिष्ठति स्थिरमक्षोभ्यं तद्वदूरुगतः कफः||१२||


 As in a pond which is large, deep and full, the after remains motionless, stable and unagitated, similarly the Kapha shifted to the things remains motionless, stable and unagitated [in Urustambha] [12]


 Further complications:

गौरवायाससङ्कोचदाहरुक्सुप्तिकम्पनैः |
भेदस्फुरणतोदैश्च युक्तो देहं निहन्त्यसून्||१३||

This ailment (urustambha or spasticity of the thighs) thereafter, gets associated with

1. Gaura – heaviness
2. Aayasa – fatigue
3. Sankocha – contracture
4. Daha – burning sensation
5. Ruk – pain
6. Supti – numbness
7. Kampana – tremor and
8. Bheda – breaking,
9. Sphurana – itching and
10. Bheda – pricking types of pain leading to the death of the patient [13]

 
Urustambha Nirukti:Definition of Urustambha:

 ऊरू श्लेष्मा समेदस्को वातपित्तेऽभिभूय तु|
स्तम्भयेत्स्थैर्यशैत्याभ्यामूरुस्तम्भस्ततस्तु सः||१४||


Kapha associated with Medas 
                    ↓
      affects Vata and Pitta
                          ↓
 to cause spasticity (Stambha) of the thighs (uru) 
                    ↓
characterized by their stiffness and coldness because of which the ailment is called Uru- Stambha (Spasticity of the things) [14]



Premonitory Signs and Symptoms:

 प्राग्रूपं ध्याननिद्रातिस्तैमित्यारोचकज्वराः|
लोमहर्षश्च छर्दिश्च जङ्घोर्वोः सदनं तथा||१५||
The premonitory signs and symptoms of Urustambha (spasticity of the thighs):
 

1. Dhyana – Fixed Gaze
2. Ati nidra – excessive sleep
3. Staimitya – excessive indolence
4. Aruchi – anorexia
5. Jwara – fever
6. Loma harsha – horripilation
7. Chardi – vomiting and
8. Jangha uru sadana – Asthenia of the calf region as well as thighs [15]

Mistaken identity:

वातशङ्किभिरज्ञानात्तस्य स्यात् स्नेहनात् पुनः|
पादयोः सदनं सुप्तिः कृच्छ्रादुद्धरणं तथा||१६||

 Mistaking it as an ailment caused by aggravated Vata Dosha, because of ignorance, if oleation therapy is administered, 
- then these results in 

• asthenia / sadanam as well as
•  supti / numbness of the legs, and 
• krichrad udharanam / the lifting of the legs becomes difficult. [16]

 Urustambha Lakshana:  Signs and symptoms of Urustambha:

 जङ्घोरुग्लानिरत्यर्थं शश्वच्चादाहवेदना|
पदं च व्यथते न्यस्तं शीतस्पर्शं न वेत्ति च||१७||
संस्थाने पीडने गत्यां चालने चाप्यनीश्वरः| 
अन्यनेयौ हि सम्भग्नावूरू पादौ च मन्यते||१८||


1. Jangha uru glani – Excessive fatigue of the calf muscles and thighs
2. Daha vedana – Constant pain with slight burning sensation
3. Feeling of pain while putting the feet on the ground
3. Sheetam sparsham na vetti cha – Insensitivity to cold touch
4. Lack of control over the functions like standing, pressing the feet on the ground, walking and movement of the lower limbs and
5. Feeling as if limbs are propelled by someone else (not by himself) and as if these are broken [17-18]


Prognosis:
 
यदा दाहार्तितोदार्तो वेपनः पुरुषो भवेत्|
ऊरुस्तम्भस्तदा हन्यात् साधयेदन्यथा नवम्||१९||

If the patient is further afflicted with burning sensation, pain and tremors, 

• then this disease Urustambha (spasticity of the thighs) leads to his death i.e he is incurable. 

If such signs and symptoms are absent, and if the ailment is of recent origin, 

• then such a patient is treated, i.e he is curable. [19]

Reasons for prohibiting Panchakarma in Urustambha:Why Panchakarma is not indicated in Urustambha:

तस्य न स्नेहनं कार्यं न बस्तिर्न विरेचनम्|
न चैव वमनं यस्मात्तन्निबोधत कारणम्||२०||
वृद्धये श्लेष्मणो नित्यं स्नेहनं बस्तिकर्म च|
तत्स्थस्योद्धरणे चैव न समर्थं विरेचनम्||२१||
कफं कफस्थानगतं पित्तं च वमनात् सुखम्|
हर्तुमामाशयस्थौ च स्रंसनात्तावुभावपि||२२||
पक्वाशयस्थाः सर्वेऽपि बस्तिभिर्मूलनिर्जयात्|
शक्या न त्वाममेदोभ्यां स्तब्धा जङ्घोरुसंस्थिताः||२३||
वातस्थाने हि तच्छैत्याद्द्वयोः स्तम्भाच्च तद्गताः|
न शक्याः सुखमुद्धर्तुं जलं निम्नादिव स्थलात्||२४||
 
The reason for which Snehakarma, Vamana, Virechana and Basti are contra-indicated in the treatment of Urustambha is being explained.
 

• Snehana and Basti therapies aggravate Kapha. 
• Purgation therapy is also too ineffective to remove Kapha localized in the thighs). 
• Kapha located in its own place (i.e Amashaya or stomach), and pitta can be easily removed by emesis. 

        - Both of these, viz, Kapha and Pitta, located in the Amashaya or stomach can be eliminated by purgation. 

• When located in Pakvashaya (Colon) all the 3 Doshas, viz, Vata Dosha, Pitta and Kapha can be rooted out by enema therapy. 
• But when associated with Ama (product of improper digestion) and fat, and especially when these are firmly located in the thighs, it is impossible to eliminate them by the above mentioned therapies.
  

•  Since the Ama and Medas are lodged in the abode of Vayu which is cold by nature and 
•  since these are firmly localized there, 

                    - it is not easy to eliminate them just as it is difficult to lift water located at a lower level. [20-24]


Line of treatment:

तस्य संशमनं नित्यं क्षपणं शोषणं तथा|
युक्त्यपेक्षी भिषक् कुर्यादधिकत्वात्कफामयोः||२५||

Since Kapha and Ama (product of improper digestion) are predominant in the pathogenesis of Urustambha, 
-                   - the physician should constantly administer appropriate alleviation therapies for their 

• Kshapana (complete extraction) and 
• Shoshana (Absorption / drying of the liquid fraction) [25]

Food and Vegetables: 

सदा रूक्षोपचाराय यवश्यामाककोद्रवान्|
शाकैरलवणैर्दद्याज्जलतैलोपसाधितैः||२६||
सुनिषण्णकनिम्बार्कवेत्रारग्वधपल्लवैः|
वायसीवास्तुकैरन्यैस्तिक्तैश्च कुलकादिभिः||२७||

The patient of Urustambha is constantly given rookshopachara / ununctuous regimes, So, 

• Yava – Barley (Hordeum vulgare) (barley), 
• Syamaka (Millet) and 
• Kodrava 

            - along with Vegetables cooked with water and oil without adding salt. 

•  Leaves of Sunisannaka, Nimba – Neem (Azadirachta indica), Aragvadha (Cassia fistula), Vayasi (Kakamachi – Solanum nigrum), Vastuka – Chenopodium murale and bitter Vegetables like Kulaka (karavellaka – Momordica charantia) are useful for the patient. [26-27]

 

Drinks:

 क्षारारिष्टप्रयोगाश्च हरीतक्यास्तथैव च|
मधूदकस्य पिप्पल्या ऊरुस्तम्भविनाशनाः||२८||

• Administration of Alkali preparations, 
• Arista (medicated wines), 
•  Haritaki—Terminalia chebula, after added with honey and Pippali – Long pepper 

                   - cures Urustambha. [28]  

Samangadi Yoga:

समङ्गां शाल्मलीं बिल्वं मधुना सहना पिबेत्|

The patient suffering from Urustambha should take

• Samanga – Rubia cordifolia, 
• Shalmali – Salmalia malabarica (Gum- resin) and
  
• Bilva – Aegle marmelos along with honey. [1/2 29] 
  

Srivestakadi Yoga:

 तथा श्रीवेष्टकोदीच्यदेवदारुनतान्यपि||२९||
चन्दनं धातकीं कुष्ठं तालीसं नलदं तथा|३०|  


The patient may also be given

• Srivestaka 
• Udicya – Andropogan vetiveria, 
• Devadaru (Cedrus deodara), 
• Nata (Valeriana wallici), 
• Chandana (Sandalwood – Santalum album), 
• Dhataki – Woodfordia fruticosa, 
• Kushta – Saussurea lappa, 
• Talisa – Taxus baccata and 
• Nalada – Nordastachys jatamamsi along with honey [29 ½ – ½ 30]

Kalkas (recipes in the form of Paste):

मुस्तं हरीतकीं लोध्रं पद्मकं तिक्तरोहिणीम्||३०||
देवदारु हरिद्रे द्वे वचां कटुकरोहिणीम्|
पिप्पलीं पिप्पलीमूलं सरलं देवदारु च||३१||
चव्यं चित्रकमूलानि देवदारु हरीतकीम्|
भल्लातकं समूलां च पिप्पलीं पञ्च तान् पिबेत्||३२||
सक्षौद्रानर्धश्लोकोक्तान् कल्कानूरुग्रहापहान्|३३|


The following 5 recipes cure Urustambha (spasticity of thighs):
1. Musta (Cyperus rotundus), Haritaki – Terminalia chebula, Lodhra (Symplocos racemosa), Padmaka – Prunus puddum and Tikta- Katukarohini – Picrorhiza kurroa
 
2. Devadaru – Cedrus deodara, Haridra (turmeric – Curcuma longa), Daru-Haridra – Berberis aristata, Vacha (Acorus calamus Linn.) And Katuka- Katukarohini – Picrorhiza kurroa

3. Pippali – Long pepper fruit – Piper longum, Pippali Mula, Sarala and Deva-Daru – Cedrus deodara
 
4. Chavya – Piper retrofractum, root of Chitraka – Plumbago zeylanica, Deva- Daru – Cedrus deodara and Haritaki – Terminalia chebula and
 
5. Bhallataka (Semecarpus anacardium Linn.), Pippali Mula and Pippali – Long pepper fruit – Piper longum.

         = All the above mentioned recipes in the form of paste are to be taken along with honey. [30 ½ – ½ 33]
 

Churna Yoga:

 The patient suffering from Urustambha should take the following recipes: 

 Sarngestadi Yoga:

शार्ङ्गेष्टां मदनं दन्तीं वत्सकस्य फलं वचाम् ||३३||
मूर्वामारग्वधं पाठां करञ्जं कुलकं तथा|
पिबेन्मधुयुतं तुल्यं चूर्णं वा वारिणाऽऽप्लुतम्||३४||
सक्षौद्रं दधिमण्डैर्वाऽप्यूरुस्तम्भविनाशनम्|
 

All these ingredients taken in equal quantities is made to a powder:

1. Sarngesta (Gunja) – Abrus precatorius
2. Madana – Randia dumetorum
3. Danti – Baliospermum montanum
4. Fruits (seeds) of Vatsaka (Holarrhena antidysenterica Wall.),
5. Vacha (Acorus calamus Linn.),
6. Murva – Marsdenia tenacissima
7. Aragvadha (Cassia fistula),
8. Patha – Cissampelos parriera
9. Karnja – Pongamia glabra and
10. Kulaka (Karavellaka – Momordica chirantia).

Adjuvant: honey added with water or with honey and whey

Murvadi Yoga:
 
 मूर्वामतिविषां कुष्ठं चित्रकं कटुरोहिणीम्||३५||
पूर्ववद्गुग्गुलुं मूत्रे रात्रिस्थितमथापि वा|
  
 the powder of

• Murva – Marsdenia tenacissima 
• Ativisa – Aconitum heterophyllum
• Kushta – Saussurea lappa, 
• Chitraka – Leadword – Plumbago zeylanica and 
• Katu-Katukarohini – Picrorhiza kurroa may be taken.
  

Guggulu in gomutra

 Guggulu – Commiphora mukul is soaked overnight in cow’s urine and taken.
 
Svarnaksiryadi Yoga: 

 स्वर्णक्षीरीमतिविषां मुस्तं तेजोवतीं वचाम्||३६||
सुराह् वं चित्रकं कुष्ठं पाठां कटुकरोहिणीम्|
लेहयेन्मधुना चूर्णं सक्षौद्रं वा जलाप्लुतम्||३७||

The powder of 

• Svarna-Ksiri – Panicum sumatrense 
• Ativisa – Aconitum heterophyllum 
• Musta (Cyperus rotundus) 
• Tejovati – Zanthoxylum alatum 
• Vacha (Acorus calamus Linn. 
• Surahva 
• Chitraka – Leadword – Plumbago zeylanica, 
• Kushta – Saussurea lappa 
• Patha – Cissampelos parriera and 
• Katuka- Katukarohini – Picrorhiza kurroa is made by adding honey.

• Alternatively, the powder may be mixed with water and honey, and taken.

फलीं  व्याघ्रनखं हेम पिबेद्वा मधुसंयुतम्|

•  The Powder of Phali (Nyagrodha – Ficus bengalensis),
• Vyaghra-Nakha – Capparis zeylanica and
•  Hema (Mesua ferrea) (Naga-Kesara) may be taken by the patient with honey.   

त्रिफलां पिप्पलीं मुस्तं चव्यं कटुकरोहिणीम्||३८||
लिह्याद्वा मधुना चूर्णमूरुस्तम्भार्दितो नरः|३९|
 

• The powder of Triphala (Haritaki – Terminalia chebula, Vibhitaka – Terminalia bellerica and Amalaki – Phyllanthus emblica), 
• Pippali – Long pepper fruit – Piper longum, 
• Musta (Cyperus rotundus),
• Cavya and 
• Katuka- Katukarohini – Picrorhiza kurroa 

                    - may be made to a Linctus/  lehya and taken. [ 33 ½ – ½ 39]

 Nourishing Therapy:

अपतर्पणजश्चेत् स्याद्दोषः सन्तर्पयेद्धि तम्||३९||
युक्त्या जाङ्गलजैर्मांसैः पुराणैश्चैव शालिभिः|

 If the diseases Urustambha is caused by Apatarpana (depletion of tissues), 
- then the patient is appropriately given 
     
Santarpana (nourishing) therapy consisting of 

• the meat of animals inhabiting Jangala Desha (the land with shrubs and small trees) and 
• old Shali rice. [39 ½ – ½ 40]

  

Oleation and Fomentation Therapies 

रूक्षणाद्वातकोपश्चेन्निद्रानाशार्तिपूर्वकः||४०||
स्नेहस्वेदक्रमस्तत्र कार्यो वातामयापहः|

If because [of excessive use] of ununctuous / rooksha therapies, 
                               ↓
                     Vata Dosha gets aggravated 
                               ↓
               causing thereby insomnia and pain, 
                               ↓
then the patient is given oleation and fomentation therapies for the alleviation of the aliments caused by Vata Dosha. [40 ½ – ½ 41] 

 Piluparnyadi Taila 

पीलुपर्णी पयस्या च रास्ना गोक्षुरको वचा||४१||
सरलागुरुपाठाश्च तैलमेभिर्विपाचयेत्|
सक्षौद्रं प्रसृतं तस्मादञ्जलिं वाऽपि ना पिबेत्||४२||

Oil is cooked by adding 

• Piluparni (Morata – Chonemorpha fragrans
•  Payasya – Impomoea paniculata,
  
• Rasna (Vanda roxburghi / Pluchea lanceolata),
  
• Goksuraka – Tribulus terrestris
  
• Vacha (Acorus calamus Linn.),
  
• Sarala,
  
• Aguru – Aquallaria agallocha and
  
• Patha – Cissampelos parriera
  

Adjuvant: 1 Prasta or 1 Anjali of this medicated oil is taken by adding honey (1/4th in quantity of the medicated oil). [41 ½ – 42]  

 Kusthadya Taila:

 कुष्ठश्रीवेष्टकोदीच्यसरलं दारु केशरम्|
अजगन्धाऽश्वगन्धा च तैलं तैः सार्षपं पचेत्||४३||
सक्षौद्रं मात्रया तच्चाप्यूरुस्तम्भार्दितः पिबेत्|
(रौक्ष्यान्मुक्त ऊरुस्तम्भात्ततश्च स विमुच्यते )||४४||


Mustard oil is cooked by adding
 

• Kushta – Saussurea lappa 
• Srivestaka 
• Udicya – Andropogan vetiveria 
• Sarala, 
• Devadaru (Cedrus deodara), 
• Kesara, 
• Ajagandha (Ajamoda – Ajowan (fruit) – Trachyspermum roxburghianum) and 
• Ashwagandha – Winter Cherry / Indian ginseng (root) – Withania somnifera
  

The patient suffering from Urustambha (spasticity should take this medicated oil in appropriate quantity by adding honey. This recipe makes the patient free from ununctuousness leading to the cure of Urustambha [43-44]
 

Saindhavadya Taila:

 द्वे पले सैन्धवात् पञ्च शुण्ठ्या ग्रन्थिकचित्रकात्|
द्वे द्वे भल्लातकास्थीनि विंशतिर्द्वे तथाऽऽढके||४५||
आरनालात् पचेत् प्रस्थं तैलस्यैतैरपत्यदम्|
गृध्रस्यूरुग्रहार्शोर्तिसर्ववातविकारनुत्||४६||

1 Prastha of oil is cooked by adding

•  2 Palas of Saindhava, 
• 5 palas of Sunthi – Zingiber officinale, 
• 2 Palas of Granthika, 
• 2 Palas of Chitraka – Leadword – Plumbago zeylanica, 
• 20 fruits of Bhallataka (Semecarpus anacardium Linn.) And 
• 2 Adhakas of Aranala (sour vinegar)

                -  intake of this medicated oil helps in the procreation of offspring.
It cures

1. Grdhrasi – sciatica,
2. Urugraha (spasticity of the thighs),
3. Arshas – Piles,
4. Arti – pain and
5. Sarva vata vikara – all types of diseases causes by the aggravated Vayu. [45-46]

 
Astakatvara Taila

पलाभ्यां पिप्पलीमूलनागरादष्टकट्वरः|
तैलप्रस्थः समो दध्ना गृध्रस्यूरुग्रहापहः||४७||
इत्यष्टकट्वरतैलम्|

 
1 Prastha of oil is cooked by adding 

• 2 Palas of Pipali-Mula and Nagara – Zingiber officinale taken together, 
• 8 Prasthas of Katvara (takra or butter- milk) and 
• 1 Prastha of yogurt. 

- This medicated oil cures sciatica and Urustambha (spasticity of thighs). Thus, ends the description of Astakatvara Taila. [47]


External Therapy: 
 
इत्याभ्यन्तरमुद्दिष्टमूरुस्तम्भस्य भेषजम्|
श्लेष्मणः क्षपणं त्वन्यद्बाह्यं शृणु चिकित्सितम्||४८||

 In the above mentioned verses (nos. 25-47), the recipes to be used internally for the cure of Urustambha are described in brief. 

Hereafter, recipes to be administered externally for the diminution of kapha will be described which you (addressed to Agnivesha by the preceptor) may hear.


UTSADANA / DRY RUBBING
 
1. वल्मीकमृत्तिका मूलं करञ्जस्य फलं त्वचम्|
इष्टकानां ततश्चूर्णैः कुर्यादुत्सादनं भृशम्||४९||

• The mud of Ant-hill, 
• the root, fruits and barks of Karanja (Pongamia pinnata), and
• bricks 

                       - is made to a powder. This is used for Utsadana (dry rubbing) frequently.
2. मूलैर्वाऽप्यश्वगन्धाया मूलैरर्कस्य वा भिषक्|
पिचुमर्दस्य वा मूलैरथवा देवदारुणः||५०||
क्षौद्रसर्षपवल्मीकमृत्तिकासंयुतैर्भिषक्|
गाढमुत्सादनं कुर्यादूरुस्तम्भे प्रलेपनम्||५१||


 Alternatively, the physician should administer this, Utsadana therapy with the help of 

• the root of Ashwagandha – Winter Cherry / Indian ginseng (root) – Withania somnifera, 
• Arka – Calotropis gigantea,
• Picumarda (Nimba – Neem (Azadirachta indica)) or 
• Devadaru (Cedrus
• deodara). 

                   -Any one of these drugs may be mixed with 

• honey, 
• Sarsapa – Brassica campestris and 
• mud of ant-hill 

                          - before being used as thickUtsadana (dry rubbing or massage) or Pralepana (external application).
3. दन्तीद्रवन्तीसुरसासर्षपैश्चापि बुद्धिमान्| 

 A wise physician may also apply the paste of 

• Danti – Baliospermum montanum, 
• Dravanti (a variety of Danti), 
• Surasa – Cinnamonum zeylanica and 
• Sarsapa – Brassica campestris 

           - for the cure of Urustambha (Spasticity of the thighs).  

 
SECHANAM
 
 तर्कारीशिग्रुसुरसाविश्ववत्सकनिम्बजैः||५२||
पत्रमूलफलैस्तोयं शृतमुष्णं च सेचनम्|

The warm decoction prepared by boiling water with 

• the leaves, roots and fruits of Tarkari (Jayanti – Sesbania egyptica), 
• Sigru – Moringa oliefera, 
• Surasa – Cinnamonum zeylanica, 
• Visva, 
• Vatsaka (Holarrhena antidysenterica Wall.) And 
• Nimba – Neem (Azadirachta indica) 

may be sprinkled over the affected part.  

SARSHAPA LEPANAM
 
 पिष्टं तु सर्षपं मूत्रेऽध्युषितं स्यात् प्रलेपनम्||५३||

 Mustard is made to a paste by triturating with cow’s urine kept overnight and used for external application. 

Vatsakadi Pralepa:
 
वत्सकः सुरसं कुष्ठं गन्धास्तुम्बुरुशिग्रुकौ|
हिंस्रार्कमूलवल्मीकमृत्तिकाः सकुठेरकाः||५४||
दधिसैन्धवसंयुक्तं कार्यमेतैः प्रलेपनम्|
(ऊरुस्तम्भविनाशाय भिषजा जानता क्रमम्)||५५||

•  Vatsaka (Holarrhena antidysenterica Wall.), 
• Surasa – Cinnamonum zeylanica, 
• Kushta – Saussurea lappa, 
• aromatic drugs (like Aguru – Aquallaria agallocha), 
• Tumburu – Zanthoxylum alatum, 
• Sigru – Moringa oleifera, 
• Himsra – Nordastachys jatamamsi, 
• Root of Arka – Calotropis gigantea, 
• mud of ant- hill and 
• Kutheraka (Parnasa – Ocimum basilicum) 

                            - is made to a paste by adding Yoghurt and Rock-salt 
                            - A physician conversant with the line of treatment should administer this paste for eternal application for the cure of Urustambha (Spasticity of the thighs).

 Shyonakadi Pariseka Pralepa:

श्योनाकं खदिरं बिल्वं बृहत्यौ सरलासनौ|
शोभाञ्जनकतर्कारीश्वदंष्ट्रासुरसार्जकान्||५६||
अग्निमन्थकरञ्जौ च जलेनोत्क्वाथ्य सेचयेत्|
 

• Shyonaka – Orchis mascula, 
• Khadira (Acacia catechu), 
• Bilva – Aegle marmelos, 
• Brihati – Solanum indicum, 
• Kantakari – Solanum xanthocarpum, 
• Sarala, 
• Asana – Pterocarpus marsupium, 
• Sobhanjana, 
• Tarkari – Sesbania aegyptica, 
• Svadamstra – Tribulus terrestris, 
• Surasa – Cinnamonum zeylanica, 
• Arjaka, 
• Agnimantha – Premna integrifolia and 
• Karanja (Pongamia pinnata) 

                              - is boiled in water. 

• This decoction is used for dhara / sprinkling over the affected part.

प्रलेपो मूत्रपिष्टैर्वाऽप्यूरुस्तम्भनिवारणः||५७||


 The above men tioned drugs may be made to a paste by triturating them with cow’s urine, and applied eternally for the cure of Urustambha (spasticity of the thighs).



कफक्षयार्थं शक्येषु व्यायामेष्वनुयोजयेत्|
स्थलान्याक्रामयेत् कल्यं शर्कराः सिकतास्तथा||५८||

 To alleviate Kapha,  

1. the able bodied patients are engaged in physical exercise, and
2.  they is made to walk over the ground covered with gravels and sand in the morning.


प्रतारयेत् प्रतिस्रोतो नदीं शीतजलां शिवाम्|
सरश्च विमलं शीतं स्थिरतोयं पुनः पुनः||५९||
तथा विशुष्केऽस्य कफे शान्तिमूरुग्रहो व्रजेत्|६०| 

3. The Patient is made to swim frequently against the current of a river with cold water but harmless (free from dangerous aquatic animals). 
4. He may also be advised swimming frequently in a pond having clean cold and stable water.

Urustambha – Line of treatment:
 
श्लेष्मणः क्षपणं यत् स्यान्न च मारुतमावहेत् ||६०||
तत् सर्वं सर्वदा कार्यमूरुस्तम्भस्य भेषजम्|
शरीरं बलमग्निं च कार्यैषा रक्षता क्रिया||६१||

•  All the therapeutic measures which alleviate Kapha but do not aggravate Vata should always be employed for the treatment of Urustambha 
• these therapeutic measures should however, be administered to the patient while protecting his physical strength and Agni (power of digestion and metabolism) [60 ½ – 61]

  
तत्र श्लोकः-
हेतुः प्राग्रूपलिङ्गानि कर्मायोग्यत्वकारणम्|
द्विविधं भेषजं चोक्तमूरुस्तम्भचिकित्सिते||६२|| 

 In this chapter on the treatment of Urustambha (spasticity of the thighs), the following topics are discussed:

1. Etiology of the disease / hetu
2. Premonitory signs and symptoms of the disease / prakrupa
3. Signs and symptoms of the disease / linga
4. Unsuitable therapeutic measures,/ ayogya karma and the reason for their unsuitability and 
5. Two categories of therapeutic measures(viz, internal and external therapies) / dvividha bheshajam [62]

 इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने ऊरुस्तम्भचिकित्सितं नाम सप्तविंशोऽध्यायः||२७||

 Thus, ends the 27th chapter with the treatment of Urustambha in the section on treatment of diseases (Chikitsa-Sthana) of Agnivesha’s work as redacted by Charaka and supplemented by Dridhabala.