Etiology : - The Vayu and the other Doshas arc deranged and aggravated by such causes as ex-tremely loud speaking, taking poison, reading at the top of the voice, external hurt or injury and exposure to cold, etc., * and finding lodgment in the sound carry.-ing channels, they affect the voice. The disease is called Svara-bheda (hoarseness of voice) and is classified into six different types. 2.
The Vataja type imparts a black colour to the face, eyes, urine and stool and the voice acquires the sound of the rough and hoarse braying of an ass †. The face, eyes and the stool and urine of the patient are tinged yellow in a case of the Pittaja type and the voice sounds sunken as if proceeding from the throat with an internal burning sensation. In the Kaphaja type the patient constantly feels a sense of constriction in his throat with mucus and is only enabled to speak slowly and softly and that specially in the day. Symptoms specifically belonging to the three preceding Dosha-originated types, are simultaneously present in the type due to the concerted action of the three Doshas (Tri-Dhoshaja) together with indistinctness of speech and incapability of articulation. This type should be deemed as incurable. 3 - 6.
* Here Pitta-aggravating and Vayu-aggravating causes also are intented by the word i.e., etc. in|
† Dallam's reading evidently is (indistinct).
In the Kshayaja type the voice emits vapour and, becoming lower and lower, it ultimately disappears. This stage of Svara-bheda (loss of voice) should be given up as incurable. In an attack of the Medoja type the patient speaks very indistinctly, the voice remaining, as it were, inside his throat. And his throat, lips and palate become sticky. 7-S.
Svara-bheda in cases of weak, old, emaciated, or fatty patient, as well as a long-standing, congenital or Tri-Doshaja one should be regarded as incurable. 9.
The body of the patient should be first rubbed with a Sneha (clarified butter, lit. - treated with emulsive measures) and the deranged bodily Dosha underlying the root of the attack should be curbed with the help of emetics, purgatives, Vasti, errhines, Avapida-Nasya, lambatives, smoke-inhalations or gargles. Measures and remedies previously mentioned in connection with the treatment of cough and asthma should be as well employed in their entirety in the present disease. Now hear me describe the medicinal remedies which arc specifically benefieial to a patient afflicted with an attack of Svara-bheda. 10.
In the Vataja type of the disease, the patient should take, after a full meal, clarified butter mixed with the expressed juice of Kasa-marda, Vartaku and Markava with Artagala (Arjua). In the alternative, Ghrita prepared from goat's milk and duly cooked with Yava-Kshara and Aiamoda or with Chitraka and Amalaka, or with Deva-daru and Agni (Chitraka) should be taken with honey. The diet of the patient in such a case should consist of boiled rice taken with treacle and clarified butter, followed by draughts of tepid water, II.
Clarified butter should be constantly used with milk in the Pittaja type of the disease. Payasa * duly prepared with the admixture of Yashti-madhu and clarified butter, should also be taken. Lambatives composed of the powdered drugs of the Madhura (Kakolyadi) group saturated with honey and clarified butter, or of powders of S'atavari or of Vala should be similarly taken. Powders of pungent drugs should be taken with a copious quantity of cow's urine or licked with oil and honey in a case of the Kaphaja type of Svara-bheda. 12 - 13.
The medical treatment in the case of the Medoja type of Svarabheda should be the same as in the Kaphaja type. The medical treatment of the Tri-Doshaja and Kshayaja types of the disease should be taken in hand without holding out any hope of recovery. Milk † duly cooked with the drugs of the Madhura group should be taken in combination with sugar and honey in a case due to the effects of loud speaking. 14 - 15.
Thus ends the fifty-third chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) treatment of hoarseness.
* Payasa is a special preparation of rice boiled with milk and sugar.
† Milk of a cow or of a she-buffalo, etc., may be used here. - Dallana.