The disease known as Mutropaghata is divided into eight different types according as an attack is induced by the deranged action of the bodily Vayu, Pitta and Kapha separately, or is due to the concerted action of all of them, or to the effects of an external blow or hurt (on the locality), or to the pressure of the feces incarcerated (in the intestine), - i.e. to the constipation of the bowels - or to the presence of any stone (As'mari in the bladder). The eighth is the one due to the presence of gravels (Sarkara in the bladder). This disease is one of the most painful and distressing ailments which assail the human body. 2.
A scanty flow of urine coming out in drops and producing an oppressive and bursting pain in the scrotum, penis and bladder, is the specific feature of the Va'tija type of the disease. The Pittaja type is characterised by the emission of bloody or high-coloured (lit. dark yellow) and (very) warm urine which produces a burning sensation in the scrotum, bladder and penis being burnt by fire, as it were. A sense of weight or heaviness in the scrotum, penis and bladder, an appearance of goose-flesh (on the skin) and the emission of cold, white and glossy (oily) urine, arc the features which mark the Kaphaja type. Burning-sensation (in the urethra, etc.), shivering (of the body), frequent emission of urine of varied colours, painful micturition and loss of consciousness are the indications which point to the Sannipalika origin of the disease which is very hard to cure. 3-6.
* Dallana's reading evidently is Mutra-krichchhra (Strangury), for he says that the variant here in some Mss. is Mutra-dosha. He says further that some do not read this chapter at all on the ground that the matter in this chapter is included in the chapters on As'mari, Mutraghata and Udavarta, etc. But, according to him, it must be read here for treatment's sake as well as on the ground of its being separately treated in other authoritative works. Madhava, Chakra-pani, Vrinda and other compilers have read this as Mutra-krichchhra in a separate chapter as here.
The presence of any ulcer in or an injury to the urethra, by any external object gives rise to an extremely distressing stricture in the case of which the characteristic symptoms of Vata-vasti manifest themselves. The suppression of the feces leads to the aggravation of the local Vayu which, in its turn, produces a distension of the abdomen and a suppression of urine accompanied with cramps (in the bladder). 7-8.
Mutra-ghita (obstructed urination) due to the presence of As'mari (stone) has been already mentioned (in the Nidana Sthana). Stones and gravels are of similar origin and exhibit similar symptoms. Now hear me describe the symptoms which are the distinguishing traits of a case of Sarkara (gravel or urinary calculus in the bladder). Flakes or particles of deranged and condensed Kapha when baked (dried ?) by the action of the deranged and aggravated Pitta and severed in pieces by the deranged bodily Vayu, are called Sarkarat (gravels) giving rise to such symptoms as cardiac troubles (pain in the heart, etc.), shivering, cramps in the loins, great diminution of the digestive fire, fainting fits and painful and obstructed urination. The pain, however, subsides with the subsidence of the desire for micturition (full evacuation of the bladder), the relief from the pain continuing until the orifice of the organ (urethra) is not again obstructed by the presence of other calculii. These are the symptoms which characterise a case of Mutraghata (obstructed urination)due to the presence of gravels in the bladder. 9.
Now I shall describe the mode of medical treatment and active therapeutic agents to be employed in the eight cases of Mutraghata. Medical measures and remedies mentioned in connection with the treatment of As'mari (stone) should also* be employed in the present instance in due succession - commencing with the application of Sneha, etc. - with proper regard to the Dosha or Dhosas involved in each case. 10.
Oil, clarified butter and lard mixed together should be duly cooked with S'va-damshtra, As'mabheda, Kumbhi (a kind of moss), Hapusha, Kantakari, Bala, S'atavari, Rasna, Varuna, Giri-karnika and the drugs of the Vidari-gandhadi group. Oil or clarified butter alone may also be similarly cooked and prepared with the above drugs. The above preparations should be internally administered, or injected into the intestines after the manner of an Anuvasana-vasti, or into the urethra as an Uttara-vasti for giving relief in cases of Vataja Mutra-krichchhra. 11-12.
The internal use of the clarified butter duly cooked with the drugs of the Trina-pancha-mula, Utpaladi, Kakolyadi and Nyagrodhadi groups, would give an instantaneous relief in a case of Pittaja Mutra-Krichchhra. The use of this Ghrita as an Uttara-vasti would also similarly give relief in a case of the present type. Any Sneha duly cooked with the preceding drugs should be similarly used after the manner of any of the three Vasti-applica-tions. Purging with milk and the expressed juice of Ikshu and of Draksha is also beneficial. Oils and Yavagus duly cooked with the drugs of the Surasadi, Ushakadi, Mustadi and the Varunadi groups would prove curative in a case of Kaphaja Mutra-krichchhra. 13 -14.
* Pallana says that the presence of the particle (meaning also) indicates that the mode of medical treatment prescribed in cases of Mutraghata should also be applied in this case.