Sushruta Samhita Uttaratantra Chapter 14 Bhedya Roga Pratisedha (Treatment of Diseases Requiring Puncturing)
The 14th chapter of Uttaratantra of Sushruta Samhita is named as Bhedya Roga Pratisedha Adhyaya. This chapter deals with the treatment of Diseases Requiring Puncturing.
अथातो भेद्यरोगप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound the treatment of Bhedya roga – diseases requiring incising / cutting open; as revealed by the venerable Dhanvantari.
Bisa Granthi Cikitsa
स्वेदयित्वा बिसग्रन्थिं छिद्राण्यस्य निराशयम् |
पक्वं भित्त्वा तु शस्त्रेण सैन्धवेनावचूर्णयेत् ||३||
कासीसमागधीपुष्पनेपाल्येलायुतेन तु |
ततः क्षौद्रघृतं दत्त्वा सम्यग्बन्धमथाचरेत् ||४||
Below mentioned are the steps involved in treating Bisa Granthi –
– Firstly, the cystic swelling in Bisa Granthi should be given with swedana – fomentation.
– Using a shastra – sharp instrument the cavity of ripened swelling should be cut open. After opening it, its contents like pus etc should be cleared out completely without leaving any traces. (Only ripened swelling should be cut open)
– The cavity should now be filled with smooth powder prepared with Saindhava, Kasisa, Magadhi, Puspa (Puspanjana), Nepali (Manasila) and Ela.
– The lesion is now bathed with a mixture of honey and ghee and then bandaged properly.
Lagana Cikitsa
रोचनाक्षारतुत्थानि पिप्पल्यः क्षौद्रमेव च |
प्रतिसारणमेकैकं भिन्ने लगण इष्यते ||५||
महत्यपि च युञ्जीत क्षाराग्नी विधिकोविदः |
Treatment of small sized Lagana – If the size of Lagana is small it should be subjected to bhedana i.e. cut open. Later, it should be applied with powder of the below mentioned separately, added with honey –
– Gorocana
– Ksara (Yavaksara)
– Thutha
– Pippali
Treatment of big sized Lagana – If the size of Lagana is big, Ksara – caustic alkali or Agni – fire cautery should be applied on it by a skilled physician / surgeon well versed with the procedure.
Anjananamika Cikitsa
Treatment of Anjananamika which has got open by itself
स्विन्नां भिन्नां विनिष्पीड्य भिषगञ्जननामिकाम् ||६||
शिलैलानतसिन्धूत्थैः सक्षौद्रैः प्रतिसारयेत् |
Swedana – Fomentation should firstly be given to Anjananamika which has opened / burst open on its own.
Nispidana – The swelling should be squeezed well.
Pratisarana – Powder of Manassila, Ela, Nata and Saindhava mixed with honey should be applied over the anjananamika which has been given swedana and squeezed thoroughly.
Treatment of Anjananamika which has not got open by itself
रसाञ्जनमधुभ्यां तु भित्त्वा वा शस्त्रकर्मवित् ||७||
प्रतिसार्याञ्जनैर्युञ्ज्यादुष्णैर्दीपशिखोद्भवैः |
Bhedana – If Anjananamika has not opened or burst open by itself, it should be subjected to bhedana – i.e. it should be cut open by a physician / surgeon who thoroughly knows the surgical procedures.
Application of Rasanjana – After Bhedana, the surgeon should apply Rasanjana mixed with honey over it.
Application of Anjana – Later, collyrium prepared from dipashika i.e. lamp black should be applied on it.
Krimigranthi cikitsa
सम्यक्स्विन्ने कृमिग्रन्थौ भिन्ने स्यात् प्रतिसारणम् ||८||
त्रिफलातुत्थकासीससैन्धवैश्च रसक्रिया |
Swedana – Krimigranthi should be properly fomented first.
Bhedana – Now, the cyst which has been fomented should be cut open by a skilled surgeon.
Rasakriya – Next, thick decoction prepared with Triphala, Tuttha, Kasisa and Saindhava should be applied over it.
Upanaha Cikitsa
भित्त्वोपनाहं कफजं पिप्पलीमधुसैन्धवैः ||९||
लेखयेन्मण्डलाग्रेण समन्तात् प्रच्छयेदपि |
Bhedana – Upanaha which is produced by morbid Kapha should be cut open by a wise surgeon.
Lepana – Paste of honey and Saindhava should be applied over it.
Lekhana – Next, Upanaha should be properly scraped all around with the help of Mandalagra Sastra.
Treatment principles of all the above said diseases
संस्नेह्य पत्रभङ्गैश्च स्वेदयित्वा यथासुखम् ||१०||
आपाकाद्विधिनोक्तेन पञ्चमेद्यानुपाचरेत् |
सर्वेष्वेतेषु विहितं विधानं स्नेहपूर्वकम् |
सम्पक्वे प्रयतो भूत्वा कुर्वीत व्रणरोपणम् ||११||
Snehana and Swedana – In all the above said Bhedya Rogas i.e. diseases fit to be treated by incising or cutting open should first be anointed. Following oleation, sudation should be comfortably given with patra bhanga – chips of dried leaves.
Pacana – all methods to cause ripening of the swellings should be adopted until they get completely ripened.
Snehapurvaka vidhanam – Treatments preceded by oleation should be done procedurally in all these diseases.
Vranaropanam – After they get ripened, they should be cut open and cleansed. Following this, the procedures of vrana ropana i.e. healing the wound are adopted.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे भेद्यरोगप्रतिषेधो नाम चतुर्दशोऽध्यायः ||१४||
Thus ends the fourteenth chapter by name ‘Bhedya roga Pratisedha’ in Uttara sthana of Susruta Samhita.
