Sushruta Samhita Uttaratantra Chapter 17 Dristigata Roga Pratisedha (Treatment of Diseases of the Pupil)
The 17th chapter of Uttaratantra of Sushruta Samhita is named as Dristigata Roga Pratisedha Adhyaya. This chapter deals with the treatment of Diseases of the Pupil.
अथातो दृष्टिगतरोगप्रतिषेधं व्याख्यास्यामः ।।१ ।।
यथोवाच भगवान् धन्वन्तरिः ।। २ ।।
We will now expound Drstigata roga pratisedha – treatment of diseases of the area of vision (pupil); as revealed by the venerable Dhanvantari.’
त्रयः साध्यास्त्रयोऽसाध्या याप्याः षट् च भवन्ति हि ।।
There are twelve diseases of Drsti – pupil. Among them –
– three diseases are sadhya – curable i.e. Dhumadarsi, Pittavidagdha Drsti and Slesma Vidagdha Drsti
– three diseases are asadhya – incurable i.e. Hrsvajadya, Nakulandhya and Gambirika and
– six diseases are yapya – controllable (cannot be completely cured but can be managed, the disease would be persistent) i.e. six types of Kaca (Timira or Linganasa)
तत्रैकस्य प्रतीकारः कीर्तितो धूमदर्शिनः ।। ३ ।।
Already, the treatment of Dhumadarsi has been described earlier in chapter 10, verse 16.
दृष्टौ पित्तविदग्धायां विदग्धायां कफेन च ।।
पित्तश्लेष्महरं कुर्याद्विधिं शस्त्रक्षतादृते ।।४ ।।
नस्यसेकाञ्जनालेपपुटपाकैः सतर्पणैः ।।
आद्ये तु त्रैफलं पेयं सर्पिस्त्रैवृतमुत्तरे || ५ ||
तैल्वकं चोभयोः पथ्यं केवलं जीर्णमेव वा ।।
Treatments which would mitigate pitta and kapha should be done in pitta vidagdha drsti and shleshma / kapha vidagdha drsti respectively, except the surgical procedures (operations).
Below mentioned therapies should be adopted –
– Nasya,
– Seka or Pariseka,
– Anjana,
– Alepa,
– Putapaka and
– Tarpana
In the first condition i.e. Pitta Vidagdha Drshti – Triphala Ghrta should be administered.
In the second condition i.e. Kapha Vidagdha Drshti – Trivrt Ghrta should be administered.
Tilvaka Ghrta or plain old ghee (which is old by many years) is suitable in both these conditions (diseases).
गैरिकं सैन्धवं कृष्णा गोदन्तस्य मषी तथा ।।६ ।।
गोमांस मरिचं बीजं शिरीषस्य मनःशिला ।।
वृन्तं कपित्यान्मधुना स्वयङ्गुप्ताफलानि च ।।७ ।।
चत्वार एते योगाः स्युरुभयोरञ्जने हिताः ।।
When used in the form of Anjana – collyrium, the below mentioned four kinds of formulae are beneficial in treatment of both these diseases i.e. pitta vidagdha drshti and kapha vidagdha drshti –
- Gairika, Saindhava, Krsna and ash of cow’s teeth;
- Gomamsa, Marica, Sirisabija and manassila;
- Tender leaves of Kapittha macerated with honey and
- Fruit of Svayamgupta macerated with honey.
कुब्जकाशोकशालाम्रप्रियङ्गुनलिनोत्पलैः ।।८ ।।
पुष्पैहरेणुकृष्णाह्वापथ्यामलकसंयुतैः ।।
सर्पिर्मधुयुतैश्चूर्णैर्वेणुनाड्यामवस्थितैः ।। ९ ।।
अञ्जयेद् द्वावपि भिषक् पित्तश्लेष्मविभावितौ ।।
Nice powder of the below mentioned herbs should be prepared –
– Kubjaka,
– Asoka,
– Sala,
– Amra,
– Priyangu,
– flower of Nalina and Utpala,
– Harenu,
– Krshnahva – Pippali,
– Pathya and
– Amalaka
This powder is mixed with ghee and honey, filled into a tube of bamboo and preserved.
Now, the physician should put this collyrium into the eyes in both pitta vidagdha drshti and sleshma vidagdha drshti.
आम्रजम्बूद्भवं पुष्पं तद्रसेन हरेणुकाम् ।। १० ।।
पिष्टवा क्षौद्राज्यसंयुक्तं प्रयोज्यमथवाऽञ्जनम् ।।
नलिनोत्पलकिञ्जल्कगैरिकैर्गोशकृद्रसैः ।। ११ ।।
गुडिकाञ्जनमेतद्वा दिनरात्र्यन्धयोर्हितम् ।।
Flowers of Amra and Jambu along with Harenu are macerated in the juice of their flowers itself. Later, honey and ghee are added to this and used as collyrium.
Below mentioned ingredients should be macerated together –
– Nalina,
– Utpala Kinjalka – stamens of lotus flowers and
– Fresh cow dung juice
Pills / wicks are made out of this. These pills are used for applying collyrium in blindness occurring at day time and night (day and night blindness).
रसाञ्जनरसक्षौद्रतालीशस्वर्णगैरिकम् ।।१२ ।।
गोशकृद्रससंयुक्तं पित्तोपहतदृष्टये ।
Below mentioned ingredients are macerated in the juice of cow dung and used as collyrium –
– Rasanjana,
– Rasa (according to Dalhana – juice of Jati leaves),
– Honey,
– Talisapatra and
– Swarna Gairika
This collyrium is beneficial in treatment of Pittavidagdha Drshti.
शीतं सौवीरकं वाऽपि पिष्ट्वाऽथ रसभावितम् ||१३||
कूर्मपित्तेन मतिमान् भावयेद्रौहितेन वा |
चूर्णाञ्जनमिदं नित्यं प्रयोज्यं पित्तशान्तये ||१४||
Sita i.e. Rasanjana or Karpura and Suviraka i.e. Sauviranjana are macerated in one of the below mentioned –
– Rasa – either mamsa rasa (meat soup) or Sakrt Rasa (juice of fresh cow dung) or
– Kurma Pitta – bile of tortoise or
– Rohita Pitta – bile of red fish
This is dried and preserved.
This Curnanjana (collyrium in powder form) should be used daily for mitigating pitta.
काशमरीपुष्पमधुकदार्वीरोध्ररसाञ्जनैः |
सक्षौद्रमञ्जनं तद्वद्धितमत्रामये सदा ||१५||
स्रोतोजं सैन्धवं कृष्णां रेणुकां चापि पेषयेत् |
अजामूत्रेण ता वर्त्यः क्षणदान्ध्याञ्जने हिताः ||१६||
Below mentioned ingredients added and mixed with honey and used as collyrium always is beneficial in this eye disease –
– Kasmari Puspa,
– Madhuka,
– Darvi,
– Rodhra and
– Rasanjana
Other recipe –
Below mentioned ingredients should be macerated in goat’s urine –
– Srotanjana,
– Saindhava,
– Krsna,
– Renuka and
– Ksanada (Haridra)
It is then made into wicks / dragees. This is beneficial when used as a collyrium.
कालानुसारिवां कृष्णां नागरं मधुकं तथा |
तालीशपत्रं क्षणदे गाङ्गेयं च यकृद्रसे ||१७||
कृतास्ता वर्तयः पिष्टाश्छायाशुष्काः सुखावहाः |
Below mentioned ingredients are macerated in the juice of liver or bile –
– Kalanusarya,
– Krsna,
– Nagara,
– Madhuka,
– Talisapatra,
– two kinds of Haridra and
– Gangeya – Musta
The paste is made into sticks or dragees and dried in shade. Later, it is used as a collyrium and it bestows comfort in these diseases.
मनःशिलाभयाव्योषबलाकालानुसारिवाः ||१८||
सफेना वर्तयः पिष्टाश्छागक्षीरसमन्विताः |१९|
Below mentioned ingredients are macerated in goat’s milk –
– Manassila,
– Abhaya,
– Vyosa,
– Bala,
– Kalanusariva and
– Phena – Samudraphena
The paste is made into dragees and used as collyrium.
गोमूत्रपित्तमदिरायकृद्धात्रीरसे पचेत् ||१९||
क्षुद्राञ्जनं रसेनान्यद्यकृतस्त्रैफलेऽपि वा |
गोमूत्राज्यार्णवमलपिप्पलीक्षौद्रकट्फलैः ||२०||
सैन्धवोपहितं युञ्ज्यान्निहितं वेणुगह्वरे |२१|
Below mentioned ingredients are boiled and made as Ksudranjana (Rasakriya – thick decoction) –
– Gomutra – cow’s urine,
– Gopitta – ox-bile,
– Madira – beer,
– Yakrt – juice of liver / bile and
– Dhatri Rasa – juice of Amalaka
Rasakriya is also prepared by boiling –
– Yakrt – liver and Triphala or Gomutra or
– Ghee, Samudraphena, Pippali, Honey, Katphala and Saindhava
The Rasakriya thus prepared is preserved in the hollow tube of bamboo. This is beneficial when used as a collyrium.
मेदो यकृद्धृतं चाजं पिप्पल्यः सैन्धवं मधु ||२१||
रसमामलकाच्चापि पक्वं सम्यङ्निधापयेत् |
कोशे खदिरनिर्माणे तद्वत् क्षुद्राञ्जनं हितम् ||२२||
Below mentioned ingredients are cooked together to form Rasakriya (thick decoction) –
– Fat, liver and ghee of goat,
– Pippali,
– Saindhava,
– Honey and
– Amalaki juice
This Rasakriya is filled into a container made from Khadira wood. This Ksudranjana i.e. collyrium of thick decoction is highly beneficial.
Slesmavidgadha drusti cikitsa
हरेणुमगधाजास्थिमज्जैलायकृदन्वितम् |
यकृद्रसेनाञ्जनं वा श्लेष्मोपहतदृष्टये ||२३||
In Sleshma Vidagdha Drshti, collyrium prepared by macerating the below mentioned ingredients in the soup of liver or bile is beneficial –
– Harenu,
– Magadhajasthi Majja (seeds of Pippali whose husk has been removed according to Dalhana),
– Ela,
– Yakrt
Naktandhya cikitsa – treatment of Night blindness
विपाच्य गोधायकृदर्धपाटितं सुपूरितं मागधिकाभिरग्निना |
निषेवितं तद्यकृदञ्जनेन निहन्ति नक्तान्ध्यमसंशयं खलु ||२४||
The liver of Godha i.e. iguana lizard is split. Magadhika – Pippali is filled in that liver. This liver is now cooked in the fire by enveloping it with plaster of mud and putting it in a heap of burning cow dung. The cooked liver should be consumed while the Pippali is made into collyrium and applied to the eyes. This recipe cures Naktandhya – night blindness without any doubt.
तथा यकृच्छागभवं हुताशने विपाच्य सम्यङ्मगधासमन्वितम् |
प्रयोजितं पूर्ववदाश्वसंशयं जयेत् क्षपान्ध्यं सकृदञ्जनान्नृणाम् ||२५||
Similarly Pippali should be filled in the goat liver and cooked in the fire. It is also used in the same manner as explained above. The liver should be consumed and the Pippali should be used as a collyrium. This quickly cures night blindness.
प्लीहा यकृच्चाप्युपभक्षिते उभे प्रकल्प्य शूल्ये घृततैलसंयुते |
ते सार्षपस्नेहसमायुतेऽञ्जनं नक्तान्ध्यमाश्वेव हतः प्रयोजिते ||२६||
The spleen and liver are pierced with an iron and are cooked over the flame. These cooked spleen and liver should be consumed together with ghee and oil. They should also be made as collyrium, added with sarsapa taila – mustard oil. It quickly cures night blindness.
नदीजशिम्बीत्रिकटून्यथाञ्जनं मनःशिला द्वे च निशे य(श)कृद्गवाम् |
सचन्दनेयं गुटिकाऽथवाऽञ्जनं प्रशस्यते वै दिवसेष्वपश्यताम् ||२७||
Below mentioned ingredients are cooked together and consumed –
– Nadija (saindhava lavana according to Dalhana),
– Simbi (moist green gram),
– Trikatu,
– Anjana (Srotonjana),
– Manassila,
– two kinds of Nisa (Haridra and Daruharidra),
– Go Yakrt (liver of cow or ox) and
– Candana
Collyrium is also prepared with the same ingredients and applied to the eyes. This is beneficial for those who are unable to see even during day time.
Kaca cikitsa- treatment of Cataract
भवन्ति याप्याः खलु ये षडामया हरेदसृक्तेषु सिराविमोक्षणैः |
विरेचयेच्चापि पुराणसर्पिषा विरेचनाङ्गोपहितेन सर्वदा ||२८||
Bloodletting should be done by venepuncture method in the six diseases which are Yapya (incurable but controllable / manageable).
Old ghee processed / boiled with purgative herbs should always be administered for the purpose of purgation.
पयोविमिश्रं पवनोद्भवे हितं वदन्ति पञ्चाङ्गुलतैलमेव तु |
भवेद्धृतं त्रैफलमेव शोधनं विशेषतः शोणितपित्तरोगयोः ||२९||
त्रिवृद्विरेकः कफजे प्रशस्यते त्रिदोषजे तैलमुशन्ति तत्कृतम् |
| Dosha producing Kaca disease | Best purgative |
| Vata | Oil of Pancangula (Eranda) added to boiled milk |
| Rakta and Pitta | Triphala Ghrta |
| Kapha | Trivrt |
| Tridosha | Oil boiled with Trivrt |
Ardha timira cikitsa – treatment of partial blindness
पुराणसर्पिस्तिमिरेषु सर्वशो हितं भवेदायसभाजनस्थितम् ||३०||
हितं च विद्यात्त्रिफलाघृतं सदा कृतं च यन्मेषविषाणनामभिः |
Purana Sarpi i.e. ghee which is old by many years is kept in an iron vessel. It can be used in many methods / forms i.e. internal consumption, collyrium etc and will be beneficial when used.
Similarly, Triphala Ghrta or ghee cooked and processed with Mesa Visananama (Mesasringi) are also beneficial.
सदाऽवलिह्यात्त्रिफलं सुचूर्णितां घृतप्रगाढां तिमिरेऽथ पित्तजे ||३१||
समीरजे तैलयुतां कफात्मके मधुप्रगाढां विदधीत युक्तितः |
| Predominant Dosha causing Timira (partial blindness) | Method of using Triphala Churna (nice powder of Triphala |
| Pitta (Pittaja Timira) | Added with more quantity of ghee should be consumed always |
| Vata (Vataja Timira) | Mixed with more of sesame oil |
| Kapha (Kaphaja Timira) | Added with more quantity of honey. |
गवां शकृत्क्वाथविपक्वमुत्तमं हितं तु तैलं तिमिरेषु नावनम् ||३२||
हितं घृतं केवल एव पैत्तिके ह्यजाविकं यन्मधुरैर्विपाचितम् |
तैलं स्थिरादौ मधुरे च यद्गणे तथाऽणुतैलं पवनासृगुत्थयोः ||३३||
| Predominant dosha causing Timira | Nasya Done with – |
| Kapha | Oil cooked with juice of fresh cow dung |
| Pitta | Ghee of goat or sheep either alone or cooked with sweet tasting herbs |
| Vata and Rakta | Oil boiled with herbs belonging to Sthiradi (Vidarigandhadi Gana) group and Madhura Gana (Kakolyadi Gana) group or Anu Taila |
सहाश्वगन्धातिबलावरीशृतं हितं च नस्ये त्रिवृतं यदीरितम् |
जलोद्भवानूपजमांससंस्कृताद्धृतं विधेयं पयसो यदुत्थितम् ||३४||
For Nasal drops, the below mentioned ghee can be used –
– ghee boiled and processed with Ashwagandha, Atibala and Vari (Satavari) or
– Trivrt Ghrta or
– Ghee obtained from milk boiled with meat of animals living in water and marshy regions
ससैन्धवः क्रव्यभुगेणमांसयोर्हितः ससर्पिः समधुः पुटाह्नयः ।।
वसाऽथ गृध्रोरगताम्रचूडजा सदा प्रशस्ता मधुकान्विताऽञ्जने ॥ ३५ ॥
The flesh of carnivorous animals and ena – black deer are cooked in Putapaka method. By this, the meat juice of these animals is obtained. To this juice is added with Saindhava Lavana, ghee and honey and used as putapaka (eye drops).
Always, the muscle fat of a vulture, snake or cock is added with honey and used as collyrium is beneficial.
प्रत्यञ्जनं स्त्रोतसि यत्समुत्थितं क्रमाद्रसक्षीरघृतेषु भावितम् ।।
Srotonjana – the anjana arising in the upriver is macerated in meat soup, milk and ghee, one after the other in an order. This should be used as Pratyanjana – counter collyrium.
Saraga timira / Kaca cikitsa
स्थितं दशाहत्रयमेतदञ्जनं कृष्णोरगास्ये कुशसंप्रवेष्टिते ।। ३६ ।।
तन्मालतीकोरकसैन्धवायुतं सदाऽञ्जनं स्यात्तिमिरेऽथ रागिणि ।।
सुभावितं वा पयसा दिनत्रयं काचापहं शास्त्रविदः प्रचक्षते ।। ३७ ।।
Anjana (srotonjana) is kept inside the mouth of a black serpent and enveloped with Kusa grass and made to remain there for thirty days. Afterwards, it is removed and macerated with buds of Malati flowers and Saindhava Lavana. Alternatively, it is kept soaked in milk and later macerated in the same milk and used as collyrium.
Benefits – According to the persons who are learned in sciences, this recipe cures Kaca – cataract.
हविर्हितं क्षीरभवं तु पैत्तिके वदन्ति नस्ये मधुरौषधैः कृतम् ।।
तत्तर्पणे चैव हितं प्रयोजितं सजाङ्गलस्तेषु च यः पुटाह्वयः ।। ३८ ||
Nasya in Pittja Kaca – Ghee prepared from milk boiled with herbs belonging to Kakolyadi Gana (sweet tasting herbs) group is the best one to be used as nasal drops in the treatment of Pittaja Kaca.
The same herbs mentioned above are cooked in Putapaka method along with the meat of animals living in arid regions. Following this, their juice is extracted and is used for administering Tarpana – bathing the eye.
रसाञ्जनक्षौद्रसितामनः शिलाः क्षुद्राञ्जनं तन्मधुकेन संयुतम् ।।
समाञ्जनं वा कनकाकरोद्भवं सुचूर्णितं श्रेष्ठमुशन्ति तद्विदः ।। ३ ९ ।।
Collyrium prepared with the below mentioned is beneficial –
– Rasanjana,
– Ksaudra – honey,
– Sita – Karpura,
– Manassila and
– Madhuka
Alternatively, equal quantity of srotonjana and that obtained from gold mines is well powdered and mixed with honey. This is applied as collyrium to the eyes and the specialists consider it to be the best recipe.
भिल्लोटगन्धोदकसेकसेचितं प्रत्यञ्जने चात्र हितं तु तुत्थकम् ।।
समेषशृङ्गाञ्जनभागसंमितं जलोद्भवं काचमलं व्यपोहति ।। ४० ।।
Bhillota and Tutthaka are soaked in Gandhodaka and macerated in the same. This is applied to the eyes as collyrium.
Alternatively, equal parts of the below mentioned are made into collyrium and applied to the eyes –
– Mesasrngi,
– Anjana (Srotonjana) and
– Jalodbhava
This helps in removing Kaca Mala.
पलाशरोहीतमधूकजा रसाः क्षौद्रेण युक्ता मदिराग्रमिश्रिताः ।।
Below mentioned ingredients made into collyrium by adding and mixing with honey and scum of madira (beer) is beneficial –
– Juice (latex / resin) of Palasa,
– Rohitaka and
– Madhuka
Kaphaja Kaca cikitsa
उशीरलोध्रत्रिफलाप्रियङ्गभिः पचेत्तु नस्यं कफरोगशान्तये ।। ४१ ।।
The below mentioned herbs are cooked along with tila taila –
– Usira,
– Rodhra,
– Triphala and
– Priyangu
This should be used as nasal drops. It mitigates diseases like Kaca produced by Kapha.
विडङ्गपाठाकिणिहीङ्गुदीत्वचः प्रयोजयेद्धूममुशीरसंयुताः ।।
Below mentioned herbs should be used together as dhuma (smoke inhalation) –
– Vidanga,
– Patha,
– Kinihi,
– Bark of Ingudi and
– Usira
वनस्पतिक्वाथविपाचितं घृतं हितं हरिद्रानलदे च तर्पणम् ।। ४२ ।।
Ghee boiled with the decoction of below mentioned ingredients should be used for tarpana –
– Vanaspatis – trees shedding milky sap (Pancavalkala),
– Haridra and
– Nalada (Usira)
समागधो माक्षिकसैन्धवाढ्यः सजाङ्गलः स्यात् पुटपाक एव च ।।
Below mentioned ingredients are cooked by Putapaka method –
– meat of animals of arid lands,
– Magadhika,
– Maksika – honey and
– more quantity of Saindhava lavana
The resultant juice is put into the eye and is beneficial.
मनः शिलात्र्यूषणशङ्खमाक्षिकैः ससिन्धुकासीसरसाञ्जनैः क्रियाः ।। ४३ ।।
हिते च कासीसरसाञ्जने तथा वदन्ति पथ्ये गुडनागरैर्युते ।।
Rasakriya i.e. thick decoction is prepared by cooking together the below mentioned ingredients –
– Manassila,
– Tryusana,
– Sankha,
– Maksika,
– Sindhu (Srotonjana),
– Kasisa and
– Rasanjana
This Rasakriya is beneficial when applied to the eyes.
Similarly, thick decoction of the below mentioned ingredients should be prepared and applied to the eyes –
– Kasisa,
– Rasanjana,
– Guda and
– Nagara
This is beneficial for the eyes according to the specialists of the eye.
यदञ्जनं वा बहुशो निषेचितं समूत्रवर्गे त्रिफलोदके शृते ।।४४ ।।
निशाचरास्थिस्थितमेतदञ्जनं क्षिपेच्च मासं सलिलेऽस्थिरे पुनः ।।
मेषस्य पुष्पैर्मधुकेन संयुतं तदञ्जनं सर्वकृते प्रयोजयेत् ।। ४५ ।।
Anjana i.e. Srotonjana should be boiled many times in the urines of animals along with Triphala powder. It is made into a thick decoction. Later this thickened decoction is filled into the hollow of bones of nocturnal animals and birds. These bones are placed in a flowing stream of water for a period of one month. After one month, they are taken out and added with flowers of Mesasrnga and Madhuka and used as a collyrium in Kaca produced by all the doshas (aggravation of all doshas together).
क्रियाश्च सर्वाः क्षतजोद्भवे हितः क्रमः परिम्लायिनि चापि पित्तहृत् ।।
Different therapies indicated for all the eye disorders like Ascyotana, Anjana, Tarpana etc. shall be adopted in Kaca produced by injury. In Parimlayi also the same treatments should be adopted. Additionally, therapies to mitigate pitta should also be adopted.
क्रमो हितः स्यन्दहरः प्रयोजितः समीक्ष्य दोषेषु यथास्वमेव च ।। ४६ ।।
दोषोदये नैव च विप्लुतिंगते द्रव्याणि नस्यादिषु योजयेद्बुधः ।।
In the treatment of this disease also, treatments indicated for Abhisyanda as appropriate to the aggravated dosha is beneficial and should hence be adopted. These treatments should be adopted when there is excessive aggravation of the doshas or when they have spread widely. Suitable herbs should be selected to prepare medicines for Nasya etc. therapies and hence the diseases should be treated.
पुनश्च कल्पेऽञ्जनविस्तरः शुभः प्रवक्ष्यतेऽन्यस्तमपीह योजयेत् ।।४७ ।।
The details of some more beneficial collyriums shall be furnished in Kriya Kalpa context (next chapter). Those Anjanas also shall be brought into use.
Prasasta ahara – beneficial foods
घृतं पुराणं त्रिफलां शतावरीं पटोलमुद्धामलकं यवानपि ।।
निषेवमाणस्य नरस्य यत्नतो भयं सुघोरात्तिमिरान्न विद्यते ।।४८ ।।
शतावरीपायस एव केवलस्तथा कृतो वाऽऽमलकेषु पायसः ।।
प्रभूतसर्पिस्त्रिफलोदकोत्तरो यवौदनो वा तिमिरं व्यपोहति ।। ४ ९ ।।
When a person consumes the below mentioned things daily, with all efforts will not have fear of dreadful Timira –
– Purana Ghrta – ghee which is old by many years,
– Triphala,
– Satavari,
– Patola,
– Mudga,
– Amalaka and
– Yava
Below mentioned recipes should be consumed –
– Payasa i.e. milk pudding prepared from only Satavari or
– Payasa prepared from Amalaka or
– Yava Odana i.e. cooked barley added with more quantity of ghee
Following this, one should drink decoction of Triphala.
This cures Timira.
जीवन्तिशाकं सुनिषण्णकं च सतण्डुलीयं वरवास्तुकं च ।।
चिल्ली तथा मूलकपोतिका च दृष्टेर्हितं शाकुनजाङ्गलं च ॥५० ॥
पटोलकर्कोटककारवेल्लवार्ताकुतर्कारिकरीरजानि ।।
शाकानि शिग्वार्तगलानि चैव हितानि दृष्टेर्घृतसाधितानि ।। ५१ ।।
Below mentioned are good for eye sight –
– Leaves of Jivanti, Sunisannaka, Tanduliyaka, Vastuka, Cilli, Mulaka Potika and
– Meat of animals living in arid regions
Below mentioned leaves cooked with ghee and used are also good for eyesight –
– Patola,
– Karkotaka,
– Karavella,
– Vartaka,
– Karira,
– Sigru and
– Artagalla
Varjya – Avoidable things
विवर्जयेत्सिरामोक्षं तिमिरे रागमागते ।।
यन्त्रेणोत्पीडितो दोषो निहन्यादाशु दर्शनम् ।। ५२ ।।
Venepuncture should not be done when Timira has attained colour. This is because instrumentation causes more aggravation of doshas. These doshas, aggravated due to instrumentation, quickly destroys the vision.
अरागि तिमिरं साध्यमाद्यं पटलमाश्रितम् ।।
कृच्छ्रं द्वितीये रागि स्यात्तृतीये याप्यमुच्यते ।। ५३ ।।
Timira is curable when it has not attained colour and localized in the first layer (prathama patala) of the eye.
Timira localized in the second patala and having attained colour is curable with difficulty.
Timira localized in the third patala is incurable and persistent.
रागप्राप्तेष्वपि हितास्तिमिरेषु तथा क्रियाः ।।
यापनार्थं यथोद्दिष्टाः सेव्याश्चापि जलौकसः ।।५४ ।।
It has been advised that even the Timira which has attained colour should be treated in order to keep it under control. Leeches can also be used for bloodletting in this condition.
Kaphaja Linganasa cikitsa
श्लैष्मिके लिङ्गनाशे तु कर्म वक्ष्यामि सिद्धये ।।
न चेदर्धेन्दुघर्माम्बुबिन्दुमुक्ताकृतिः स्थिरः ।। ५५ ।।
विषमो वा तनुर्मध्ये राजिमान् वा बहुप्रभः ।।
दृष्टिस्थो लक्ष्यते दोषः सरुजो वा सलोहितः ।। ५६ ।।
Now, the surgical treatment for the cure of Lingnanasa – blindness produced by Kapha shall be described.
Surgical treatment should be done only in the below mentioned conditions –
– when doshas localized on the drshti – pupil is not in the shape of half moon, sweet drop or a pearl
– when drshti is static (fixed, without movement),
– when drshti is irregular,
– when drshti is thin in the middle having linens,
– when it is very bright, painful or painless
Sastra cikitsa vidhi – procedure for surgical operation for cataract
स्निग्धस्विन्नस्य तस्याथ काले नात्युष्णशीतले ।।
यन्त्रितस्योपविष्टस्य स्वां नासां पश्यतः समम् ।।५७ ।।
मतिमान् शुक्लभागौ द्वौ कृष्णान्मुक्त्वा ह्यपाङ्गतः ।।
उन्मील्य नयने सम्यक् सिराजालविवर्जिते ।।५८ ।।
नाधो नोर्ध्वं न पार्श्वाभ्यां छिद्रे दैवकृते ततः ।।
शलाकया प्रयत्नेन विश्वस्तं यववक्रया || ५ ९ ।।
मध्यप्रदेशिन्यङ्गुष्ठस्थिरहस्तगृहीतया ।।
दक्षिणेन भिषक् सव्यं विध्येत् सव्येन चेतरत् ।। ६० ।।
वारिबिन्द्वागमः सम्यग् भवेच्छब्दस्तथा व्यधे ।।
संसिच्य विद्धमात्रं तु योषित्स्तन्येन कोविदः ।।६१ ।।
स्थिरे दोषे चले वाऽपि स्वेदयेदक्षि बाह्यतः ।।
सम्यक् शलाकां संस्थाप्य भङ्गैरनिलनाशनैः ।।६२ ।।
शलाकाग्रेण तु ततो निर्लिखेदृष्टिमण्डलम् ।।
विध्यतो योऽन्यपार्श्वेऽक्ष्णस्तं रुद्धवा नासिकापुटम् ।। ६३ ।।
उच्छिङ्गनेन हर्तव्यो दृष्टिमण्डलगः कफः ।।
निरभ्र इव धर्माशुर्यदा दृष्टिः प्रकाशते ।। ६४ ।।
तदाऽसौ लिखिता सम्यग् ज्ञेया या चापि निर्व्यथा ।
(एवं त्वशक्ये निर्हर्तुं दोषे प्रत्यागतेऽपि वा ।। ६५ ।।
स्नेहाद्यैरुपपन्नस्य व्यधो भूयो विधीयते ।। )
ततो दृष्टेषु रूपेषु शलाकामाहरेच्छनैः ।।६६ ।।
घृतेनाभ्यज्य नयनं वस्त्रपट्टेन वेष्टयेत् ।।
ततो गृहे निराबाधे शयीतोत्तान एव च ।। ६७ ।।
उद्गारकासक्षवथुष्टीवनोत्कम्पनानि च ।।
तत्कालं नाचरेदूर्ध्वं यन्त्रणा स्नेहपीतवत् ।। ६८ ।।
Oleation and sudation therapies should be given at a time which is neither very hot nor very cold. After this, the patient should be made to sit on a stool / chair and restrained from making any movements (he should be held by attendants not allowing him to move). He should be instructed to look at his nose steadily.
Now, the intelligent physician should keep the eye of the patient wide open.
He should now select
– a place near the apanga (outer angle / outer canthus)
– avoiding the two third portion of sukla (white of the eye – sclera) from krshna (cornea),
– devoid of a network of veins,
– neither very above, below or to the side and
– near to the god made natural orifice (pupil) and
– make an incision with a rod like instrument having a very small cutting edge in the shape of barley
Next, the physician should hold the rod like instrument firmly with the middle and index fingers and thumb of his right hand, should incise the left eye and with his left hand should incise the right eye.
Signs of incision properly done – A drop of water i.e. serous fluid resembling water comes out accompanied with a small sound.
Now, the physician should fill the eye of the patient with breast milk. He should also give fomentation over the eye irrespective of doshas, whether steady or unsteady. Fomentation should be given by using bits of vata mitigating leaves (patra pinda sweda).
Now, the physician holding the instrument should scrape the pupil (drshti mandala) of the other eye firmly and then incise it.
The physician should then instruct the patient to close his nostrils tightly and suck up with force. This is the ideal method of removing kapha from Drsti Mandala.
Signs of proper scraping (incision, cut) –
– patient is able to see the sun in the sky devoid of clouds,
– the patient’s sight is shining i.e. is clear or unhazy and
– the eye is devoid of pain
The patient should be administered oleation and other therapies following which incising should be done once again more deeply in the below mentioned conditions –
– if doshas (disease) cannot be removed by this method (explained above) at once or
– when the doshas have accumulated once again (disease has recurred)
The instrument should be removed out slowly when the person is able to see the objects. After this, the eye should be bathed with ghee and bandaged with bands of cloth.
The patient is then shifted to a house which is free from hindrances and made to lie down with his face up.
The patient is also instructed not to indulge in the below mentioned during that time
– belching,
– coughing,
– sneezing,
– spitting and
– shivering
Restraints related to foods and activities here are same as those prescribed for persons who have undergone oleation therapy i.e. those who have consumed fats.
त्र्यहात् त्र्यहाच्च धावेत कषायैरनिलापहैः ।।
वायोर्भयात् त्र्यहादूर्ध्वं स्वेदयेदक्षि पूर्ववत् ।। ६९ ।।
शाहमेवं संयम्य हितं दृष्टिप्रसादनम् ।।
पश्चात्कर्म च सेवेत लघ्वन्नं चापि मात्रया ।।७० ।।
There is always a fear of aggravation of vata. Therefore, eyes should be washed with decoction prepared with vata mitigating eyes once in three days.
The eyes should be fomented as described earlier (verse 62) after the third day.
The post operative measures such as Nasya, Tarpana, Shirovasti etc. (according to Acharya Dalhana) should be adopted after treating the eyes like this for a period of ten days. Also, the patient should consume light foods in limited quantities.
सिराव्यधविधौ पूर्व नरा ये च विवर्जिताः ।।
न तेषां नीलिकां विध्येदन्यत्राभिहिताद्भिषक् ।। ७१ ।।
पूर्यते शोणितेनाक्षि सिरावेधाद्विसर्पता ।।
तत्र स्त्रीस्तन्ययष्ट्याह्नपक्कं सेके हितं घृतम् ।।७२।।
The physician should never do venepuncture in Nilika (Linganasa) at places of the eye other than those indicated, especially in those who are declared as unfit / rejectable for venepuncture procedure (ref – sarira sthana – chapter 8).
If done, the eye becomes filled with exuding blood. In this condition it is beneficial to conduct pariseka (shower, eye bath) with breast milk or ghee prepared with Yashtimadhu.
अपाङ्गासन्नविद्धे तु शोफशूलानुरक्तताः ।।
तत्रोपनाहं भ्रूमध्ये कुर्याच्चोष्णाज्यसेचनम् ।।७३ ।।
व्यधेनासन्नकृष्णेन रागः कृष्णं च पीड्यते ।।
तत्राधः शोधनं सेकः सर्पिषा रक्तमोक्षणम् ।। ७४ ।।
अथाप्युपरि विद्वे तु कष्टा रुक् संप्रवर्तते ।।
तत्र कोष्णेन हविषा परिषेकः प्रशस्यते ।।७५।।
शूलानुरागास्त्वत्यर्थमधोवेधेन पिच्छिलः ।।
शलाकामनु चास्त्रावस्तत्र पूर्वचिकित्सितम् ।। ७६ ।।
रागाश्रुवेदनास्तम्भहर्षाश्चातिविघट्टिते ।।
स्नेहस्वेदौ हितौ तत्र हितं चाप्यनुवासनम् ।।७७।।
दोषस्त्वधोऽपकृष्टोऽपि तरुणः पुनरूर्ध्वगः ।।
कुर्याच्छुक्लारुणं नेत्रं तीव्ररुङ्नष्टदर्शनम् ।। ७८ ।।
मधुरैस्तन्त्र सिद्धेन घृतेनाक्ष्णः प्रसेचनम् ।।
शिरोबस्तिं च तेनैव दद्यान्मांसैश्च भोजनम् ।। ७९ ।।
Signs and symptoms of cutting / incising done very near to outer canthus of the eye (apanga) –
– swelling,
– pain,
– lacrimation and
– redness
Treatment – If these symptoms occur, warm poultice should be applied on the affected eye / eyes. Also, ghrta dhara should be done i.e. warm ghee should be poured as dhara in between the eyebrows.
Signs and symptoms of cutting / incising done very close to krsna – cornea –
– redness,
– pain (in cornea)
Treatment – Below mentioned treatments should be done-
– purgation,
– pouring ghee on corneal region and
– venepuncture
Signs and symptoms of cutting / incising done below the indicated site –
– severe pain,
– excessive tears coming out,
– redness and
– slimy exudation after removing the instrument
Treatment – should be done as stated above.
Signs and symptoms of cutting / incising done deeply –
– redness,
– lacrimation,
– pain,
– loss of movements and
– tingling sensation
Treatment – In this condition, oleation, sudation and oil enema are beneficial.
When linganasa disease (cataract) is unripe, it gives rise to whitish red colour (of the eyes), severe pain and loss of vision, in spite of the upward doshas being brought downward (by cutting or incising).
Treatment – Ghee boiled and prepared with herbs predominantly having a sweet taste should be used for filling the eyes. The same ghee shall be used for administering Sirobasti – pooling of medicated fats (oil or ghee) over the head. Foods predominantly having or made of meat should be given to the patient for eating.
दोषस्तु संजातबलो घनः संपूर्णमण्डलः ।।
प्राप्य नश्येच्छलाकाग्रं तन्वभ्रमिव मारुतम् ।।८० ।।
मूर्धाभिघातव्यायामव्यवायवमिमूर्च्छनैः ।।
दोषः प्रत्येति कोपाच्च विद्वोऽतितरुणश्च यः ।। ८१ ।।
Doshas become solid when they have attained strength. They occupy the entire Dristimandala. They damage the thin tip (sharp flat edge) of the instrument inserted in the eye and make it blunt, inactive and sluggish, just like the wind quickly destroys thin clouds.
Below mentioned are the causes of doshas becoming greatly aggravated –
– injury to the head,
– physical exercise,
– copulation,
– vomiting,
– fainting and
– anger and
– cutting or incising linganasa when it is in an unripe state
Sastra Gunavaguna – bad and good instrument
शलाका कर्कशा शूलं, खरा दोषपरिप्लुतिम् ।।
व्रणं विशालं स्थूलाग्रा, तीक्ष्णा हिंस्यादनेकधा ।। ८२ ।।
जलास्त्रावं तु विषमा, क्रियासङ्गमथास्थिरा ।।
करोति वर्जिता दोषैस्तस्मादेभिर्हिता भवेत् ।।८३ ।।
अष्टाङ्गुलायता मध्ये सूत्रेण परिवेष्टिता ।।
अङ्गुष्ठपर्वसमिता वक्रयोर्मुकुलाकृतिः ।।८४ ।।
ताम्रायसी शातकुम्भी शलाका स्यादनिन्दिता ।।
Rod line instrument, –
– if rough, gives rise to pain;
– if coarse (blunt, irregular) produces spreading of the Doshas;
– if its tip (edge) is thick it gives rise to a wide / broad wound;
– if very sharp, causes troubles (wounds) of many kinds;
– if irregular produces exudation of watery fluid;
– if irregular (curved) and unsteady (loose) causes hindrance to work (of surgery)
Therefore, an instrument devoid of these blemishes should be used for getting benefits and good results.
The instrument having the below mentioned features is said to be ideal –
– it should be of eight angula (16cm) in length,
– should be wound with thread in its middle,
– should have the thickness of the thumb,
– its face i.e. sharp edge should be in the shape of a flower bud,
– it should have been made of either copper, iron or gold
रागः शोफोऽर्बुदं चोषो बुद्रुदं शूकराक्षिता ।।८५।।
अधिमन्तादयश्चान्ये रोगाः स्युर्व्यधदोषजाः ।।
अहिताचारतो वाऽपि यथास्वं तानुपाचरेत् ।।८६ ।।
Below mentioned are the diseases / complications produced by improper cutting (incising) or by improper activities –
– reddish colouration of the eye,
– swelling,
– tumour,
– sucking pain,
– appearance of pig-like eyes i.e. eyes which are always looking downwards,
– adhimantha – glaucoma etc.
These should be promptly and appropriately treated.
रुजायामक्षिरागे वा योगान् भूयो निबोध मे ।।
गैरिकं सारिवा दूर्वा यवपिष्टं घृतं पयः ।।८७।।
सुखालेपः प्रयोज्योऽयं वेदनारागशान्तये ।।
मृदुभृष्टैस्तिलैर्वाऽपि सिद्धार्थकसमायुतैः ।।८८ ।।
मातुलुङ्गरसोपेतैः सुखालेपस्तदर्थकृत् ।।
पयस्यासारिवापत्रमञ्जिष्ठामधुकैरपि ।।८९ ।।
अजाक्षीरान्वितैर्लेपः सुखोष्णः पथ्य उच्यते ।।
दारुपद्मकशुण्ठीभिरेवमेव कृतोऽपि वा ।। ९० ।।
द्राक्षामधुककुष्ठैर्वा तद्वत् सैन्धवसंयुतैः ।।
रोघ्रसैन्धवमृद्वीकामधुकैर्वाऽप्यजापयः ।। ९१ । ।
शृतं सेके प्रयोक्तव्यं रुजारागनिवारणम् ।।
मधुकोत्पलकुष्ठैर्वा द्राक्षालाक्षासितायुतैः ।।
ससैन्धवैः शृतं क्षीरं रुजारागनिबर्हणम् ।। ९२ ।।
शतावरीपृथक्पर्णीमुस्तामलकपद्मकैः ।।
साजक्षीरैः शृतं सर्पिर्दाहशूलनिबर्हणम् ।।९३ ।।
वातघ्नसिद्धे पयसि सिद्धं सर्पिश्चतुर्गुणे ।।
काकोल्यादिप्रतीवापं तद्युञ्ज्यात् सर्वकर्मसु ।।१४।।
Next, the medicinal formulations which will be useful in treating the pinkish and reddish colouration of the eyes will be explained by me.
A mixture or recipe prepared from the below mentioned ingredients may be used in the form of poultice on the eyes to mitigate pain and redness of the eye –
– gairika,
– sariva,
– durva,
– flour of yava and
– milk
For applying on the face – slightly fried tila added with siddhartaka and macerated with matulunga juice may be used.
Below mentioned ingredients are macerated in goat’s milk –
– Payasya,
– Sariva,
– Patra
– Manjistha and
– Madhuka
The resultant paste is beneficial when comfortably applied on the face.
Similarly, the paste of Daru, Padmaka and Sunthi, prepared in the same method shall be used for the same purpose.
For Pariseka i.e. bathing the eye, the below mentioned recipes boiled and prepared in goat’s milk shall be used –
– Draksha, Madhuka, Kustha and Saindhava or
– Rodhra, Saindhava, Mrdvika and Madhuka
These recipes would help in mitigating pain and redness.
Similarly, the below mentioned are boiled and prepared in goat’s milk –
– Madhuka,
– Utpala,
– Kustha,
– Draksha,
– Laksha,
– Sita and
– Saindhava
It is used to provide relief from pain and redness.
Ghee is prepared with the below mentioned ingredients –
– Satavari,
– Prthakparni,
– Musta,
– Amalaka,
– Padmaka and
– Goat’s milk
This ghee is used for bathing the eyes. It cures burning sensation and pain.
Medicated ghee is prepared by cooking the below mentioned ingredients together –
– decoction prepared from vata mitigating herbs – four parts,
– ghee – one part and
– paste of Kakolyadi Gana – one part
This ghee is used for all purposes i.e. for bathing the eye, nasal drops etc. therapies.
शाम्यत्येवं न चेच्छूलं स्निग्धस्विन्नस्य मोक्षयेत् ।।
ततः सिरां दहेद्वाऽपि मतिमान् कीर्तितं यथा । । ९५ । ।
If the pain does not subside by these treatments, the patient should be subjected to oleation and sudation therapies. After these, the physician shall conduct venepuncture or burn the vein with fire (cauterization using fire) as described previously.
दृष्टेरतः प्रसादार्थमञ्जने शृणु मे शुभे ।।
मेषशृङ्गस्य पुष्पाणि शिरीषधवयोरपि ।। ९६ ।।
सुमनायाश्च पुष्पाणि मुक्ता वैदूर्यमेव च ।।
अजाक्षीरेण संपिष्य ताम्रे सप्ताहमावपेत् ।। ९७।।
प्रविधाय च तद्वर्तीयजयेच्चाञ्जने भिषक् ।।
स्त्रोतोजं विद्रुम्ं फेनं सागरस्य मनः शिलाम् ।। ९८ ।।
मरिचानि च तद्वर्ती: कारयेच्चापि पूर्ववत् ।।
दृष्टिस्थैर्यार्थमेतत्तु विदध्यादञ्जने हितम् ।। ९९ ।।
Now, listen to the anjana formulation for getting clear vision.
Below mentioned ingredients should be macerated in goat’s milk –
– flowers of Mesasrnga, Sirisa, Dhava and Sumana,
– Mukta,
– Vaidurya
Now, it is kept in a copper vessel for a time period of seven days. After seven days, it is made into wicks (sticks, dragees) and used to apply collyrium.
Wicks are also made with the below mentioned ingredients as described earlier –
– Srotaja – Srotonjana,
– Vidruma,
– Samudraphena,
– Manassila and
– Marica
These should be used as collyrium. It will bestow steadiness of vision.
भूयो वक्ष्यामि मुख्यानि विस्तरेणाञ्जनानि च ।।
कल्पे नानाप्रकाराणि तान्यपीह प्रयोजयेत् ।।१००।।
In the Kriyakalpa context in the next chapter, I shall describe many more important collyrium recipes which may be effectively administered to the eyes.
इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे दृष्टिगतरोगविज्ञानीयो नाम सप्तदशोऽध्यायः ।।१७।।
Thus ends the seventeenth chapter by name Drustigataroga Pratisedha in Uttara Sthana of Susrutha Samhita.
