The chapter on the treatment of bhagandara is introduced according to the teaching of Dhanvantari. Five forms of bhagandara have been described. Of these, shambukavarta and the form caused by a retained foreign body are said to be incurable, while the remaining forms are difficult to treat.
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Show commentary
నిదానేఽపి భగందరాణాం సాధ్యాసాధ్యవిభాగే పూర్వోక్తే పునరిహ చికిత్సితవిధానాయానుకథనం ప్రకరణాంతరత్వాదితి న పౌనరుక్త్యం||1-3||
Meaning of the commentary
The commentary explains that the curable and incurable forms were already distinguished in the diagnostic section. Their repetition here is justified because this is a new context devoted to treatment, and therefore it is not needless repetition.
Key terms
bhagandara
The anorectal tract disorder treated in this chapter.
shambUkAvarta (shambukavarta)
One of the five named forms, classified here as incurable.
shalyanimitta (shalya-nimitta)
A form attributed to a foreign body, classified here as incurable.
For a patient affected by a bhagandara swelling, the text first prescribes the elevenfold sequence of measures beginning with reducing therapy and ending with purgation, while the swelling is still unripe. Once it has matured, the patient is to be oleated, fomented by immersion, positioned, and restrained as in the treatment of arshas. After determining whether the tract opens outward or inward, a probe is introduced, the tract and its cavity are raised, and the text directs excision with an instrument. For an inward-opening tract, it describes applying the apparatus correctly, locating the opening while the patient strains, introducing the probe, and making the incision. It also permits cautery or alkali when indicated, presenting this as the general approach to all forms.
The commentary identifies the sequence from reducing therapy through purgation as the regimen taught in the chapter on two kinds of wound. It says that the reference to mature swellings also includes those that have already burst. An outward opening is called paracina and an inward opening avacina; the eshani is a metal or similar probe. The additional directions clarify management of the inward-opening form. The final statement is understood to mean that fire cautery or alkali is used only after determining that it is appropriate.
Key terms
apakvapiDaka (apakva-pidaka)
A swelling that has not yet matured.
parAcIna (paracina)
An outward-opening tract, according to the commentary.
avAcIna (avacina)
An inward-opening tract, according to the commentary.
eShaNI (eshani)
A probing instrument, explained as a metal or similar rod.
kShAra (kshara)
A caustic alkaline agent used in the historical procedure.
For the shataponaka form, the physician is instructed to create wounds in the spaces between the tracts. After those wounds have healed, the remaining tracts are to be treated.
The commentary explains nadyantara as the intervening area among three or four closely situated tracts that are filling. It adds that bhishak here means a well-trained physician.
Key terms
shataponaka
The form characterized by multiple openings or tracts.
nADI (nadi)
A pathological tract or channel in this context.
nADyantara (nadyantara)
The intervening space among nearby tracts.
bhiShak (bhishak)
A physician, specified by the commentary as properly trained.
When the tracts are connected with one another and extend outward, the text says they should be excised in several separate stages. A physician who cuts unconnected tracts together in a single operation would create a widely open wound and split the anal region. Stool and urine would then follow that open path, and vata would cause pronounced distension and anal pain. In such a situation, the text says that even a physician well versed in the discipline could become perplexed. Therefore, a widely open wound should not be made in shataponaka.
The commentary introduces these verses as the harm that follows when cutting is performed before the proximity and arrangement of the tracts have been properly determined. It explains anekadha as 'in several ways or divisions,' atopa as distension, and vivrita as a wound with a gaping mouth.
For the disorder with many openings, a knowledgeable physician is instructed to choose one of several named incision patterns: ardhalangalaka, langalaka, sarvatobhadraka, or gotirthaka. Afterward, the drainage paths are said to be treated all around with fire cautery. The text observes that shataponaka is difficult to treat in a delicate or fearful patient.
The commentary derives langala from the shape of a plough and describes ardhalangalaka as resembling half a plough. It offers alternatives for sarvatobhadraka: the shape of a particular seat or couch, or a circular form resembling an elephant goad. It also preserves several explanations of gotirthaka: a form like the stream of a walking cow's urine, like a cow's vulva, or like the hoof-marked drinking place used by cattle. A cited passage further distinguishes the incision patterns by their sides and lengths, and says sarvatobhadraka divides the anal region in four while avoiding the perineal seam; gotirthaka is made from the side. The commentary adds that the drainage routes are treated after cutting and that alkali may be used as an alternative to fire. The case is difficult because the tracts are numerous.
Key terms
ardhalA~ggalaka (ardha-langalaka)
A named incision pattern compared with half a plough.
lA~ggalaka (langalaka)
A named incision pattern compared with a plough.
sarvatobhadraka
A named incision pattern for which the commentary preserves more than one shape explanation.
gotIrthaka (gotirthaka)
A named incision pattern with several alternative shape interpretations.
sevanI (sevani)
The midline seam that the cited operative description says should be avoided.
रुजास्रावापहं तत्र स्वेदमाशु प्रयोजयेत् |
स्वेदद्रव्यैर्यथोद्दिष्टैः कृशरापायसादिभिः ||१२||
ग्राम्यानूपौदकैर्मांसैर्लावाद्यैर्वाऽपि विष्किरैः |
वृक्षादनीमथैरण्डं बिल्वादिं च गणं तथा ||१३||
कषायं सुकृतं कृत्वा स्नेहकुम्भे निषेचयेत् |
नाडीस्वेदेन तेनास्य तं व्रणं स्वेदयेद्भिषक् ||१४||
तिलैरण्डातसीमाषयवगोधूमसर्षपान् |
लवणान्यम्लवर्गं च स्थाल्यामेवोपसाधयेत् ||१५||
आतुरं स्वेदयेत्तेन तथा सिध्यति कुर्वतः |
स्विन्नं च पाययेदेनं कुष्ठं च लवणानि च ||१६||
वचाहिङ्ग्वजमोदं च समभागानि सर्पिषा |
मार्द्वीकेनाथवाऽम्लेन सुरासौवीरकेण वा ||१७||
ततो मधुकतैलेन तस्य सिञ्चेद्भिषग्व्रणम् |
परिषिञ्चेद्गुदं चास्य तैलैर्वातरुजापहैः ||१८||
विधिनाऽनेन विण्मूत्रं स्वमार्गमधिगच्छति |
अन्ये चोपद्रवास्तीव्राः सिध्यन्त्यत्र न संशयः ||१९||
शतपोनक आख्यात... |२०|
Meaning of the śloka
After the procedure, the text prescribes fomentation intended to relieve pain and discharge, using specified warming materials such as krishara and payasa. It describes preparing a decoction with meats from domestic, marsh-dwelling, aquatic, and certain bird sources, together with vrikshadani, castor, and the bilvadi group, placing it in an oil vessel, and applying its warmth to the wound through a tube. It next lists sesame, castor, flax, masha, barley, wheat, mustard, salts, and sour substances for another warming application. After fomentation, it prescribes an oral mixture of kushtha, salts, vacha, hingu, and ajamoda in equal proportions with ghee, or with one of several fermented or sour liquids. The wound is then said to be irrigated with madhuka oil and the anal region with oils described as relieving vata-associated pain. The text claims that this regimen restores stool and urine to their proper paths and settles severe complications.
The commentary presents this as aftercare for reducing pain once an operation has been performed. It defines krishara as a preparation of rice, sesame, and masha, and payasa as rice cooked in milk. It preserves Gayi's alternative reading, 'there the steadfast physician who knows the method.' Vrikshadani is identified as bandaka, while some call it vrikshakalambika; the bilvadi group is identified with brihat-panchamula, and the sour group is the one taught in the discussion of tastes. The commentary identifies mardvika as grape wine, amla as kanjika, and sauviraka as a variety of kanjika. It says the drink is intended to restore the passage of stool and urine and kindle digestive activity. When pitta or blood is weak and vata strong, it explains the subsequent oily irrigation, with madhuka oil prepared by the general decoction-and-paste method and other oils drawn from the treatment of vata disorders. Other complications include distension and rectal prolapse.
Key terms
sveda
A warming or fomentation measure used here as postoperative care.
kRusharA (krishara)
A preparation explained here as rice with sesame and masha.
pAyasa (payasa)
Rice cooked in milk.
nADIsveda (nadi-sveda)
Fomentation in which warmth or vapor is conveyed through a tube.
mArdvIka (mardvika)
Grape wine, according to the commentary.
gudabhraMsha (guda-bhramsha)
Rectal prolapse, listed among possible complications.
For the ushtragriva form, the text directs the tract to be probed and cut, followed by the application of alkali. Fire cautery is not favored here for removing putrid tissue. It then prescribes a paste of ground sesame mixed with ghee, followed by a bandage and irrigation with ghee. On the third day the dressing is removed and cleansing is performed according to the condition. Once the wound is known to be clean, healing measures are applied in due order.
The commentary identifies ushtragriva as the pitta-associated form and says alkali is used to remove putrid tissue. It preserves Gayi's alternative reading concerning probing the ushtragriva before cutting and applying alkali. The bandage is described as a gophanaka arrangement, with leather and a central opening. Irrigation is with ghee; cleansing and healing use measures appropriate to pitta-type wounds. 'In due order' means without departing from the proper sequence and only when the healing stage has been reached. No special incision form is specified because this form has a single tract.
Key terms
uShTragrIva (ushtragriva)
The pitta-associated form of bhagandara discussed here.
pUtimAMsa (puti-mamsa)
Putrid or unhealthy tissue.
kShArakarma (kshara-karma)
Application of a caustic alkaline agent as a historical procedure.
gophaNaka (gophanaka)
The bandage arrangement identified by the commentary.
उत्कृत्यास्रावमार्गंस्तु परिस्राविणि बुद्धिमान् ||२३||
क्षारेण वा स्रावगतिं दहेद्धुतवहेन वा |
सुखोष्णेनाणुतैलेन सेचयेद्गुदमण्डलम् ||२४||
उपनाहाः प्रदेहाश्च मूत्रक्षारसमन्विताः |
वामनीयौषधैः कार्याः परिषेकाश्च मात्रया ||२५||
मृदुभूतं विदित्वैनमल्पस्रावरुगन्वितम् |
गतिमन्विष्य शस्त्रेण छिन्द्यात् खर्जूरपत्रकम् ||२६||
चन्द्रार्धं चन्द्रचक्रं च सूचीमुखमवाङ्मुखम् |
छित्त्वाऽग्निना दहेत् सम्यगेवं क्षारेण वा पुनः ||२७||
ततः संशोधनैरेव मृदुपूर्वैर्विशोधयेत् |२८|
Meaning of the śloka
For the parisravi form, a knowledgeable physician is instructed first to excise the routes of discharge and treat them with alkali or fire cautery. The anal region is then irrigated with comfortably warm anu oil. Bandages, pastes containing urine and alkali, and measured irrigations prepared with drugs classed as emetic are prescribed. When the condition has softened and the discharge and pain have become slight, the principal tract is located and one of several named incision patterns is made: kharjurapatraka, ardhacandra, candracakra, or a downward-facing sucimukha. After cutting, the text again directs appropriate cautery with fire or alkali, followed by cleansing that begins with mild measures.
The commentary identifies parisravi as the kapha-associated form, with openings discharging on every side; this explains the plural 'routes of discharge.' It says the surrounding openings are first excised and treated while the central tract is initially left intact. Only after the strong discharge has diminished is the main central tract located and cut. Anu oil is used to settle pain from the incision; upanaha means a bandage, pradeha a paste, mutra cow urine, and the emetic group includes madanaphala and related substances. Matra means in a small amount. The named cuts are explained by shape: kharjurapatraka resembles a date-palm leaf through paired transverse rows; ardhacandra follows a curved central tract like a half-moon; candracakra has a circular resemblance, though the commentary's anatomical description is complex; sucimukha narrows from a broad inner root to a fine opening and faces downward. Cleansing is first mild and later strong after the patient's bowel state has been assessed.
Key terms
parisrAvI (parisravi)
The kapha-associated form characterized by discharge from many openings.
aNutaila (anu-taila)
A named medicated oil used here for irrigation after cutting.
kharjUrapatraka (kharjura-patraka)
A named incision pattern likened to a date-palm leaf.
ardhacandra (ardha-candra)
A half-moon-shaped incision pattern.
candracakra (candra-cakra)
A circular or moon-disc incision pattern whose detailed explanation is textually complex.
sUcImukha (suci-mukha)
A needle-point-shaped tract or incision, broad within and narrow at its opening.
बहिरन्तर्मुखश्चापि शिशोर्यस्य भगन्दरः ||२८||
तस्याहितं विरेकाग्निशस्त्रक्षारावचारणम् |
यद्यन्मृदु च तीक्ष्णं च तत्तत्तस्यावचारयेत् ||२९||
Meaning of the śloka
When a child has a bhagandara with both external and internal openings, the text says that purgation and the application of fire, instruments, or alkali are unsuitable. Whatever measures are used should be moderated between mild and strong for that child.
The commentary says that, because a special approach is required for a child, the verse prohibits the other interventions just listed. It nevertheless refers to particular milder choices within operative treatment and purgation, citing named groups or substances such as tvaksara and caturangula. The apparently opposed words 'mild' and 'strong' mean that treatment should be neither excessively strong nor excessively mild, illustrated by kakamaci that is neither excessively heating nor cooling.
Key terms
shishu
A child, for whom the text requires a specially moderated approach.
bahirantarmukha (bahir-antar-mukha)
Having both an external and an internal opening.
vireka
Purgative treatment, prohibited here in its usual form for the child.
agnishastrakShAra (agni-shastra-kshara)
Fire cautery, cutting instruments, and caustic alkali, listed as unsuitable here.
mRudu-tIkShNa (mridu-tikshna)
A balance between mild and strong rather than either extreme.
Powder of aragvadha, nisha, and kala, moistened with honey and ghee and placed at the tip of a wick, is described as beneficial for cleansing wounds. This preparation is said to remove the tract quickly, as wind disperses a cloud.
The commentary identifies aragvadha as kritamalaka, nisha as haridra, and kala as ahimsra. It explains agravarti as a densely formed thread wick. The commentary gives no further explanation of the comparison with wind and cloud.
Key terms
Aragvadha (aragvadha)
A substance identified by the commentary as kritamalaka.
nishA (nisha)
A substance identified here as haridra.
kAlA (kala)
A substance identified here as ahimsra.
agravarti
A densely formed thread wick used in the historical wound treatment.
vraNashodhana (vrana-shodhana)
Cleansing of a wound in the framework of this passage.
आगन्तुजे भिषङ्नाडीं शस्त्रेणोत्कृत्य यत्नतः ||३१||
जम्ब्वोष्ठेनाग्निवर्णेन तप्तया वा शलाकया |
दहेद्यथोक्तं मतिमांस्तं व्रणं सुसमाहितः ||३२||
कृमिघ्नं च विधिं कुर्याच्छल्यानयनमेव च |३३|
Meaning of the śloka
For a bhagandara caused by an external factor, the physician is told to open the tract carefully with an instrument and cauterize the wound as previously described, using a heated jambvoshtha instrument or probe. Measures directed against krimi are also prescribed, together with removal of a foreign body when one is present.
The commentary says that these verses introduce treatment of bhagandara caused by a foreign body. It describes jambvoshtha as a black-stone instrument whose tip resembles the fruit of jambu. The instruction concerning foreign-body removal applies when a foreign body is actually present.
Key terms
Agantuja (agantuja)
Arising from an external cause, understood here in relation to a foreign body.
nADI (nadi)
The pathological tract to be treated in this passage.
jambvoShTha (jambvoshtha)
A historical cautery instrument described as having a jambu-fruit-shaped tip.
kRumighna vidhi (krimighna vidhi)
Measures directed against organisms termed krimi in the source.
This condition may be undertaken for treatment only after its doubtful outcome has been explained; the form arising from all three doshas is to be avoided.
The commentary states that, of the two remaining forms, both are considered incurable, but the verse allows only a conditional possibility of success for one of them. It therefore directs that treatment be begun after first declaring the uncertain prognosis, while the tridoshaja form is excluded from treatment.
Key terms
pratyAkhyAya (pratyakhyaya)
After explaining or declaring the unfavorable and uncertain prognosis.
Arabhya (arabhya)
May be undertaken for treatment under the stated condition.
tridoShaja (tridoshaja)
Arising from the combined involvement of all three doshas.
pAkShikI siddhi (pakshiki siddhi)
A conditional or uncertain possibility of successful treatment.
After presenting the procedures for the different forms in sequence, the passage addresses pain caused by surgical cutting. It recommends a warm stream of anu taila, sitting over steam from a heated vessel containing vata-alleviating substances and covered by a perforated dish after the anal region has been anointed, directing steam through a tube while the patient lies down, or immersion in warm water; these are said to quiet the pain.
The commentary says that these measures, beginning with an oil stream, are introduced to settle pain following instrument use in all forms of bhagandara. It limits anu taila alone to pain attributed to vata. It gives bhadradaru and eranda groups as examples of vata-alleviating substances. Steam fomentation is specified when vayu is associated with rakta and pitta.
Key terms
shastrapatana (shastra-patana)
Application of a surgical instrument or cutting that produces postoperative pain.
aNutaila (anu taila)
An oil preparation recommended here as a warm stream for pain attributed to vata.
pariSheka (parisheka)
Pouring a stream of liquid over the affected area.
bAShpasveda (bashpa-sveda)
Steam fomentation described for pain relief.
avagAha (avagaha)
Immersion or sitting in warm water in this context.
A discerning physician is instructed to prepare upanaha applications, including those of the salvana type, using the skins of kadalimriga, lopaka, and priyaka.
The commentary introduces this as upanaha fomentation for pain attributed jointly to vata and kapha. It describes kadalimriga as an animal commonly seen in the eastern region, mottled, about the size of a very large cat, tiger-like, and dwelling in holes. Lopaka is identified as langalaka, a kind of jackal. Priyaka is identified as lalitaka and described as smooth, long, and resembling a python. Ajina means skin or hide.
Key terms
upanAha (upanaha)
A warm external application used as a form of fomentation.
sAlvaNa (salvana)
A named type of upanaha preparation referenced by the verse.
kadalImRuga (kadalimriga)
An animal described by the commentary as mottled, large-cat-sized, and hole-dwelling.
lopAka (lopaka)
An animal identified as langalaka, a kind of jackal.
priyaka
An animal identified as lalitaka and described as long, smooth, and python-like.
The commentary identifies dipyaka as ajamoda, the sour liquid as kanjika, sura as a kind of alcoholic drink, and sauviraka as a variety of kanjika. It says that this preparation too is intended to relieve pain situated in the anal region and abdomen.
Key terms
kaTutrika (katutrika)
A group of three pungent substances named in the formulation.
dIpyaka (dipyaka)
A substance identified by the commentary as ajamoda.
kA~jjika (kanjika)
A sour fermented liquid used as a vehicle.
surA (sura)
A type of alcoholic drink named as a vehicle.
sauvIraka (sauviraka)
A variety of kanjika according to the commentary.
gudakoShThagata vedanA (guda-koshthagata vedana)
Pain located in the anal region and abdomen, the stated target of the formulation.
Jyotishmati, langalaki, shyama, danti, trivrit, sesame, kushtha, shatahva, golomi, tilvaka, girikarnika, kasisa, and the two substances called kanchanakshiri form a group regarded as cleansing for the wound.
The commentary introduces specialized groups for cleansing, raising the base of, and healing wounds caused by bhagandara. It identifies jyotishmati as kunkumardanika, langali as kaliharika, shyama as a variety of trivrit, golomi as durva, tilvaka as pattika-rodhra, and girikarnika as shvetasyanda. It says there are two kanchanakshiri substances: one is kankushtha, and the other is a large-leaved, yellow-latex plant called yavatikta. Members of the group may be used according to availability, and this group is classed as cleansing for bhagandara in decoctions and related preparations.
Key terms
shodhana
Cleansing of a bhagandara wound in this context.
jyotiShmatI (jyotishmati)
A substance identified here as kunkumardanika.
shyAmA (shyama)
A particular variety of trivrit according to the commentary.
tilvaka
A substance identified here as pattika-rodhra.
kA~jcanakShIrI (kanchanakshiri)
A name applied here to two substances, kankushtha and a yellow-latex, large-leaved yavatikta.
yathAlAbha (yathalabha)
Use of members of the group according to what is available.
Adhikarana ౧౭ (౪౦) · Śloka ౪౧
త్రివృత్తిలా నాగదంతీ మంజిష్ఠా పయసా సహ ||40||
ఉత్సాదనం భవేదేతత్ సైంధవక్షౌద్రసంయుతం |41|
The commentary identifies nagadanti as dantini. It defines utsadana here as filling or raising a depressed wound bed by means of an applied paste. It also preserves an alternative reading: some read 'with ghee' instead of 'with milk.'
Key terms
trivRut (trivrit)
A named substance included in the historical application.
nAgadantI (nagadanti)
A substance identified by the commentary as dantini.
ma~jjiShThA (manjishtha)
A named substance included in the application.
utsAdana (utsadana)
Raising or filling a depressed wound bed through an applied paste.
payas
Milk in the main reading; some recensions instead read ghee.
sarpiSh (sarpis)
Ghee, preserved as the alternative reading in place of milk.
The passage lists two groups of substances. A preparation beginning with rasanjana, the two haridras, manjishtha, tender neem leaves, trivrit, tejovati, and danti is said to remove nadi-vrana. Another combination of kushtha, trivrit, tila, danti, magadhi, rock salt, honey, rajani, triphala, and tuttha is said to be useful for cleansing a wound.
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Show commentary
రసాంజనాదికుష్ఠాదియోగౌ రోపణశోధనౌ||41-42||-
Meaning of the commentary
The commentary identifies the two formulations, beginning respectively with rasanjana and kushtha, as serving the functions of wound healing and wound cleansing. Its compressed wording does not explicitly assign each function to one particular formula.
Key terms
nADIvraNa (nadi-vrana)
A channel-like or sinus-type wound in the terminology of the passage.
ropaNa (ropana)
Promoting the healing or closure of a wound.
vraNashodhana (vrana-shodhana)
Cleansing a wound.
tuttha
A mineral substance included in the wound-cleansing combination.
The listed substances—including magadhi, madhuka, rodhra, kushtha, ela, harenuka, samanga, dhataki, sariva, both rajanis, priyangu, sarjarasa, padmaka, lotus stamens, sudha, vacha, langalaki, beeswax, and rock salt—are to be assembled and processed in oil. The resulting oil is described as beneficial for healing in glandular swellings, circular skin lesions, disorders designated meha, and bhagandara.
The commentary identifies magadhi as pippali. It explains samanga as anjalikarika, while preserving another opinion that it is varahakranta. It then supplies a general preparation ratio: the medicinal paste is one quarter of the fat, and the liquid is four times the fat. Because no liquid is specified here, it interprets the liquid as water, citing the rule that water is understood wherever a required liquid has not been named.
Key terms
mAgadhI (magadhi)
Identified by the commentary as pippali.
sama~ggA (samanga)
Identified as anjalikarika, with varahakranta preserved as an alternative identification.
snehapAka (sneha-paka)
Processing medicinal substances in a fatty medium such as oil.
bhagandara
The disorder treated in this chapter, involving a tract or lesion in the perineal region.
न्यग्रोधादिगणश्चैव हितः शोधनरोपणे |
तैलं घृतं वा तत्पक्वं भगन्दरविनाशनम् ||४७||
Meaning of the śloka
The nyagrodhadi group is said to be useful for cleansing and healing. Oil or ghee prepared with that group is described as removing bhagandara.
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Show commentary
శోధనరోపణే ‘కషాయాదిభిః’ ఇతి శేషః||47||
Meaning of the commentary
The commentary supplies an omitted qualification: cleansing and healing are to be understood as being carried out with decoctions and other preparations of the nyagrodhadi group.
Key terms
nyagrodhAdigaNa (nyagrodhadi-gana)
The classical group of substances beginning with nyagrodha.
shodhana
Cleansing of the affected wound or tract in this context.
ropaNa (ropana)
Supporting wound healing or closure.
bhagandara
The perineal tract disorder addressed by the chapter.
Oil is to be processed with trivrit, danti, haridra, arka root, loha, hayamaraka, vidanga essence, triphala, the milky exudates of snuhi and arka, honey, and beeswax. This preparation is especially designated for addressing bhagandara.
The commentary identifies loha here as aguru, hayamaraka as karavira, and snuhi as sehunda. It adds that this oil too is to be prepared according to the general rule governing the proportion of medicinal paste in medicated oil.
Key terms
loha
Identified by the commentary as aguru in this formulation.
hayamAraka (hayamaraka)
Identified by the commentary as karavira.
snuhI (snuhi)
Identified as sehunda, whose milky exudate is included in the formula.
sAmAnyakalkaparibhAShA (samanya-kalka-paribhasha)
The general rule governing the medicinal paste used when preparing medicated oil.
The passage directs that oil be processed with the listed substances, including chitraka, arka, trivrit, patha, malapu, hayamaraka, sudha, vacha, langalaki, saptaparna, suvarcika, and jyotishmati. This strongly acting oil is described as especially useful for causing discharge in bhagandara. A discerning physician should also consult the teachings on the two kinds of wounds when deciding upon cleansing, healing, and restoration of normal coloration according to the wound's stage.
The commentary identifies malapu as kakodumbarika, hayamaraka as karavira, sudha as snuhi, and suvarcika as svarjikshara. It preserves a variant reading: in place of 'this is syandana,' the text may read 'this is visyandana.' Under that reading the name is explained as apt because the preparation causes pronounced discharge and dislodges the doshas.
Key terms
syandana
Causing flow or discharge; the descriptor used for the oil in the received reading.
visyandana
The variant reading, explained as strongly inducing discharge and dislodging doshas.
savarNakaraNa (savarna-karana)
Restoring the affected area toward its normal coloration.
A person skilled in instruments should remove the rim of the arshas instrument above its opening. The modified instrument, shaped like a half moon, is then designated for use in bhagandara.
The commentary says that the verse specifies how the bhagandara instrument differs from the arshas instrument: a particular part of the latter is removed, beginning with the instruction concerning the region above its opening.
Key terms
arshoyantra (arsho-yantra)
An instrument associated with the treatment of arshas and used here as the basis for a modified instrument.
bhagandarayantra (bhagandara-yantra)
The specially modified instrument intended for the bhagandara context.
ardhendusannibha (ardhendu-sannibha)
Resembling a half moon in shape.
yantravit
A person knowledgeable and skilled in surgical instruments.
Adhikarana ౨౪ (౫౪) · Śloka ౫౪
వ్యాయామం మైథునం కోపం పృష్ఠయానం గురూణి చ |
సంవత్సరం పరిహరేదుపరూఢవ్రణో నరః ||54||
Even after the wound has healed, the person should avoid strenuous exercise, sexual intercourse, anger, riding on an animal's back, and heavy foods for one year.
The commentary explains that these restrictions are stated because recurrence or continued association of the disorder is feared even after a bhagandara wound has healed.
Key terms
uparUDhavraNa (uparudha-vrana)
A wound that has closed or healed.
anubandha
Persistence, recurrence, or a continuing complication feared after healing.