After Sharirasthana, the Cikitsasthana begins. Dvivraniya is the teaching devoted to two wounds, and cikitsita means the counteraction or treatment of disorder.
Wounds are of two kinds: sharira, arising internally from vata, pitta, kapha, blood, or their combination; and agantu, arising from external injury by people, animals, birds, dangerous creatures, reptiles or aquatic creatures, falls, compression, blows, fire, alkali, poison, strong medicines, fragments, pottery shards, horns, wheels, arrows, axes, spears, lances, and other weapons. Although both share the nature of a wound, the chapter is called 'Two Wounds' because their causes and the purposes of treatment differ.
Some read 'arising from the body' instead of simply 'bodily.' The repeated conjunction indicates that both categories will be explained and may become associated with each other. 'Injury' applies separately to each external agent. The commentary identifies examples within the animal and weapon lists and explains fragments as pieces of wood or similar material and kapala as a potsherd. The name dvivraniya rests on two modes of origin and therefore different treatment aims, including cooling.
Immediately after any externally caused wound, the text prescribes cooling measures like those used for pitta to calm the heat spreading from trauma, and honey with ghee to promote joining. These are the treatment aims specific to its mode of origin. Later, according to the particular dosha involvement, it is treated like a bodily wound.
The cooling measure is applied at the time the injury occurs; kshatoshma is the heat said to arise from the collision of the blow and prasrita means spread out. Cooling counters the cause, while joining counters the wound itself. The conjunction also associates honey and ghee with cooling and with calming vata and blood obstructed and disturbed in their pathways. 'Later' is interpreted as after seven days because a fresh wound retains that status for seven days; subsequent contamination differs according to vata and the other doshas.
Key terms
kShatoShman (kshatoshman)
Heat attributed to a recent traumatic wound.
shItakriyA (shita-kriya)
Cooling measures.
sandhAna (sandhana)
Joining or union of wound edges.
doShopaplava (doshopaplava)
Contamination or complication attributed to doshas.
In summary, dosha-related wound complication has fifteen forms because of the capacity of the factors to spread and combine, as described in the section on questions concerning wounds. Some count a sixteenth form by including the pure wound.
The fifteen arise from vata, pitta, kapha, and blood occurring separately and in combinations. Their further combinations with tissues and wastes are said to be innumerable. A wound affected by any of these fifteen patterns is counted among them, while the sixteenth, shuddha wound, is free from all such involvement.
Key terms
doShopaplava (doshopaplava)
Dosha-related contamination or complication of a wound.
The signs of a wound are of two kinds, general and specific. Pain is the general sign. The verbal root vrana conveys damaging or altering the body's appearance, and that which does so is called a wound. The specific signs are the distinguishing features of vata and the other factors.
The twofold signs correspond to pure and impure wounds. Ruk means pain generally. The etymology is understood as causing discoloration or altered appearance of the body. A wound without dosha signs is the pure wound suitable for healing treatment, whereas a wound bearing the specific signs is impure.
Key terms
ruk
Pain, the general wound sign.
vraNa (vrana)
A wound, etymologically explained as altering the body.
shuddha
Classified as pure or free of dosha signs.
ashuddha
Classified as impure because specific dosha signs are present.
The text describes wound appearances, discharges, sensations, odor, texture, and severity attributed separately to vata, pitta, kapha, and blood and to their various combinations. Features include dark, red, yellow, pale, or mixed color; dryness or sliminess; heat or cold; itching, throbbing, stretching, pricking, splitting, burning, suppuration, numbness, heaviness, or severe pain; differing amounts and qualities of discharge; raised edges, hardness, pustules, foul odor, and spreading. A wound involving all four factors displays many colors, pains, and discharges. A pure wound resembles the surface of the tongue in color, softness, unctuousness, and smoothness, is level and well formed, painless, and without discharge.
The commentary explains the sensory terms: sphurana is repeated movement, ayama feels like lengthening a contracted part, toda like needles, bhedana like tearing skin, nirdahana like burning to ash, and nirmathana like churning. It clarifies raised wound margins, rigid networks of sira and snayu, coral-like red tissue, black blisters and pustules, sharp alkaline or fish-wash odors, numb touch, and the clear upper layer of ghee used as a comparison. In combined patterns, color and discharge are supplied from the component descriptions. For the pure wound, 'like the tongue's surface' qualifies color, softness, unctuousness, and smoothness; well situated means level rather than raised or depressed.
Pratisarana is not counted separately because it remains within the lightening and darkening procedures. Some omit seven procedures beginning with restoring and removing hair, then count the seven cleansing and seven healing uses of decoction through powder separately to reach sixty. The commentator rejects this because those preparations have fourteen subuses but remain seven general categories and the omitted procedures must be read. Gayadasa omits pacana, while Jejjata omits hair removal; their extensive disagreement and their alternative calculations are not reproduced.
Among these approaches, decoction, wick, paste, ghee, oil, concentrated extract, and powder may serve both cleansing and healing. Eight are surgical procedures. Arresting blood, alkali, fire, instruments, diet, protective rites, and bandaging have been described previously. Unction, sweating, emesis, purgation, ordinary and uttara enemas, head purgation, nasal medication, smoke, and holding medicine in the mouth will be explained elsewhere. The remaining procedures are explained here.
The seven preparations have both purposes. The eight surgical procedures run from cutting through suturing, excluding tearing, and were described in the chapter on eight surgical acts. The commentary subdivides arresting blood into decoction, cooling, maturation, and burning; alkali into drinkable and topical types; and protective rites into fumigation, wearing herbs, and mantra. Diet and bandaging are located in earlier chapters. Ten systemic procedures belong to the Panchakarma discussion. With twenty-eight remaining procedures, the total becomes sixty.
Key terms
shodhana
Cleansing of a wound or preparation.
ropaNa (ropana)
Promoting wound healing.
shastrakRutyA (shastra-kritya)
A procedure performed with a surgical instrument.
shoNitAsthApana (shonita-sthapana)
Measures intended to arrest bleeding.
Adhikarana ૯ (૧૦) · Śloka ૧૦
ષડ્વિધઃ પ્રાગુપદિષ્ટઃ શોફઃ, તસ્યૈકાદશોપક્રમા ભવન્ત્યપતર્પણાદયો વિરેચનાન્તાઃ; તે ચ વિશેષેણ શોથપ્રતીકારે વર્તન્તે, વ્રણભાવમાપન્નસ્ય ચ ન વિરુધ્યન્તે; શેષાસ્તુ પ્રાયેણ વ્રણપ્રતીકારહેતવ એવ ||૧૦||
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षड्विधः प्रागुपदिष्टः शोफः, तस्यैकादशोपक्रमा भवन्त्यपतर्पणादयो विरेचनान्ताः; ते च विशेषेण शोथप्रतीकारे वर्तन्ते, व्रणभावमापन्नस्य च न विरुध्यन्ते; शेषास्तु प्रायेण व्रणप्रतीकारहेतव एव ||१०||
Meaning of the śloka
The sixfold swelling has already been described. Eleven approaches, from dietary reduction through purgation, are especially applied to swelling, and they remain compatible after swelling has developed into a wound. Most of the remaining approaches are chiefly directed to the wound itself.
This identifies the distinct field of the first eleven procedures as swelling that causes a wound. Although swelling differs from a wound, these procedures count among the sixty because they can still be used once the swelling has assumed the condition of a wound. The other procedures chiefly counter the wound. Dietary reduction is named first because it is regarded as principal.
Key terms
shopha
Swelling or inflammatory enlargement in the classical classification.
vraNabhAva (vrana-bhava)
The state in which swelling has developed into a wound.
Here apatarpana specifically means not eating, rather than every depleting measure such as emesis, because those are listed separately. 'All swellings' means the fifteen dosha patterns, not traumatic swelling, since the aim is to calm heightened doshas. It is included even for vata swelling because it counters the disorder, or because ama may precede vata involvement. It is called general because it is considered helpful across these swellings and foremost because the text claims rapid effect.
Key terms
apatarpaNa (apatarpana)
Here, abstaining from food.
shopha
Internally classified swelling.
Ama (ama)
A classical state of incompletely processed material.
To calm an increase of doshas in a body considered obstructed by them, apatarpana may be undertaken only after assessing both the dosha and the person's vital strength.
Calming heightened doshas is the intended result, being bound or obstructed by doshas is the indication, and assessment of dosha and prana sets the limit. The obstruction is understood to include all channels filled by doshas and ama, along with affected tissues and wastes, in a well-nourished body. Dosha and vital strength must be assessed together; the conjunction also adds age, constitution, and the other customary factors to be examined.
Key terms
doShocchrAya (doshocchraya)
Increase or predominance of a dosha.
doShAnaddha (doshanaddha)
Considered obstructed by doshas and ama.
prANa (prana)
Vital strength or capacity in this treatment decision.
prakRuti (prakriti)
Constitution, one of the assessment factors.
Adhikarana ૧૨ (૧૩) · Śloka ૧૩
ઊર્ધ્વમારુતતૃષ્ણાક્ષુન્મુખશોષશ્રમાન્વિતૈઃ |
ન કાર્યં ગર્ભિણીવૃદ્ધબાલદુર્બલભીરુભિઃ ||૧૩||
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ऊर्ध्वमारुततृष्णाक्षुन्मुखशोषश्रमान्वितैः |
न कार्यं गर्भिणीवृद्धबालदुर्बलभीरुभिः ||१३||
Meaning of the śloka
Apatarpana should not be used in people with upward-moving maruta, thirst, hunger, dry mouth, or exhaustion, nor in pregnant women, older people, children, weak people, or those who are fearful.
Upward maruta may mean disorders such as breathlessness and cough; others define it as a separate disorder marked by excessive belching whether fed, fasting, or asleep and attributed to udana and vyana. Another reading refers to illness such as convulsion caused by maruta. Some manuscripts read bhrama, dizziness, instead of shrama, exhaustion. The commentary distinguishes dry mouth or dizziness from clear vata-pitta states from similar findings caused by obstruction with ama, for which reduction is still contemplated. In pregnancy and the other named groups, the prohibition applies when disease is not immediately life-threatening.
Key terms
UrdhvamAruta (urdhva-maruta)
A disputed term interpreted as respiratory illness, excessive belching, or another upward vata disorder.
shrama
Exhaustion; some manuscripts instead read bhrama, dizziness.
शोफेषूत्थितमात्रेषु व्रणेषूग्ररुजेषु च |
यथास्वैरौषधैर्लेपं प्रत्येकश्येन कारयेत् ||१४||
Meaning of the śloka
For newly arisen swellings and wounds with intense pain, the text directs that an appropriate medicinal paste be applied separately according to each type.
'Newly arisen' means just developed. For vata and other swellings, the appropriate agents are said to include matulunga and related substances, durva and related substances, or ajagandha and related substances. Some read 'as previously stated' instead of 'their own,' but the meaning is treated as the same. Pratyekashas means one by one, according to each type.
यथा प्रवज्वलिते वेश्मन्यम्भसा परिषेचनम् |
क्षिप्रं प्रशमयत्यग्निमेवमालेपनं रुजः ||१५||
प्रह्लादने शोधने च शोफस्य हरणे तथा |
उत्सादने रोपणे च लेपः स्यात्तु तदर्थकृत् ||१६||
Meaning of the śloka
Just as pouring water quickly quiets a blazing fire in a house, the text says a paste calms pain. A paste is applied for soothing, cleansing, reducing swelling, raising a depressed wound, promoting healing, and related purposes.
The fire analogy illustrates the claimed effect of alepa on pain associated with swelling. Prahladana means making comfortable through relief of pain. Shodhana is explained here as promoting the eruption or expression of disturbed material in the wound. Utsadana raises a depressed wound. The conjunction after healing also includes depressing excessive tissue, restoring color, and other aims. The detailed application is taught elsewhere and the substances in separate groups.
Key terms
prahlAdana (prahladana)
Soothing or making comfortable.
shodhana
Cleansing, explained here through expression of disturbed material.
For vata-type swelling and pain, the text prescribes non-cold pouring liquids made from ghee, oil, fermented grain liquid, meat broth, or decoctions of vata-reducing herbs. For swelling attributed to pitta, blood, trauma, or poison, it prescribes non-hot liquids such as milk, ghee, honey, sugar water, sugarcane juice, sweet herbs, or decoctions of latex-bearing trees. For kapha-type swelling it prescribes non-cold oil, urine, alkaline water, sura, sour fermented liquid, or decoctions of kapha-reducing herbs. As water calms fire, the text says pouring quickly calms the fire of dosha.
The passage specifies both indication, relief of pain as the aim, and the liquids used. Dhanyamla is kanjika; vata-reducing herbs include bhadradaru. Sugar water means water mixed with sugar, sweet herbs include the Kakolyadi group, and latex-bearing trees include vata. Ksharodaka is the water obtained after filtering alkali. Kapha-reducing herbs include kaleyaka and aguru.
Key terms
pariSheka (parisheka)
Pouring a liquid over the affected area.
dhAnyAmla (dhanyamla)
A sour fermented grain liquid, identified as kanjika.
kShArodaka (ksharodaka)
Water obtained by filtering an alkaline preparation.
अभ्यङ्गस्तु दोषमालोक्योपयुक्तो दोषोपशमं मृदुतां च करोति ||१९||
स्वेदविम्लापनादीनां क्रियाणां प्राक् स उच्यते |
पश्चात् कर्मसु चादिष्टः स च विस्रावणादिषु ||२०||
Meaning of the śloka
When massage is selected after assessing the dosha, it is said to calm that dosha and soften the affected area. Massage is prescribed before procedures such as sudation and vimlapana, and after procedures beginning with drainage.
The commentary assigns oil massage to vata and kapha conditions, and repeatedly washed ghee or similar ghee to pitta, rakta, poisoning, and related conditions. Regarding sequence, massage precedes the seven non-oleation measures from sudation and vimlapana through purgation. Among measures from drainage through irrigation, excluding internal oleation, emesis, and purgation, massage follows the procedure.
Key terms
abhya~gga (abhyanga)
Therapeutic oil or ghee massage.
doSha (dosha)
The classical factor assessed when choosing the massage substance.
shatadhautaghRuta (shatadhautaghrita)
Ghee repeatedly washed and assigned here to pitta, rakta, and related conditions.
vimlApana (vimlapana)
A softening and dispersing procedure for swelling.
The commentary understands painful here as pain associated with vata and kapha, because the accompanying qualities concern those doshas. Daruna is explained as dryness, aging-like hardness, or rigidity caused by vayu; other authorities interpret it as immobility. The method is said to be described later under pancakarma.
Key terms
svedana
Therapeutic heating or sudation.
shopha
Swelling or inflammatory enlargement.
dAruNa (daruna)
Severe, rigid, dry-hard, or immobile, with alternative explanations preserved by the commentary.
vraNa (vrana)
A wound or ulcer with similar painful and hard qualities.
For firm swellings with mild pain, vimlapana should be performed gently. After oiling and warming the area, a knowledgeable physician is to rub it slowly with a bamboo tube, the palm, or the thumb.
The commentary glosses sthira as hard and interprets mild pain as indicating predominance of kapha; another view assigns it to combined vata and kapha. Tala means the palm or sole. Vimlapana is the dispersal or softening of swelling by rubbing with a finger or similar means. The supplied commentary appears to end incompletely after verse 22.
Key terms
vimlApana (vimlapana)
Gentle rubbing intended to soften or disperse a swelling.
sthira
Firm or hard.
veNunADI (venunadi)
A bamboo tube used historically as a rubbing implement.
A poultice is prescribed for swellings in the ama and partly ripened stages. An unripe swelling is said to subside, while one that has begun to ripen proceeds to full suppuration.
If a swelling does not resolve with the measures ending in purgation, the text directs sampacana. The named medicines are combined with curd, buttermilk, sura, sour fermented liquid, and grain sour; made oily and salty; and cooked into a poultice of suitable consistency. Wrapped hot in a castor leaf, it is bound over the swelling. If the swelling is tending toward suppuration, suitable food is also advised.
The commentary explains that the preceding measures run from depletion through purgation. The medicines are those such as flax root and seeds listed in the referenced formulation, used in equal amounts with four times the combined liquids. The preparation should be clearly salty and neither too wet nor too dry; its texture is compared by different authorities to gruel or a small cake. Sambhojana is interpreted as beneficial unrestricted food that neither greatly increases kapha nor causes complications, implying warm, unctuous, and related dietary qualities. Sudhira instead defines it as a meal combining wholesome and unwholesome foods, an interpretation rejected by Jejjata and Gayadasa. Gayadasa does not count pacana separately because he regards it as the result of poulticing.
Key terms
sampAcana (sampachana)
A measure intended to bring a persistent swelling toward maturation or suppuration.
utkArikA (utkarika)
A cooked poultice compared to gruel or a small cake.
upanAha (upanaha)
Binding a warm preparation over the swelling.
sambhojana
Suitable eating; the commentary preserves competing definitions.
pAka (paka)
Ripening or suppuration toward which the swelling is said to progress.
वेदनोपशमार्थाय तथा पाकशमाय च ||२७||
अचिरोत्पतिते शोफे कुर्याच्छोणितमोक्षणम् |
सशोफे कठिने ध्यामे सरक्ते वेदनावति ||२८||
संरब्धे विषमे चापि व्रणे विस्रावणं हितम् |
सविषे च विशेषेण जलौकोभिः पदैस्तथा ||२९||
वेदनायाः प्रशान्त्यर्थं पाकस्याप्राप्तये तथा |३०|
Meaning of the śloka
For a newly arisen swelling, bloodletting is prescribed to relieve pain and prevent suppuration. Drainage is also considered beneficial for a wound that is swollen, hard, dusky or red, painful, broadly inflamed at its base, uneven, or associated with poison. Leeches or multiple small incisions are specified, especially in a poisoned wound, with the same aims of calming pain and preventing suppuration.
The commentary glosses acirotpanna as newly developed and permits bloodletting by leeches or pracchana. Dhyama means dark or reddish-black, sarakta means red-colored, samrabdha means broad at the base, and vishama means uneven or having raised and depressed portions. It emphasizes bloodletting in a wound associated with poison. The supplied commentary appears incomplete after the verse marker.
Key terms
shoNitamokShaNa (shonitamokshana)
Therapeutic bloodletting.
visrAvaNa (visravana)
Drainage or letting out blood or fluid.
jalaukA (jalauka)
A leech used for historical bloodletting.
pracchAna (pracchana)
Bloodletting through multiple superficial incisions.
saMrabdha (samrabdha)
Inflamed or broad-based, according to the commentary.
For wounded patients who have complications, dryness, emaciation, or wasting caused by the wound, the text prescribes drinking an oleaginous preparation cooked with medicines appropriate to the individual condition.
The commentary says the complications meant here are not the five wound characteristics of smell, color, discharge, pain, and shape, but complications affecting the injured patient, such as trembling and paralysis of one side. Wound-related wasting means depletion caused by the wound. The oleaginous substance is prepared with the medicine specific to the relevant dosha. Some teachers understand this as taking clear fat directly, distinct from taking it mixed with food.
Key terms
snehapAna (snehapana)
Internal consumption of an oleaginous preparation.
upadrava
A complication affecting the wounded patient, such as those listed by the commentary.
vraNashoShin (vranashoshin)
A person wasted or depleted because of a wound.
acchapAna (acchapana)
Drinking a clear oleaginous substance directly rather than mixed with food.
उत्सन्नमांसशोफे तु कफजुष्टे विशेषतः ||३१||
सङ्क्लिष्टश्या(ध्या)मरुधिरे व्रणे प्रच्छर्दनं हितम् |३२|
Meaning of the śloka
Therapeutic emesis is said to be beneficial particularly when a wound has elevated fleshy swelling, is affected by kapha, and contains impaired dusky blood.
The commentary explains elevated fleshy swelling as raised tissue swelling and kaphajushta as invaded or affected by kapha. Sanklishta blood is impaired, while the transmitted shyama/dhyama wording describes it as somewhat dark. Pracchardana is glossed as emesis. The supplied commentary appears incomplete after the verse marker.
The commentary says vatapitta here means pitta combined with subordinate vata, rather than two independently equal doshas, because a purely vata condition is assigned basti. By the same reasoning, if kapha is combined with subordinate vata, emesis may be inferred. Although swelling was not explicitly mentioned for internal oleation, emesis, and purgation, the chapter's subject implies that these three also apply to particular states of swelling. Vranakovida means an expert in wounds. The supplied commentary appears incomplete after the verse marker.
Key terms
vAtapitta (vatapitta)
A combined state interpreted here as pitta-predominant with associated vata.
virecana (virechana)
Therapeutic purgation.
vraNa (vrana)
A wound or ulcer, here described as long-standing.
The commentary gives two readings of apaka: conditions without suppuration, such as fatty or kapha nodules and certain fleshy growths, or conditions with only slight suppuration, such as valmika. This double sense is attributed to the negative particle. Gayi reads apakavatsu, but Jejjata rejects that reading while retaining the same meaning. Hard means firm and fixed means immobile. 'Decay of tendon and so forth' extends to sira, dhamani, and related structures. Prapta means appropriate.
Key terms
cchedana (chhedana)
Surgical excision or cutting away.
apAka (apaka)
Interpreted alternatively as absence of suppuration or slight suppuration.
snAyukotha (snayukotha)
Decay or necrosis involving a tendon or ligament-like structure.
sthira
Fixed or immobile.
sirA (sira)
A vessel-like structure included by the commentary among related tissues.
अन्तःपूयेष्ववक्त्रेषु तथैवोत्सङ्गवत्स्वपि ||३४||
गतिमत्सु च रोगेषु भेदनं प्राप्तमुच्यते |३५|
Meaning of the śloka
Incision is said to be appropriate for disorders containing pus internally but lacking an opening, those with a deep overhanging cavity, and wounds possessing an abnormal tract.
The commentary explains avaktra as having no opening. Utsanga is a long-standing, deep hollow in a wound produced after pus has broken through, compared with an overhanging cavity. One opinion identifies unmargi and utsangi with named fistula types, but the commentator rejects this because those types are incurable and therefore unsuitable for probing. Instead, unmargi wounds are those whose tract leaves a straight path and proceeds crookedly, while utsangi wounds have an upward pocket. Prapta means appropriate.
Key terms
bhedana
Surgical incision or opening.
antaHpUya (antahpuya)
Containing pus internally.
avaktra
Lacking an external opening.
utsa~gga (utsanga)
A deep, overhanging or upward pocket in a chronic wound.
बालवृद्धासहक्षीणभीरूणां योषितामपि ||३५||
मर्मोपरि च जातेषु रोगेषूक्तेषु दारणम् |
सुपक्वे पिण्डिते शोफे पीडनैरुपपीडिते ||३६||
पाकोद्वृत्तेषु दोषेषु तत्तु कार्यं विजानता |
सुपिष्टैर्दारणद्रव्यैर्युक्तैः क्षारेण वा पुनः ||३७||
Meaning of the śloka
For the disorders already described when they occur in children, older people, those unable to tolerate a procedure, depleted or fearful people, women, or over a marma, the text prescribes darana rather than direct cutting. It is to be performed by a knowledgeable practitioner on a well-ripened, localized swelling that has been compressed and whose doshas have risen close to the skin, using finely ground splitting substances or a caustic alkali.
The commentary explains that pressure is applied with compressing substances and that the ripened contents must be superficial and situated in the skin. The darana substances include chirabilva and others listed in the referenced formulation. The alkali is a topical caustic; some authorities specify yavakshara.
Key terms
dAraNa (darana)
Opening or rupturing a swelling with medicinal or caustic substances.
marma
A vital anatomical point over which direct intervention is treated cautiously.
supakva
Fully ripened or suppurated.
pIDana (pidana)
Compression used to localize or raise the contents.
pratisAraNIyakShAra (pratisaraniyakshara)
A topical caustic alkali applied by rubbing or placement.
A physician is instructed to use scraping for wounds that are hard, have thick rounded margins, repeatedly split open, or contain hard elevated flesh. The amount of scraping is adjusted: level scraping, more thorough scraping, complete removal, or scraping evenly to the measure of the wound margins with a surgical instrument.
The commentary first maps four wound types to different extents: a hard wound deficient in flesh is scraped level; thick rounded margins are scraped more deeply; repeatedly splitting tissue is removed completely; and hard elevated flesh is made level with the four sides of the wound. Other authorities instead define sama as deep scraping, sulikhita as gentle scraping, and niravashesha as total scraping. Suvira, Jejjata, and Brahmadeva recognize four separate indications. Still others connect the instructions differently: hard wounds with thick rounded margins should be scraped until properly treated, meaning made level, completely scraped, and brought even with the margins. Repetition implies repeated application of the instrument. Vrana-vartman means the four wound sides, and the commentary insists on a surgical instrument rather than rough plant leaves.
Key terms
lekhana
Surgical scraping or curettage of wound tissue.
vraNavartman (vranavartman)
The margins or four sides of a wound.
sama
Level or even scraping, though one alternative interpretation takes it as deep scraping.
sulikhita
Well or thoroughly scraped; alternatively interpreted as gentle scraping.
The commentary says these are used when a surgical instrument is unavailable. Kshauma is flax linen, plota is a cloth rag, picu is cotton fiber, phena is sea foam, and yavashuka is interpreted as barley alkali.
Key terms
kShauma (kshauma)
Flax linen used as a historical scraping material.
A physician is instructed to probe gently sinus wounds, wounds containing a foreign body, crooked tracts, and upward pockets, using tender plant stems, animal hairs, a finger, or a probe. Narrow, bleeding tracts near the eyelid or anus are to be explored with smooth tender stems of cucchu or upodaka.
The commentary takes nadivrana as sinus tracts and shalyagarbha as wounds containing a foreign body. One view identifies unmargi with fistula-in-ano and utsangi with shambukavarta, but this is rejected because those incurable forms should not be probed. Unmargi instead means a wound whose tract departs from a straight route and runs crookedly; utsangi means an upward pocket. Karira denotes a tender plant stem, bala hair from animals such as elephant or boar, and eshani a probing rod or instrument. A widely open cavity may alternatively be examined with a finger. Probing is used to determine the course of the wound. Smooth plant stems are assigned to small-opening, bleeding tracts near the eyelid or anus. Cucchu is identified with a locally named plant and upodaka with another local plant name.
Key terms
nADIvraNa (nadivrana)
A sinus wound or wound with a channel-like tract.
shalya
A retained foreign body within a wound.
unmArgin (unmargin)
A wound tract that deviates from a straight path and runs crookedly.
utsa~ggin (utsangin)
A wound possessing an upward pocket or overhanging cavity.
In wounds whose openings are either closed or open, a discerning physician should remove a foreign body in the manner already described when it displays the signs that removal is appropriate.
The commentary identifies this as the proper setting for extraction. A foreign body fit for removal is one other than the categories described as immediately fatal or as causing death when extracted, and other similarly excluded conditions.
For a disease treatable by puncture, the instrument should be introduced at the prescribed site and to the prescribed extent, and the morbid material should be drained as previously stated.
The commentary identifies ascites and urinary enlargement or swelling as examples historically treated by puncture. The depth and placement must not exceed what is specified: for ascites it gives a depth compared with the pad of the thumb, while for abscess and related swellings it cites an incision placed two or three fingerbreadths away. The first half of the verse concerns puncture and the second drainage, thus naming two measures.
Key terms
vyadhana
Puncture with a surgical instrument.
srAvaNa (sravana)
Drainage or evacuation of accumulated material.
dakodara
A classical abdominal fluid condition, commonly rendered as ascites.
mUtravRddhi (mutra-vriddhi)
A classical urinary-region enlargement or swelling.
अपाकोपद्रुता ये च मांसस्था विवृताश्च ये |
यथोक्तं सीवनं तेषु कार्यं सन्धानमेव च ||४५||
Meaning of the śloka
Wounds situated in flesh, free from complications of suppuration, and lying open should be sutured and their edges brought together as previously described.
The commentary explains apakopadruta as free from the complications of suppuration and vivrita as having a gaping mouth. The prescribed suturing method is the one given in the chapter on the eight surgical procedures. Sandhana is additional to suturing and means joining the lips or edges of the wound. The verse therefore states two measures: suturing and approximation.
पूयगर्भानणुद्वारान् व्रणान्मर्मगतानपि |
यथोक्तैः पीडनद्रव्यैः समन्तात् परिपीडयेत् ||४६||
शुष्यमाणमुपेक्षेत प्रदेहं पीडनं प्रति |
न चाभिमुखमालिम्पेत्तथा दोषः प्रसिच्यते ||४७||
Meaning of the śloka
Wounds containing pus, having no outlet, or involving a marma are to be pressed from all sides with the previously described compressing substances. The applied paste should be left until it dries. It should not be spread directly over the wound opening, so that the pus can discharge by itself.
The commentary says the compressing substances are the sticky barks, roots, and similar materials listed in the Mishraka section. 'From all sides' means all around the wound. Pradeha means an applied paste, and the material expected to flow out is pus. Here pidana means compression produced with medicinal substances.
Key terms
pUyagarbha (puya-garbha)
Containing pus within the wound.
aNudvAra (anudvara)
Having no adequate outlet for drainage.
marmagata (marma-gata)
Involving a vital anatomical point or region.
pIDana (pidana)
Compression around a wound using an applied medicinal preparation.
The commentary includes venesection and similar procedures among the causes. Stopping excessive blood flow is called shonitasthapana and is said to have four forms cited from an earlier chapter: joining or constricting, promoting clotting, cauterizing or chemically transforming, and burning or thermal cautery.
Key terms
shoNita (shonita)
Blood.
atipravRtti (ati-pravritti)
Excessive or uncontrolled flow.
shoNitAsthApana (shonita-sthapana)
The set of historical measures used to arrest bleeding.
dahana
Burning or cautery as a historical hemostatic measure.
Wounds with burning, suppuration, and fever attributed to aggravated pitta, and wounds overwhelmed by blood, are to receive cooling treatment. The text recommends thin applications made from previously stated cooling substances ground with milk and moistened with ghee, together with very cool irrigations.
The commentary defines nirvapana as easing the pain of a pitta-and-blood-affected wound that is suppurating and feels as though it is burning. The cooling substances include durva and others listed in the Mishraka section. They are ground with milk. The paste should not be thick, because even sandalwood in a smooth, dense layer is said to produce burning and suppuration. Seka means irrigation or pouring. The verse therefore gives two cooling measures: irrigation and a thin paste.
Key terms
nirvApaNa (nirvapana)
Cooling or soothing treatment for a burning, inflamed wound.
pittakopa (pitta-kopa)
Aggravation of pitta used to explain heat, burning, and suppuration.
pradeha
A thin external medicinal paste in this context.
seka
Irrigation or pouring liquid over the affected area.
व्रणेषु क्षीणमांसेषु तनुस्राविष्वपाकिषु |
तोदकाठिन्यपारुष्यशूलवेपथुमत्सु च ||५१||
वातघ्नवर्गेऽम्लगणे काकोल्यादिगणे तथा |
स्नैहिकेषु च बीजेषु पचेदुत्कारिकां शुभाम् ||५२||
तेषां च स्वेदनं कार्यं स्थिराणां वेदनावताम् |५३|
Meaning of the śloka
For wounds with loss of flesh, thin discharge, lack of suppuration, pricking pain, hardness, roughness, severe pain, or trembling, the text directs preparation of an utkarika from the vata-pacifying group, sour substances, the Kakolyadi group, and oily seeds. This is used to warm wounds that are firm and painful.
The commentary regards loss of flesh and the other listed features as effects of vata. It identifies the ingredient groups with bhadradaru and related vata-pacifying substances, sour liquids such as sauvira and tushodaka, and oily seeds such as sesame, flax, mustard, and castor. Equal portions of the vata-pacifying group, Kakolyadi group, and oily seeds are combined with four times their amount of sour liquids and cooked into an utkarika resembling a drinkable gruel, neither too thick nor too dense.
Key terms
utkArikA (utkarika)
A cooked medicinal poultice or gruel-like preparation used here for warming.
kShINamAMsa (kshina-mamsa)
Loss or depletion of flesh in a wound.
svedana
Warming or fomentation.
snaihika bIja (snaihika-bija)
Oil-rich seeds such as sesame, flax, mustard, and castor.
The commentary introduces this and the following passages as seven types of cleansing and healing preparations, from decoctions through powders, assigned according to the kind of wound. Here cleansing is done with decoctions prepared from shankhini, ankota, sumana, and other substances listed earlier in the Mishraka section.
Deep wounds with a retained foreign body, narrow openings, or involvement of flesh are to be cleansed in sequence with wicks containing cleansing substances. The sequence also applies to deep wounds covered by putrid flesh and to severely vitiated wounds, using pastes made from the previously listed wick ingredients as available.
The cleansing ingredients are ajagandha, ajashringi, and others listed in the Mishraka section. 'In sequence' means beginning with fine wicks and then using progressively thicker ones. The phrase 'covered by putrid flesh' describes deeply recessed wounds rather than internal wounds. 'Greatly affected by dosha' means severely contaminated or vitiated; the commentary takes the doshas here as vata and kapha, not pitta, because pitta-affected wounds are assigned to medicated ghee.
Key terms
antaHshalya (antah-shalya)
A foreign body retained within a wound.
aNumukha (anu-mukha)
Having a very narrow opening.
varti
A medicinal wick introduced into a wound.
pUtimAMsa (puti-mamsa)
Putrid or devitalized flesh.
mahAdoSha (maha-dosha)
A wound regarded as severely vitiated or contaminated.
The commentary says the ghee is cooked with cleansing substances such as kasisa and ajagandha. It gives the historical preparation: cotton fruit equal in quantity to the combined cleansing ingredients, ghee four times the paste, and water four times the ghee, cooked until the medicated ghee is obtained.
Key terms
pittapraduShTa (pitta-pradushta)
Affected by aggravated pitta in the classical framework.
shodhanasarpiH (shodhana-sarpis)
Medicated ghee intended for wound cleansing.
kArpAsIphala (karpasi-phala)
Cotton fruit used in the formulation.
kAsIsa (kasisa)
A mineral substance, commonly associated with ferrous sulfate, used historically in preparations.
Raised, fleshy wounds that are dry and have little discharge are to be cleansed by a knowledgeable physician with oil containing a predominance of mustard oil.
The commentary interprets these as wounds dominated by kapha and vata: elevation is attributed to kapha, while dryness and scant discharge are attributed to vata. The oil is sesame oil with a larger share of mustard oil, prepared with peacock and other cleansing substances listed in the Mishraka section.
Key terms
utsannamAMsa (utsanna-mamsa)
Having raised or overgrown fleshy tissue.
asnigdha
Dry or lacking unctuousness.
alpasrAva (alpa-srava)
Having scant discharge.
sarShapasneha (sarshapa-sneha)
Mustard oil or an oil component derived from mustard.
For wounds with firm flesh that are not cleansed by oil, the text prescribes a concentrated cleansing extract. A decoction of the previously stated substances is reduced, then combined with Saurashtra clay, kasisa, manahshila, and haritala. It is mixed thoroughly with citron juice and honey, placed on the wounds, and left for no more than three days at a time.
The earlier substances are shalasara and related materials from the Mishraka section. Their decoction is made with sixteen parts water reduced to one eighth, or eight parts reduced to one quarter, then strained and cooked again. Powdered Saurashtra clay, kasisa, manahshila, and haritala are added in measured quantities when the remaining decoction reaches a syrup-like consistency. Citron juice and honey serve only as processing additions, and thorough grinding unifies the ingredients. The application is limited to exactly three days because longer use is said to risk tearing or splitting the wound tissue.
Key terms
rasakriyA (rasa-kriya)
A concentrated extract produced by reducing a decoction.
surAShTrajA (saurashtraja)
Saurashtra clay or mineral earth in the commentary.
manaHshilA (manahshila)
A toxic arsenic sulfide mineral used historically.
haritAla (haritala)
Orpiment, an arsenic sulfide mineral used historically.
A knowledgeable physician should treat foul-smelling wounds associated with fat that are described as not deep by applying fine cleansing powders derived from the ingredients used for cleansing wicks.
The commentary glosses agambhira as superficial. It also preserves another reading, 'deep wounds associated with fat,' but says Gayi does not accept it. The cleansing powders include kasisa and related substances, while the wick-derived substances include ajagandha and others.
Key terms
medojuShTa (medo-jushta)
Associated with or involving fatty tissue.
agambhIra (agambhira)
Superficial or not deep in the accepted reading.
cUrNashodhana (churna-shodhana)
Cleansing treatment using a fine powder.
shodhanavarti (shodhana-varti)
A cleansing wick whose ingredients are reused here as powder.
For wounds that show the signs of cleanliness, a knowledgeable physician should use a healing decoction prepared from the substances previously specified.
After assigning seven preparations, beginning with decoctions, to the cleansing of unclean wounds, the commentary says the same kinds of preparations are now directed toward healing clean wounds. The signs of a clean wound are those described earlier in passages beginning 'not afflicted by the three doshas' or 'resembling the surface of the tongue.' The relevant healing substances include banyan and others previously listed.
Key terms
shuddhavraNa (shuddha-vrana)
A wound displaying the text's classical signs of cleanliness.
ropaNa (ropana)
Promoting wound healing or closure.
kaShAya (kashaya)
A medicinal decoction.
vaTa (vata)
Banyan, named among the historical healing ingredients.
The commentary takes avedana primarily to mean completely without pain, while others interpret it as having only slight pain. The healing wicks are made from ingredients such as soma, amrita, ashvagandha, and kakoli listed for that purpose.
Key terms
avedana
Painless according to one reading, or only slightly painful according to another.
gambhIra vraNa (gambhira-vrana)
A deep wound.
ropaNavarti (ropana-varti)
A medicinal wick intended historically to promote healing.
amRtA (amrita)
A plant ingredient named for the healing wick, often identified with guduchi but requiring contextual verification.
For wounds from which putrid flesh has separated, but in which flesh is not regrowing, the text prescribes sesame paste mixed with honey. It explains this paste as balancing vata, pitta, and kapha through its sweet, warm, unctuous, astringent, and bitter qualities. Combined with cleansing or healing agents, it is said to cleanse or heal: neem leaf and honey are named for cleansing, and these with ghee for healing. Some authorities similarly recommend barley paste, saying it calms an unripe swelling, matures one already inflamed, opens one that is ripe, cleanses one already open, and promotes healing.
The wound has shed decayed flesh but still lacks tissue regrowth. The general paste was described earlier, while sesame and honey are specified here. Although sesame has qualities that might aggravate different doshas, its own effect is compared to amalaki and it is said to carry the actions of substances combined with it. A variant reads only that the combination heals and does not accept the additional cleansing function. Some explain yavakalka as barley paste acting like sesame; Jejjata and Gayadasa instead parse it as barley paste containing sesame. This combined paste is assigned five actions—softening, maturation, opening, cleansing, and healing—while sesame paste alone has two or possibly three. The conjunction also adds correction of wound deformity.
Key terms
tilakalka (tila-kalka)
Sesame paste used as a wound preparation.
yavakalka (yava-kalka)
Barley paste, with a disputed interpretation regarding added sesame.
Externally caused wounds are those due to weapons and similar trauma and, before seven days have passed, are considered not yet complicated by doshas. The named healing formulation is the one beginning with prithakparni and atmagupta described in the Mishraka section.
For wounds dominated by kapha and vata, the knowledgeable physician is directed to prepare a healing oil with the medicines prescribed for that purpose.
अबन्ध्यानां चलस्थानां शुद्धानां च प्रदुष्यताम् ||७२||
द्विहरिद्रायुतां कुर्याद्रोपणार्थां रसक्रियाम् |७३|
Meaning of the śloka
For wounds that cannot be bandaged, lie at moving sites, or become contaminated again after cleansing, the text prescribes a concentrated healing preparation containing the two haridras.
Examples of wounds unsuitable for bandaging include those attributed to pitta, blood, poison, or trauma. Moving sites are joints. Some read 'pure wounds that do not heal' instead of 'pure wounds becoming contaminated again,' understanding nonhealing to result from location at a moving site and similar causes. The commentary gives a detailed preparation from Nyagrodhadi and Triphala decoctions reduced to specified fractions, then thickened and mixed with the two haridra powders and honey. Unlike a cleansing rasakriya, it is said to be continued until the wound heals.
Key terms
calasthAna (cala-sthana)
A moving anatomical site, explained as a joint.
rasakriyA (rasakriya)
A concentrated preparation produced by reducing a decoction.
For even wounds situated in the skin with firm flesh, the knowledgeable physician is instructed to use a healing powder according to the method described previously.
Sudhira explains that the method applies generally to bodily and traumatic wounds because vata, pitta, and kapha may affect both; with the reading dosha-visheshatah, treatment varies according to the particular dosha. Others supply an omitted conjunction and distinguish general measures, such as sesame-neem paste, from measures selected by dosha, such as the first two Panchamula groups. Gayi says the same method applies to all wound disorders beginning with vidradhi because it was stated for wounds generally, but it must be adapted to the dosha involved.
Key terms
shodhana
Wound cleansing in the classical regimen.
ropaNa (ropana)
Promotion of healing.
doShAvisheShataH (doshavisheshatah)
Without a distinct dosha limitation; another reading supports treatment by specific dosha.
vidradhi
A deep inflammatory swelling or abscess-like disorder.
Adhikarana ૫૨ (૭૫) · Śloka ૭૬
એષ આગમસિદ્ધત્વાત્તથૈવ ફલદર્શનાત્ ||૭૫||
મન્ત્રવત્ સમ્પ્રયોક્તવ્યો ન મીમાંસ્યઃ કથઞ્ચન |૭૬|
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एष आगमसिद्धत्वात्तथैव फलदर्शनात् ||७५||
मन्त्रवत् सम्प्रयोक्तव्यो न मीमांस्यः कथञ्चन |७६|
Meaning of the śloka
Because this cleansing and healing method is established by authoritative tradition and its results are said to be observed, the text instructs that it be applied like a mantra and not subjected to questioning.
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એષઃ શોધનરોપણવિધિઃ| આગમસિદ્ધત્વાદિતિ આગમઃ શાસ્ત્રં, તેન સિદ્ધત્વાત્ પ્રસિદ્ધત્વાદિત્યર્થઃ| ફલદર્શનાત્ આરોગ્યદર્શનાત્| ન મીમાંસ્યો ન વિચાર્ય ઇત્યર્થઃ||૭૫||-
Meaning of the commentary
'This' refers to the cleansing and healing method. Agama means authoritative scripture or teaching, and observed result means the appearance of recovery. Na mimamsyah is explained as 'not to be examined or debated.'
Key terms
Agama (agama)
Authoritative textual or transmitted teaching.
phaladarshana (phala-darshana)
Observation of the claimed result.
mantravat
To be applied like a mantra or authoritative formula.
Using one's own judgment, the medicines previously taught should also be allocated as appropriate among the seven preparation forms beginning with decoction.
After prohibiting debate about formulations explicitly stated by tradition, the text permits reasoning where a formulation has not been specified. The seven forms are decoction, wick, paste, ghee, oil, concentrated extract, and powder.
For wounds affected by vata, the first two Panchamula groups and a group that reduces vata are assigned to each of the seven preparations. For pitta-affected wounds, the Nyagrodhadi and Kakolyadi groups are assigned. For kapha-affected wounds, the Aragvadhadi group and a group described as heating are assigned. Where doshas are combined, the corresponding groups are combined.
The heating group means one whose potency is hot and which reduces kapha, such as Mushkakadi or Surasadi. For combined involvement the groups are combined. The entire passage applies to both cleansing and healing preparations.
Key terms
pa~jcamUla (panchamula)
A group of five roots; two such groups are referenced.
nyagrodhAdi (Nyagrodhadi)
A classical medicinal group assigned here to pitta-affected wounds.
kAkolyAdi (Kakolyadi)
A classical medicinal group assigned here to pitta-affected wounds.
AragvadhAdi (Aragvadhadi)
A classical medicinal group assigned here to kapha-affected wounds.
वातात्मकानुग्ररुजान् सास्रावानपि च व्रणान् ||८०||
सक्षौमयवसर्पिर्भिर्धूपनाङ्गैश्च धूपयेत् |८१|
Meaning of the śloka
The text prescribes fumigation with linen, barley, ghee, and specified fumigation ingredients for wounds considered vata-type, severely painful, and discharging.
Severe pain and discharge together are taken to indicate involvement of vata and kapha. Kshauma is linen made from flax. The other fumigation ingredients are those in the earlier formulation beginning with shriveshtaka and sarjarasa.
परिशुष्काल्पमांसानां गम्भीराणां तथैव च ||८१||
कुर्यादुत्सादनीयानि सर्पींष्यालेपनानि च |
मांसाशिनां च मांसानि भक्षयेद्विधिवन्नरः ||८२||
विशुद्धमनसस्तस्य मांसं मांसेन वर्धते |८३|
Meaning of the śloka
For dry wounds with little flesh and for deep wounds, the text recommends ghee preparations and pastes intended to raise the wound bed. It also tells a meat-eating person to eat, according to rule, the flesh of carnivorous animals, claiming that in a person with a clear mind flesh is increased by flesh.
Dry wounds with little flesh are classified as vata-type and deep wounds as blood-pitta type. Utsadana ingredients include apamarga and ashvagandha; they are used to prepare ghee and paste for raising a depressed wound. The internal measure refers to eating flesh of animals such as tigers. 'Clear-minded' means free of grief, anger, and similar disturbance. Jejjata instead says the carnivore meat is served disguised, so the person remains unaware and mentally undisturbed.
Key terms
utsAdana (utsadana)
An attempt to raise or fill a depressed wound bed.
Raised soft flesh means soft tissue projecting above the wound. Avasadana is making an elevated wound lower. The substances previously specified include kasisa and others.
Key terms
utsannamAMsa (utsanna-mamsa)
Soft tissue raised above the wound surface.
avasAdana (avasadana)
Reducing or depressing raised wound tissue.
kAsIsa (kasisa)
A mineral substance named for the powdered preparation.
कठिनानाममांसानां दुष्टानां मातरिश्वना ||८४||
मृद्वी क्रिया विधातव्या शोणितं चापि मोक्षयेत् |
वातघ्नौषधसंयुक्तान् स्नेहान् सेकांश्च कारयेत् ||८५||
मृदुत्वमाशुरोहं च गाढो बन्धः करोति हि |८६|
Meaning of the śloka
For hard, deficient-flesh wounds considered damaged by vata, the text prescribes softening measures and also bloodletting. It directs internal and external use of sweet, unctuous, mildly warm, and salty preparations, with vata-reducing fats and pouring treatments. It states that a firm bandage produces softness and rapid healing.
Amamsa means having little flesh, and Matarishvan means vata. Softening treatment consists of pastes and related measures using sweet, unctuous, mildly warm, and salty agents internally and externally. When vata is accompanied by blood, bloodletting is prescribed; when accompanied by kapha, fats and pouring are used. A tight bandage is credited with both softening and rapid healing.
For wounds with excessively soft flesh, the text recommends hardening. Equal parts of finely powdered bark from dhava, priyangu, ashoka, and rohini, together with triphala, dhataki flowers, rodhra, and sarjarasa, are to be sprinkled on the wound.
स्रवतोऽश्मभवान्मूत्रं ये चान्ये रक्तवाहिनः |
निःशेषच्छिन्नसन्धींश्च साधयेदग्निकर्मणा ||८९||
Meaning of the śloka
The text prescribes thermal cautery for wounds resulting from cutting during stone removal that continue to leak urine, for other wounds carrying blood, and for joints or wound edges that have been completely severed.
The commentary connects the instruction specifically with wounds created by incision during removal of a urinary stone. Although such wounds leak urine, they must not be burned while fresh and while urine is still following that route. Only after seven days, if the wound has failed to unite and urine has not returned to its normal passage, does the commentary prescribe cauterization.
Key terms
agnikarma
Thermal cauterization used historically on selected wounds.
ashmarI (ashmari)
A urinary stone whose surgical removal is said to create the wound.
mUtrasrAvi (mutrasravi)
Continuing to discharge urine through the wound.
raktavAhin (raktavahin)
Carrying or discharging blood.
chinnasandhi
A completely severed union, joint, or wound connection.
For a healed wound whose scar remains pale, the text prescribes a darkening procedure. Bhallataka fruits, first conditioned in cow urine and then milk, are cut and heated in a two-pot apparatus sealed mouth to mouth over a fire of cow dung. The oil that drips out is collected gradually. Hooves of domestic and marsh-dwelling animals are burned and powdered, and this powder is mixed with the oil and applied to the pale scar. Oils from woody cores and other oily fruits are to be prepared in the same manner.
The commentary places this among procedures intended to restore the appearance of a healed but discolored wound. It supplies seven days for the initial cow-urine conditioning and, by analogy with the following formula, seven nights in cow milk. The upper pot must have a perforated cover so the fruits do not fall. Domestic animals include horses and marsh animals include buffaloes. Oils from pith, wood, pinditaka, bibhitaka, and similar sources are processed like bhallataka; when intended for darkening, they are combined with ash from the burned hooves.
Key terms
kRuShNakarma (krishnakarma)
A historical procedure intended to darken a pale healed scar.
bhallAtaka (bhallataka)
Semecarpus anacardium, used here to extract a strongly irritant oil.
shapha
Animal hoof, burned to ash for the preparation.
sArasneha (sarasneha)
Oil extracted from the core or heartwood of a plant.
For a dark healed scar, the text prescribes a lightening or color-restoring procedure. Rohini fruit kept for seven nights in goat milk is finely ground with that milk and applied. Other preparations combine fresh earthen-pot powder, vaidula, sarja, kasisa, and madhuka with honey; or hollow out a kapittha fruit, fill it with goat urine, kasisa, rochana, tuttha, haritala, manahshila, bamboo scraping, and prapunnada-rasanjana, then bury it beneath an arjuna tree for a month before application.
The aim is restoration of color in a dark healed scar. Gayi reads barkara instead of goat milk and discusses whether it means milk of a young goat, a goat whose kid has matured, or another specially named milk, while noting limited established usage. Rohini is interpreted as a type of haritaki; others identify bitter gourd, and another reading has katuka fruit. 'With that' means with the same milk. Kapalika is newly fired earthenware powder, though others interpret nava as a freshly prepared application. Vaidula is understood as willow root and sarja as the root of the sarja tree. The inner pulp of kapittha is removed before filling it. Bamboo scraping means bamboo bark, and arjuna is identified as kakubha. The supplied commentary ends incompletely.
Key terms
pANDukarma (pandukarma)
A historical procedure intended to lighten or restore color to a dark healed scar.
rohiNIphala (rohiniphala)
Variably identified as a type of haritaki, bitter gourd, or katuka fruit.
kAsIsa (kasisa)
A mineral substance, commonly interpreted as ferrous sulfate.
tuttha
A copper-containing mineral substance used in the preparation.
कुक्कुटाण्डकपालानि कतकं मधुकं समम् ||९९||
तथा समुद्रमण्डूकी मणिचूर्णं च दापयेत् |
गुटिका मूत्रपिष्टास्ता व्रणानां प्रतिसारणम् ||१००||
Meaning of the śloka
Equal amounts of eggshell, kataka, and madhuka, together with samudramanduki and powdered gemstone, are ground with urine into pills and rubbed onto scars to restore their color.
This is presented for residual pallor or darkness remaining after the preceding scar-color procedures. Samudramanduki is identified as a water shell; Brahmadeva calls it a pearl oyster. Because Jejjata explains the context elsewhere, gemstone powder is also interpreted as pearl powder, though crystal and similar powders are mentioned. Pratisarana means rubbing. The aim is only color matching, so the commentary treats this as a continuation of the pale- and dark-scar procedures rather than an additional therapeutic category.
Key terms
samudramaNDUkI (samudramanduki)
A marine shell, alternatively identified as a pearl oyster.
maNicUrNa (manichurna)
Powdered crystal or gemstone, alternatively interpreted as pearl powder.
To promote hair growth, the text recommends applying elephant-tusk charcoal with high-grade rasanjana, claiming that hair can grow even on the palms. It also says earth first coated with oil and then dusted with ash made from the skin, hair, hooves, horns, and bones of quadrupeds becomes hairy. A paste of kasisa and tender naktamala leaves ground with kapittha juice is described as especially effective for producing hair.
The commentary supplies goat milk as an additional ingredient with elephant-tusk charcoal and rasanjana. It claims repeated experience of the formula in hair loss. Quadrupeds include horses, cattle, buffaloes, and similar animals; the oiled ground is subsequently covered with their tissue ash. Naktamala leaves are identified as tender karanja leaves.
Key terms
romasa~jjanana (romasanjanana)
A procedure intended to induce hair growth.
hastidantamasI (hastidantamasi)
Charcoal or soot prepared from elephant tusk.
rasA~jjana (rasanjana)
A concentrated medicinal substance used in the topical formula.
kAsIsa (kasisa)
A mineral substance used with karanja leaves.
naktamAla (naktamala)
Karanja, whose tender leaves are used in the preparation.
Because hair-filled wounds are said not to heal properly, the text directs removal of hair with a razor, scissors, or forceps. It then lists depilatory preparations: a bracketed verse gives conch powder and haritala ground with sour liquid; other formulas combine bhallataka oil with snuhi latex, or banana and shyonaka ash with haritala, salt, and shami seed ground in cold water. Another formula burns the tail of a house lizard with banana, haritala, and ingudi seed, then matures the ash with oil and water in sunlight to destroy hair.
The commentary identifies the scissors as an instrument for cutting beard hair and sandamsha as a forceps used for nasal hair. Shyonaka is the long-stalked plant and ala is haritala. Shami seed forms one compound; older physicians claim red-fruited shami removes hair both topically and when eaten. All ingredients in that formula are ground with cold water. The house lizard has a local name, rambha means banana, and inguda is the ingudi seed. Gayi treats all the verses beginning with bhallataka oil as a variant passage and instead reads another formula beginning with koshataki, which is not reproduced because it was unavailable.
Key terms
romashAtana (romashatana)
Removal or destruction of hair.
sandaMsha (sandamsha)
A forceps-like instrument used historically to remove hair.
bhallAtakataila (bhallatakataila)
Strongly irritant oil from Semecarpus anacardium.
snuhIkShIra (snuhikshira)
Caustic latex of a Euphorbia species.
haritAla (haritala)
Arsenic-containing orpiment.
AgAragodhikA (agaragodhika)
A house lizard used as an animal-derived ingredient.
मूत्राघाते मूत्रदोषे शुक्रदोषेऽश्मरीव्रणे |
तथैवार्तवदोषे च बस्तिरप्युत्तरो हितः ||११०||
Meaning of the śloka
Uttara-basti is described as beneficial when urinary retention, disorders of urine or shukra, a wound associated with urinary stone, or a disorder of artava arises from a wound.
The commentary reads nihshanka as free from concern about impact and the landing of flies or similar contaminants. Some read nihsanga, meaning freed from contact with causes of injury. The preceding section on pastes has already stated which wounds should or should not be bandaged and how. Some manuscripts add a verse before this one claiming that proper pastes and bandaging prevent deterioration, level the margins, ease pain, and give comfort, but earlier commentators did not accept it, so it is neither reproduced nor explained in this edition.
Key terms
bandha
A wound dressing or bandage.
niHsha~gka (nihshanka)
Free from concern about impact or contamination, in one reading.
niHsa~gga (nihsanga)
Variant reading interpreted as free from contact with causes of injury.
स्थिराणामल्पमांसानां रौक्ष्यादनुपरोहताम् |
पत्रदानं भवेत् कार्यं यथादोषं यथर्तु च ||११२||
एरण्डभूर्जपूतीकहरिद्राणां तु वातजे |
पत्रमाश्वबलं यच्च काश्मरीपत्रमेव च ||११३||
पत्राणि क्षीरवृक्षाणामौदकानि तथैव च |
दूषिते रक्तपित्ताभ्यां व्रणे दद्याद्विचक्षणः ||११४||
पाठामूर्वागुडूचीनां काकमाचीहरिद्रयोः |
पत्रं च शुकनासाया योजयेत् कफजे व्रणे ||११५||
अकर्कशमविच्छिन्नमजीर्णं सुकुमारकम् |
अजन्तुजग्धं मृदु च पत्रं गुणवदुच्यते ||११६||
स्नेहमौषधसारं च पट्टः पत्रान्तरीकृतः |
नादत्ते यत्ततः पत्रं लेपस्योपरि दापयेत् ||११७||
शैत्यौष्ण्यजननार्थाय स्नेहसङ्ग्रहणाय च |
दत्तौषधेषु दातव्यं पत्रं वैद्येन जानता ||११८||
Meaning of the śloka
For firm wounds with little flesh that fail to heal because of dryness, leaves are to be placed according to dosha and season. Castor, birch, putika, turmeric, ashvabala, and kashmari leaves are named for vata; leaves of latex-bearing trees and aquatic plants for wounds affected by rakta and pitta; and patha, murva, guduchi, kakamachi, turmeric, and shukanasa for kapha. A suitable leaf is non-rough, intact, fresh, thin, insect-free, and soft. Placed between the medicinal paste and bandage, it prevents the cloth from absorbing the oil and medicinal essence and helps maintain the desired cooling or warming effect.
The commentary gives regional or alternative plant identifications: ashvabala is upodaki, while Brahmadeva describes a fenugreek-like plant found in Yavana country; latex-bearing trees include banyan and related trees, and aquatic leaves include lotus and water lily. Murva is a vine used for bowstrings. Shukanasa has several regional names and identifications. Ajirna means fresh, sukumaraka thin, and ajantujagdha not eaten by insects. The leaf separates the bandage from the medicine so the cloth does not take up its oil or potency. An alternative reading says the leaf prevents the medicated oil from being spoiled by the bandage cloth. Cooling is intended for pitta-rakta wounds and warming for vata-kapha wounds.
Key terms
patradAna (patradana)
Placing a leaf layer over a medicated wound application.
kShIravRukSha (kshiravriksha)
A latex-bearing tree such as banyan.
audakapatra
A leaf of an aquatic plant such as lotus or water lily.
shukanAsA (shukanasa)
A plant with several regional identifications preserved by the commentary.
When flies deposit larvae in a wound, the text describes severe swelling, varied intense pain such as piercing, burning, and itching, and bloody discharge. It recommends washing and filling the wound with the surasadi group; using bark of saptaparna, karanja, arka, nimba, and rajadana ground with cow urine; irrigating with alkaline water; and covering the wound with a piece of meat to draw away the organisms. It says twenty kinds of krimi will be described later.
The commentary supplies 'wound' as what the larvae consume and explains bhrishadaruna as extremely distressing. The varied pains include piercing, burning, itching, and other forms. Dhavana means washing and seka irrigation. The meat piece is used to cover the wound. The later classification is located in the Uttara-tantra chapter on krimi disorders.
Key terms
kRumi (krimi)
Larvae or wound organisms deposited here by flies.
dhAvana (dhavana)
Washing or cleansing the wound.
pUraNa (purana)
Filling the wound with a medicinal preparation.
kShArodaka (ksharodaka)
Alkaline water used historically for irrigation.
mAMsapeshi (mamsapeshi)
A piece of meat used historically to attract or remove larvae.
For people who have been ill a long time, are emaciated, or are wasting because of a wound, the text prescribes the full nourishing regimen while protecting bodily digestive capacity.
The commentary defines brimhana as a regimen that builds the body. The explicit word kaya, body, indicates that unmentioned factors such as the person's emaciation, dosha, suitability, and related conditions must also be considered. Some read simply that the nourishing regimen should be undertaken while protecting agni.
Key terms
bRuMhaNa (brimhana)
A nourishing or body-building regimen.
vraNashoShin (vranashoshin)
A person depleted or wasted because of a wound.
kAyAgni (kayagni)
The body's digestive and metabolic capacity in the classical framework.
sAtmya (satmya)
Individual suitability or accustomed compatibility considered by the commentary.
विषजुष्टस्य विज्ञानं विषनिश्चयमेव च |
चिकित्सितं च वक्ष्यामि कल्पेषु प्रतिभागशः ||१२४||
Meaning of the śloka
The signs of substances affected by poison, the determination of the type of poison, and its treatment will be explained separately in the Kalpasthana sections.
The commentary supplies food, drink, and similar substances as what may be affected by poison. Vijnana means recognition through signs; vishanishcaya means correct determination of plant, animal, and other poison categories; and pratibhagasha means each separately.
Key terms
viShajuShTa (vishajushta)
Affected or contaminated by poison.
vij~jAna (vijnana)
Recognition through characteristic signs.
viShanishcaya (vishanishchaya)
Determination of the poison category.
sthAvaraviSha (sthavaravisha)
Poison of plant or immobile origin in the classical classification.
ja~ggamaviSha (jangamavisha)
Poison of animal or mobile origin in the classical classification.
kalpasthAna (Kalpasthana)
The division in which toxicology is treated in detail.
दोषप्रच्यावनार्थाय रुजादाहक्षयाय च |
जिह्वादन्तसमुत्थस्य हरणार्थं मलस्य च ||१२७||
शोधनो रोपणश्चैव व्रणस्य मुखजस्य वै |
उष्णो वा यदि वा शीतः कवलग्रह इष्यते ||१२८||
Meaning of the śloka
For a wound in the mouth, holding a liquid preparation in the mouth is recommended to dislodge doshas, reduce pain and burning, remove coating arising from the tongue and teeth, cleanse the wound, and support healing. The preparation may be warm or cool according to the condition.
The commentary calls this practice kavala-graha. Dosha removal may use decoctions of triphala, grapes, and similar substances. A cleansing preparation uses cleansing ingredients, while a healing one uses healing ingredients. A warm preparation is assigned to wounds attributed to vata and kapha, and a cool one to those attributed to blood and pitta.
Key terms
kavalagraha (kavala-graha)
Holding or moving a medicinal liquid in the mouth.
Diseases and wounds above the clavicle that are attributed to kapha and vata and accompanied by swelling, discharge, and pain are to be treated with medicinal smoke.
A knowledgeable person should continually provide every wounded patient with food that is modest in quantity, itself light, unctuous, warm, and supportive of digestive fire.
The first use of 'light' means small in quantity. The next refers to foods considered inherently light, such as red rice and meat of animals from dry regions. The dietary instruction extends through the quality of kindling digestion. Although foods such as cow's ghee were already described in the conduct for a wounded patient, they are repeated here because the present topic is the complete set of treatment measures.
Key terms
laghumAtra (laghu-matra)
Small or moderate in portion size.
laghu
Light to digest in the classical dietary framework.
snigdha
Unctuous or containing fat.
agnidIpana (agni-dipana)
Considered supportive of digestive capacity.
jA~ggalamAMsa (jangala-mamsa)
Meat of animals from dry or arid habitats in the classical classification.
A person suffering from a wound should be protected at all times from beings associated with the night, using the prescribed protective rites together with yamas and niyamas.
The commentary takes 'at all times' to mean both day and night. The protective observances include fumigation with guggulu and related substances and mantras prescribed in Ayurveda. It lists five yamas: nonviolence, truthfulness, nonstealing, celibacy, and withdrawal from worldly dealings; and five niyamas: freedom from anger, service to the teacher, cleanliness, light eating, and vigilance. With this, the commentary says the sixty treatment measures have been described in their proper indications and sequence.
Key terms
nishAcara (nishachara)
A night-roaming being feared in the historical protective framework.
rakShAvidhAna (raksha-vidhana)
A prescribed protective rite or observance.
yama
One of five ethical restraints listed by the commentary.
niyama
One of five personal observances listed by the commentary.
dhUpa (dhupa)
Fumigation or incense used in the historical rite.
A wound is described as having six causal roots, involving eight bodily sites, recognized through five sets of signs, treated by the sixty stated measures, and managed through four necessary factors.
The six causes are vata, pitta, kapha, blood, their combined involvement, and external injury. The commentary includes two- and multi-dosha combinations within sannipata because the term can denote the coming together of two or more. The eight sites are skin, flesh, sira, snayu, joints, bone, body cavities, and marma. One explanation of the five sets of signs assigns them to vata, pitta, kapha, sannipata, and external injury, with blood sharing pitta-like signs; but external injury is also described as having pitta-and-blood signs, creating a difficulty. The commentary therefore offers another explanation: the five diagnostic features are odor, color, discharge, pain, and shape. The four factors are physician, patient, attendant, and medicine. Brahmadeva preserves a variant reading meaning 'for which sixty measures have been prescribed.'
Key terms
ShaNmUla (shan-mula)
Having six causal roots.
aShTaparigrAhI (ashta-parigrahi)
Involving eight bodily sites or supports.
sannipAta (sannipata)
Combined involvement of multiple doshas.
vraNavastu (vrana-vastu)
One of the bodily tissues or sites in which a wound is situated.
pa~jcalakShaNa (pancha-lakshana)
Five sets of signs, interpreted alternatively as dosha categories or as odor, color, discharge, pain, and form.
Adhikarana ૮૩ (૧૩૫) · Śloka ૧૩૫
યોઽલ્પૌષધકૃતો યોગો બહુગ્રન્થભયાન્મયા |
દ્રવ્યાણાં તત્સમાનાનાં તત્રાવાપો ન દુષ્યતિ ||૧૩૫||
View original
योऽल्पौषधकृतो योगो बहुग्रन्थभयान्मया |
द्रव्याणां तत्समानानां तत्रावापो न दुष्यति ||१३५||
Meaning of the śloka
Because the author avoided an excessively long treatise, some formulas contain only a few medicines. Adding substances that are equivalent to those ingredients is not considered objectionable.
The commentary presents this as a basis for reasoned adaptation of short cleansing, healing, and similar formulas. Equivalent substances are those comparable to the stated ingredients in taste, qualities, potency, and post-digestive effect; they may be added to the formula. It preserves another reading: 'the formula made with few medicines by the author seeking a concise treatise.'
Key terms
alpatAuShadhakRta yoga (alpa-aushadha-krita-yoga)
A formulation made with only a few medicinal ingredients.
AvApa (avapa)
Addition or inclusion of another substance.
rasa
Taste as a criterion for classical drug equivalence.
vIrya (virya)
Potency or active energetic quality in classical pharmacology.
प्रसङ्गाभिहितो यो वा बहुदुर्लभभेषजः |
यथोपपत्ति तत्रापि कार्यमेव चिकित्सितम् ||१३६||
Meaning of the śloka
When a treatment has been mentioned incidentally, contains many medicines, or requires a medicine that is difficult to obtain, treatment should still be undertaken according to what is appropriately available.
The commentary explains yathopapatti as according to availability. It gives three examples. An incidentally mentioned treatment is a group of medicines inferred for combined-dosha swelling because the preceding context lists groups for vata-, pitta-, and kapha-related swelling. A formula with many medicines is exemplified by two Panchamula groups and a vata-reducing group, where available members may be used. A difficult medicine is one unavailable in a particular place or season; here too treatment is adjusted to what can be obtained.
Key terms
prasa~ggAbhihita (prasanga-abhihita)
Mentioned incidentally or inferred from the surrounding context.
bahubheShaja (bahu-bheshaja)
Containing numerous medicinal ingredients.
durlabhabheShaja (durlabha-bheshaja)
A medicine difficult to obtain in a given place or time.
Even if a substance is listed within a medicinal group, it should be removed when unsuitable for the disease; a suitable substance may be added even when it was not explicitly named.
The commentary says the verse establishes both principles for the same disease: an unsuitable listed ingredient is omitted, and a suitable unlisted ingredient may be included.
Key terms
gaNokta dravya (ganokta-dravya)
A substance named within a classical medicinal group.
ayaugika
Unsuitable or inappropriate for the particular disease.
yaugika
Suitable or appropriate for the particular disease.
उपद्रवास्तु विविधा व्रणस्य व्रणितस्य च |
तत्र गन्धादयः पञ्च व्रणस्योपद्रवाः स्मृताः ||१३८||
ज्वरातिसारौ मूर्च्छा च हिक्का च्छर्दिररोचकः |
श्वासकासाविपाकाश्च तृष्णा च व्रणितस्य तु ||१३९||
Meaning of the śloka
Complications may arise from either the wound itself or the wounded patient. Five features beginning with odor are considered complications of the wound. Complications affecting the patient include fever, diarrhea, fainting, hiccup, vomiting, loss of appetite, breathlessness, cough, indigestion, and thirst.
The commentary introduces the complications and says that the word 'and' after fainting also includes conditions not explicitly listed, such as spreading inflammatory disease described as visarpa.
Key terms
upadrava
A complication arising from a wound or affecting the wounded person.
gandhAdayaH pa~jca (gandhadayah pancha)
Five wound features beginning with odor, cross-referenced rather than fully listed here.
mUrcchA (murchha)
Fainting or loss of consciousness.
shvAsa (shvasa)
Difficulty or abnormality of breathing.
visarpa
A spreading disorder included by the commentary among unlisted complications.
Although these wound treatments have been explained here in detail, the text says they will be described again later in the chapter on treating fresh wounds.
The commentary explains that, despite the detailed account of wound procedures already given, treatment will be discussed again in the later Sadyovrana-cikitsita chapter. Gayi preserves a different reading: these procedures have been stated here only briefly and will be explained there in detail.
Key terms
vraNakriyA (vrana-kriya)
A treatment measure used for wounds.
anAgatAvekShaNa (anagata-avekshana)
A forward reference to material that will appear later.
sadyovraNacikitsita (sadyo-vrana-cikitsita)
The later chapter on treatment of fresh traumatic wounds.
vyAsa (vyasa)
Detailed or expanded presentation.
sa~gkShepa (sankshepa)
Concise or abbreviated presentation in Gayi's variant.
Adhikarana પુષ્પિકા · Śloka ૧
ઇતિ સુશ્રુતસંહિતાયાં ચિકિત્સાસ્થાને દ્વિવ્રણીયચિકિત્સિતં નામ પ્રથમોઽધ્યાયઃ ||૧||
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इति सुश्रुतसंहितायां चिकित्सास्थाने द्विव्रणीयचिकित्सितं नाम प्रथमोऽध्यायः ||१||
Meaning of the śloka
Thus ends the first chapter of the Cikitsasthana in the Sushruta Samhita, entitled 'Treatment of the Two Kinds of Wounds.'
The commentary states that the first chapter of the Cikitsasthana is complete in the Nibandhasangraha commentary on Sushruta composed by Dalhana; the transmitted text notes a spelling variant in Dalhana's name.
Key terms
dvivraNIya (dvi-vraniya)
Concerning the two kinds of wounds, commonly understood in this chapter as endogenous and traumatic.