The verse establishes the teacher-disciple sequence. Dhanvantari is called foremost among royal sages who uphold dharma. Vagvisharada means one whose speech is meaningful, properly formed, engaging, and free from needless repetition. Anvashat means 'instructed.'
Key terms
dhanvantari (Dhanvantari)
The authoritative teacher in this textual lineage.
Three causes of variation in wound shape are identified: the different kinds of weapon edge, the different forms of the weapon's point or face, and the different bodily sites struck.
आयताश्चतुरस्राश्च त्र्यस्रा मण्डलिनस्तथा |
अर्धचन्द्रप्रतीकाशा विशालाः कुटिलास्तथा ||५||
शरावनिम्नमध्याश्च यवमध्यास्तथाऽपरे |
एवम्प्रकाराकृतयो भवन्त्यागन्तवो व्रणाः ||६||
दोषजा वा स्वयं भिन्ना, न तु वैद्यनिमित्तजाः |७|
Meaning of the śloka
Externally caused wounds may be long, square, triangular, circular, crescent-shaped, broad, curved, depressed in the center like a shallow dish, or raised in the middle like a barley grain. Dosha-born wounds that open by themselves may also have such shapes, whereas wounds deliberately made by a physician are excluded from this statement.
The commentary glosses the geometric forms and understands self-opened wounds as swellings that mature and rupture on their own. Physician-made incisions are excluded because their long, broad, even, and well-divided shapes are described elsewhere as desirable wound qualities and are deliberately produced only at suitable sites.
Key terms
AgantuvraNa (agantu-vrana)
A wound caused externally.
doShaja (doshaja)
Attributed to internal dosha disturbance.
svayaM bhinna (svayam-bhinna)
Matured and opened spontaneously.
Adhikarana 5 (7) · Śloka 8
bhiṣagvraṇākr̥tijñō hi na mōhamadhigacchati ||7||
bhr̥śaṁ durdarśarūpēṣu vraṇēṣu vikr̥tēṣvapi |8|
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भिषग्व्रणाकृतिज्ञो हि न मोहमधिगच्छति ||७||
भृशं दुर्दर्शरूपेषु व्रणेषु विकृतेष्वपि |८|
Meaning of the śloka
A physician who understands wound shapes does not become confused even when wounds are severely distorted and difficult to look at.
छिन्नं भिन्नं तथा विद्धं क्षतं पिच्चितमेव च ||९||
घृष्टमाहुस्तथा षष्ठं तेषां वक्ष्यामि लक्षणम् |१०|
Meaning of the śloka
The six types are chinna, cut or severed; bhinna, penetrating into a cavity; viddha, punctured; kshata, irregularly cut and torn; picchita, crushed; and ghrishta, abraded. Their signs will now be explained.
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tadēva ṣaḍvidhatvamāha- chinnamityādi| chinnaṁ bhinnaṁ ca sadhārēṇa śastrēṇa, viddhaṁ punaraṇumukhēna śastrēṇa, kṣatādīni tu pāṣāṇalaguḍādibhirapi syuḥ||9||-
Meaning of the commentary
Chinna and bhinna are produced by a sharp-edged weapon, whereas viddha is made by a fine-pointed one. Kshata and the later types may also be produced by stones, clubs, and similar blunt objects.
Transverse means lying crosswise and straight means not curved; both are qualified as elongated. Gatra-patana includes a hand or another body part being severed by a weapon, while the conjunction also includes a part that is cut but not completely detached.
Key terms
chinna
An elongated cut, including partial or complete severance.
Bhinna is described as injury to an internal receptacle by the point of a lance, spear, sword, horn, or similar object, with some substance then flowing from it.
Shakti is a three-pointed weapon, rishti is identified as sharbala, and vishana means horn; 'point' applies to each item. Ashaya means an internal site beginning with amashaya. The unspecified discharge depends on the organ injured: blood from the abdomen, liver, or spleen; urine from the bladder; and feces from the intestinal reservoir.
Key terms
bhinna
A penetrating wound of an internal cavity or organ.
Ashaya (ashaya)
An internal receptacle or organ-site.
srAva (srava)
Material discharged from the injured site.
Adhikarana 10 (12) · Śloka 13
sthānānyāmāgnipakvānāṁ mūtrasya rudhirasya ca ||12||
hr̥duṇḍukaḥ phupphusaśca kōṣṭha ityabhidhīyatē |13|
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स्थानान्यामाग्निपक्वानां मूत्रस्य रुधिरस्य च ||१२||
हृदुण्डुकः फुप्फुसश्च कोष्ठ इत्यभिधीयते |१३|
Meaning of the śloka
The term koshtha here includes the sites of undigested food, digestive fire, digested material, urine, and blood, together with the heart, unduka, and lungs.
When the internal cavity is penetrated and fills with blood, the text describes fever and burning; bleeding from the urinary passage, rectum, mouth, or nose; fainting, breathlessness, thirst, abdominal distension, loss of appetite, retention of stool, urine, and flatus, sweating, red eyes, a metallic smell in the mouth, foul body odor, and pain in the heart and sides of the chest or abdomen.
'It' refers to koshtha. Blood is mentioned because it is present throughout. The commentary says bleeding below the navel emerges through the rectum or urinary passage, while bleeding above the navel emerges through the mouth or nose. Abhaktacchanda is lack of desire for food, sanga is retention, and lohagandhitva is a smell like iron in the mouth.
... विशेषं चात्र मे शृणु |
आमाशयस्थे रुधिरे रुधिरं छर्दयेत् पुनः ||१६||
आध्मानमतिमात्रं च शूलं च भृशदारुणम् |
पक्वाशयगते चापि रुजो गौरवमेव च ||१७||
शीतता चाप्यधो नाभेः खेभ्यो रक्तस्य चागमः |१८|
Meaning of the śloka
The text adds specific signs: when blood is situated in the amashaya, the person vomits blood and develops extreme distension and very severe pain. When it reaches the pakvashaya there are pains, heaviness, coldness below the navel, and blood emerging from bodily channels.
Even when the intestinal receptacle is not visibly torn, the text says blood may fill the intestines through minute openings, as water can enter a closed-mouthed pot through fine holes, producing heaviness there.
The pot analogy answers how blood could fill the intestinal region without an obvious rupture: water can enter a covered vessel through tiny perforations. The resulting heaviness belongs to the intestinal receptacle.
सूक्ष्मास्यशल्याभिहतं यदङ्गं त्वाशयाद्विना ||१९||
उत्तुण्डितं निर्गतं वा तद्विद्धमिति निर्दिशेत् |२०|
Meaning of the śloka
When a body part other than an internal receptacle is struck by a fine-pointed foreign object and the wound opening is raised, whether the object remains or has come out, it is termed viddha.
Ashaya refers to the internal sites beginning with amashaya. Uttundita means having a raised opening, and nirgata means that the foreign object has exited.
An irregular wound of a body part that is neither extensively cut through nor deeply penetrated, but has features of both chinna and bhinna, is called kshata.
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kṣatalakṣaṇamāha- nāticchinnamityādi| nāticchinnaṁ nātyarthadvidhābhūtam| nātibhinnaṁ nātyarthavidīrṇam| ubhayōriti cchinnabhinnayōrityarthaḥ| viṣamaṁ vraṇamiti vraṇasya vaiṣamyaṁ nimnōnnatatvaṁ, na tu kr̥cchrasādhyatvam||20||-
Meaning of the commentary
Not extensively chinna means not divided into two, and not extensively bhinna means not deeply torn open. Its irregularity refers to uneven raised and depressed areas, not to being difficult to treat.
Key terms
kShata (kshata)
An irregular injury combining cutting and tearing features.
viShama (vishama)
Uneven in contour, with raised and depressed areas.
Adhikarana 16 (21) · Śloka 22
prahārapīḍanābhyāṁ tu yadaṅgaṁ pr̥thutāṁ gatam ||21||
sāsthi tat piccitaṁ vidyānmajjaraktapariplutam |22|
A body part made broad and flattened by a blow or compression, with bone involved and permeated by marrow and blood, is classified as picchita, a crush injury.
A blow includes impact from a club or similar object, while compression may come from a door or mechanical device. The part becomes widened; 'with bone' means bone is involved, and it is filled with marrow and blood.
Key terms
piccita (picchita)
A crushed or compressed injury.
prahAra (prahara)
A forceful blow.
pIDana (pidana)
Compression.
majjan
Marrow.
Adhikarana 17 (22) · Śloka 23
vigatatvagyadaṅgaṁ hi saṅgharṣādanyathā'pi vā ||22||
uṣāsrāvānvitaṁ tattu ghr̥ṣṭamityupadiśyatē |23|
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विगतत्वग्यदङ्गं हि सङ्घर्षादन्यथाऽपि वा ||२२||
उषास्रावान्वितं तत्तु घृष्टमित्युपदिश्यते |२३|
Meaning of the śloka
When skin is removed from a body part by friction or another cause and there is a burning sensation and discharge, the injury is called ghrishta, an abrasion.
Vigata-tvag means deprived of skin, and sangharsha means rubbing against another object. Some manuscripts read anyajad api instead of anyatha api, meaning friction arising from another object. Usha is a particular burning sensation.
Cut, penetrating, puncture, and irregular cut-tear wounds bleed excessively. The text says loss of blood allows vata to produce severe pain and prescribes drinking fat, warm fat pouring, rich meat preparations and krishara poultices, warm grain fomentation, unctuous pastes, and enemas prepared with vata-reducing medicines.
After defining the six fresh wounds, the text gives a common treatment for the first four. The pouring uses mildly warm fat. Veshavara is boneless, cooked, fatty minced meat; krishara is gruel made from sesame, rice, and masha, and upanaha is a poultice or binding. Some understand grain fomentation as warm masha and other grains; others interpret dhanya as sour fermented grain liquid through an omitted second element. Oral fat is assigned to wounds above the navel and enema to those below it.
पिच्चिते च विघृष्टे च नातिस्रवति शोणितम् ||२६||
अगच्छति भृशं तस्मिन् दाहः पाकश्च जायते |
तत्रोष्मणो निग्रहार्थं तथा दाहप्रपाकयोः ||२७||
शीतमालेपनं कार्यं परिषेकश्च शीतलः |२८|
Meaning of the śloka
Crush injuries and abrasions do not bleed greatly. When blood does not flow, the text says intense burning and suppuration arise; it therefore prescribes a cool paste and cool pouring to restrain heat, burning, and maturation.
The same treatment is given for picchita and ghrishta because both are understood to retain blood rather than discharge it. Some manuscripts instead read: 'a cool paste, pouring, purification, and bloodletting.' Purification is then interpreted as emesis for injury above the navel, purgation for central-body injury with burning, enema below the navel, and bloodletting where blood has congealed.
The text concludes that the complete treatment of fresh wounds is presented in summary through the six previously described classes beginning with chinna.
The commentary identifies this as a summary of what has already been stated. Samarpita means properly set forth, and jneya means that it should be understood in this way. The supplied commentary ends incompletely after the verse marker.
Key terms
sadyovraNa (sadyovrana)
A fresh or acute traumatic wound.
chinna
A cut or severed wound, the first of the six classes referenced.
samarpita
Properly or fully set forth.
Adhikarana 21 (29-30) · Śloka 30
ata ūrdhvaṁ pravakṣyāmi chinnānāṁ tu cikitsitam ||29||
yē vraṇā vivr̥tāḥ kēcicchiraḥpārśvāvalambinaḥ |
tān sīvyēdvidhinōktēna badhnīyādgāḍhamēva ca ||30||
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अत ऊर्ध्वं प्रवक्ष्यामि छिन्नानां तु चिकित्सितम् ||२९||
ये व्रणा विवृताः केचिच्छिरःपार्श्वावलम्बिनः |
तान् सीव्येद्विधिनोक्तेन बध्नीयाद्गाढमेव च ||३०||
Meaning of the śloka
The text now begins treatment of cut wounds. Wounds that gape widely and hang from the head or side are to be sutured by the previously stated method and firmly bandaged.
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atha mūrdhādyavayavāśrayaṁ cikitsāviśēṣamāha- ata ūrdhvamityādi| vivr̥tā vyāttamukhāḥ| śiraḥpārśvāvalambinō mastakapārśvāvalambanaśīlāḥ, anyē tu śirō'valambinastathā pārśvāvalambinaścētyēvaṁ vyākhyānayanti| vidhinōktēna r̥jugranthisēvanādinā sīvyēdityarthaḥ||29-30||
Meaning of the commentary
Vivrita means having a widely opened mouth. Shirah-parshvavalambin is interpreted as tissue hanging from the side of the head; others divide it into wounds hanging from the head and wounds hanging from the side. The stated suturing method includes straight stitches and knots.
Key terms
vivRuta (vivrita)
Gaping or widely open.
shiraHpArshvAvalambin (shirahparshvavalambin)
Hanging from the side of the head, or alternatively separate head- and side-hanging wounds.
sIvana (sivana)
Surgical suturing.
Rujugranthi (rijugranthi)
A straight form of stitch or knot referenced by the commentary.
A completely displaced or severed ear is to be restored to its position, sutured as described, and its passage nourished with medicated oil. For a cut at the posterior junction of the neck, even when air passes through it, the parts are to be aligned, continuously sutured, and firmly bandaged. Goat ghee is used for irrigation, and the patient is kept on the back for eating and resting so the neck remains stabilized.
The commentary understands the ear as completely cut from its place and the oil as prepared with vata-calming medicines. Krikatika is the posterior limit of the neck. The instruction to suture despite escaping air is treated as an exception to the earlier rule that an air-transmitting wound is incurable. Proper placement means returning the structure to its normal position. Remaining supine is extended from eating to sleeping, urination, defecation, and related activities to keep the neck stable.
Key terms
karNa (karna)
The external ear being repositioned and sutured.
kRukATikA (krikatika)
The posterior neck junction or its lower boundary.
For severe transverse, gaping wounds of the four limbs, the joints and bones are to be promptly restored in order and the wound sutured. It is then rapidly secured with a spiral bandage, irrigated with oil, and supported by a sling-like leather bandage or another suitable dressing.
The four shakhas are the four limbs. The joints and bones are first returned to their proper position and suturing follows the earlier method. Anupurvasha is interpreted as similar to the previously described method. Vellitaka implies a spiral form of bandaging.
Key terms
shAkhA (shakha)
One of the four limbs.
sandhi
A joint requiring alignment in the historical account.
The transmitted verse says that a person with a wound on the back should lie face upward, while one with a wound on the chest should lie in the opposite position.
One explanation says supine positioning for a back wound allows morbid material to drain; otherwise retained material forms a pocket and causes complications. It cites Jejjata as saying a chest-wound patient should avoid lying supine and a back-wound patient should support the breast and chest, because discharge otherwise cannot escape. Gayi reads the verse oppositely: a person with a back wound should lie prone, while one with a chest wound should lie supine.
Key terms
pRuShThavraNa (prishthavrana)
A wound of the back.
urovraNa (urovrana)
A wound of the chest.
uttAna (uttana)
Lying face upward or supine.
adhomukha
Lying face downward or prone.
utsa~gga (utsanga)
A dependent pocket in which discharge is said to collect.
For a limb completely severed, the text directs cauterizing it with oil, enclosing it in a sheath-like bandage, and then applying measures for healing.
This is presented as a separate method for complete severance of a limb. Koshabandha means a sheath or pouch-like bandage. Healing treatment follows because cautery is considered to have already performed the cleansing action.
An oil cooked with sandalwood, padmaka, rodhra, utpala, priyangu, turmeric, madhuka, and milk is described as a principal preparation for healing the preceding wound.
The commentary specifies milk as the eighth ingredient and gives it at four times the amount. It explains that explicitly calling it eighth indicates that the oil is cooked with milk rather than water. Others say the count names the preparation as the 'eight-part oil.' The supplied commentary ends incompletely.
Key terms
vraNaropaNa (vranaropana)
A preparation intended to promote wound healing.
padmaka
A named plant ingredient in the historical oil.
rodhra
A named astringent plant ingredient.
utpala
Water-lily or lotus-like flower used in the formula.
payaH (payas)
Milk, counted as the eighth component.
Adhikarana 27 (39-40) · Śloka 41
candanaṁ karkaṭākhyā ca sahē māṁsyāhvayā'mr̥tā ||39||
harēṇavō mr̥ṇālaṁ ca triphalā padmakōtpalē |
trayōdaśāṅgaṁ trivr̥tamētadvā payasā'nvitam ||40||
tailaṁ vipakvaṁ sēkārthē hitaṁ tu vraṇarōpaṇē |41|
A second wound-healing oil is prepared for irrigation with thirteen named plant ingredients—sandalwood, karkatashringi, the two saha plants, mamsi or its variant, guduchi, peas, mrinala, triphala, padmaka, and blue utpala—together with milk and three fatty substances.
Karkatakhya is karkatashringi; the two saha plants are mashaparni and mudgaparni; amrita is guduchi; harenava means peas; mrinala is interpreted here as ushira; and utpala as blue water lily. Trivrita is explained as oil combined with ghee, animal fat, and marrow. Milk is fourfold. Some read somahvaya instead of mamsyahvaya and identify it as trisandhika or, by others, somalata. Gayi excludes marrow and understands trivrita as three fats, interpreting the milk-cooked preparation accordingly. The supplied commentary ends incompletely.
Key terms
trayodashA~gga (trayodashanga)
Composed of thirteen named plant ingredients.
trivRuta (trivrita)
Combined with three fatty substances, with disagreement about whether marrow is included.
sahe
The pair mashaparni and mudgaparni.
mAMsyAhvayA (mamsyahvaya)
A plant name for which some read somahvaya.
mRuNAla (mrinala)
Interpreted by the commentary here as ushira.
Adhikarana 28 (41-43) · Śloka 43
ata ūrdhvaṁ pravakṣyāmi bhinnānāṁ tu cikitsitam ||41||
bhinnaṁ nētramakarmaṇyamabhinnaṁ lambatē tu yat |
tannivēśya yathāsthānamavyāviddhasiraṁ śanaiḥ ||42||
pīḍayēt pāṇinā samyak padmapattrāntarēṇa tu |
tatō'sya tarpaṇaṁ kāryaṁ nasyaṁ cānēna sarpiṣā ||43||
The text begins treatment of perforating injuries. An eye that is ruptured and no longer functions is distinguished from one that hangs out but remains unruptured. The latter is gently returned to its place without disturbing its vessels, then supported by the hand with lotus petals interposed. Afterward, ocular filling and nasal treatment are prescribed with the stated ghee.
Although bhinna was earlier defined for internal cavities, the eye is also treated as an ashaya here. Akarmaṇya means unable to perform vision and its other functions; others interpret it as incurable. An unruptured, still-functional eye is considered treatable. Avyaviddhasira means without agitating its vessels; under the variant avyaviddhashira it means keeping the head straight. Lotus petals are interposed for softness and to exclude heat. Tarpana means filling after honey and ghee have been applied. Some read ajena, with goat-derived ghee, instead of anena, 'with this.'
Key terms
bhinnanetra
A ruptured or perforated eye.
akarmaNya (akarmanya)
Nonfunctional, though some interpret it as incurable.
avyAviddhasira (avyaviddhasira)
Without disturbing the vessels; variant avyaviddhashira means with the head kept straight.
tarpaNa (tarpana)
Ocular filling or retention of a medicinal substance.
nasya
Administration of medicine through the nose.
Adhikarana 29 (44) · Śloka 45
ājaṁ ghr̥taṁ kṣīrapātraṁ madhukaṁ cōtpalāni ca |
jīvakarṣabhakau caiva piṣṭvā sarpirvipācayēt ||44||
sarvanētrābhighātē tu sarpirētat praśasyatē |45|
Goat ghee, cow ghee, milk, madhuka, utpala, jivaka, and rishabhaka are cooked into a ghee preparation that the text praises for all injuries to the eye.
The commentary gives a complex proportional explanation. Goat ghee and the four plant ingredients are treated in equal relation, cow ghee is the main cooking fat, and milk is added in a larger measure. It acknowledges that ghee itself cannot literally be ground, so grinding applies as possible while the statement chiefly establishes ingredient proportions. Another interpretation uses equal goat and cow ghee with the plant paste. Gayi gives one prastha of goat ghee, one adhaka of milk, and two palas each of the four plants. Repetition of the word ghee is taken to restrict ocular filling and nasal use to this preparation alone.
Key terms
AjaghRuta (ajaghrita)
Goat-derived ghee used in the preparation.
jIvaka (jivaka)
A named medicinal plant in the historical formula.
RuShabhaka (rishabhaka)
A named medicinal plant paired with jivaka.
kShIrapAtra (kshirapatra)
A vessel-measure of milk, interpreted quantitatively by the commentary.
When a mass of fat protrudes from an abdominal wound, the text directs coating it with astringent ash and earth, tying its base with thread, and cutting it with a heated instrument after applying honey. The wound is bandaged, and after food is digested, ghee—or milk when internal oleation is omitted—is prescribed with various herbs, sugar, lac, castor or danti, and gokshura for pain and burning. The text warns that leaving the fatty mass uncut can lead to distension, pain, or death and refers to an oil described for a fatty lump.
The ash is alkaline ash from trees such as sarja and arjuna, and the earth is black soil; another reading has astringent powder rather than ash. The root of the protruding mass is tied. A heated instrument is said to prevent suppuration, and cutting is reserved for tissue that cannot be returned or retained. Chitra is interpreted as castor, though others say danti. The commentary preserves two ways of arranging the milk preparations, while some authorities combine them into one, citing Vagbhata. It also supplies detailed historical cooking proportions and daily quantities. The oil referred to later is the dvikaranja formula.
Key terms
medovarti
A protruding roll or mass of fat from an abdominal wound.
udarabheda
An open or penetrating injury of the abdomen.
agnitaptashastra
A surgical instrument heated in fire.
ATopa (atopa)
Abdominal distension or rumbling attributed to leaving the mass untreated.
citrA (chitra)
Interpreted as castor, with danti as an alternative identification.
त्वचोऽतीत्य सिरादीनि भित्त्वा वा परिहृत्य वा |
कोष्ठे प्रतिष्ठितं शल्यं कुर्यादुक्तानुपद्रवान् ||५०||
Meaning of the śloka
A foreign body that passes through the skin, pierces or bypasses vessels and other tissues, and becomes lodged in the abdominal cavity produces the complications previously described.
The commentary understands 'vessels and so forth' to include sira, flesh, snayu, joints, and bone after penetration of the seven skin layers. The signs of severed sira were described earlier. The complications are those given in the chapter on detecting a concealed foreign body, including abdominal distension, obstruction, and abscess.
Key terms
shalya
A penetrating foreign body lodged in the body.
koShTha (koshtha)
The internal abdominal cavity.
sirA (sira)
A vessel-like structure that may be pierced or bypassed.
snAyu (snayu)
A tendon- or ligament-like structure.
vidradhi
A deep abscess listed among possible complications.
Adhikarana 32 (51) · Śloka 51
tatrāntarlōhitaṁ pāṇḍuṁ śītapādakarānanam |
śītōcchvāsaṁ raktanētramānaddhaṁ ca vivarjayēt ||51||
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तत्रान्तर्लोहितं पाण्डुं शीतपादकराननम् |
शीतोच्छ्वासं रक्तनेत्रमानद्धं च विवर्जयेत् ||५१||
Meaning of the śloka
In this setting, the text considers a person unsuitable for treatment when there is internal bleeding accompanied by pallor, cold feet, hands and face, cold breathing, red eyes, abdominal tension, and failure of wastes or doshas to move through their normal routes.
The commentary identifies antarlohita as blood fallen into the abdominal cavity, pandu as pale or white, and anaddha as obstruction of dosha and waste from their proper paths. It says a patient with a retained foreign body and these signs should be left untreated because the condition is considered incurable.
Key terms
antarlohita
Internal accumulation of blood in the abdominal cavity.
pANDu (pandu)
Pale or blanched appearance.
shItocchvAsa (shitocchvasa)
Cold breath or respiration.
Anaddha (anaddha)
Obstruction of normal passage of wastes and doshas.
आमाशयस्थे रुधिरे वमनं पथ्यमुच्यते |
पक्वाशयस्थे देयं च विरेचनमसंशयम् ||५२||
आस्थापनं च निःस्नेहं कार्यमुष्णैर्विशोधनैः |
यवकोलकुलत्थानां निःस्नेहेन रसेन च ||५३||
भुञ्जीतान्नं यवागूं वा पिबेत् सैन्धवसंयुताम् |
अतिनिःस्रुतरक्तो वा भिन्नकोष्ठः पिबेदसृक् ||५४||
Meaning of the śloka
For blood located in the amashaya, the text prescribes emesis; for blood in the pakvashaya, purgation; and for the vata region, a non-oily decoction enema using hot cleansing substances such as cow urine. Food made from barley, jujube, and horse gram broth or salted gruel is advised. For a person with a perforated abdomen who has lost excessive blood, drinking blood is prescribed.
The commentary equates pakvashaya here with pittashaya and assigns asthapana or niruha enema to the vatashaya. It explains the hot cleansing enema as using cow urine and similar substances. After cleansing, the specified food is intended to direct blood normally. It contrasts this with the final instruction for excessive blood loss, where blood is drunk to sustain life.
Key terms
AmAshaya (amashaya)
The upper digestive receptacle in which blood is said to be located.
pakvAshaya (pakvashaya)
A lower digestive region, equated here by the commentary with pittashaya.
The text says that a person may survive a perforated abdominal cavity when feces, urine, and flatus return to their proper routes and complications have resolved.
For bowel protruding through an abdominal wound, the text says intact bowel should be returned in its original arrangement. One opinion also allows joining a divided bowel by having ants bite across its edges and cutting off their bodies. Contaminated bowel is washed with milk, coated with grass, blood, or dust according to the transmitted wording, lubricated with ghee, and gradually returned by a person with trimmed nails. Dry bowel is moistened with milk and ghee. The text then describes touching the throat, startling with water, lifting and shaking the patient to settle the bowel, enlarging a wound if necessary, suturing it, bandaging, pouring ghee, administering warm ghee with castor oil, applying a polyherbal oil, and observing restrictions for a year.
The commentary preserves two interpretations: only intact bowel may be returned, or the wording simply means it must be returned in its original orientation. It discusses the ant-head method for divided bowel and Gayi's variant naming a large ant. Milk washing and the wording around grass, blood, and dust are explained, as are three attempts to restore position by throat touch, startling, and shaking. There is disagreement whether wound enlargement applies only to a small opening or also to abundant protruding bowel. Misplaced or tangled bowel is said to be fatal. The dressing is interpreted as honey-ghee coated, and castor oil is intended to soften stool and promote downward movement of vata. Jejjata and Gayi give different preparation methods for the healing oil. The year-long regimen includes avoiding intercourse and exercise.
Key terms
niShkrAntAntra (nishkrantantra)
Bowel protruding outside an abdominal wound.
pipIlikAshirograsta (pipilikashirograsta)
Edges held by ant heads in a historical intestinal closure method.
maladharAkalA (maladharakala)
The bowel-supporting layer to which intestine is said to return.
gupita
Tangled or mutually displaced.
citrAtaila (chitrataila)
Castor oil in the commentary's interpretation.
ropaNataila (ropanataila)
A polyherbal oil intended historically to promote healing.
For displaced testes, the text describes sprinkling the feet and eyes with water, returning the testes, suturing the scrotum with a tunnasevani stitch, applying a sling-like support around the waist, and avoiding oily irrigation because it moistens the wound. A healing oil is then prepared from tagara, aguru, cardamom, jati, sandalwood, padmaka, manahshila, daruharidra, guduchi, and tuttha.
The commentary supplies that the scrotal structures are what have been displaced. Mushka means the testes or scrotal contents, and tunnasevani is a particular stitch. Gophanika is compared with a loincloth or supportive sling, fixed at the waist to prevent movement. The oil is withheld initially to avoid excessive moisture. Kalanusarya is tagara, and shila is identified as manahshila. The supplied commentary ends incompletely.
Key terms
nirastamuShka (nirastamushka)
Displaced or exposed testicular and scrotal structures.
After removal of a foreign body from the head, the text directs inserting a wick made of hair into the wound. Without it, mastulunga is said to flow from the wound and vayu may kill the patient. As healing proceeds, one hair at a time is gradually withdrawn.
This begins treatment of puncture wounds at the head. The foreign body has been extracted, and the hair wick is inserted fully to close the wound opening. Mastulunga is described as a strength-giving head substance resembling congealed ghee. Its loss is said to lead to death through vayu. The treatment follows the stated method, and hairs are gradually pulled out as the wound heals. The supplied commentary ends incompletely.
Key terms
shirashshalya (shirahshalya)
A foreign body penetrating the head.
bAlavarti (balavarti)
A wound wick constructed from hair.
mastulu~gga (mastulunga)
A classical head substance described as congealed-ghee-like and strength-giving.
After a foreign body has been removed from another part of the body, an oil-smeared cloth wick is to be inserted. Once bleeding has been brought to an end, the regimen for a fresh wound is said to be beneficial.
The commentary explains that the omitted object is a shalya removed from a body part. The wick is cloth coated with oil, specifically interpreted as sesame oil because cakra oil is prescribed subsequently. After the wound has been rendered free of bleeding, partly to avoid suppuration, measures for fresh wounds such as honey and ghee are applied with the aim of joining tissue.
Key terms
shalya
A retained foreign body understood as removed before this treatment.
Long, deeply penetrating wounds with narrow tracks are first to be made free of blood and then filled with cakra oil through a fine tubular instrument.
The commentary explains duravagadha as extending far inward. Netra is a wound-irrigating tube described as eight fingerbreadths long with a channel the width of a green gram. Cakra oil is interpreted either as oil collected from the wooden parts of a sesame-oil press according to the method used for subtle oil, or as freshly expressed sesame oil. Tarpayet means to fill the wound.
Key terms
dUrAvagADha (dura-avagadha)
Penetrating far and deeply into tissue.
netra
A narrow tubular wound-irrigation instrument.
cakrataila (chakra-taila)
Oil associated with the sesame press, with two explanations preserved.
The text lists samanga, rajani, padma, trivarga, tuttha, vidanga, katuka, pathya, guduchi, and karanjika as ingredients to be combined and cooked into an oil described as excellent for healing when the wound has reached the appropriate stage.
The commentary identifies samanga as manjishtha, rajani as haridra, padma as bhargi, trivarga as triphala, pathya as haritaki, and karanjika as the fruit of naktamala. Although pathya is already included through triphala, it is named again to indicate that it is used in double proportion, following the rule that a repeatedly named ingredient in a ghee, oil, or formula is doubled. 'At the proper time' means when complications from doshas are absent and wound healing is appropriate.
Key terms
trivarga (tri-varga)
Triphala, the group of three fruits.
tuttha
A copper-based mineral substance used historically.
pathyA (pathya)
Haritaki, repeated to signal a double share.
ropaNataila (ropana-taila)
A medicated oil intended historically to promote healing.
An oil cooked with talisha, padmaka, mansi, harenu, aguru, chandana, two kinds of haridra, lotus seeds, ushira, and madhuka is also described as an excellent healing oil for fresh wounds.
The commentary says kshata is the injury earlier defined as neither excessively cut nor excessively split. Its general regimen includes honey, ghee, and oil massage. A crushed injury receives the measures stated for fractures, including binding, pouring liquids, and a dry diet; the reading is understood to incorporate binding and related treatments.
Key terms
kShata (kshata)
A defined type of wound, neither excessively cut nor extensively split.
piccita (picchita)
A crushed or compressed injury.
bhagnavadvidhi (bhagnavad-vidhi)
Management according to the historical fracture regimen.
The commentary says pain is cooled or relieved with madhuka and other cooling substances. Gayi instead explains that it is cooled by pouring honey and ghee. Powders of shala, sarja, arjuna, and related plants are then applied.
विश्लिष्टदेहं पतितं मथितं हतमेव च ||७७||
वासयेत्तैलपूर्णायां द्रोण्यां मांसरसाशनम् |
अयमेव विधिः कार्यः क्षीणे मर्महते तथा ||७८||
Meaning of the śloka
A person whose body or limbs have been displaced, who has fallen, been violently churned or twisted, or struck should be placed in a wooden trough filled with oil and fed meat broth. The same regimen is directed for exhaustion and injury to a marma.
The commentary describes vishlishta-deha as displacement of a limb from its normal position through bending, pulling, climbing, falling, assault, or similar force. Patita is a fall from a tree or comparable height; mathita is violent agitation by something stronger; and hata is being struck by a fast object, staff, fist, or the like. Droni is a wooden, boat-shaped trough. Kshina includes exhaustion from travel, and marma injury includes damage to sites such as the heart.
Key terms
vishliShTadeha (vishlishta-deha)
A body or limb displaced from its normal position by trauma.
mathita
Violently twisted, shaken, or agitated by force.
droNI (droni)
A wooden boat-shaped trough, here filled with oil.
marmahata (marma-hata)
Injured at a vital anatomical site.
Adhikarana 45 (79) · Śloka 79
rōpaṇē saparīṣēkē pānē ca vraṇināṁ sadā |
tailaṁ ghr̥taṁ vā saṁyōjyaṁ śarīrartūnavēkṣya hi ||79||
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रोपणे सपरीषेके पाने च व्रणिनां सदा |
तैलं घृतं वा संयोज्यं शरीरर्तूनवेक्ष्य हि ||७९||
Meaning of the śloka
For healing applications, irrigation, and drinking by wounded patients, either oil or ghee is to be selected with attention to the person's constitution and the season.
The commentary assigns oil to a vata-kapha constitution and to seasons such as winter, while ghee is assigned to a blood-pitta constitution and seasons such as autumn.
The commentary says this concise instruction applies by extension formulas described elsewhere, including one beginning with prapaundarika, manjishtha, madhuka, ushira, and padmaka.
Key terms
atidesha
Extension of a rule or treatment from another stated context.
pittavidradhi (pitta-vidradhi)
An abscess classified as arising from pitta.
sadyovraNa (sadyo-vrana)
A fresh traumatic wound.
ghRuta (ghrita)
Ghee used as the base of a historical medicinal preparation.
The commentary assigns moderately cool ghee to a person or season characterized by pitta and blood, especially autumn, and bala oil to a vata-kapha constitution or a cold season.
The listed plants and minerals—including samanga, rajani, padma, pathya, tuttha, suvarcala, padmaka, rodhra, madhuka, vidanga, harenuka, talisha leaf, nalada, chandana, lotus filament, manjishtha, ushira, laksha, shoots of latex-bearing trees, priyala seed, and unripe tinduka fruits—are to be gathered as available and cooked into an oil. The text describes it as healing for all fresh wounds that are not vitiated.
The commentary explains samanga as manjishtha, padma as bhargi, suvarcala as suryabhakta, harenuka as renuka, and taruna fruits as unripe fruits. It presents the formula generally for healing all fresh wounds considered clean or unvitiated.
Key terms
aduShTa sadyovraNa (adushta sadyo-vrana)
A fresh wound regarded as not vitiated or complicated.
tuttha
A copper-based mineral ingredient used historically.
kShIriNAM pallava (kshirinaam pallava)
Young shoots of latex-bearing trees.
ropaNa (ropana)
Healing-promoting treatment in the text's framework.
For seven days, fresh wounds are to receive astringent, sweet, cooling, and unctuous measures. After that, the treatment described previously is to be followed.
The commentary says the previous treatment means that given in Dvivraniya. Jejjata regards this verse as not belonging to the original authoritative text, whereas Gayi accepts it as authentic; the present commentator also accepts it.
Key terms
kaShAya (kashaya)
Astringent in taste or action within the classical framework.
madhura
Sweet.
shIta (shita)
Cooling.
snigdha
Unctuous.
anArSha (anarsha)
Regarded as not originating from the authoritative ancient source.
दुष्टव्रणेषु कर्तव्यमूर्ध्वं चाधश्च शोधनम् ||८६||
विशोषणं तथाऽऽहारः शोणितस्य च मोक्षणम् |
कषायं राजवृक्षादौ सुरसादौ च धावनम् ||८७||
तयोरेव कषायेण तैलं शोधनमिष्यते |
क्षारकल्पेन वा तैलं क्षारद्रव्येषु साधितम् ||८८||
Meaning of the śloka
For vitiated wounds, the text prescribes cleansing upward and downward, drying measures and diet, bloodletting, washing with decoctions from the Rajavrikshadi or Surasadi groups, and cleansing oil prepared from those decoctions. It also permits oil prepared by a method involving alkaline substances such as mushkaka and palasha.
The commentary assigns upward cleansing to emesis and nasal purgation, downward cleansing to purgation and decoction enema, drying to fasting, and drying foods to bitter, pungent, and astringent items. It allocates emesis to kapha wounds above the navel, purgation to pitta or pitta-site disorders, enema to vata disorders below the trunk with obstructed pathways, and nasal purgation to kapha disorders of the head. Rajavrikshadi is identified with Aragvadhadi. A cleansing oil is cooked with a quarter-part paste in decoctions of the two groups. For alkaline oil, it describes repeated filtration of alkali through water and cooking oil in four times the alkaline liquid. Some authorities include pastes of alkaline plants; others prepare it without paste.
Key terms
duShTavraNa (dushta-vrana)
A wound regarded as vitiated, contaminated, or complicated.
Urdhvashodhana (urdhva-shodhana)
Upward cleansing, interpreted as emesis or nasal purgation.
adhashshodhana (adhah-shodhana)
Downward cleansing, interpreted as purgation or enema.
द्रवन्ती चिरबिल्वश्च दन्ती चित्रकमेव च |
पृथ्वीका निम्बपत्राणि कासीसं तुत्थमेव च ||८९||
त्रिवृत्तेजोवती नीली हरिद्रे सैन्धवं तिलाः |
भूमिकदम्बः सुवहा शुकाख्या लाङ्गलाह्वया ||९०||
नैपाली जालिनी चैव मदयन्ती मृगादनी |
सुधामूर्वार्ककीटारिहरितालकरञ्जिकाः ||९१||
यथोपपत्ति कर्तव्यं तैलमेतैस्तु शोधनम् |
घृतं वा यदि वा प्राप्तं कल्काः संशोधनास्तथा ||९२||
Meaning of the śloka
The text lists numerous plant and mineral substances that may be used, as available, to prepare a cleansing oil or ghee for vitiated wounds, or as cleansing pastes when appropriate.
The commentary gives many identifications and alternatives: dravanti as cirita-patra; cirabilva as tree karanjaka; danti as udumbara-parni; prithvika as large cumin, though others say cardamom or hingupatrika; tejovati as kakamardanika; nili as nilanjanika sharada; bhumikadamba as munditika; suvaha as godhapadi; shukakhya as carmakaravata; langalahvaya as kaliharika; naipali as manahshila; jalini as koshataki; madayanti as mendika or nakharanjani; mrigadani as indravaruni; sudha as sehunda; murva as corasnayuh; kitari as vidanga, though others read kitamarini; and karanjika as naktamala fruit. 'As appropriate' depends on body and season. Oil is assigned to raised, dry, scantily discharging wounds; ghee to deep, burning, suppurating pitta wounds; and pastes to deep wounds covered by putrid flesh or heavily vitiated.
Key terms
yathopapatti
According to availability and contextual suitability.
naipAlI (naipali)
Identified by the commentary as manahshila, an arsenic sulfide mineral.
haritAla (haritala)
Orpiment, an arsenic sulfide mineral.
sudhA (sudha)
Identified as sehunda, a caustic latex-bearing plant.
For a vata-type wound, the text prescribes a paste of rock salt, trivrit, and castor leaf. For a pitta-type wound, it prescribes trivrit, haridra, and madhuka with sesame. For a kapha-type wound, it lists sesame, tejohva, danti, svarjika, and citraka. It states that the regimen for vitiated wounds should also be applied to wounds associated with meha and kushtha.
The sixfold classification of fresh wounds has already been stated. The text asserts that even those who speak categorically cannot establish a classification beyond it.
The commentary says this rejects disagreement about the six categories beginning with chinna. 'Beyond this' means proposing seven or more categories, which even habitual makers of definite assertions cannot establish as necessary.
Some people, proud of their learning, attach prefixes and particles to the wound terms and describe many additional varieties. However numerous their expressions, all remain contained within the six categories, just as particular instances are contained within a general class. The sixfold division is therefore held to be final.
The commentary illustrates forms created with prefixes: samyak-chinna becomes sanchinna, cut all around becomes paricchinna, and slightly cut becomes acchinna. With particles or modifiers it gives aticchinna for cut beyond measure, succhinna for an especially or commendably cut form, and ishacchinna for slightly cut. These verbal varieties still fall within the six categories beginning with chinna. As bending, raising, extending, and contracting are particular motions included under action in general, all varieties of cutting are included under cutting, and the same logic applies to the remaining five categories. The particle tu emphasizes that there are precisely six.
Key terms
upasarga
A prefix attached to a base wound term.
nipAta (nipata)
A particle or modifier used to create a verbal subtype.
chinna
A cut wound, serving as a general category.
visheSha (vishesha)
A particular subtype included within a general class.
sAmAnya (samanya)
A general category that encompasses its particular forms.
The commentary states that the second chapter of the Cikitsasthana is complete in Dalhana's Nibandhasangraha commentary on Sushruta; the transmitted text notes a spelling variant in Dalhana's name.