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AYANAACADEMYby Dr Vijaya Dwarampudi
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૨૧. શૂકરોગચિકિત્સિતમ્

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Adhikarana ૧ (૧-૨) · Śloka ૨

અથાતઃ શૂકદોષચિકિત્સિતં વ્યાખ્યાસ્યામઃ ||૧|| યથોવાચ ભગવાન્ ધન્વન્તરિઃ ||૨||

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अथातः शूकदोषचिकित्सितं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now the treatment of disorders caused by śūka will be explained, as taught by the revered Dhanvantari.

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શૂકાદિદોષચિકિત્સિતમિતિ જ્ઞેયમ્, આદિશબ્દસ્ય લુપ્તત્વાત્; તત્રાદિશબ્દેન નિદાનોક્તા અભિઘાતનિમિત્તા દુર્ભગનિમિત્તાશ્ચાત્ર જ્ઞાતવ્યાઃ||૧-૨||

Meaning of the commentary

The commentary says that the chapter title should be understood as ‘treatment of disorders caused by śūka and other causes,’ because a word meaning ‘and others’ has been omitted. This implied expression includes the disorders described in the diagnostic section as arising from injury and from durbhaga-related causes.

Key terms

śūkadoṣa
The class of disorders whose treatment is introduced in this chapter.
abhighātanimitta
Arising from injury, included by the commentary under the omitted ‘other’ causes.
durbhāganimitta
A source category named by the commentary whose precise contextual sense requires specialist confirmation.
Dhanvantari
The authoritative teacher to whom the instruction is attributed.

Adhikarana ૨ (૩) · Śloka ૩

સંલિખ્ય સર્ષપીં સમ્યક્ કષાયૈરવચૂર્ણયેત્ | કષાયેષ્વેવ તૈલં ચ કુર્વીત વ્રણરોપણમ્ ||૩||

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संलिख्य सर्षपीं सम्यक् कषायैरवचूर्णयेत् | कषायेष्वेव तैलं च कुर्वीत व्रणरोपणम् ||३||

Meaning of the śloka

After properly scraping the sarṣapī lesion, it should be dusted with astringent medicinal powders. A wound-healing oil should also be prepared from those same astringent substances.

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સંલિખ્યેત્યાદિ| કષાયૈરિતિ કષાયવૃક્ષચૂર્ણૈરવચૂર્ણયેત્, કષાયવૃક્ષૈર્મિશ્રકોક્તશોધનકષાયસાધનદ્રવ્યૈશ્ચૂર્ણીકૃતૈરવચૂર્ણયેદિત્યર્થઃ| તેષુ રોપણકષાયસાધનદ્રવ્યેષુ પાદિકેષુ જલં ચતુર્ગુણં દત્ત્વા રોપણં તૈલં કુર્યાત્||૩||

Meaning of the commentary

The commentary explains that the dusting powders are made from astringent trees, specifically the cleansing-decoction ingredients stated in the Miśraka section after they have been powdered. For the healing oil, the wound-healing decoction ingredients are used in one-quarter proportion and cooked with four times as much water.

Key terms

sarṣapī
The named lesion treated in this passage.
saṃlikhya
Having scraped or scarified the lesion.
kaṣāya
Astringent medicinal substances, understood here as powdered trees and as ingredients for the oil.
vraṇaropaṇa taila
An oil intended to promote healing of the wound.

Adhikarana ૩ (૪) · Śloka ૪

અષ્ઠીલિકાં જલૌકોભિર્ગ્રાહયેચ્ચ પુનઃ પુનઃ | તથા ચાનુપશામ્યન્તીં કફગ્રન્થિવદુદ્ધરેત્ ||૪||

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अष्ठीलिकां जलौकोभिर्ग्राहयेच्च पुनः पुनः | तथा चानुपशाम्यन्तीं कफग्रन्थिवदुद्धरेत् ||४||

Meaning of the śloka

For aṣṭhīlikā, leeches should be applied repeatedly. If the condition still does not subside, it should be removed in the manner prescribed for a kapha-granthi.

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અષ્ઠીલિકામિત્યાદિ| કફગ્રન્થેરિવ શસ્ત્રેણોદ્ધરણમ્||૪||

Meaning of the commentary

The commentary specifies that removal is performed with a surgical instrument, just as for a kapha-granthi.

Key terms

aṣṭhīlikā
The named firm lesion treated in this passage.
jalaukā
A leech, used here for repeated blood removal.
kapha-granthi
A kapha-associated nodular swelling whose method of removal supplies the comparison.
śastra
A surgical instrument used for the stated removal.

Adhikarana ૪ (૫-૬) · Śloka ૬

સ્વેદયેદ્ગ્રથિતં શશ્વન્નાડીસ્વેદેન બુદ્ધિમાન્ | સુખોષ્ણૈરુપનાહૈશ્ચ સુસ્નિગ્ધૈરુપનાહયેત્ ||૫|| કુમ્ભીકાં પાકમાપન્નાં ભિન્દ્યાચ્છુદ્ધાં તુ રોપયેત્ | તૈલેન ત્રિફલાલોધ્રતિન્દુકામ્રાતકેન તુ ||૬||

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स्वेदयेद्ग्रथितं शश्वन्नाडीस्वेदेन बुद्धिमान् | सुखोष्णैरुपनाहैश्च सुस्निग्धैरुपनाहयेत् ||५|| कुम्भीकां पाकमापन्नां भिन्द्याच्छुद्धां तु रोपयेत् | तैलेन त्रिफलालोध्रतिन्दुकाम्रातकेन तु ||६||

Meaning of the śloka

A grathita lesion should be fomented regularly with tubular steam and covered with comfortably warm, well-oiled poultices. When a kumbhīkā lesion has reached suppuration, it should be opened; after it has been cleansed, healing should be promoted with oil prepared from triphalā, lodhra, tinduka, and āmrātaka.

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સ્વેદયેદિત્યાદિ| શશ્વત્ પ્રતિદિનમ્| સુસ્નિગ્ધૈરિત્યુપનાહવિશેષણમ્| તૈલેન ત્રિફલાદિકલ્કપાદેન જલચતુર્ગુણસિદ્ધેન રોપયેત્||૫-૬||

Meaning of the commentary

The commentary explains śaśvat as ‘every day’ and states that ‘well-oiled’ qualifies the poultices. It further says that the healing oil is cooked with a paste of triphalā and the other named ingredients in one-quarter proportion and with four times as much water.

Key terms

grathita
The named indurated or knotted lesion for which fomentation and poulticing are described.
nāḍīsveda
Fomentation in which heat or steam is conveyed through a tube.
upanāha
A warm, unctuous poultice or bandaged application.
kumbhīkā
The named lesion that is opened after reaching the suppurative stage.
vraṇaropaṇa
Promotion of wound healing after cleansing.

Adhikarana ૫ (૭) · Śloka ૭

ગ્રાહયિત્વા જલૌકોભિરલજીં સેચયેત્તતઃ | કષાયૈસ્તેષુ સિદ્ધં ચ તૈલં રોપણમિષ્યતે ||૭||

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ग्राहयित्वा जलौकोभिरलजीं सेचयेत्ततः | कषायैस्तेषु सिद्धं च तैलं रोपणमिष्यते ||७||

Meaning of the śloka

After applying leeches to alajī, the affected area should be irrigated. Oil prepared with decoctions of astringent trees is regarded as promoting healing.

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ગ્રાહયિત્વેત્યાદિ| કષાયૈઃ કષાયવૃક્ષકષાયૈઃ, કષાયવૃક્ષાઃ પ્લક્ષાદયઃ||૭||

Meaning of the commentary

The commentary explains that the word kaṣāya refers here to decoctions of astringent trees, including plakṣa and others.

Key terms

alajī
The classical disorder treated in this passage.
jalaukā
A leech used for bloodletting in the described historical treatment.
kaṣāyavṛkṣa
Astringent trees, such as plakṣa, whose decoctions are used to prepare the oil.
ropaṇa
Promoting the healing of the affected tissue.

Adhikarana ૬ (૮) · Śloka ૮

બલાતૈલેન કોષ્ણેન મૃદિતં પરિષેચયેત્ | મધુરૈઃ સર્પિષા સ્નિગ્ધૈઃ સુખોષ્ણૈરુપનાહયેત્ ||૮||

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बलातैलेन कोष्णेन मृदितं परिषेचयेत् | मधुरैः सर्पिषा स्निग्धैः सुखोष्णैरुपनाहयेत् ||८||

Meaning of the śloka

The affected area, after gentle manipulation, should be irrigated with lukewarm balā oil. It should then be covered with a comfortably warm, unctuous poultice made with substances of the madhura group and ghee.

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બલેત્યાદિ| મધુરાણિ કાકોલ્યાદીનિ||૮||

Meaning of the commentary

The commentary identifies the madhura substances as kākolī and the other drugs of that group. It provides no further explanation of the procedure.

Key terms

balātaila
Oil prepared with balā, used here for lukewarm irrigation.
mṛdita
Gently pressed or manipulated before irrigation.
madhura
The sweet-category substances, explained by the commentary as kākolī and related drugs.
upanāha
A warm, unctuous poultice applied externally.

Adhikarana ૭ (૯) · Śloka ૯

સમ્મૂઢપિડકાં ક્ષિપ્રં જલૌકોભિરુપાચરેત્ | ભિત્ત્વા પર્યાગતાં ચાપિ લેપયેત્ ક્ષૌદ્રસર્પિષા ||૯||

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सम्मूढपिडकां क्षिप्रं जलौकोभिरुपाचरेत् | भित्त्वा पर्यागतां चापि लेपयेत् क्षौद्रसर्पिषा ||९||

Meaning of the śloka

Sammūḍhapiḍakā should promptly be treated with leeches. When the swelling has matured, it is opened and then dressed with honey and ghee.

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સમ્મૂઢેત્યાદિ| પર્યાગતા પક્વા||૯||

Meaning of the commentary

The commentary explains paryāgatā as pakvā, meaning that the lesion has matured or reached the stage of suppuration.

Key terms

sammūḍhapiḍakā
The classical localized swelling or eruption addressed here.
jalaukā
A leech used for bloodletting in the historical regimen.
paryāgatā
A lesion that has matured; the commentary glosses it as pakvā.
kṣaudrasarpis
Honey and ghee used together as a topical dressing.

Adhikarana ૮ (૧૦-૧૨) · Śloka ૧૨

અવમન્થે ગતે પાકં ભિન્ને તૈલં વિધીયતે | ધવાશ્વકર્ણપત્તઙ્ગસલ્લકીતિન્દુકીકૃતમ્ ||૧૦|| ક્રિયાં પુષ્કરિકાયાં તુ શીતાં સર્વાં પ્રયોજયેત્ | જલૌકોભિર્હરેચ્ચાસૃક્ સર્પિષા ચાવસેચયેત્ ||૧૧|| સ્પર્શહાન્યાં હરેદ્રક્તં પ્રદિહ્યાન્મધુરૈરપિ | ક્ષીરેક્ષુરસસર્પિર્ભિઃ સેચયેચ્ચ સુશીતલૈઃ ||૧૨||

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अवमन्थे गते पाकं भिन्ने तैलं विधीयते | धवाश्वकर्णपत्तङ्गसल्लकीतिन्दुकीकृतम् ||१०|| क्रियां पुष्करिकायां तु शीतां सर्वां प्रयोजयेत् | जलौकोभिर्हरेच्चासृक् सर्पिषा चावसेचयेत् ||११|| स्पर्शहान्यां हरेद्रक्तं प्रदिह्यान्मधुरैरपि | क्षीरेक्षुरससर्पिर्भिः सेचयेच्च सुशीतलैः ||१२||

Meaning of the śloka

When avamantha has suppurated and has been opened, oil prepared with dhava, aśvakarṇa, pattaṅga, sallakī, and tindukī is prescribed. In puṣkarikā, all treatment should be cooling: blood is removed with leeches and the area is irrigated with ghee. In loss of sensation, bloodletting is performed, a paste of madhura substances is applied, and very cool milk, sugarcane juice, and ghee are used for irrigation.

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અવમન્થેત્યાદિ| અશ્વકર્ણઃ પૂર્વદેશે ‘ગન્ધમુણ્ડ’ ઇતિ ખ્યાતોઽશ્વત્થસદૃશઃ| પત્તઙ્ગં રક્તચન્દનમ્||૧૦-૧૨||

Meaning of the commentary

The commentary identifies aśvakarṇa as a tree known in the eastern region as gandhamuṇḍa and resembling aśvattha. It identifies pattaṅga as red sandalwood. It does not further explain the disease names or the remaining measures in verses 10–12.

Key terms

avamantha
A classical disorder treated here after suppuration and opening.
puṣkarikā
A classical condition for which cooling measures and leech bloodletting are prescribed.
sparśahāni
Loss or impairment of tactile sensation in the affected area.
aśvakarṇa
A named tree described by the commentary as gandhamuṇḍa in the eastern region and as resembling aśvattha.
pattaṅga
A substance identified by the commentary as red sandalwood.

Adhikarana ૯ (૧૩) · Śloka ૧૩

પિડકામુત્તમાખ્યાં ચ બડિશેનોદ્ધરેદ્ભિષક્ | ઉદ્ધૃત્ય મધુસંયુક્તૈઃ કષાયૈરવચૂર્ણયેત્ ||૧૩||

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पिडकामुत्तमाख्यां च बडिशेनोद्धरेद्भिषक् | उद्धृत्य मधुसंयुक्तैः कषायैरवचूर्णयेत् ||१३||

Meaning of the śloka

The physician should remove the lesion called uttamā with a hook. After removing it, the site should be dusted with medicinal powders combined with honey.

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પિડકામિત્યાદિ| કષાયૈઃ ચૂર્ણૈરિત્યર્થઃ| શોધનકાલે તુ શોધનદ્રવ્યૈશ્ચૂર્ણીકૃતૈરવચૂર્ણયેત્, રોપણકાલે તુ રોપણૈરેવ||૧૩||

Meaning of the commentary

The commentary explains that kaṣāya here means powdered medicinal substances. During the cleansing (śodhana) stage, powders made from cleansing substances should be sprinkled; during the healing (ropaṇa) stage, substances intended for healing should be used instead.

Key terms

uttamā piḍakā
The named lesion addressed in this passage.
baḍiśa
A hook described as the instrument for removing the lesion.
śodhana
The cleansing stage of wound management in the commentary.
ropaṇa
The healing stage for which healing substances are selected.

Adhikarana ૧૦ (૧૪) · Śloka ૧૫

રસક્રિયા વિધાતવ્યા લિખિતે શતપોનકે | પૃથક્પર્ણ્યાદિસિદ્ધં ચ દેયં તૈલમનન્તરમ્ ||૧૪|| ક્રિયાં કુર્યાદ્ભિષક્ પ્રાજ્ઞસ્ત્વક્પાકસ્ય વિસર્પવત્ |૧૫|

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रसक्रिया विधातव्या लिखिते शतपोनके | पृथक्पर्ण्यादिसिद्धं च देयं तैलमनन्तरम् ||१४|| क्रियां कुर्याद्भिषक् प्राज्ञस्त्वक्पाकस्य विसर्पवत् |१५|

Meaning of the śloka

After the śataponaka lesion has been scraped, a rasakriyā preparation should be applied. Oil prepared with the group beginning with pṛthakparṇī should then be given. A knowledgeable physician should manage tvakpāka in the manner described for visarpa.

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રસક્રિયેત્યાદિ| રસક્રિયા ફાણિતાકૃતિઃ, શોધનકાલે શોધનદ્રવ્યકષાયકૃતા, રોપણકાલે રોપણદ્રવ્યકષાયકૃતા| પૃથક્પર્ણ્યાદિસિદ્ધં તૈલં સામાન્યસ્નેહપરિભાષાકલ્પેન; પૃથક્પર્ણ્યાદીનિ મિશ્રકે રોપણઘૃતપઠિતાનિ કાકોલ્યાદિવર્જિતાનિ| વિસર્પવત્ પિત્તવિસર્પવદિત્યર્થઃ||૧૪||-

Meaning of the commentary

The commentary defines rasakriyā as a preparation with the consistency of phāṇita. In the cleansing stage it is made from a decoction of cleansing substances, and in the healing stage from a decoction of healing substances. The oil with pṛthakparṇī and related substances is to be prepared according to the general method for medicated oils. The relevant pṛthakparṇī group is the one listed for the healing ghee in the Miśraka section, excluding the kākolī group. ‘As for visarpa’ is explained specifically as treatment following that for pittaja visarpa. The supplied commentary ends abruptly after the verse reference.

Key terms

śataponaka
The named lesion that the verse describes as having been scraped.
rasakriyā
A concentrated preparation described by the commentary as having a phāṇita-like consistency.
pṛthakparṇī
The first-named substance in the group used to prepare the medicated oil.
tvakpāka
A named disorder whose management is compared here with that of pittaja visarpa.
visarpa
The classical disease category used as the treatment comparison; the commentary specifies its pittaja form.

Adhikarana ૧૧ (૧૫-૧૮) · Śloka ૧૮

રક્તવિદ્રધિવચ્ચાપિ ક્રિયા શોણિતજેઽર્બુદે ||૧૫|| કષાયકલ્કસર્પીંષિ તૈલં ચૂર્ણં રસક્રિયામ્ | શોધનં રોપણં ચૈવ વીક્ષ્ય વીક્ષ્યાવચારયેત્ ||૧૬|| હિતં ચ સર્પિષઃ પાનં પથ્યં ચાપિ વિરેચનમ્ | હિતઃ શોણિતમોક્ષશ્ચ યચ્ચાપિ લઘુ ભોજનમ્ ||૧૭|| અર્બુદં માંસપાકં ચ વિદ્રધિં તિલકાલકમ્ | પ્રત્યાખ્યાય પ્રકુર્વીત ભિષક્ સમ્યક્ પ્રતિક્રિયામ્ ||૧૮||

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रक्तविद्रधिवच्चापि क्रिया शोणितजेऽर्बुदे ||१५|| कषायकल्कसर्पींषि तैलं चूर्णं रसक्रियाम् | शोधनं रोपणं चैव वीक्ष्य वीक्ष्यावचारयेत् ||१६|| हितं च सर्पिषः पानं पथ्यं चापि विरेचनम् | हितः शोणितमोक्षश्च यच्चापि लघु भोजनम् ||१७|| अर्बुदं मांसपाकं च विद्रधिं तिलकालकम् | प्रत्याख्याय प्रकुर्वीत भिषक् सम्यक् प्रतिक्रियाम् ||१८||

Meaning of the śloka

A blood-origin arbuda should also be managed in the manner described for a blood-origin vidradhi. Decoctions, pastes, ghee preparations, oils, powders, and rasakriyā, together with cleansing and healing measures, should be employed only after repeatedly assessing the condition. Drinking ghee, suitable purgation, bloodletting, and light food are also said to be beneficial. For arbuda, māṃsapāka, vidradhi, and tilakālaka, the physician should first give a guarded prognosis and then undertake the appropriate treatment carefully.

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રક્તેત્યાદિ| શોણિતજે અર્બુદે લિઙ્ગજે રક્તાર્બુદે| વીક્ષ્ય વીક્ષ્યેતિ દ્વિવ્રણીયોક્તામવસ્થાં સમ્યક્ નિરૂપ્યેત્યર્થઃ| અવચારયેત્ કષાયાદીનીત્યર્થઃ||૧૫-૧૮||

Meaning of the commentary

The commentary identifies the blood-origin arbuda here as the raktārbuda occurring in the genital organ. The repeated expression ‘after assessing’ means that the physician should correctly determine the wound stage described in the Dvivraṇīya section. ‘Should employ’ refers to the decoctions and the other measures listed in the verse.

Key terms

śoṇitaja arbuda
A blood-origin arbuda; the commentary specifies raktārbuda of the genital organ.
vidradhi
A named swelling or lesion whose blood-origin treatment is used as the comparison.
śodhana
Cleansing measures selected according to the assessed stage of the lesion.
ropaṇa
Healing measures selected according to the assessed stage of the lesion.
pratyākhyāya
Giving a guarded or unfavorable prognosis before undertaking treatment.
tilakālaka
One of the named serious conditions for which the verse requires prognostic caution.

Adhikarana પુષ્પિકા · Śloka ૨૧

ઇતિ સુશ્રુતસંહિતાયાં ચિકિત્સાસ્થાને શૂકરોગચિકિત્સિતં નામૈકવિંશોઽધ્યાયઃ ||૨૧||

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इति सुश्रुतसंहितायां चिकित्सास्थाने शूकरोगचिकित्सितं नामैकविंशोऽध्यायः ||२१||

Meaning of the śloka

Thus ends the twenty-first chapter of the Cikitsāsthāna in the Suśruta Saṃhitā, entitled ‘Treatment of Śūkaroga.’

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ઇતિ શ્રીડલ્હ(હ્લ)ણવિરચિતાયાં નિબન્ધસઙ્ગ્રહાખ્યાયાં સુશ્રુતવ્યાખ્યાયાં ચિકિત્સાસ્થાને એકવિંશતિતમોઽધ્યાયઃ||૨૧||

Meaning of the commentary

Thus ends the twenty-first chapter of the Cikitsāsthāna in Dalhaṇa’s commentary on Suśruta called the Nibandhasaṅgraha. The supplied source records a spelling variant in Dalhaṇa’s name as ‘Dalha(hla)ṇa.’

Key terms

Cikitsāsthāna
The section of the Suśruta Saṃhitā devoted to treatment.
Śūkarogacikitsita
The chapter title, meaning the treatment of Śūkaroga.
Nibandhasaṅgraha
The title of Dalhaṇa’s commentary on the Suśruta Saṃhitā.
← 20. kṣudrarōgacikitsitam22. mukharōgacikitsitam →