17. visarpanāḍīstanarōgacikitsitam

Name: Sushruta Samhita
Author: Sushruta

Devanagari IAST (Roman)Telugu Tamil Malayalam Kannada Gujarati Bengali Gurmukhi

Adhikarana 1 (1-2) · Śloka 3

athātō visarpanāḍīstanarōgacikitsitaṁ vyākhyāsyāmaḥ ||1|| yathōvāca bhagavān dhanvantariḥ ||2|| sādhyā visarpāstraya āditō yē na sannipātakṣatajau hi sādhyau |3|

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अथातो विसर्पनाडीस्तनरोगचिकित्सितं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२|| साध्या विसर्पास्त्रय आदितो ये न सन्निपातक्षतजौ हि साध्यौ |३|

Meaning of the śloka

Now the treatment of visarpa, nāḍī and diseases of the breast will be explained, as taught by Bhagavān Dhanvantari. Of the forms of visarpa described, the first three are curable; those arising from sannipāta and from injury are not curable.

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sādhyā ityādi| sādhyāsādhyavibhāgakaraṇaṁ punaścikitsitaprakramāt||1-2||-

Meaning of the commentary

The commentator says that the division into curable and incurable types is stated again here because the discussion is entering the treatment section.

Key terms

visarpa: A classical disease category characterized in this text by a spreading disorder; the chapter begins its treatment here.
nāḍī: In this chapter title, the classical category of a persistent tract or channel-like lesion.
stanaroga: The group of diseases affecting the breast discussed in this chapter.
sannipātaja: Arising from the combined disturbance of all three doṣas; stated here to be incurable.
kṣataja: Arising from injury; stated here to be incurable.

Adhikarana 2 (3) · Śloka 3

sādhyēṣu tatpathyagaṇairvidadhyāddhr̥tāni sēkāṁśca tathōpadēhān ||3||

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साध्येषु तत्पथ्यगणैर्विदध्याद्धृतानि सेकांश्च तथोपदेहान् ||३||

Meaning of the śloka

For the curable types, the physician should prepare medicated ghee using the groups of substances appropriate to each condition, and should likewise employ sprinkling or pouring treatments and external applications.

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tēṣāṁ sarvēṣāmēva sāmānyacikitsitasūtraṁ nirdiśannāha- sādhyēṣvityādi| tatpathyagaṇairyathākramaṁ vātapittakaphajēṣu vātādidōṣaharagaṇaiḥ||3||

Meaning of the commentary

The commentator identifies this as a general rule of treatment for all the curable forms. ‘Appropriate groups’ means that vāta-, pitta-, and kapha-origin varieties are to receive groups of substances that counter the corresponding doṣa, respectively.

Key terms

sādhya: A type considered amenable to treatment in the classical prognosis.
pathyagaṇa: A group of substances regarded as appropriate for the particular doṣa-based form.
ghṛta: Clarified butter prepared with medicinal substances in the described treatment.
seka: A local treatment involving sprinkling or pouring liquid over the affected area.
upadeha: An external application placed upon the affected area.

Adhikarana 3 (4-5) · Śloka 5

mustāśatāhvāsuradārukuṣṭhavārāhikustumburukr̥ṣṇagandhāḥ | vātātmakē cōṣṇagaṇāḥ prayōjyāḥ sēkēṣu lēpēṣu tathā śr̥tēṣu ||4|| yat pañcamūlaṁ khalu kaṇṭakākhyamalpaṁ mahaccāpyatha vallijaṁ ca | taccōpayōjyaṁ bhiṣajā pradēhē sēkē ghr̥tē cāpi tathaiva tailē ||5||

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मुस्ताशताह्वासुरदारुकुष्ठवाराहिकुस्तुम्बुरुकृष्णगन्धाः | वातात्मके चोष्णगणाः प्रयोज्याः सेकेषु लेपेषु तथा शृतेषु ||४|| यत् पञ्चमूलं खलु कण्टकाख्यमल्पं महच्चाप्यथ वल्लिजं च | तच्चोपयोज्यं भिषजा प्रदेहे सेके घृते चापि तथैव तैले ||५||

Meaning of the śloka

For a vāta-origin condition, mustā, śatāhvā, suradāru, kuṣṭha, vārāhī, kustumburu, kṛṣṇagandhā, and substances belonging to the warming groups are prescribed in liquids for seka, in external pastes, and in medicated decoctions. The physician should also use the small and great thorn-named pañcamūla groups and the creeper group in external applications, seka, medicated ghee, and medicated oil.

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mustētyādi| kr̥ṣṇagandhā śōbhāñjanakaḥ, śamītyaparē| uṣṇagaṇā bhadradārvādayaḥ pippalyādayaśca| yadityādi tr̥ṇākhyaṁ pañcamūlamapahāya śēṣāṇi catvāri pañcamūlāni grāhyāṇi||4-5||

Meaning of the commentary

The commentator identifies kṛṣṇagandhā as śobhāñjanaka, while another view takes it as śamī. The warming groups include those beginning with bhadradāru and those beginning with pippalī. For the next verse, the commentator says that the grass group of pañcamūla is excluded and the other four pañcamūla groups are intended.

Key terms

vātatmaka: A form attributed predominantly to vāta in the classical classification.
uṣṇagaṇa: Groups of substances classed as warming; the commentary gives bhadradāru- and pippalī-beginning groups as examples.
pañcamūla: A named group of five roots; the commentary understands four such groups here after excluding the grass group.
pradeha: A medicinal paste or coating applied externally.
kṛṣṇagandhā: A plant name read as śobhāñjanaka by the commentator, with śamī preserved as an alternative identification.

Adhikarana 4 (6-9) · Śloka 9

kasēruśr̥ṅgāṭakapadmagundrāḥ saśaivalāḥ sōtpalakardamāśca | vastrāntarāḥ pittakr̥tē visarpē lēpā vidhēyāḥ saghr̥tāḥ suśītāḥ ||6|| hrīvēralāmajjakacandanāni srōtōjamuktāmaṇigairikāśca | kṣīrēṇa piṣṭāḥ saghr̥tāḥ suśītā lēpāḥ prayōjyāstanavaḥ sukhāya ||7|| prapauṇḍarīkaṁ madhukaṁ payasyā mañjiṣṭhikā padmakacandanē ca | sugandhikā cēti sukhāya lēpaḥ paittē visarpē bhiṣajā prayōjyaḥ ||8|| nyagrōdhavargaiḥ pariṣēcanaṁ ca ghr̥taṁ ca kuryāt svarasēna tasya | śītaiḥ payōbhiśca madhūdakaiśca saśarkarairikṣurasaiśca sēkān ||9||

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कसेरुशृङ्गाटकपद्मगुन्द्राः सशैवलाः सोत्पलकर्दमाश्च | वस्त्रान्तराः पित्तकृते विसर्पे लेपा विधेयाः सघृताः सुशीताः ||६|| ह्रीवेरलामज्जकचन्दनानि स्रोतोजमुक्तामणिगैरिकाश्च | क्षीरेण पिष्टाः सघृताः सुशीता लेपाः प्रयोज्यास्तनवः सुखाय ||७|| प्रपौण्डरीकं मधुकं पयस्या मञ्जिष्ठिका पद्मकचन्दने च | सुगन्धिका चेति सुखाय लेपः पैत्ते विसर्पे भिषजा प्रयोज्यः ||८|| न्यग्रोधवर्गैः परिषेचनं च घृतं च कुर्यात् स्वरसेन तस्य | शीतैः पयोभिश्च मधूदकैश्च सशर्करैरिक्षुरसैश्च सेकान् ||९||

Meaning of the śloka

For pitta-origin visarpa, very cool applications are described using kaseru, śṛṅgāṭaka, padma, gundrā, śaivāla, utpala, and mud, combined with ghee and placed with cloth between the application and the body. Thin, cool applications ground with milk and ghee are also described from hrīvera, lāmajjaka, candana, srotoja, pearl, and gairika. Another soothing application uses prapauṇḍarīka, madhuka, payasyā, mañjiṣṭhikā, padmaka, candana, and sugandhikā. The passage further prescribes pouring treatments using the nyagrodha group, ghee prepared from its fresh juice, and cool milk, honey-water, sugared water, or sugarcane juice.

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pittavisarpacikitsitamāha- kasērvityādi| śr̥ṅgāṭakaṁ jalamadhyē trikaṇṭakam| gundrā paharakabhēdaḥ| saśaivalāḥ śaivālayuktā ityarthaḥ| kardamaḥ paṅka ityarthaḥ| vastrāntarā vastrēṇāntarīkr̥tāḥ, tē hi sukhēnāpanētuṁ śakyantē| hrīvērētyādi hrīvēraḥ vālakam| lāmajjaka uśīramūlam | srōtōjaṁ sauvīrāñjanam| tanavaḥ acchāḥ| sukhāyēti tanutvānnōṣmāṇamantaḥ pravēśayatītyarthaḥ| śrīvāgbhaṭa āha- “ślakṣṇaśuṣkaghanō lēpaścandanasyāpi dāhakr̥t| tvaggatasyōṣmaṇō rōdhācchītakr̥ccānyathā'gurōḥ”- iti| prapauṇḍarīkamityādi payasyā kṣīravidārī ; jējjaṭācāryastu arkapuṣpīmāha| sugandhikā utpalasārivā| nyagrōdhētyādi| madhūdakaṁ madhumiśramudakam||6-9||

Meaning of the commentary

The commentator introduces these as treatments for pitta-origin visarpa and explains several terms: śṛṅgāṭaka is a three-spined aquatic plant; gundrā is a kind of pahāraka; ‘with śaivāla’ means accompanied by aquatic moss or algae; and kardama means mud. Cloth is interposed so the application can be removed easily. Hrīvera is identified as vālaka, lāmajjaka as the root of uśīra, and srotoja as sauvīrāñjana. ‘Thin’ means not dense. Its stated comfort comes from not trapping heat within. A verse attributed to Vāgbhaṭa is cited: even sandalwood paste, if smooth, dry, and thick, causes burning by obstructing heat at the skin, whereas otherwise it cools. Payasyā is identified as kṣīravidārī, but Jejjaṭa calls it arkapuṣpī; sugandhikā is identified as utpalasārivā. Madhūdaka means water mixed with honey.

Key terms

pittakṛta visarpa: Visarpa attributed to pitta in the classical classification.
vastrāntara: Applied with a layer of cloth interposed, explained as permitting easier removal.
tanavaḥ: Thin or non-dense applications, intended here to avoid trapping heat.
payasyā: Identified as kṣīravidārī by one interpretation and as arkapuṣpī by Jejjaṭa.
madhūdaka: Water mixed with honey.

Adhikarana 5 (10-13) · Śloka 13

ghr̥tasya gaurīmadhukāravindarōdhrāmburājādanagairikēṣu | tatharṣabhē padmakasārivāsu kākōlimēdākumudōtpalēṣu ||10|| sacandanāyāṁ madhuśarkarāyāṁ drākṣāsthirāpr̥śniśatāhvayāsu | kalkīkr̥tāsūdakamatra dattvā nyagrōdhavargasya tathā sthirādēḥ ||11|| gaṇasya bilvādikapañcamūlyāścaturguṇaṁ kṣīramathāpi tadvat | prasthaṁ vipakvaṁ pariṣēcanēna paittīrnihanyāttu visarpanāḍīḥ ||12|| visphōṭaduṣṭavraṇaśīrṣarōgān pākaṁ tathā''syasya nihanti pānāt | grahārditē śōṣiṇi cāpi bālē ghr̥taṁ hi gauryādikamētadiṣṭam ||13||

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घृतस्य गौरीमधुकारविन्दरोध्राम्बुराजादनगैरिकेषु | तथर्षभे पद्मकसारिवासु काकोलिमेदाकुमुदोत्पलेषु ||१०|| सचन्दनायां मधुशर्करायां द्राक्षास्थिरापृश्निशताह्वयासु | कल्कीकृतासूदकमत्र दत्त्वा न्यग्रोधवर्गस्य तथा स्थिरादेः ||११|| गणस्य बिल्वादिकपञ्चमूल्याश्चतुर्गुणं क्षीरमथापि तद्वत् | प्रस्थं विपक्वं परिषेचनेन पैत्तीर्निहन्यात्तु विसर्पनाडीः ||१२|| विस्फोटदुष्टव्रणशीर्षरोगान् पाकं तथाऽऽस्यस्य निहन्ति पानात् | ग्रहार्दिते शोषिणि चापि बाले घृतं हि गौर्यादिकमेतदिष्टम् ||१३||

Meaning of the śloka

The passage describes Gauryādi ghṛta. Ghee is cooked with a paste containing gaurī, madhuka, aravinda, rodhra, ambu, rājādana, gairika, ṛṣabha, padmaka, sārivā, kākolī, medā, kumuda, utpala, candana, madhuśarkarā, drākṣā, sthirā, pṛśni, and śatāhvā. Liquids from the nyagrodha group, the sthirādi group, and the great bilvādi pañcamūla are added, together with milk. The prepared ghee is described for pouring over pitta-origin visarpa and nāḍī disorders. When taken internally, it is also claimed in the text to address visphoṭa, duṣṭavraṇa, diseases of the head, suppuration of the mouth, and certain disorders affecting children, including grahārdita and śoṣa.

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gauryādighr̥tamāha- ghr̥tasyētyādi| gaurī haridrā, gōrōcanētyanyē| aravindaṁ padmam| ambu vālakam| rājādanaṁ kṣīrikā| r̥ṣabhaḥ kūrcaśīrṣakaḥ svanāmaprasiddhaḥ| madhunaḥ śarkarā madhuśarkarā| sthirā śālaparṇī| gauryādiśatāhvāntānāṁ kalkīkr̥tānāṁ catvāri palāni, nyagrōdhādērvidārigandhādērmahatō'pi pañcamūlasya trayāṇāmudakaṁ kvāthaṁ caturguṇaṁ ghr̥tasya, kṣīramapi gavyaṁ caturguṇamiti; prasthaṁ ghr̥tasyēti dvātriṁśatpalāni dravadravyatvāt; anyē punaḥ kalkamānamaṣṭapalamāhuḥ||10-13||

Meaning of the commentary

The commentator identifies gaurī as haridrā, while others interpret it as gorocanā; aravinda as padma; ambu as vālaka; rājādana as kṣīrikā; ṛṣabha as the plant known as kūrcaśīrṣaka; and sthirā as śālaparṇī. Madhuśarkarā is explained as sugar derived from honey. The paste from gaurī through śatāhvā is said to measure four pala. Decoctions from three groups—nyagrodhādi, vidārigandhādi, and the great pañcamūla—are each taken at four times the ghee, and cow's milk likewise at four times the ghee. A prastha of ghee is explained as thirty-two pala because ghee is a liquid substance. Another opinion assigns eight pala as the quantity of paste.

Key terms

Gauryādi ghṛta: The named medicated-ghee preparation described in verses 10–13.
gaurī: Identified as haridrā by the commentator, while another interpretation takes it as gorocanā.
prastha: A classical measure; the commentary equates the stated amount of ghee here with thirty-two pala.
kalka: The paste component of the preparation; authorities cited in the commentary differ between four and eight pala.
duṣṭavraṇa: A classically described impaired or difficult wound for which the text claims benefit.

Adhikarana 6 (14-15) · Śloka 15

ajā'śvavagandhā saralā sakālā saikaiṣikā cāpyathavā'jaśr̥ṅgī | gōmūtrapiṣṭō vihitaḥ pradēhō hanyādvisarpaṁ kaphajaṁ sa śīghram ||14|| kālānusāryāgurucōcaguñjārāsnāvacāśītaśivēndraparṇyaḥ | pālindimuñjātamahīkadambā hitā visarpēṣu kaphātmakēṣu ||15||

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अजाऽश्ववगन्धा सरला सकाला सैकैषिका चाप्यथवाऽजशृङ्गी | गोमूत्रपिष्टो विहितः प्रदेहो हन्याद्विसर्पं कफजं स शीघ्रम् ||१४|| कालानुसार्यागुरुचोचगुञ्जारास्नावचाशीतशिवेन्द्रपर्ण्यः | पालिन्दिमुञ्जातमहीकदम्बा हिता विसर्पेषु कफात्मकेषु ||१५||

Meaning of the śloka

For kapha-origin visarpa, the passage describes an external application ground with cow urine from ajā, aśvagandhā, saralā, kālā, and ekaiṣikā, or alternatively ajaśṛṅgī, and claims that it acts quickly. It also lists kālānusāryā, aguru, coca, guñjā, rāsnā, vacā, śītaśiva, indraparṇī, pālindī, muñjāta, and mahīkadamba as useful in kapha-origin forms.

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kaphavisarpacikitsāmāha- ajētyādi| ajā ajagandhā ‘bōbaī’ iti lōkē| saralā trivr̥t| kālā kāsamardaḥ | ēkaiṣikā śatāvarī , anyē trivr̥dbhēdamāhuḥ| ajaśr̥ṅgī chāgalaviṣāṇikā, ‘uttamāraṇī’ iti lōkē; gayadāsācāryēṇa karkaṭaśr̥ṅgī vyākhyātā| kālānusāryētyādi- kālānusāryā tagaraṁ, cōcaḥ tvak, guñjā cirahiṇṭikā, śītaśivaṁ śatapuṣpābhēdaḥ, indraparṇī indravāruṇī, atra gayadāsācāryēṇa indrapuṣpī paṭhitā vyākhyātā ca; indrapuṣpī lāṅgalakī| pālindiḥ kālavallī, muñjāta uttarāpathajaḥ svalpakandaḥ, mahīkadambō'lambuṣā muṇḍitikēti lōkē, jējjaṭācāryō bhūkadambamāha||14-15||

Meaning of the commentary

The commentator identifies ajā as ajagandhā, locally called bobāī; saralā as trivṛt; and kālā as kāsamarda. Ekaiṣikā is taken as śatāvarī, though others regard it as a variety of trivṛt. Ajaśṛṅgī is identified as chāgalaviṣāṇikā, locally called uttamāraṇī, while Gayadāsa interprets it as karkaṭaśṛṅgī. In the second list, kālānusāryā is tagara, coca is tvak, guñjā is cirahiṇṭikā, and śītaśiva is a variety of śatapuṣpā. Indraparṇī is identified as indravāruṇī, but Gayadāsa reads and explains indrapuṣpī, which is identified as lāṅgalakī. Pālindī is kālavallī; muñjāta is described as a small tuber from the northern region; and mahīkadamba as alambuṣā, locally called muṇḍitikā, whereas Jejjaṭa calls it bhūkadamba.

Key terms

kaphaja visarpa: Visarpa attributed to kapha in the classical classification.
ekaiṣikā: Identified as śatāvarī by one view and as a variety of trivṛt by another.
ajaśṛṅgī: Identified as chāgalaviṣāṇikā in one account and as karkaṭaśṛṅgī by Gayadāsa.
indraparṇī: Identified as indravāruṇī, alongside Gayadāsa's variant reading indrapuṣpī, identified as lāṅgalakī.
mahīkadamba: Identified as alambuṣā or muṇḍitikā, while Jejjaṭa gives bhūkadamba.

Adhikarana 7 (16) · Śloka 17

gaṇastu yōjyō varuṇapravr̥ttaḥ kriyāsu sarvāsu vicakṣaṇēna | saṁśōdhanaṁ śōṇitamōkṣaṇaṁ ca śrēṣṭhaṁ visarpēṣu cikitsitaṁ hi ||16|| sarvāṁśca pakvān pariśōdhya dhīmān vraṇakramēṇōpacarēdyathōktam |17|

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गणस्तु योज्यो वरुणप्रवृत्तः क्रियासु सर्वासु विचक्षणेन | संशोधनं शोणितमोक्षणं च श्रेष्ठं विसर्पेषु चिकित्सितं हि ||१६|| सर्वांश्च पक्वान् परिशोध्य धीमान् व्रणक्रमेणोपचरेद्यथोक्तम् |१७|

Meaning of the śloka

The discerning physician should employ the group of medicines beginning with Varuṇa in all the indicated therapeutic applications. In visarpa, purification and bloodletting are described as the foremost treatments. After thoroughly cleansing every lesion that has suppurated, the learned physician should treat it according to the previously stated sequence for wound care.

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gaṇa ityādi| varuṇapravr̥ttō gaṇō varuṇādiḥ| kriyāsu sarvāsu pānādikāsu| ārambhē sarvēṣāṁ sāmānyacikitsitē saṁśamanamabhidhāya samprāptau saṁśōdhanamuddiśannāha- saṁśōdhanamityādi| raktāvasēcanaṁ jalaukābhiḥ, sarvēṣāmēva raktapittapradhānatvādalābuśr̥ṅgayōstatra duravacāratvāt||16||-

Meaning of the commentary

The commentary identifies the group beginning with Varuṇa as the Varuṇādi group and says that ‘all applications’ includes internal administration and related uses. It explains that the general treatment first described pacifying measures; when the disease process has developed, the text then directs purification. Bloodletting is specified here as being performed with leeches because these conditions are regarded as predominantly involving rakta and pitta, while the gourd and horn methods are considered difficult to apply at the affected site.

Key terms

Varuṇādi gaṇa (varuṇādi-gaṇa): The classical group of substances beginning with Varuṇa, prescribed here for the indicated applications.
visarpa: The spreading disorder discussed in this part of the chapter; the classical term is retained without assigning one modern diagnosis.
saṃśodhana: Purificatory treatment, contrasted by the commentary with the pacifying treatment mentioned earlier.
śoṇitamokṣaṇa (śoṇita-mokṣaṇa): Bloodletting; the commentary specifies leech application in this context.
vraṇakrama (vraṇa-krama): The previously described sequence of care for a wound.

Adhikarana 8 (17-19) · Śloka 20

nāḍī tridōṣaprabhavā na sidhyēcchēṣāścatasnaḥ khalu yatnasādhyāḥ ||17|| tatrānilōtthāmupanāhya pūrvamaśēṣataḥ pūyagatiṁ vidārya | tilairapāmārgaphalaiśca piṣṭvā sasaindhavairbandhanamatra kuryāt ||18|| prakṣālanē cāpi sadā vraṇasya yōjyaṁ mahadyat khalu pañcamūlam | hiṁsrāṁ haridrāṁ kaṭukāṁ balāṁ ca gōjihvikāṁ cāpi sabilvamūlām ||19|| saṁhr̥tya tailaṁ vipacēdvraṇasya saṁśōdhanaṁ pūraṇarōpaṇaṁ ca |20|

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नाडी त्रिदोषप्रभवा न सिध्येच्छेषाश्चतस्नः खलु यत्नसाध्याः ||१७|| तत्रानिलोत्थामुपनाह्य पूर्वमशेषतः पूयगतिं विदार्य | तिलैरपामार्गफलैश्च पिष्ट्वा ससैन्धवैर्बन्धनमत्र कुर्यात् ||१८|| प्रक्षालने चापि सदा व्रणस्य योज्यं महद्यत् खलु पञ्चमूलम् | हिंस्रां हरिद्रां कटुकां बलां च गोजिह्विकां चापि सबिल्वमूलाम् ||१९|| संहृत्य तैलं विपचेद्व्रणस्य संशोधनं पूरणरोपणं च |२०|

Meaning of the śloka

A nāḍī arising from all three doṣas is said not to be curable, while the other four types can be managed only with effort. For a vāta-origin nāḍī, the passage first prescribes an external poultice; the entire course of pus is then to be opened. A dressing made from a paste of sesame, fruits of Apāmārga, and rock salt is to be applied. For washing the wound, Mahāpañcamūla together with Hiṃsrā, Haridrā, Kaṭukā, Balā, Gojihvikā, and the root of Bilva is prescribed. Combining these substances, oil is to be prepared for cleansing, filling, and healing the wound.

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nāḍīnāmavasaraḥ- nāḍītyādi| tatrētyādi| upanāhya pācanadravyairavabaddhvā; tannēcchati gayī, kasmāt? nāḍīvacanāt, nahyapakvē vraṇē nāḍīti; tasmādvātaharadravyairēvōpanāhaḥ| prakṣālana ityādi| saṁhr̥tya ēkīkr̥tya| snēhacaturthāṁśō bhēṣajakalkaḥ, snēhāccaturguṇō dravaḥ, anēna nyāyēna paktavyam| dravō'tra jalam, “anuktē dravakāryē tu sarvatra salilaṁ smr̥tam” (ci. 31) iti vacanāt||17-19||-

Meaning of the commentary

Introducing the treatment of nāḍī, the commentator explains upanāhya as binding the area with substances that promote maturation. Gayī rejects that reading: since the condition is already called nāḍī, it cannot be an unripe wound, and therefore understands the poultice as made specifically with vāta-alleviating substances. Saṃhṛtya means combining the ingredients. The commentary also gives the standard preparation rule: the medicinal paste is one quarter of the oil and the liquid is four times the oil. Because no liquid is specified here, it is understood to be water, following the cited rule that water is assumed whenever the liquid medium is unstated.

Key terms

nāḍī: A classical term for a channel-like, discharging wound condition in this passage, retained without imposing one modern diagnosis.
tridoṣaprabhavā (tridoṣa-prabhavā): Arising from all three doṣas; this type is described as incurable in the verse.
upanāha: An external poultice or bandaged application; the commentary preserves disagreement about whether its purpose is maturation or vāta alleviation.
pūyagati (pūya-gati): The full path or tract followed by pus.
Mahāpañcamūla (mahā-pañcamūla): The classical group of five major roots included in the wound-washing decoction.
śodhana-pūraṇa-ropaṇa: Cleansing, filling, and promoting healing of the wound, the three stated purposes of the prepared oil.

Adhikarana 9 (20-21) · Śloka 21

pittātmikāṁ prāgupanāhya dhīmānutkārikābhiḥ sapayōghr̥tābhiḥ ||20|| nipātya śastraṁ tilanāgadantīyaṣṭyāhvakalkaiḥ paripūrayēttām | prakṣālanē cāpi sasōmanimbā niśā prayōjyā kuśalēna nityam ||21||

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पित्तात्मिकां प्रागुपनाह्य धीमानुत्कारिकाभिः सपयोघृताभिः ||२०|| निपात्य शस्त्रं तिलनागदन्तीयष्ट्याह्वकल्कैः परिपूरयेत्ताम् | प्रक्षालने चापि ससोमनिम्बा निशा प्रयोज्या कुशलेन नित्यम् ||२१||

Meaning of the śloka

For a pitta-type nāḍī, the learned physician is first directed to apply warm, porridge-like poultices prepared with milk and ghee. After using a surgical instrument, the tract is to be filled with pastes of sesame, Nāgadantī, and Yaṣṭyāhva. For regular washing, Niśā together with Soma and Nimba is prescribed for use by a skilled practitioner.

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pittētyādi| utkārikābhiḥ lapsikābhiḥ| nāgadantī dantī| sōmaḥ sōmasañjñaḥ , sōmalatētyanyē; kaṭphala iti jējjaṭācāryaḥ; tannēcchati gayī, tasya tīkṣṇōṣṇatvāt||20-21||

Meaning of the commentary

The commentary glosses utkārikā as lapsikā, a porridge-like preparation, and identifies Nāgadantī as Dantī. It preserves several different identifications of Soma: one reading treats it as the plant named Soma, another as Somalatā, while Jejjaṭācārya identifies it as Kaṭphala. Gayī rejects the Kaṭphala identification because of its sharp and heating qualities.

Key terms

pittātmikā nāḍī: A nāḍī condition characterized in the classical account as being of pitta nature.
utkārikā: A porridge-like external preparation, glossed by the commentary as lapsikā.
Nāgadantī (nāgadantī): A named ingredient identified by the commentary as Dantī.
Yaṣṭyāhva (yaṣṭyāhva): A named ingredient included in the paste placed in the tract.
Soma (soma): A disputed ingredient variously identified as Soma, Somalatā, or Kaṭphala; Gayī rejects the last identification.
Niśā (niśā): A named substance prescribed with Soma and Nimba for washing.

Adhikarana 10 (22) · Śloka 22

śyāmātribhaṇḍītriphalāsu siddhaṁ haridrayō rōdhrakavr̥kṣayōśca | ghr̥taṁ sadugdhaṁ vraṇatarpaṇēna hanyādgatiṁ kōṣṭhagatā'pi yā syāt ||22||

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श्यामात्रिभण्डीत्रिफलासु सिद्धं हरिद्रयो रोध्रकवृक्षयोश्च | घृतं सदुग्धं व्रणतर्पणेन हन्याद्गतिं कोष्ठगताऽपि या स्यात् ||२२||

Meaning of the śloka

Ghee is to be prepared with milk and with Śyāmā, Tribhaṇḍī, Triphalā, the two Haridrās, Rodhra, and Vṛkṣaka. Used to nourish the wound, it is said to overcome even a tract that has extended into the internal cavity.

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śyāmētyādi|- śyāmā vr̥ddhadārukaḥ| tribhaṇḍī trivr̥t| vr̥kṣakaḥ kuṭajaḥ||22||

Meaning of the commentary

The commentary identifies Śyāmā as Vṛddhadāruka, Tribhaṇḍī as Trivṛt, and Vṛkṣaka as Kuṭaja.

Key terms

Śyāmā (śyāmā): A named ingredient identified by the commentary as Vṛddhadāruka.
Tribhaṇḍī (tribhaṇḍī): A named ingredient identified by the commentary as Trivṛt.
Vṛkṣaka (vṛkṣaka): A named ingredient identified by the commentary as Kuṭaja.
vraṇatarpaṇa (vraṇa-tarpaṇa): Nourishing or sustaining treatment of the wound with the prepared ghee.
koṣṭhagatā gati (koṣṭha-gatā gati): A tract described as having extended into an internal cavity or deep body space.

Adhikarana 11 (23-25) · Śloka 25

nāḍīṁ kaphōtthāmupanāhya samyak kulatthasiddhārthakaśaktukiṇvaiḥ | mr̥dūkr̥tāmēṣya gatiṁ viditvā nipātayēcchastramaśēṣakārī ||23|| dadyādvraṇē nimbatilān sadantīn surāṣṭrajāsaindhavasamprayuktān | prakṣālanē cāpi karañjanimba jātyakṣapīlusvarasāḥ prayōjyāḥ ||24|| suvarcikāsaindhavacitrakēṣu nikumbhatālītalarūpikāsu | phalēṣvapāmārgabhavēṣu caiva kuryāt samūtrēṣu hitāya tailam ||25||

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नाडीं कफोत्थामुपनाह्य सम्यक् कुलत्थसिद्धार्थकशक्तुकिण्वैः | मृदूकृतामेष्य गतिं विदित्वा निपातयेच्छस्त्रमशेषकारी ||२३|| दद्याद्व्रणे निम्बतिलान् सदन्तीन् सुराष्ट्रजासैन्धवसम्प्रयुक्तान् | प्रक्षालने चापि करञ्जनिम्ब जात्यक्षपीलुस्वरसाः प्रयोज्याः ||२४|| सुवर्चिकासैन्धवचित्रकेषु निकुम्भतालीतलरूपिकासु | फलेष्वपामार्गभवेषु चैव कुर्यात् समूत्रेषु हिताय तैलम् ||२५||

Meaning of the śloka

For a kapha-origin nāḍī, the passage prescribes a thorough poultice with Kulattha, Siddhārthaka, Śaktu, and Kiṇva. Once softened, the physician is to probe it, determine the course of the tract, and use a surgical instrument so that nothing remains untreated. Nimba and sesame combined with Dantī, Saurāṣṭrajā, and rock salt are to be placed in the wound. Fresh juices of Karañja, Nimba, Jāti, Akṣa, and Pīlu are prescribed for washing. Oil prepared with Suvarcikā, rock salt, Citraka, Nikumbha, Tālītala, Rūpikā, fruits of Apāmārga, and urine is described as beneficial.

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nāḍīmityādi| kiṇvaḥ surābījam| aśēṣakārī vaidyaḥ| dadyādityādi| surāṣṭrajā tuvaramr̥ttikā| prakṣālanē ityādi| nikumbhō dantī| tālītalaṁ muśalīmūlaṁ ; nalamityanyē paṭhanti, tatra nalaḥ śuṣiraparvā svanāmaprasiddhaḥ| rūpikā śvētārkaḥ| ‘nīlīphalarūpikābhiḥ’ iti kēcit paṭhanti; nīlīphalaṁ śāradaṁ phalaṁ, śrīphalikēti lōkē||23-25||

Meaning of the commentary

The commentary defines Kiṇva as the fermenting seed or starter of surā and explains aśeṣakārī as a physician who completes the treatment without leaving anything undone. Saurāṣṭrajā is identified as Tuvaramṛttikā and Nikumbha as Dantī. Tālītala is identified as the root of Muśalī, though some read Nala instead; Nala is then described as the commonly known plant with hollow joints. Rūpikā is identified as Śvetārka. Another reading has ‘Nīlīphala and Rūpikā’; Nīlīphala is explained as a seasonal fruit popularly called Śrīphalikā.

Key terms

kaphotthā nāḍī: A nāḍī condition described as arising from kapha.
Kiṇva (kiṇva): The fermenting starter used for surā, according to the commentary.
eṣya gatiṃ viditvā: After probing and determining the course of the tract.
Saurāṣṭrajā (saurāṣṭrajā): A named substance identified by the commentary as Tuvaramṛttikā.
Tālītala (tālītala): Identified as Muśalī root, although an alternative reading gives Nala.
Rūpikā (rūpikā): Identified as Śvetārka; another textual reading places it alongside Nīlīphala.

Adhikarana 12 (26-28) · Śloka 28

nāḍīṁ tu śalyaprabhavāṁ vidārya nirhr̥tya śalyaṁ praviśōdhya mārgam | saṁśōdhayēt kṣaudraghr̥tapragāḍhaistilaistatō rōpaṇamāśu kuryāt ||26|| kumbhīkakharjūrakapitthabilvavanaspatīnāṁ ca śalāṭuvargaiḥ | kr̥tvā kaṣāyaṁ vipacēttu tailamāvāpya mustāsaralāpriyaṅgūḥ ||27|| sugandhikāmōcarasāhipuṣpaṁ rōdhraṁ vidadhyādapi dhātakīṁ ca | ētēna śalyaprabhavā tu nāḍī rōhēdvraṇō vā sukhamāśu caiva ||28||

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नाडीं तु शल्यप्रभवां विदार्य निर्हृत्य शल्यं प्रविशोध्य मार्गम् | संशोधयेत् क्षौद्रघृतप्रगाढैस्तिलैस्ततो रोपणमाशु कुर्यात् ||२६|| कुम्भीकखर्जूरकपित्थबिल्ववनस्पतीनां च शलाटुवर्गैः | कृत्वा कषायं विपचेत्तु तैलमावाप्य मुस्तासरलाप्रियङ्गूः ||२७|| सुगन्धिकामोचरसाहिपुष्पं रोध्रं विदध्यादपि धातकीं च | एतेन शल्यप्रभवा तु नाडी रोहेद्व्रणो वा सुखमाशु चैव ||२८||

Meaning of the śloka

A nāḍī caused by a retained foreign body is to be opened; the foreign body is removed and the tract thoroughly cleansed. It is then to be cleansed with sesame richly mixed with honey and ghee, after which measures to promote rapid healing are prescribed. A decoction is prepared from the tender fruits of Kumbhīka, Kharjūra, Kapittha, Bilva, and the vanaspati trees. Oil is cooked with this decoction and Mustā, Saralā, Priyaṅgu, Sugandhikā, Mocarasa, Ahipuṣpa, Rodhra, and Dhātakī. The text states that by this means a foreign-body-origin nāḍī, or a wound, heals readily and quickly.

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nāḍīmityādi| kumbhīkaḥ sthalakumbhikā, vanaspatayō vaṭādyāḥ, kumbhikādīnāṁ śalāṭūni kōmalaphalāni grāhyāṇi| saralā trivr̥t| sugandhikā utpalasārivā| mōcarasaḥ śālmalīcumpaḥ| ahipuṣpaṁ nāgakēśaram||26-28||

Meaning of the commentary

The commentary identifies Kumbhīka as Sthalakumbhikā and says that vanaspati refers to trees such as Vaṭa. For Kumbhīka and the other named plants, their tender fruits are to be used. Saralā is identified as Trivṛt, Sugandhikā as Utpalasārivā, Mocarasa as Śālmalī-cumpa, and Ahipuṣpa as Nāgakeśara.

Key terms

śalyaprabhavā nāḍī (śalya-prabhavā nāḍī): A nāḍī tract attributed in the passage to a retained foreign body.
śalya: A foreign body that the passage directs the practitioner to remove.
mārga: The course or tract that is to be thoroughly cleansed after removal of the foreign body.
śalāṭu: Tender or immature fruits, specified by the commentary for Kumbhīka and the other named plants.
Mocarasa (mocarasa): A named ingredient identified by the commentary as Śālmalī-cumpa.
Ahipuṣpa (ahipuṣpa): A named ingredient identified by the commentary as Nāgakeśara.

Adhikarana 13 (29-33) · Śloka 33

kr̥śadurbalabhīrūṇāṁ nāḍī marmāśritā ca yā | kṣārasūtrēṇa tāṁ cchindyānna tu śastrēṇa buddhimān ||29|| ēṣaṇyā gatimanviṣya kṣārasūtrānusāriṇīm | sūcīṁ nidadhyādgatyantē tathōnnamyāśu nirharēt ||30|| sūtrasyāntaṁ samānīya gāḍhaṁ bandhaṁ samācarēt | tataḥ kṣārabalaṁ vīkṣya sūtramanyat pravēśayēt ||31|| kṣārāktaṁ matimān vaidyō yāvanna chidyatē gatiḥ | bhagandarē'pyēṣa vidhiḥ kāryō vaidyēna jānatā ||32|| arbudādiṣu cōtkṣipya mūlē sūtraṁ nidhāpayēt | sūcībhiryavavakrābhirācitān vā samantataḥ | mūlē sūtrēṇa badhnīyācchinnē cōpacarēdvraṇam ||33||

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कृशदुर्बलभीरूणां नाडी मर्माश्रिता च या | क्षारसूत्रेण तां च्छिन्द्यान्न तु शस्त्रेण बुद्धिमान् ||२९|| एषण्या गतिमन्विष्य क्षारसूत्रानुसारिणीम् | सूचीं निदध्याद्गत्यन्ते तथोन्नम्याशु निर्हरेत् ||३०|| सूत्रस्यान्तं समानीय गाढं बन्धं समाचरेत् | ततः क्षारबलं वीक्ष्य सूत्रमन्यत् प्रवेशयेत् ||३१|| क्षाराक्तं मतिमान् वैद्यो यावन्न छिद्यते गतिः | भगन्दरेऽप्येष विधिः कार्यो वैद्येन जानता ||३२|| अर्बुदादिषु चोत्क्षिप्य मूले सूत्रं निधापयेत् | सूचीभिर्यववक्राभिराचितान् वा समन्ततः | मूले सूत्रेण बध्नीयाच्छिन्ने चोपचरेद्व्रणम् ||३३||

Meaning of the śloka

For a person who is emaciated, weak, or fearful, and for a nāḍī that is situated near a marma, the discerning physician is instructed to divide it with a kṣārasūtra rather than a surgical instrument. The course is first traced with a probe; a needle carrying the kṣārasūtra is placed at the end of the tract, raised, and promptly withdrawn. The ends of the thread are brought together and firmly tied. After assessing the strength of the alkali, another alkali-coated thread is introduced, continuing until the tract is divided. The same method is stated for bhagandara. In arbuda and related swellings, a thread is placed at the root after lifting the lesion; broad-rooted lesions may be pierced around their circumference with curved needles and tied at the root, and the resulting wound is then treated.

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kr̥śētyādi| kṣārasūtrēṇa kṣārāktasūtrēṇa| tatra kṣārasūtrāvacāraṇāprakāraṁ nirdiśannāha- ēṣaṇyētyādi| arbudādiṣviti ādiśabdādgranthyādīnāṁ grahaṇam| tanumūlēṣu arbudādiṣu, utkṣipya mūlē kṣārasūtraṁ nidhāpayēt; viśālamūlāṁścārbudādīn kṣārasūtrapratiṣṭhāpanārthē sarvataḥ sūcībhirāvidhya , mūlē kṣārasūtrēṇa badhnīyāt||29-33||

Meaning of the commentary

The commentator explains kṣārasūtra as a thread coated with alkali and then identifies the following verses as a description of how it is applied. The word ādi in arbudādi includes granthi and similar swellings. In lesions with a narrow base, the kṣārasūtra is to be placed at the root after the lesion is raised. For broad-rooted arbuda and related lesions, the commentary says that needles are passed around the lesion so the kṣārasūtra can be established and tied at its root.

Key terms

nāḍī: A pathological tract or channel described in this chapter, retained as a classical clinical term.
marma: A classically designated vital or vulnerable anatomical site near which direct cutting is avoided here.
kṣārasūtra: A thread coated with an alkaline substance, described here as a historical means of gradually dividing a tract or lesion base.
bhagandara: A classical disease category for which the same thread procedure is stated.
arbuda: A classical term for a swelling or mass treated at its root in this passage.
granthi: A nodular swelling included by the commentary under the expression arbudādi.

Adhikarana 14 (34-41) · Śloka 42

yā dvivraṇīyē'bhihitāstu vartyastāḥ sarvanāḍīṣu bhiṣagvidadhyāt | ghōṇṭāphalatvaglavaṇāni lākṣāpūgīphalaṁ cālavaṇaṁ ca patram ||34|| snuhyarkadugdhēna tu kalka ēṣa vartīkr̥tō hantyacirēṇa nāḍīḥ | bibhītakāmrāsthivaṭapravālā harēṇukāśaṅkhinibījamasyaḥ ||35|| vārāhikandaśca tathā pradēyō nāḍīṣu tailēna ca miśrayitvā ||36|| dhattūrajaṁ madanakōdravajaṁ ca bījaṁ kōśātakī śukanasā mr̥gabhōjinī ca | aṅkōṭabījakusumaṁ gatiṣu prayōjyaṁ lākṣōdakāhr̥tamalāsu vikr̥tya cūrṇam ||37|| tathā ca gōmāṁsamasīṁ hitāya kōṣṭhāśritasyādaratō diśanti | vartīkr̥taṁ mākṣikasamprayuktaṁ nāḍīghnamuktaṁ lavaṇōttamaṁ vā ||38|| duṣṭavraṇē yadvihitaṁ ca tailaṁ tat sarvanāḍīṣu bhiṣagvidadhyāt | cūrṇīkr̥tairatha vimiśritamēbhirēva tailaṁ prayuktamacirēṇa gatiṁ nihanti ||39|| ēṣvēva mūtrasahitēṣu vidhāya tailaṁ tat sādhitaṁ gatimapōhati saptarātrāt | piṇḍītakasya tu varāhavibhāvitasya mūlēṣu kandaśakalēṣu ca sauvahēṣu ||40|| tailaṁ kr̥taṁ gatimapōhati śīghramētat kandēṣu cāmaravarāyudhasāhvayēṣu | bhallātakārkamaricairlavaṇōttamēna siddhaṁ viḍaṅgarajanīdvayacitrakaiśca ||41|| syānmārkavasya ca rasēna nihanti tailaṁ nāḍīṁ kaphānilakr̥tāmapacīṁ vraṇāṁśca |42|

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या द्विव्रणीयेऽभिहितास्तु वर्त्यस्ताः सर्वनाडीषु भिषग्विदध्यात् | घोण्टाफलत्वग्लवणानि लाक्षापूगीफलं चालवणं च पत्रम् ||३४|| स्नुह्यर्कदुग्धेन तु कल्क एष वर्तीकृतो हन्त्यचिरेण नाडीः | बिभीतकाम्रास्थिवटप्रवाला हरेणुकाशङ्खिनिबीजमस्यः ||३५|| वाराहिकन्दश्च तथा प्रदेयो नाडीषु तैलेन च मिश्रयित्वा ||३६|| धत्तूरजं मदनकोद्रवजं च बीजं कोशातकी शुकनसा मृगभोजिनी च | अङ्कोटबीजकुसुमं गतिषु प्रयोज्यं लाक्षोदकाहृतमलासु विकृत्य चूर्णम् ||३७|| तथा च गोमांसमसीं हिताय कोष्ठाश्रितस्यादरतो दिशन्ति | वर्तीकृतं माक्षिकसम्प्रयुक्तं नाडीघ्नमुक्तं लवणोत्तमं वा ||३८|| दुष्टव्रणे यद्विहितं च तैलं तत् सर्वनाडीषु भिषग्विदध्यात् | चूर्णीकृतैरथ विमिश्रितमेभिरेव तैलं प्रयुक्तमचिरेण गतिं निहन्ति ||३९|| एष्वेव मूत्रसहितेषु विधाय तैलं तत् साधितं गतिमपोहति सप्तरात्रात् | पिण्डीतकस्य तु वराहविभावितस्य मूलेषु कन्दशकलेषु च सौवहेषु ||४०|| तैलं कृतं गतिमपोहति शीघ्रमेतत् कन्देषु चामरवरायुधसाह्वयेषु | भल्लातकार्कमरिचैर्लवणोत्तमेन सिद्धं विडङ्गरजनीद्वयचित्रकैश्च ||४१|| स्यान्मार्कवस्य च रसेन निहन्ति तैलं नाडीं कफानिलकृतामपचीं व्रणांश्च |४२|

Meaning of the śloka

For all nāḍī tracts, the physician is directed to use the cleansing wicks taught in the chapter on two kinds of wounds. The passage then lists several compound wicks, powders, ashes, and medicated oils made from named plant, mineral, and animal-derived substances, sometimes combined with latex, honey, salt, urine, or other liquids. These preparations are said to cleanse or remove the tract, including tracts attributed to kapha and vāta, apacī, and wounds.

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tataḥ paraṁ sarvanāḍīnāṁ sāmānyavidhimāha- yā ityādi| miśrakōktātītāvēkṣaṇēna dvivraṇīyē'bhihitā ‘antaḥśalyānaṇumukhān’ (ci. 1) ityādivākyē vartyaḥ śōdhanāḥ prayōjyāḥ| ihāpi vartiṁ nirdiśannāha- ghōṇṭētyādi| ghōṇṭāphalaṁ badarīphalaṁ, tasya tvak valkalam| lavaṇāni saindhavādīni| alavaṇā kākamardanikā , tasyā idaṁ patramālavaṇam| bibhītakētyādi śaṅkhinī yavatiktā| bibhītakāmrāsthyādīnāṁ dāhēna masyaḥ kṣārā ityarthaḥ| vārāhikandō gr̥ṣṭikākandaḥ| tathētyādi tēnaiva prakārēṇa gōmāṁsasyāpi masīṁ kōṣṭhāśritāsu nāḍīṣu hitāya ādarēṇa pratipādayanti| vartīkr̥tamityādi pakvamadhusaindhavavartirapi nāḍīharā| duṣṭētyādi|- duṣṭavraṇē yadvihitaṁ ca tailamiti sarvavraṇē “dravantī cirabilvaṁ” ityādinā vargēṇa “yathōpapatti kartavyaṁ tailamētēṣu śōdhanam” (ci. 2) ityabhihitam| dhattūrajamityādi dhattūrajaṁ bījam| madōtpādakāḥ kōdravā madanakōdravāḥ; anyē tu vyākhyānayanti- madanaṁ kōdravajaṁ bījaṁ cēti| kōśātakī dēvadālī| śukanasā carmakāravaṭaḥ| mr̥gabhōjinī indravāruṇī| aṅkōṭabījapuṣpayuktaiḥ kr̥taṁ cūrṇaṁ gatiṣu dēyam| lākṣōdakāhr̥tamalāsu lākṣādigaṇakvāthaprakṣālanēna āsamantāt hr̥tamalāsu, dōṣāpanayanācchuddhāsvityarthaḥ; anyē tu lākṣōdakaprakṣālanēna bhēdanapīḍanābhyāṁ ca hr̥tamalāsu gatiṣu, dhattūramadanakōdravādicūrṇaṁ vikr̥tyālōḍya lākṣōdakēnaiva prayōjyamiti sambandhaṁ kathayanti| cūrṇīkr̥tairityādi| ēbhirēva dhattūrakādibhiścūrṇīkr̥tairmiśrīkr̥tya tailaṁ prayuktamacirēṇa gatiṁ nihantīti jējjaṭaḥ; gayī tu, ‘tailaṁ kr̥taṁ gatimapōhati śīghramēva’ iti paṭhitvā kr̥tagrahaṇāttailaṁ sāmānyapākaparibhāṣayā kr̥taṁ sādhitaṁ gatimapōhatīti vyākhyāti| ēṣvityādi|- ēṣvēva dhattūrakādibījādiṣvityarthaḥ| piṇḍītakasyētyādi| varāhapiṇḍītakamūlasuvahakādiśakalēṣu vajrakandēṣu ca snēhapākasāmānyaparibhāṣayā siddhaṁ tailaṁ nāḍīharam| vistaramāha- piṇḍītakastrividhaḥ kr̥ṣṇapuṣpaḥ, śvētapuṣpaḥ, pītapuṣpaśca; tēṣvatra varāhavarṇapuṣpairvibhāvyata iti varāhavibhāvitaḥ kr̥ṣṇapuṣpō grāhyaḥ; suvahā gandhanākulī nāpiṇīti lōkē, gōdhāpadītyaparē, kandālītyanyē, tasyāḥ kandaśakalēṣu kandakhaṇḍēṣu; kr̥taṁ saṁskr̥tam| ‘kandēṣu cāmaravarāyudhasāhvayēṣu’ ityatra amaravara indrastasyāyudhaṁ vajraṁ tēna samāna āhvayaḥ sañjñā yēṣāṁ tē amaravarāyudhasāhvayā vajrakandāstēṣu| cakārāt ‘tailaṁ kr̥tam’ ityanuvartatē| bhallātakētyādi mārkavarasēna bhr̥ṅgarājarasēna||34-41||-

Meaning of the commentary

The commentator connects the cleansing wicks with the earlier instruction for narrow-mouthed wounds containing an internal foreign body. Ghoṇṭā fruit is identified as badarī, with its bark intended; lavaṇāni includes rock salt and other salts, while alavaṇā is identified as kākamardanika and the reading refers to its leaf. Śaṅkhinī is identified as yavatiktā, and the ashes of bibhītaka, mango stone, and related materials are understood as alkaline substances. Vārāhikanda is identified as gṛṣṭikākanda. The text is also taken to recommend ash of beef for a tract situated in an internal cavity, and a cooked honey-and-rock-salt wick as another tract-removing preparation. The oil prescribed earlier for a contaminated wound is extended to all nāḍī tracts. The commentary records alternative readings: madanakodrava may mean intoxicating kodrava, while others parse madana and seed of kodrava separately; some interpret cleansing with lākṣā decoction alone, while others also include opening and pressure before applying the powder mixed with that liquid. Jejjaṭa says oil mixed with the powdered ingredients removes the tract quickly; Gayī reads that properly prepared oil does so, understanding kṛta according to the general rule for cooking medicated oil. The commentator further distinguishes three forms of piṇḍītaka and selects the dark-flowered form here, while reporting differing identifications of suvahā as gandhanākulī or nāpiṇī, godhāpadī, or kandālī. Vajrakanda is explained through its name as a tuber named after its resemblance to Indra's thunderbolt, and mārkava juice is identified as bhṛṅgarāja juice.

Key terms

varti: A medicated wick described for cleansing a pathological tract.
nāḍī: The pathological tract or channel targeted by the preparations in this passage.
śodhana: Cleansing, specifically the intended action of the wicks and wound preparations here.
lākṣodaka: A liquid or decoction associated with lākṣā, used for washing or mixing according to differing interpretations.
apacī: A classical disease category mentioned among the conditions the final oil is said to address.
suvahā: A named plant whose identification is disputed in the commentary.

Adhikarana 15 (42-44) · Śloka 45

stanyē gatē vikr̥timāśu bhiṣak tu dhātrīṁ pītāṁ ghr̥taṁ pariṇatē'hani vāmayēttu ||42|| nimbōdakēna madhumāgadhikāyutēna vāntāgatē'hani ca mudgarasāśanā syāt | ēvaṁ tryahaṁ caturahaṁ ṣaḍahaṁ vamēdvā sarpiḥ pibēttriphalayā saha saṁyutaṁ vā ||43|| bhārgīṁ vacāmativiṣāṁ suradāru pāṭhāṁ mustādikaṁ madhurasāṁ kaṭurōhiṇīṁ ca | dhātrī pibēttu payasaḥ pariśōdhanārtha māragvadhādiṣu varaṁ madhunā kaṣāyam ||44|| sāmānyamētadupadiṣṭamatō viśēṣāddōṣān payōnipatitān śamayēdyathāsvam |45|

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स्तन्ये गते विकृतिमाशु भिषक् तु धात्रीं पीतां घृतं परिणतेऽहनि वामयेत्तु ||४२|| निम्बोदकेन मधुमागधिकायुतेन वान्तागतेऽहनि च मुद्गरसाशना स्यात् | एवं त्र्यहं चतुरहं षडहं वमेद्वा सर्पिः पिबेत्त्रिफलया सह संयुतं वा ||४३|| भार्गीं वचामतिविषां सुरदारु पाठां मुस्तादिकं मधुरसां कटुरोहिणीं च | धात्री पिबेत्तु पयसः परिशोधनार्थ मारग्वधादिषु वरं मधुना कषायम् ||४४|| सामान्यमेतदुपदिष्टमतो विशेषाद्दोषान् पयोनिपतितान् शमयेद्यथास्वम् |४५|

Meaning of the śloka

When breast milk has become altered, the physician is instructed to give the wet nurse ghee and induce vomiting later in the day with a neem decoction combined with honey and māgadhikā. On the day after vomiting, her food is to be mung broth. Vomiting may be repeated after intervals of three, four, or six days, or she may drink ghee prepared with triphalā. For cleansing the milk, the wet nurse is directed to take a decoction containing the named substances Bhārgī, vacā, ativisā, suradāru, pāṭhā, the mustādi group, madhurasā, and kaṭurohiṇī, or preferably a decoction from the āragvadhādi group with honey. After these general measures, doṣas that have entered the milk are to be pacified individually with their respective opposing measures.

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stanya ityādi| stanyē dōṣaurvikr̥tiṁ gatē parigatē| pariṇatē'hani sāyaṅkāla , pītāṁ ghr̥taṁ saṁśamanamēva ghr̥taṁ pītavatīṁ, ētacca prataptakanakanikarapītalōhitē savitari snēhapānakalpasyāpavādaḥ| sāmānyōktamapi kaphaghnadravyasaṁskr̥taṁ ghr̥tam| jējjaṭādayastu pariṇatē niṣpannē snēhaphalē sati snigdhāmityarthaḥ, ahani tasminnēva divasē| tannēcchati gayī, sāmānyavākyēnaiva snigdhāya vamanasya vihitatvāt| svēdasya pūrvakarmatvāt svinnāṁ, nimbōdakēna nimbakvāthēna vāmayēt| vāntāgatē'hani ca mudgarasāśanā syāt natu vamanadivasē bhōjayēdityarthaḥ| tatra prathamavamanēna kaphasya niḥśēṣamanapahr̥tatvādaśuddhadēhāṁ snēhasvēdāvantarā'ntarā sēvayitvā ṣaḍahaṁ vā caturahaṁ tryahaṁ vā yāvadviśuddhiriti, śuddhadēhāyāstu punarvamanaṁ tyājyam, anyathā glāniḥ stanyakṣayaśca| tasmācchuddhadēhā vātapittānubandhē snēhapākaparibhāṣayā triphalāsiddhaṁ sarpiḥ pibēdēvēti vāśabdādvyavasthitārthāllabhyatē| saṁśōdhanamabhidhāya saṁśamanamāha- bhārgīmityādi| mustādikaṁ dravyasaṅgrahaṇīyōktam| madhurasā mūrvā ‘cōrasnāyuḥ’ iti lōkē| bhārgyādibhiḥ saha mustādērgaṇasya kaṣāyapānaṁ varaṁ śrēṣṭham| payōnipatitān stanyanipatitān| śamayēdyathāsvamiti yasya yadātmakaṁ pratyanīkaṁ tēna śamayēditi||42-44||-

Meaning of the commentary

The commentator takes alteration of stanya to mean that the doṣas have pervaded the milk. One interpretation places the vomiting in the evening after the wet nurse has taken soothing ghee, treated with generally indicated kapha-reducing substances. Jejjaṭa and others instead understand pariṇate as the point when oleation has produced its proper effect and ahani as that same day. Gayī rejects that reading because the general rule already prescribes vomiting for an oleated person; the commentary also supplies fomentation as a preliminary measure. Nimbodaka means neem decoction. Mung broth is given on the day after vomiting, not on the day of vomiting. Because one emesis may not completely remove kapha, the still-uncleansed woman is said to receive intermittent oleation and fomentation and repeat emesis at three-, four-, or six-day intervals until cleansed. Repeating it in a person already cleansed is rejected because it may cause exhaustion and loss of breast milk. In a cleansed woman with associated vāta or pitta, the alternative particle vā is interpreted restrictively to support taking ghee prepared with triphalā. The commentary then turns from cleansing to pacification, identifies madhurasā as mūrvā, and considers the decoction of Bhārgī and the other listed substances, including the mustādi group, especially suitable. Finally, yathāsvam means pacifying each doṣa in the milk with the measure opposed to that particular doṣa.

Key terms

stanya: Breast milk, described here as altered through the presence of doṣas.
dhātrī: The wet nurse or nursing woman who is the subject of the regimen.
vamana: Therapeutically induced vomiting in the historical regimen.
saṃśodhana: Cleansing, here described as a means of purifying breast milk.
saṃśamana: Pacification after cleansing, directed according to the particular doṣa involved.
yathāsvam: According to each one individually, explained as applying the corresponding opposing measure to each doṣa.

Adhikarana 16 (45-47) · Śloka 47

rōgaṁ stanōtthitamavēkṣya bhiṣagvidadhyā dyadvidradhāvabhihitaṁ bahuśō vidhānam ||45|| sampacyamānamapi taṁ tu vinōpanāhaiḥ sambhōjanēna khalu pācayituṁ yatēta | śīghraṁ stanō hi mr̥dumāṁsatayōpanaddhaḥ sarvaṁ prakōthamupayātyavadīryatē ca ||46|| pakvē tu dugdhahariṇīḥ parihr̥tya nāḍīḥ kr̥ṣṇaṁ ca cūcukayugaṁ vidadhīta śastram | āmē vidāhini tathaiva gatē ca pākaṁ dhātryāḥ stanau satatamēva ca nirduhīta ||47||

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रोगं स्तनोत्थितमवेक्ष्य भिषग्विदध्या द्यद्विद्रधावभिहितं बहुशो विधानम् ||४५|| सम्पच्यमानमपि तं तु विनोपनाहैः सम्भोजनेन खलु पाचयितुं यतेत | शीघ्रं स्तनो हि मृदुमांसतयोपनद्धः सर्वं प्रकोथमुपयात्यवदीर्यते च ||४६|| पक्वे तु दुग्धहरिणीः परिहृत्य नाडीः कृष्णं च चूचुकयुगं विदधीत शस्त्रम् | आमे विदाहिनि तथैव गते च पाकं धात्र्याः स्तनौ सततमेव च निर्दुहीत ||४७||

Meaning of the śloka

After examining a disease arising in the breast, the physician should repeatedly apply the treatment described for vidradhi. Even while it is maturing, an attempt is to be made to bring it to suppuration through suitable food and without poultices, because the breast, being composed of soft tissue, quickly undergoes extensive putrefactive change and may rupture when poulticed. Once it is fully suppurated, an incision is prescribed while avoiding the milk-carrying channels and the dark nipple-and-areola region. In the unripe, inflamed, and suppurated stages, the wet nurse's breasts are to be emptied regularly.

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sambhōjanēnēti yathēṣṭabhōjanēnētyarthaḥ| upanāhō hyatyarthaṁ pākakāri, tasmādupanāhaniṣēdhamāha- śīghramityādi| hi sphuṭaṁ, prakōthaṁ pūtimāṁsatām| āmētyādi āmē vidagdhatāparihārāya, vidāhini vipākaparihārāya, pakvē nāḍīvraṇaparihārāya, stanau nirduhīta||45-47||

Meaning of the commentary

The commentator explains sambhojana as allowing food as desired. Because a poultice promotes suppuration very strongly, the text specifically prohibits it here. Prakotha is explained as the state of putrefied tissue. Regular emptying of the breasts is assigned different purposes by stage: in the unripe stage it is intended to prevent inflammatory damage, in the actively inflamed stage to prevent progression to suppuration, and in the suppurated stage to prevent formation of a nāḍī wound or tract.

Key terms

stanotthita roga: A disease arising in the breast.
vidradhi: The classical disease category whose treatment is extended to the breast condition.
upanāha: A poultice, prohibited here because the commentary says it strongly hastens suppuration.
prakotha: Putrefactive deterioration of tissue, as explained by the commentary.
dugdhahariṇī nāḍī: A milk-carrying channel that the verse directs the physician to avoid during incision.
nirduhīta: To empty or express the breast, prescribed regularly across the stated stages.

Adhikarana puṣpikā · Śloka 17

iti suśrutasaṁhitāyāṁ cikitsāsthānē visarpanāḍīstanarōgacikitsitaṁ nāma saptadaśō'dhyāyaḥ ||17||

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इति सुश्रुतसंहितायां चिकित्सास्थाने विसर्पनाडीस्तनरोगचिकित्सितं नाम सप्तदशोऽध्यायः ||१७||

Meaning of the śloka

Thus ends the seventeenth chapter of the Cikitsāsthāna in the Sushruta Samhita, entitled ‘Treatment of Visarpa, Nāḍī, and Diseases of the Breast.’

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iti śrīḍalha(hla)ṇaviracitāyāṁ nibandhasaṅgrahākhyāyāṁ suśrutavyākhyāyāṁ cikitsāsthānē saptadaśō'dhyāyaḥ||17||

Meaning of the commentary

The commentary's colophon states that the seventeenth chapter of the Cikitsāsthāna is complete in the Nibandhasaṅgraha commentary on the Sushruta Samhita composed by Śrī Dalhaṇa. The supplied text shows an editorial variation in the spelling of Dalhaṇa's name.

Key terms

Cikitsāsthāna (cikitsāsthāna): The treatment section of the Sushruta Samhita.
visarpa: A classical disease category included in the chapter title.
nāḍī: A pathological tract or channel included in the chapter title.
stanaroga: Diseases of the breast, the third subject named in the chapter title.
Nibandhasaṅgraha (nibandhasaṅgraha): The title of Dalhaṇa's commentary named in the colophon.

← 16. vidradhicikitsitam 18. granthyapacyarbudagalagaṇḍacikitsitam →