௧௪. பேத்யரோகப்ரதிஷேதாத்யாயஃ

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Adhikarana ௧ (௧-௨) · Śloka ௨

அதாதோ பேத்யரோகப்ரதிஷேதஂ வ்யாக்யாஸ்யாமஃ ||௧|| யதோவாச பகவாந் தந்வந்தரிஃ ||௨||

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अथातो भेद्यरोगप्रतिषेधं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now the chapter on the management of disorders requiring bhedana (opening or incision) will be explained, as taught by Bhagavan Dhanvantari.

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லேக்யப்ரதிஷேதாநந்தரஂ பித்த்வா லிகேதிதி வசநாத்பேத்யரோகப்ரதிஷேதாரம்பஃ- அதாத இத்யாதி||௧-௨||

Meaning of the commentary

Following the chapter on lekhya disorders, this chapter begins the management of bhedya disorders because the preceding instruction states that an affected structure should first be opened and then scraped.

Key terms

भेद्यरोग (bhedya-roga): Disorders for which opening or incision is prescribed in the source.
लेख्य (lekhya): A condition or procedure involving scraping, referenced as the topic of the preceding chapter.
धन्वन्तरि (Dhanvantari): The authoritative teacher to whom the instruction is attributed.

Adhikarana ௨ (௩-௪) · Śloka ௪

ஸ்வேதயித்வா பிஸக்ரந்திஂ சித்ராண்யஸ்ய நிராஶயம் | பக்வஂ பித்த்வா து ஶஸ்த்ரேண ஸைந்தவேநாவசூர்ணயேத் ||௩|| காஸீஸமாகதீபுஷ்பநேபால்யேலாயுதேந து | ததஃ க்ஷௌத்ரகதஂ தத்த்வா ஸம்யக்பந்தமதாசரேத் ||௪||

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स्वेदयित्वा बिसग्रन्थिं छिद्राण्यस्य निराशयम् | पक्वं भित्त्वा तु शस्त्रेण सैन्धवेनावचूर्णयेत् ||३|| कासीसमागधीपुष्पनेपाल्येलायुतेन तु | ततः क्षौद्रघृतं दत्त्वा सम्यग्बन्धमथाचरेत् ||४||

Meaning of the śloka

After fomenting a mature bisagranthi, its openings are to be incised with an instrument so that no residual cavity or pocket remains. The source then prescribes dusting it with saindhava combined with kasisa, Magadhi, pushpanjana, Nepali and ela. Thereafter, honey and ghee are applied and an appropriate bandage is placed.

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ஸ்வேதயித்வேத்யாதி| பிஸக்ரந்திஂ பக்வஂ ஸ்வேதயித்வா, அநந்தரமஸ்ய பக்வஸ்ய பிஸக்ரந்தேஃ ஸ்விந்நஸ்ய சித்ராணி நிராஶயஂ பித்த்வா, ஸைந்தவேந காஸீஸாதியுக்தேநாவசூர்ணயேத்| நிராஶயமிதி ஆஶயஸ்ய உத்ஸங்கஸ்யாபாவோ யதா ஸ்யாத்ததா பித்த்வேத்யர்தஃ| புஷ்பஂ புஷ்பாஞ்ஜநஂ, நேபாலீ மநஃஶிலா| ததஃ ப்ரதிஸாரணாதநந்தரஂ ஸந்தாநார்தஂ க்ஷௌத்ரகததாநம்| கேசித் ‘ஸம்யக்பந்தமதாசரேத்’ இத்யத்ர ‘பந்தேநோக்தேந யோஜயேத்’ இதி படந்தி| ஸம்யக்ஶப்தேந ஶிதிலதா பந்தஸ்ய க்யாப்யதே||௩-௪||

Meaning of the commentary

The commentary explains that a mature bisagranthi is first fomented. Once softened, its openings are incised in a manner that leaves no asaya, understood here as a residual recess or pocket. Saindhava mixed with the listed substances is then used for pratisarana. It identifies pushpa as pushpanjana and Nepali as manahshila. Honey and ghee are subsequently applied for sandhana, or bringing the tissues together. An alternative reading has 'it should be treated with the prescribed bandage' in place of 'an appropriate bandage should then be applied.' The word samyak is explained as indicating that the bandage should be loose rather than tight.

Key terms

बिसग्रन्थि (bisagranthi): The lesion being treated by fomentation and opening in this passage.
निराशयम् (nirasayam): So that no residual recess or pocket remains after opening.
प्रतिसारण (pratisarana): Local application or rubbing of the prescribed substances onto the opened lesion.
नेपालि (Nepali): Identified by the commentary as manahshila, a hazardous mineral substance.
सन्धान (sandhana): Bringing the treated tissues or wound surfaces together.

Adhikarana ௩ (௫) · Śloka ௬

ரோசநாக்ஷாரதுத்தாநி பிப்பல்யஃ க்ஷௌத்ரமேவ ச | ப்ரதிஸாரணமேகைகஂ பிந்நே லகண இஷ்யதே ||௫|| மஹத்யபி ச யுஞ்ஜீத க்ஷாராக்நீ விதிகோவிதஃ |௬|

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रोचनाक्षारतुत्थानि पिप्पल्यः क्षौद्रमेव च | प्रतिसारणमेकैकं भिन्ने लगण इष्यते ||५|| महत्यपि च युञ्जीत क्षाराग्नी विधिकोविदः |६|

Meaning of the śloka

For a lagaṇa that has been opened, the source recommends each of the following separately as a pratisarana: rochana, kshara, tuttha, pippali or honey. In a large lagaṇa, a practitioner knowledgeable in the prescribed method is also directed to employ kshara and agni.

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லகணஸ்ய சிகித்ஸாமாஹ- ரோசநேத்யாதி| ரோசநா கோரோசநா, க்ஷாரோ யவக்ஷாரஃ| ஏதாநி ப்ரதிஸாரணாந்யல்பே லகணே பிந்நே ஸதி யோஜ்யாநி| ஏகைகமிதி வசநேந கோரோசநாதிபிரேகைகஶஃ ப்ரதிஸாரணஂ விதேயமித்யர்தஃ| அல்பலகணசிகித்ஸாமபிதாய மஹாலகணசிகித்ஸாமாஹ- மஹத்யபி ச யுஞ்ஜீதேத்யாதி| மஹதி குருதரே இதி| யுஞ்ஜீதேதி பிந்நே ஸதி லகணே க்ஷாராக்நீ ப்ரயுஞ்ஜீத; ததநந்தரஂ தத்காலமேவ க்ஷாராக்நிதக்தவ்ரணவச்சிகித்ஸா, பஶ்சாத் ஸாமாந்யவ்ரணவத்| கோவிதஃ பண்டிதஃ||௫||-

Meaning of the commentary

The commentary presents this as treatment for lagaṇa. It identifies rochana as gorochana and kshara as yavakshara. In a small lagaṇa that has been opened, the listed substances are to be used one at a time for pratisarana. It then distinguishes the treatment of a larger or more severe lagaṇa: after opening it, the knowledgeable practitioner is said to employ kshara and agni. Immediately afterward it is managed like a wound produced by kshara or agni, and subsequently like an ordinary wound. Kovida means one who is learned or skilled in the method.

Key terms

लगण (lagana): The eye-region lesion discussed here, classified as small or large in the commentary.
प्रतिसारण (pratisarana): Separate local application of one prescribed substance after the lesion has been opened.
क्षार (kshara): An alkaline or caustic agent, identified here as yavakshara in the list and also prescribed procedurally for a large lesion.
अग्नि (agni): Thermal cautery in the procedural context of treating a large lagaṇa.
तुत्थ (tuttha): A mineral substance listed for local application in the historical formulation.

Adhikarana ௪ (௬) · Śloka ௭

ஸ்விந்நாஂ பிந்நாஂ விநிஷ்பீட்ய பிஷகஞ்ஜநநாமிகாம் ||௬|| ஶிலைலாநதஸிந்தூத்தைஃ ஸக்ஷௌத்ரைஃ ப்ரதிஸாரயேத் |௭|

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स्विन्नां भिन्नां विनिष्पीड्य भिषगञ्जननामिकाम् ||६|| शिलैलानतसिन्धूत्थैः सक्षौद्रैः प्रतिसारयेत् |७|

Meaning of the śloka

After the añjananāmikā has been fomented and has opened, the physician should express it and then rub it with a preparation of manaḥśilā, elā, nata, and saindhava mixed with honey.

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ஸ்வயஂ பிந்நாயா அஞ்ஜநநாமிகாயாஶ்சிகித்ஸாமாஹ- ஸ்விந்நாமித்யாதி| பிந்நாஂ ஸ்வயம்பிந்நாம்| விநிஷ்பீட்யேதி ஸ்நேஹஸ்வேதபூர்வகஂ நிஷ்பீடநஂ கத்வா, ஶிலா மநஃஶிலா, ஏலா ஸூக்ஷ்மைலா, நதஂ தகரஂ, ஸிந்தூத்தஂ ஸைந்தவம்| ப்ரதிஸாரயேத் கர்ஷயேத்||௬||-

Meaning of the commentary

The commentator presents the treatment of an añjananāmikā that has opened by itself. The lesion is to be expressed after prior oleation and fomentation. He identifies śilā as manaḥśilā, elā as the small variety of cardamom, nata as tagara, and sindhūttha as saindhava, and explains pratisārayet as rubbing the preparation over the site.

Key terms

अञ्जननामिका (añjananāmikā): The eye or eyelid disorder being treated; the passage does not establish a modern diagnostic equivalent.
विनिष्पीड्य (viniṣpīḍya): Having expressed or pressed out the contents after the preparatory measures described by the commentator.
मनःशिला (manaḥśilā): The mineral substance identified by the commentary for śilā in the historical preparation.
नत (nata): An ingredient identified by the commentator as tagara.
प्रतिसारण (pratisāraṇa): Rubbing or applying a medicinal preparation over the treated site.

Adhikarana ௫ (௭) · Śloka ௮

ரஸாஞ்ஜநமதுப்யாஂ து பித்த்வா வா ஶஸ்த்ரகர்மவித் ||௭|| ப்ரதிஸார்யாஞ்ஜநைர்யுஞ்ஜ்யாதுஷ்ணைர்தீபஶிகோத்பவைஃ |௮|

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रसाञ्जनमधुभ्यां तु भित्त्वा वा शस्त्रकर्मवित् ||७|| प्रतिसार्याञ्जनैर्युञ्ज्यादुष्णैर्दीपशिखोद्भवैः |८|

Meaning of the śloka

Alternatively, a practitioner skilled in surgical procedures should open it, rub the site with rasāñjana and honey, and then apply the warm añjanas produced from a lamp flame.

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அபிந்நாஞ்ஜநநாமிகாசிகித்ஸாமாஹ- ரஸாஞ்ஜநேத்யாதி| ஸ்வயமபிந்நாமஞ்ஜநநாமிகாஂ பூர்வஂ ஸ்விந்நாஂ ஶஸ்த்ரகர்மவித்பித்த்வா ரஸாஞ்ஜநமதுப்யாஂ ப்ரதிஸார்ய ததுத்தரகாலஂ தீபஶிகோத்பவைஃ கஜ்ஜலாக்யைரஞ்ஜநைர்யோஜயேதிதி பிண்டார்தஃ||௭||-

Meaning of the commentary

The commentator explains the treatment of an añjananāmikā that has not opened by itself. After it has first been fomented, a practitioner skilled in surgery opens it, applies rasāñjana with honey by rubbing, and afterward uses the lamp-flame products called kajjala as añjana. This is given as the overall sense of the passage.

Key terms

अभिन्नाञ्जननामिका (abhinnāñjananāmikā): An añjananāmikā that has not opened spontaneously.
शस्त्रकर्मवित् (śastrakarmavit): A practitioner knowledgeable in operative procedures.
रसाञ्जन (rasāñjana): A substance named for the historical topical preparation; its exact material identification should be professionally verified.
दीपशिखोद्भव (dīpaśikhodbhava): Produced from a lamp flame, explained by the commentator as kajjala.
अञ्जन (añjana): A preparation intended for application to the eye in the source's historical treatment context.

Adhikarana ௬ (௮) · Śloka ௯

ஸம்யக்ஸ்விந்நே கமிக்ரந்தௌ பிந்நே ஸ்யாத் ப்ரதிஸாரணம் ||௮|| த்ரிபலாதுத்தகாஸீஸஸைந்தவைஶ்ச ரஸக்ரியா |௯|

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सम्यक्स्विन्ने कृमिग्रन्थौ भिन्ने स्यात् प्रतिसारणम् ||८|| त्रिफलातुत्थकासीससैन्धवैश्च रसक्रिया |९|

Meaning of the śloka

When the kṛmigranthi has been properly fomented and opened, pratisāraṇa is to be performed. A concentrated preparation is then made with triphalā, tuttha, kāsīsa, and saindhava.

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க்ரிமிக்ரந்திசிகித்ஸாமாஹ- ஸம்யகித்யாதி| ஸம்யக்ஸ்விந்நே இதி லோசநோசிதஸ்வேதஸ்விந்நே, அநந்தரஂ பேதிதே ப்ரதிஸாரணமிதி; அநுக்தமப்யஞ்ஜநநாமிகோத்திஷ்டமஞ்ஜநமதுப்யாஂ ப்ரதிஸாரணஂ, ததநந்தரஂ த்ரிபலாக்வாதேந துத்தகாஸீஸஸைந்தவாவாபேந ரஸக்ரியா||௮||-

Meaning of the commentary

The commentator introduces the treatment of kṛmigranthi. Proper fomentation means fomentation suited to the eye, followed by opening and then pratisāraṇa. Although the verse does not state its ingredients here, he carries forward the rasāñjana-and-honey pratisāraṇa prescribed for añjananāmikā. After that, a rasakriyā is prepared from a decoction of triphalā with tuttha, kāsīsa, and saindhava added.

Key terms

कृमिग्रन्थि (kṛmigranthi): The named eye or eyelid disorder addressed in this passage; no modern diagnostic equivalence is established here.
सम्यक्स्विन्न (samyaksvinna): Properly fomented, which the commentary specifies as fomentation appropriate for the eye.
प्रतिसारण (pratisāraṇa): Rubbing or topical application after the lesion has been opened.
त्रिफला (triphalā): The three-fruit formulation used here as a decoction base.
रसक्रिया (rasakriyā): A concentrated medicinal preparation made here from the stated decoction and added substances.

Adhikarana ௭ (௯) · Śloka ௧௦

பித்த்வோபநாஹஂ கபஜஂ பிப்பலீமதுஸைந்தவைஃ ||௯|| லேகயேந்மண்டலாக்ரேண ஸமந்தாத் ப்ரச்சயேதபி |௧௦|

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भित्त्वोपनाहं कफजं पिप्पलीमधुसैन्धवैः ||९|| लेखयेन्मण्डलाग्रेण समन्तात् प्रच्छयेदपि |१०|

Meaning of the śloka

After opening a kaphaja upanāha, it should be treated with pippalī, honey, and saindhava. It may be scraped all around with a maṇḍalāgra instrument and may also be scarified.

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ஶ்லேஷ்மோபநாஹசிகித்ஸாமாஹ- பித்த்வேத்யாதி| ஶ்லேஷ்மோபநாஹோ பேத்யஃ, மஹாந்நீருஜஶ்ச லேக்யஃ, ரக்தாநுபந்தஶ்ச ப்ரச்சநீயஃ; ஶ்லேஷ்மோபநாஹே பிந்நே லிகிதே ப்ரச்சிதேऽபி ச பிப்பல்யாதிபிரேகமேவ ப்ரதிஸாரணம்||௯||-

Meaning of the commentary

The commentator explains the treatment of śleṣmopanāha. It is to be opened; when it is large and painless, scraping is indicated; and when blood is involved, scarification is indicated. Whether it has been opened, scraped, or scarified, the same local application made with pippalī and the other stated substances is used.

Key terms

कफज उपनाह (kaphaja upanāha): An upanāha condition attributed here to kapha.
पिप्पलीमधुसैन्धव (pippalī-madhu-saindhava): Pippalī, honey, and saindhava, named for the local application.
मण्डलाग्र (maṇḍalāgra): The instrument specified for scraping around the lesion.
लेखन (lekhana): Scraping, associated by the commentary with a large, painless lesion.
प्रच्छन (pracchana): Scarification, associated by the commentary with involvement of blood.

Adhikarana ௮ (௧௦-௧௧) · Śloka ௧௧

ஸஂஸ்நேஹ்ய பத்ரபங்கைஶ்ச ஸ்வேதயித்வா யதாஸுகம் ||௧௦|| ஆபாகாத்விதிநோக்தேந பஞ்சமேத்யாநுபாசரேத் | ஸர்வேஷ்வேதேஷு விஹிதஂ விதாநஂ ஸ்நேஹபூர்வகம் | ஸம்பக்வே ப்ரயதோ பூத்வா குர்வீத வ்ரணரோபணம் ||௧௧||

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संस्नेह्य पत्रभङ्गैश्च स्वेदयित्वा यथासुखम् ||१०|| आपाकाद्विधिनोक्तेन पञ्चमेद्यानुपाचरेत् | सर्वेष्वेतेषु विहितं विधानं स्नेहपूर्वकम् | सम्पक्वे प्रयतो भूत्वा कुर्वीत व्रणरोपणम् ||११||

Meaning of the śloka

The five conditions designated for opening should, before suppuration, be managed by first applying unctuous treatment and then giving comfortable fomentation with pieces of leaves, according to the prescribed method. In all these conditions, the prescribed regimen begins with unctuous treatment. Once the lesion is fully matured, the practitioner should act carefully and undertake healing of the wound.

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ஏஷாஂ பஞ்சாநாமபி மேத்யாநாஂ பிஸக்ரந்த்யாதீநாமாமாநாமாதௌ ஸஂஶமநஂ நிர்திஶந்நாஹ- ஸஂஸ்நேஹ்யேத்யாதி| பத்ரபங்கைஃ பத்ரகண்டைஃ; அந்யே பத்ரபங்கஶப்தேந பல்லவமாஹுஃ| விதிநா அபதர்பணாதிநா ஸாமாந்யஶோதப்ரதீகாரேண| ஸ்நேஹபூர்வகஂ விதாநமிதி ஸ்நேஹஸ்வேதரக்தாஸ்ராவவிரேசநாதி, நயநபுத்புதஜாந்யத்ர வமநஂ ச||௧௦-௧௧||

Meaning of the commentary

The commentator says that this passage first prescribes pacifying treatment for the five conditions designated for opening, beginning with bisagranthi, while they are still immature. Patrabhaṅga is explained by some as pieces of leaves, while others understand it as tender shoots. The prescribed method refers to general measures for swelling, beginning with apatarpaṇa. The regimen preceded by sneha includes oleation, fomentation, bloodletting, purgation, and related measures; vomiting is also mentioned, with an exception connected to nayanabudbuda. The precise syntax and scope of that exception require textual review.

Key terms

पञ्च मेद्य (pañca medya): The five conditions identified as requiring opening or incision.
पत्रभङ्ग (patrabhaṅga): Explained alternatively as pieces of leaves or as tender shoots used with fomentation.
आपाक (āpāka): The stage before suppuration or full maturation of the lesion.
अपतर्पण (apatarpaṇa): A reducing or non-nourishing measure cited as the beginning of general treatment for swelling.
व्रणरोपण (vraṇaropaṇa): Measures intended to promote healing of the wound after the lesion has matured.

Adhikarana புஷ்பிகா · Śloka ௧௪

இதி ஸுஶ்ருதஸஂஹிதாயாமுத்தரதந்த்ராந்தர்கதே ஶாலாக்யதந்த்ரே பேத்யரோகப்ரதிஷேதோ நாம சதுர்தஶோऽத்யாயஃ ||௧௪||

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इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे भेद्यरोगप्रतिषेधो नाम चतुर्दशोऽध्यायः ||१४||

Meaning of the śloka

Thus ends the fourteenth chapter, named ‘Prevention and Treatment of Diseases Requiring Opening,’ in the Śālākya section of the Uttaratantra of the Suśruta Saṃhitā.

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இதி ஶ்ரீடல்ஹ(ஹ்ல)ணவிரசிதாயாஂ நிபந்தஸங்க்ரஹாக்யாயாஂ ஸுஶ்ருதவ்யாக்யாயாமுத்தரதந்த்ராந்தர்கதே ஶாலாக்யதந்த்ரே சதுர்தஶோऽத்யாயஃ||௧௪||

Meaning of the commentary

Thus ends the fourteenth chapter of the Śālākya section within the Uttaratantra in Śrī Dalhaṇa’s commentary on the Suśruta Saṃhitā entitled Nibandhasaṅgraha. The supplied source preserves the commentator’s name in the variant-looking form Dalha(hla)ṇa.

Key terms

भेद्यरोगप्रतिषेध (bhedyaroga-pratiṣedha): The chapter title, concerning the prevention and treatment of disorders designated for opening.
भेदन (bhedana): Opening or incision, the procedure defining the class of disorders named in the chapter title.
शालाक्यतन्त्र (śālākyatantra): The textual or clinical section under which the chapter is placed.
उत्तरतन्ट्र (uttaratantra): The division of the Suśruta Saṃhitā containing this chapter.
निबन्धसङ्ग्रह (Nibandhasaṅgraha): The title of Dalhaṇa’s commentary.

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