३८. योनिव्यापत्प्रतिषेधाध्यायः

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Adhikarana १ (१-२) · Śloka २

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

Meaning of the śloka

Now we shall explain the chapter on the prevention and treatment of disorders of the yoni. Thus spoke the venerable Dhanvantari.

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ग्रहोत्पत्त्यध्यायानन्तरं ‘तिर्यग्योनिं मानुषं च’ इति वचनेन योनेर्नामसङ्कीर्तनात् कुमारजन्मविकारकारणत्वाच्च योनेर्व्यापच्चिकित्सितार्थं योनिव्यापत्प्रतिषेधाध्यायारम्भो युज्यत इत्याह- अथात इत्यादि| योनिव्यापदो योनिरोगाः, तेषां प्रतिषेधश्चिकित्सितमिति||१-२||

Meaning of the commentary

After the chapter on the origin of the grahas, the text begins this chapter because the yoni was mentioned in the expression concerning animal and human birth, and because disorders of the yoni can affect the birth of a child. Yonivyapad here means disorders of the yoni, and pratishedha means their treatment.

Key terms

yonivyapat (yonivyāpad): A disorder affecting the yoni in the classical classification.
pratiShedha (pratiṣedha): Prevention or treatment; the commentary specifies treatment here.
yoni: The female reproductive tract or generative passage in this context.

Adhikarana २ (३) · Śloka ४

प्रवृद्धलिङ्गं पुरुषं याऽत्यर्थमुपसेवते | रूक्षदुर्बलबाला या तस्या वायुः प्रकुप्यति ||३|| स दुष्टो योनिमासाद्य योनिरोगाय कल्पते |४|

Meaning of the śloka

When a young woman who is dry and weak engages excessively in intercourse with a man whose genital organ is greatly enlarged, vāyu becomes aggravated in her. That disturbed vāyu reaches the yoni and becomes capable of producing a disorder there.

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प्रवृद्धेत्यादि| रूक्षदुर्बलबाला या स्त्री प्रवृद्धलिङ्गमतिप्रलम्बमेहनं पुरुषमतिशयेन सेवते| तस्या वायुः प्रकोपमापद्यते, स वायुः प्रकुपितः सन् पित्तश्लेष्माणौ कोपयति, अथवा वातः पित्तश्लेष्माणौ स्वहेतुभिः कुपितौ गृहीत्वा योनिरोगाय कल्पते समर्थो भवति||३||-

Meaning of the commentary

The commentary explains pravṛddhaliṅga as an excessively long male organ and understands the intercourse as excessive. In a young woman who is dry and weak, vāyu thereby becomes aggravated. Once aggravated, it may provoke pitta and śleṣman; alternatively, vāta may join pitta and śleṣman that have already been aggravated by their own causes, and in this way contribute to a disorder of the yoni.

Key terms

pravRuddhali~gga (pravṛddhaliṅga): A greatly enlarged or excessively elongated male genital organ in the source description.
rUkShadurbalabAlA (rūkṣa-durbala-bālā): A young woman described as dry and physically weak.
vAyuH (vāyuḥ): Vāyu or vāta, described as becoming aggravated.

Adhikarana ३ (४-५) · Śloka ६

त्रयाणामपि दोषाणां यथास्वं लक्षणेन तु ||४|| विंशतिर्व्यापदो योनेर्निर्दिष्टा रोगसङ्ग्रहे | मिथ्याचारेण याः स्त्रीणां प्रदुष्टेनार्तवेन च ||५|| जायन्ते बीजदोषाच्च दैवाच्च शृणु ताः पृथक् |६|

Meaning of the śloka

The disorders are to be recognized through the respective signs of each of the three doṣas. Twenty disorders of the yoni were listed in the compendium of diseases. They may arise in women from improper conduct, from disturbed ārtava, from a defect of bīja, or from daiva; hear them explained separately.

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तेषां योनिरोगाणां सामान्यज्ञानोपायमाह- त्रयाणामित्यादि| यथास्वं लक्षणेन योनिरोगं जानीयादित्यर्थः||४-५||-

Meaning of the commentary

The commentary presents a general method for recognizing these disorders: each yoniroga should be identified by the characteristic signs of the doṣa associated with it.

Key terms

doSha (doṣa): One of the three classical regulatory factors whose characteristic signs are used for classification.
Artava (ārtava): Female reproductive or menstrual material in this context.
bIjadoSha (bījadoṣa): A defect or disturbance of the reproductive seed in the classical account.
daiva: A causative category attributed to fate or forces beyond ordinary human action.

Adhikarana ४ (६-८) · Śloka ९

उदावर्ता तथा वन्ध्या विप्लुता च परिप्लुता ||६|| वातला चेति वातोत्थाः, पित्तोत्था रुधिरक्षरा | वामिनी स्रंसिनी चापि पुत्रघ्नी पित्तला च या ||७|| अत्यानन्दा च या योनिः कर्णिनी चरणाद्वयम् | श्लेष्मला च कफाज्ज्ञेया, षण्डाख्या फलिनी तथा ||८|| महती सूचिवक्त्रा च सर्वजेति त्रिदोषजा |९|

Meaning of the śloka

The disorders said to arise from vāta are Udāvartā, Vandhyā, Viplutā, Pariplutā, and Vātalā. Those attributed to pitta are Rudhirakṣarā, Vāminī, Sraṃsinī, Putraghnī, and Pittalā. Those attributed to kapha are Atyānandā, Karṇinī, the two Caraṇā disorders, and Śleṣmalā. Those called Ṣaṇḍā, Phalinī, Mahatī, Sūcivaktrā, and Sarvajā are attributed to all three doṣas.

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वातजाः पञ्च योनिव्यापद आह- उदावर्तेत्यादि| उदावर्ता, वन्ध्या, विप्लुता, परिप्लुता, वातला, इति पञ्च वातोत्थाः| पित्तजाः पञ्चाह- रुधिरक्षरा, वामिनी, स्रंसिनी, पुत्रघ्नी, पित्तला, इति पञ्च पित्तोत्थाः| कफजाः पञ्चोच्यन्ते- अत्यानन्दा, कर्णिनी, चरणाद्वयं, श्लेष्मला, इति पञ्च कफोत्थाः| सन्निपातजाः पञ्चोच्यन्ते- षण्डी, फलिनी, महती, सूचिवक्त्रा, सर्वजा, इति पञ्च सन्निपातजाः||६-८||-

Meaning of the commentary

The commentary arranges the twenty yonivyāpads into four groups of five. Udāvartā through Vātalā are vāta-origin disorders; Rudhirakṣarā through Pittalā are pitta-origin disorders; Atyānandā, Karṇinī, the two Caraṇā forms, and Śleṣmalā are kapha-origin disorders; and Ṣaṇḍī, Phalinī, Mahatī, Sūcivaktrā, and Sarvajā are sannipāta disorders involving all three doṣas.

Key terms

vAtotthAH (vātotthāḥ): Classified as arising from vāta.
pittotthA (pittotthā): Classified as arising from pitta.
kaphAt (kaphāt): Classified as arising from kapha.
tridoShajA (tridoṣajā): Classified as involving all three doṣas.

Adhikarana ५ (९-११) · Śloka ११

सफेनिलमुदावर्ता रजः कृच्छ्रेण मुञ्चति ||९|| वन्ध्यां नष्टार्तवां विद्याद्विप्लुतां नित्यवेदनाम् | परिप्लुतायां भवति ग्राम्यधर्मे रुजा भृशम् ||१०|| वातला कर्कशा स्तब्धा शूलनिस्तोदपीडिता | चतसृष्वपि चाद्यासु भवन्त्यनिलवेदनाः ||११||

Meaning of the śloka

In Udāvartā, menstruation is discharged with difficulty and is frothy. Vandhyā is marked by loss of menstruation. Viplutā has constant pain, while Pariplutā causes severe pain during sexual intercourse. Vātalā is rough, rigid, and afflicted by colicky and needle-pricking pain. Signs of aggravated anila also occur in the first four disorders.

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वातजानां योनिव्यापदां पृथग्लक्षणमाह- सफेनिलमित्यादि| या उदावर्ता योनिः सा फेनिलं फेनसहितं रज आर्तवं कृच्छ्रेण दुःखेन मुञ्चति| विप्लुता नित्यं रुजावती, परिप्लुता पुनर्व्यवाय एव पीडावतीत्यनयोर्भेदः| वातलेत्यादि| स्तब्धा तनटितेव| शूलं वातशूलं, निस्तोदः सूचीभिरिव व्यधनम्| किं वातलायामेवानिलवेदना भवन्ति उतान्यास्वपीत्याह- चतसृष्वित्यादि| आद्यासु उदावर्तादिष्वपीत्यर्थः||९-११||

Meaning of the commentary

The commentary explains that Udāvartā releases frothy menstrual flow painfully or with difficulty. It distinguishes Viplutā, in which pain is constant, from Pariplutā, in which pain specifically occurs during intercourse. In Vātalā, stabdhā means rigid or tense; śūla is pain attributed to vāta, and nistoda is a sensation like being pierced by needles. The final statement clarifies that vāta-type pains occur not only in Vātalā but also in the preceding four disorders beginning with Udāvartā.

Key terms

rajaH (rajas): Menstrual discharge in this passage.
udAvartA (udāvartā): A classical yonivyāpad characterized here by difficult, frothy menstrual discharge.
shUla (śūla): Colicky or severe pain, attributed here to vāta.
nistoda: A pricking pain compared with needle piercing.

Adhikarana ६ (१२-१४) · Śloka १४

सदाहं प्रक्षरत्यस्रं यस्यां सा लोहितक्षरा | सवातमुद्गिरेद्बीजं वामिनी रजसा युतम् ||१२|| प्रस्रंसिनी स्यन्दते तु क्षोभिता दुःप्रसूश्च या | स्थितं स्थितं हन्ति गर्भं पुत्रघ्नी रक्तसंस्रवात् ||१३|| अत्यर्थं पित्तला योनिर्दाहपाकज्वरान्विता | चतसृष्वपि चाद्यासु पित्तलिङ्गोच्छ्रयो भवेत् ||१४||

Meaning of the śloka

The condition in which blood or menstrual flow is discharged with burning is called Lohitakṣarā. In Vāminī, bīja is expelled together with vāta and mixed with menstrual blood. Prasraṃsinī discharges when disturbed and is associated with difficult childbirth. Putraghnī repeatedly destroys an established pregnancy through bleeding. Pittalā is intensely affected by burning, suppuration, and fever. Prominent signs of pitta also occur in the first four disorders.

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सदाहमित्यादि| अस्रम् आर्तवं, ‘सदाहं क्षीयते रक्तं यस्यां सा लोहितक्षया’ इति केचित् पठन्ति| बीजं शुक्रम्| उद्गिरेत् वमेत्| रजसा युतम् आर्तवमिश्रम्| स्यन्दते स्रवति, क्षोभिता सञ्चालिता, दुःप्रसूः दुःखेन प्रसूयते या एवंविधा योनिः सा प्रस्रंसिनीति सम्बन्धः| दुःप्रसूश्चेत्यत्रान्ये ‘दुःप्रजायना’ इति पठन्ति, दुष्टीभूतापत्यमार्गेति व्याख्यानयन्ति| स्थितमित्यादि| स्थितं स्थितं गर्भं हन्ति नोत्पन्नमात्रम्| चतसृषु आद्यासु लोहितक्षरादिषु| पित्तलिङ्गोच्छ्रयः ओषचोषादिका वेदनाः||१२-१४||

Meaning of the commentary

The commentary identifies asra here with menstrual blood. It also records an alternative reading: ‘where blood diminishes with burning, that is Lohitakṣayā,’ rather than Lohitakṣarā. Bīja is explained as semen, udgiret as expelling or vomiting out, and rajasā yutam as mixed with menstrual blood. Prasraṃsinī is understood as a condition that discharges when moved or disturbed and in which childbirth is difficult. Another reading has duḥprajāyanā, interpreted as corruption of the passage for offspring. Putraghnī is said to destroy pregnancies after they have become established, rather than immediately at conception. In the first four conditions beginning with Lohitakṣarā, pitta signs such as burning and scorching sensations predominate.

Key terms

lohitakSharA (lohitakṣarā): A classical yonivyāpad marked in the main reading by bleeding or menstrual discharge with burning.
vAminI (vāminī): A classical condition described as expelling bīja mixed with menstrual blood.
prasraMsinI (prasraṃsinī): A classical condition described as discharging when disturbed and as involving difficult childbirth.
putraghnI (putraghnī): A classical category associated in the text with repeated loss of established pregnancies through bleeding.

Adhikarana ७ (१५-१७) · Śloka १७

अत्यानन्दा न सन्तोषं ग्राम्यधर्मेण गच्छति | कर्णिन्यां कर्णिका योनौ श्लेष्मासृग्भ्यं प्रजायते ||१५|| मैथुनेऽचरणा पूर्वं पुरुषादतिरिच्यते | बहुशश्चातिचरणादन्या बीजं न विन्दति ||१६|| श्लेष्मला पिच्छिला योनिः कण्डूयुक्ताऽतिशीतला | चतसृष्वपि चाद्यासु श्लेष्मलिङ्गोच्छ्रितिर्भवेत् ||१७||

Meaning of the śloka

A condition called Atyananda is described as not attaining satisfaction through sexual intercourse. In Karnini, a fleshy projection called karnika develops in the vaginal passage from shleshma and blood. The condition Charani is described as becoming excessively active before the man during intercourse, while Aticharana is said not to obtain bija because of repeated excessive intercourse. A shleshmala vaginal condition is slimy, associated with itching, and very cold. In these first four conditions, signs of aggravated shleshma are prominent.

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अत्यानन्देत्यादि| ग्राम्यधर्मेण मैथुनेन| कर्णिका मांसकन्दी| मैथुनेत्यादि| पूर्वा चरणी अतिरिच्यते मैथुनाचरणेऽधिका भवति; अन्ये ‘मैथुनेऽचरणा पूर्वं’ इति पठन्ति, शेषं समम्| पुरुषात् पूर्वमतिरिच्यते, अत्यर्थं कण्डूयत इत्यर्थः| बहुशो अतिचरणात् मैथुनात्, अन्या अतिचरणा, बीजं गर्भाङ्कुरजननं, न विन्दति न प्राप्नोति| ‘बहुशश्चातिचरणी तयोर्बीजं न तिष्ठति’ इति केचित् पठन्ति, अतिचरणा बहुशो मैथुनं व्रजति, तयोश्चरणातिचरणयोर्बीजं न तिष्ठति, स्थितिं न करोतीत्यर्थः| श्लेष्मलेत्यादि| आद्यासु अत्यानन्दादिषु श्लेष्मलिङ्गोच्छ्रितिः पैच्छिल्यकण्ड्वादिकाः||१५-१७||

Meaning of the commentary

The commentary glosses gramya-dharma as sexual intercourse and karnika as a fleshy, tuber-like projection. For Charani, it explains that the woman becomes excessive or especially active during intercourse. It preserves another reading, 'maithune 'charana purvam,' and interprets the phrase as becoming excessive before the man, with intense itching also indicated. For Aticharana, repeated or excessive intercourse is said to prevent bija, understood as the generative seed or beginning of an embryo, from being obtained. Another transmitted reading says that in Charani and Aticharani the bija does not remain or become established. In Atyananda and the other conditions just listed, the prominent shleshma signs include sliminess and itching.

Key terms

atyAnandA (atyananda): The named condition described as lack of satisfaction through intercourse.
karNikA (karnika): A fleshy projection described in the vaginal passage.
caraNI (charani): A named condition associated in the commentary with excessive activity during intercourse.
aticaraNA (aticharana): A named condition linked by the text with repeated excessive intercourse and failure of bija to remain.
bIja (bija): The generative seed, explained here as the beginning that gives rise to an embryo.
shleShmali~gga (shleshma-linga): Signs attributed to shleshma, such as sliminess and itching in this context.

Adhikarana ८ (१८-२०) · Śloka २०

अनार्तवस्तना षण्डी खरस्पर्शा च मैथुने | अतिकायगृहीतायास्तरुण्याः फलिनी भवेत् ||१८|| विवृताऽतिमहायोनिः सूचीवक्त्राऽतिसंवृता | सर्वलिङ्गसमुत्थाना सर्वदोषप्रकोपजा ||१९|| चतसृष्वपि चाद्यासु सर्वलिङ्गोच्छ्रितिर्भवेत् | पञ्चासाध्या भवन्तीमा योनयः सर्वदोषजाः ||२०||

Meaning of the śloka

Shandi is described as lacking menstruation and breasts and as having a rough sensation during intercourse. A young woman subjected to intercourse with a man of excessively large bodily proportions is said to develop the condition called Phalini. Vivrita is a vaginal passage that is excessively wide, while Suchivaktra is excessively constricted like the eye of a needle. Sarvaja arises from aggravation of all the doshas and displays all their signs. In the first four of these conditions, the full range of doshic signs may become prominent. These five vaginal disorders arising from all the doshas are stated to be incurable.

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सान्निपातिकाः पञ्चोच्यन्ते| वन्ध्याषण्ड्योः सस्तनत्वनिस्तनत्वे विशेषतः| स्वरस्पर्शा चेति चकारान्मैथुनद्वेषनिषेधः| अतिकायो बृहत्साधनो नरस्तेन गृहीताया फलिनीति सञ्ज्ञा, ‘अफलिनी’ इत्यन्ये पठन्ति, तत्र अतिकायगृहीता या तरुणी सा अफलिनी अप्रजा इति व्याख्या| अतिविवृता महायोनिरुच्यते| सूचीवक्त्रा अतिसंवृता अत्यर्थसङ्कुचितमुखी, सङ्कुचितमुखेत्युच्यते| सर्वलिङ्गा सर्वचिह्ना, सर्वसमुत्थाना सर्वकारणा, या सा सर्वजा कथ्यते| चतसृष्वित्यादि| चतसृष्वपि चाद्यासु षण्डीप्रभृतिषु; सर्वलिङ्गोच्छ्रितिरिति रौक्ष्यतोदादिका वातलिङ्गोच्छ्रितयः, चोषादिकाः पित्तलिङ्गोच्छ्रितयः, स्नेहकण्ड्वादिकाः श्लेष्मलिङ्गोच्छ्रितयश्च||१८-२०||

Meaning of the commentary

The commentary introduces five sannipatika conditions. It says that the distinction between Vandhya and Shandi particularly concerns the presence or absence of breasts. The transmitted phrase about roughness also implies aversion to intercourse. Phalini is named in relation to a young woman having intercourse with a man described as having an excessively large sexual organ. Another reading has aphalini; under that reading, the woman is explained as childless. An excessively open passage is called Mahayoni or Vivrita. Suchivaktra is extremely closed or has a markedly constricted opening. Sarvaja has every sign and arises from every stated cause. In Shandi and the other first four conditions, signs attributed to all three doshas are prominent: dryness and piercing pain from vata, burning and related signs from pitta, and unctuousness, itching, and related signs from shleshma.

Key terms

ShaNDI (shandi): A historical named condition described here by absent menstruation and breast development.
phalinI (phalini): A named condition for which the commentary also preserves the reading aphalini.
vivRutA (vivrita): A condition described as an excessively wide vaginal passage.
sUcIvaktrA (suchivaktra): A condition described as having an extremely constricted opening.
sarvadoShaprakopajA (sarva-dosha-prakopaja): Arising, in the source's framework, from aggravation of all the doshas.
asAdhyA (asadhya): Classified by the source as not amenable to treatment.

Adhikarana ९ (२१) · Śloka २१

प्रतिदोषं तु साध्यासु स्नेहादिक्रम इष्यते | दद्यादुत्तरबस्तींश्च विशेषेण यथोदितान् ||२१||

Meaning of the śloka

For the vaginal disorders considered treatable, a sequence beginning with oleation is recommended according to the particular dosha. The specifically indicated forms of uttara-basti are also to be administered according to the stated distinctions.

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प्रतीत्यादि| साध्यासु योनिव्यापत्सु प्रतिदोषं यः स्नेहादिक्रमः स इष्यत इत्यर्थः| एतेन यस्य दोषस्य यः प्रत्यनीकः स्नेहस्तेन स्नेहेन संस्नेह्य संस्वेद्य ततो वमनादीन् साध्यास्ववचारयेदित्यर्थः| यथोदितानिति वातादिभेदेनेत्यर्थः||२१||

Meaning of the commentary

The commentary explains that, in treatable yonivyapad conditions, the therapeutic sequence beginning with sneha is selected in opposition to the particular dosha involved. The person is first oleated with the appropriate sneha and then subjected to fomentation, after which procedures beginning with vamana are employed in treatable cases. 'As stated' means that uttara-basti is differentiated according to vata and the other doshas.

Key terms

yonivyApatsu (yonivyapatsu): In the vaginal or reproductive disorders classified in this chapter.
pratidoShaM (prati-dosham): According to, and therapeutically opposed to, the particular dosha.
snehAdikrama (snehadi-krama): A therapeutic sequence beginning with oleation.
uttarabasti (uttara-basti): A classical internal administration procedure prescribed here in dosha-specific forms.

Adhikarana १० (२२-२३) · Śloka २४

कर्कशां शीतलां स्तब्धामल्पस्पर्शां च मैथुने | कुम्भीस्वेदैरुपचरेत् सानूपौदकसंयुतैः ||२२|| मधुरौषधसंयुक्तान् वेशवारांश्च योनिषु | निक्षिपेद्धारयेच्चापि पिचुतैलमतन्द्रितः ||२३|| धावनानि च पथ्यानि कुर्वीतापूरणानि च |२४|

Meaning of the śloka

For a vaginal condition described as rough, cold, rigid, and having diminished sensation during intercourse, the text prescribes localized kumbhi-sveda using materials associated with marsh-dwelling and aquatic animals. Preparations called veshavara mixed with sweet-class medicines are to be placed in the vaginal passage, and medicated oil is to be retained there on a cotton pledget with sustained attention. Suitable washes and filling applications are also to be used.

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कर्कशामित्यादि| अल्पस्पर्शामिति अतिव्यवायक्रुद्धवातजनितसुप्तित्वात्| ‘शीतलां’ इत्यत्रान्ये तु ‘तुमुलाम्’ इति पठन्ति, तत्र शूलतोदवेदनासङ्कुलामिति व्याख्या| कुम्भीस्वेदैः आनूपौदकमांसवातघ्नद्रव्यक्वाथपूर्णां कुम्भीं कृत्वा भूमौ निखन्य तदुपरि शय्यां संस्थाप्याग्निसन्तप्तलौहपाषाणगुडकान् क्वाथे निक्षिप्य तदुत्थितैर्बाष्पस्वेदैर्योनिप्रदेशमात्रगामिभिरुपचरेत्; अन्ये तु कुम्भीं वातहरद्रव्यानूपौदकमांसपूर्णां सजलां कृत्वा प्रवृत्तोष्माणं गृह्णीयादिति व्याख्यानयन्ति| उपनाहविशेषमाह- मधुरेत्यादि| मधुराणि काकोल्यादीनि कल्कीकृतानि, तैर्युक्तान् वेशवारान् कृतान्नवर्गोक्तान् योनिषु निक्षिपेत्, पिचुतैलं पिचुना तुलकेन तैलं वातघ्नद्रव्यक्वाथसिद्धं योनिषु धारयेत्| अतन्द्रितो निरन्तरकारीत्यर्थः | पिचुतैलं बलाशृतमित्यन्ये| धावनानि प्रक्षालनानि| पथ्यानि वातहरौषधसिद्धानीत्यर्थः||२२-२३||-

Meaning of the commentary

The commentary attributes diminished sensation to numbness produced by vata aggravated through excessive intercourse. It preserves the alternative reading tumula in place of shitala; under that reading, the condition is interpreted as being filled with colicky and piercing pain. One explanation of kumbhi-sveda describes a buried pot containing a decoction of vata-reducing substances and meat from marsh-dwelling and aquatic animals, over which a bed is arranged; heated iron or stone balls are placed in the liquid so that the rising steam reaches only the vaginal region. Another explanation describes taking the heat from a water-filled pot containing the same general class of substances. The next measure is explained as a particular poultice: sweet-class drugs such as Kakoli are made into a paste and combined with veshavara before vaginal placement. A cotton pledget carries oil prepared with a decoction of vata-reducing drugs; another opinion identifies the oil as one prepared with Bala. The treatment is described as continuous. Dhavana means washing, and the suitable washes are those prepared with vata-reducing medicines.

Key terms

alpasparshA (alpa-sparsha): Diminished sensation, explained by the commentary as numbness.
kumbhIsveda (kumbhi-sveda): A localized steam-fomentation procedure involving a pot, described in two interpretations.
veshavAra (veshavara): A prepared food-based formulation used here as a carrier for medicinal pastes.
picutaila (pichu-taila): Medicated oil retained on a cotton pledget.
dhAvanAni (dhavanani): Washing or cleansing applications.
ApUraNAni (apuranani): Filling applications mentioned by the verse.

Adhikarana ११ (२४) · Śloka २४

ओषचोषान्वितासूक्तं कुर्याच्छीतं विधिं भिषक् ||२४||

Meaning of the śloka

For conditions accompanied by heat and burning, the physician should employ the cooling regimen that has been stated.

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शीतं विधिं रक्तपित्तहरम्||२४||

Meaning of the commentary

The commentary explains the cooling regimen as one that alleviates rakta and pitta.

Key terms

oSha (osha): A sensation of heat or burning in this context.
coSha (chosha): Burning or smarting sensation.
shItaM vidhiM (shitam vidhim): The cooling therapeutic regimen referred to by the text.
raktapittaharam (rakta-pitta-haram): Described as alleviating rakta and pitta.

Adhikarana १२ (२५) · Śloka २५

दुर्गन्धां पिच्छिलां चापि चूर्णैः पञ्चकषायजैः | पूरयेद्राजवृक्षादिकषायैश्चापि धावनम् ||२५||

Meaning of the śloka

For a condition described as foul-smelling and slimy, the passage prescribes filling the vaginal passage with powders made from the five astringent plants and washing it with decoctions of the Rājavṛkṣa group.

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दुर्गन्धां पित्तेन, पिच्छिलां कफेन| पञ्च कषाया न्यग्रोधोदुम्बरप्लक्षाश्वत्थगर्दभाण्डाः| तच्चूर्णेन योनिं पूरयेत्| राजवृक्षादिः आरग्वधादिः||२५||

Meaning of the commentary

The commentary associates foul smell with pitta and sliminess with kapha. It identifies the five astringent plants as Nyagrodha, Udumbara, Plakṣa, Aśvattha, and Gardabhāṇḍa, and says their powder is used to fill the vaginal passage. It explains the Rājavṛkṣa group as the Āragvadhādi group.

Key terms

durgandhā: A vaginal condition characterized here by foul smell.
picchilā: A slimy or viscid vaginal condition, associated by the commentary with kapha.
pañcakaṣāya: The five astringent plants enumerated in the commentary.
dhāvana: Washing or irrigation described as a local procedure.

Adhikarana १३ (२६) · Śloka २६

योन्यां तु पूयस्राविण्यां शोधनद्रव्यसम्भृतैः | सगोमूत्रैः सलवणैः शोधनं हितमिष्यते ||२६||

Meaning of the śloka

When there is purulent discharge from the vaginal passage, cleansing is considered beneficial with preparations containing cleansing substances together with cow urine and salt.

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शोधनद्रव्याणि मिश्रकोक्तानि||२६||

Meaning of the commentary

The commentary states that the cleansing substances intended here are those taught in the Miśraka section.

Key terms

pūyasrāviṇī: A condition marked by discharge described as pus-like.
śodhana: Cleansing treatment in the specific local context of this passage.
gomūtra: Cow urine, included in the historical preparation.
lavaṇa: Salt, included with the cleansing substances.

Adhikarana १४ (२७-३०) · Śloka ३०

बृहतीफलकल्कस्य द्विहरिद्रायुतस्य च | कण्डूमतीमल्पस्पर्शां पूरयेद्धूपयेत्तथा ||२७|| वर्तिं प्रदद्यात् कर्णिन्यां शोधनद्रव्यसम्भृताम् | प्रस्रंसिनीं घृताभ्यक्तां क्षीरस्विन्नां प्रवेशयेत् ||२८|| पिधाय वेशवारेण ततो बन्धं समाचरेत् | प्रतिदोषं विदध्याच्च सुरारिष्टासवान् भिषक् ||२९|| प्रातः प्रातर्निषेवेत रसोनादुद्धृतं रसम् | क्षीरमांसरसप्रायमाहारं विदधीत च ||३०||

Meaning of the śloka

For a vaginal condition with itching and diminished sensation, the text directs filling and fumigation with a paste of Bṛhatī fruit combined with the two Haridrās. For the condition called Karṇinī it prescribes a wick containing cleansing substances. For Prasraṃsinī it describes lubrication with ghee, fomentation with milk, repositioning, closure with veśavāra, and bandaging. The physician is then to prescribe measures according to the doṣa, including surā, ariṣṭa, and āsava. The person is advised to take expressed garlic juice each morning and a diet consisting chiefly of milk and meat broth.

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तथाशब्दाद्धूपनमपि बृहतीफलादिभिरेव||२७-३०||

Meaning of the commentary

The commentary explains that the word ‘also’ indicates that fumigation too is to be performed with Bṛhatī fruit and the other substances just mentioned.

Key terms

Bṛhatīphala (bṛhatīphala): Fruit of Bṛhatī used in the paste and, according to the commentary, in fumigation.
dviharidrā: The two substances called Haridrā in the historical formulation.
Karṇinī (karṇinī): A classical category of vaginal disorder for which a medicated wick is described.
Prasraṃsinī (prasraṃsinī): A classical category involving displacement or descent, treated here by a manual local procedure.
veśavāra: A preparation used here to cover or close the area before bandaging; its exact practical form requires expert review.
surāriṣṭāsava: Fermented preparations named as part of doṣa-specific management.

Adhikarana १५ (३१-३२) · Śloka ३२

शुक्रार्तवादयो दोषाः स्तनरोगाश्च कीर्तिताः | क्लैब्यस्थानानि मूढस्य गर्भस्य विधिरेव च ||३१|| गर्भिणीप्रतिरोगेषु चिकित्सा चाप्युदाहृता | सर्वथा तां प्रयुञ्जीत योनिव्यापत्सु बुद्धिमान् | अपप्रजातारोगांश्च चिकित्सेदुत्तराद्भिषक् ||३२||

Meaning of the śloka

Disorders of śukra and ārtava and related conditions, diseases of the breast, the causes of klaibya, and both the causes and management of mūḍhagarbha have already been described. Treatment has also been stated for illnesses occurring during pregnancy. A knowledgeable physician should apply those teachings, as appropriate, to yonivyāpats, and should treat illnesses of a woman who has delivered prematurely by drawing on the later teachings.

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शुक्रेत्यादि| शुक्रार्तवादयो दोषाः शुक्रशोणितशुद्धिशारीरे सलक्षणचिकित्सिता उक्ताः; आदिशब्दाद्धात्रीस्तन्यदोषाश्च| स्तनरोगा विसर्पनाडीस्तनरोगनिदाने, तच्चिकित्सिते तच्चिकित्सा उक्ता| क्लैब्यस्थानानि क्लैब्यकारणानि क्षीणबलीयवाजीकरणोदितानि| मूढगर्भस्येति स्थानानीत्यत्रापि सम्बध्यते, तेन मूढगर्भस्य स्थानानि कारणानि, विधिरेव च क्रिया चेत्यर्थः| एतद्द्वयं मूढगर्भनिदाने तच्चिकित्सिते चोक्तम्| गर्भिणीप्रतिरोगेष्विति गर्भिणीप्रतिरोगेषु गर्भिण्या मासानुमासं प्रतिरोगेषु रक्तस्रावादिषु चिकित्सोक्ता| चिकित्सा चेति चकाराद्गर्भिण्याः स्वस्थाया अपि चिकित्सा उदाहृता गर्भिणीव्याकरणशारीरे| केचित् ‘गर्भिणीप्रतिरोगेषु’ इत्यत्र ‘गर्भिणीप्रतिमासेषु’ इति पठन्ति| तां चिकित्सां योनिव्यापत्स्वपि सर्वथा प्रयुञ्जीतेत्यर्थः| अपप्रजाता अकालप्रसूता, तस्या रोगान् ज्वरादिकान्| तानुत्तरादुत्तरतन्त्रोक्तज्वरादिचिकित्सितात्| रोगांश्चेति चकार उत्तरतन्त्रादित्यत्र योजनीयः| तेनापप्रजातारोगानुत्तरादुत्तरतन्त्रोक्ताच्चिकित्सेत्, चकारादपतानकादीन् संहितोक्तेन विधिना चिकित्सेदित्यर्थः| अन्ये तु ‘उत्तरान्’ इति पठन्ति, उत्तरकालभाविनोऽपतानकादीन् भिषक् चिकित्सेत्, ‘स्वैश्चिकित्सितैः’ इति शेषः||३१-३२||

Meaning of the commentary

The commentary says that disorders of śukra and ārtava, with their features and treatment, were taught in the section on purification of śukra and śoṇita; ‘and related conditions’ also includes defects of a wet nurse’s milk. Breast diseases and their treatment were explained in the relevant diagnostic and treatment sections. The causes of klaibya were taught in the chapter on strengthening and vājīkaraṇa. The word ‘causes’ is also connected with mūḍhagarbha, so both its causes and its procedure or management are intended, as taught in the corresponding diagnostic and treatment chapters. For pregnant women, treatment was taught for month-by-month disorders such as bleeding, and, by the force of ‘also,’ care of the healthy pregnant woman was described in the Garbhiṇīvyākaraṇa section. Some read ‘during each month of pregnancy’ instead of ‘in each disorder of pregnancy.’ These teachings are to be applied as appropriate to yonivyāpats. Apaprajātā means a woman who has delivered before term; her illnesses such as fever are to be treated from the corresponding later chapters of the Uttaratantra. The commentary also connects the word ‘and’ with ‘from the Uttaratantra,’ adding that conditions such as apatānaka are to be treated by the method stated in the Saṃhitā. Another reading has ‘later-arising’ conditions such as apatānaka, which the physician should treat by their respective treatments.

Key terms

śukra-ārtava: The reproductive substances whose disorders are said to have been discussed earlier.
klaibya: A classical category whose causes were discussed in a prior strengthening and vājīkaraṇa context.
mūḍhagarbha: A classical obstetric condition for which causes and management were taught elsewhere.
apaprajātā: According to the commentary, a woman who has delivered prematurely.
apatānaka: A serious condition cited as requiring treatment according to its separate textual teaching.

Adhikarana पुष्पिका · Śloka २

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कुमारतन्त्रे योनिव्यापत्प्रतिषेधो नाम(द्वादशोऽध्यायः, आदितोऽ)ष्टत्रिंशत्तमोऽध्यायः ||३८|| उत्तरतन्त्रे द्वितीयं कौमारतन्त्रं समाप्तम् ||२||

Meaning of the śloka

Thus ends the chapter named ‘Prevention and Treatment of Yonivyāpat’ in the Kumāratantra within the Uttaratantra of the Suśrutasaṃhitā, identified in the transmitted wording as the twelfth chapter of this subsection and the thirty-eighth chapter overall. The second division of the Uttaratantra, the Kaumāra-tantra, is concluded.

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इति श्रीडल्ह(ह्ल)णविरचितायां निबन्धसङ्ग्रहाख्यायां सुश्रुतव्यायामुत्तरतन्त्रान्तर्गते कौमारभृत्यतन्त्रे योनिव्यापत्प्रतिषेधाध्यायोऽष्टत्रिंशत्तमः||३८||

Meaning of the commentary

The colophon of Dalhaṇa’s Nibandhasaṅgraha states that the chapter on prevention and treatment of yonivyāpat, within the Kaumārabhṛtya-tantra of the Uttaratantra in the Suśruta tradition, is the thirty-eighth chapter.

Key terms

Yonivyāpatpratiṣedha (yonivyāpatpratiṣedha): The title of the chapter concerning prevention and treatment of vaginal or reproductive disorders.
Kumāratantra (kumāratantra): The textual division that the source colophon says concludes here.
Kaumārabhṛtyatantra (kaumārabhṛtyatantra): The division named in Dalhaṇa’s commentary colophon.
Nibandhasaṅgraha (nibandhasaṅgraha): The title of Dalhaṇa’s commentary.

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