The sixteenth chapter of Chikitsasthana of Sushruta Samhita is known as as Vidradhi Cikitsitam Adhyaya. This chapter offers with Therapy of Abscess.
अथातोविद्रधीनांचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।
We’ll now propound Vidradhi Chikitsa-treatment of abscess; as revealed by the venerable Dhañvañtari.
Sadhyāsādhyata – Prognosis
उक्ताविद्रधयःषड्येतेष्वसाध्यस्तुसर्वजः।।
शेषेष्वामेषुकर्तव्यात्वरितंशोफवत्क्रिया।।३।।
Vidradhi is of six varieties and that has been already described earlier i.e. within the 9th chapter of Nidana Sthana. Amongst these six kinds of Vidradhi, Sarvaja or SannipatajaVidradhi i.e. that kind which is brought on by simultaneous aggravation of all three doshas is incurable. The remedy for different kinds of vidradhi ought to be on the strains of treating Sopha – inflammatory swelling. These therapies ought to be rapidly accomplished of their ama Avastha – unripe stage.
VātajaVidradhi Cikitsā – Therapy of abscess of vāta origin
वातघ्नमूलकल्कैस्तुघृततैलवसायुतैः।।
सुखोष्णोबहलोलेपःप्रयोज्योवातविद्रधौ।।४।।
सानूपौदकमांसस्तुकाकोल्यादिःसतर्पणः।।
स्नेहाम्लसिद्धोलवणःप्रयोज्यश्चोपनाहने।।५।।
वेशवारैःसकृशरैःपयोभिःपायसैस्तथा।।
स्वेदयेत्सततंचापिनिहरेच्चापिशोणितम्।।६।।
सचेदेवमुपक्रान्त :पाकायाभिमुखोयदि।।
तंपाचयित्वाशस्त्रेणभिन्द्याद्भिन्नंचशोधयेत्।।७।।
पञ्चमूलकषायेणप्रक्षाल्यलवणोत्तरैः।।
तैलैर्भद्रादिमधुकसंयुक्तैःप्रतिपूरयेत्।।८।।
वैरेचनिकयुक्तेनत्रैवृतेनविशोध्यच।।
पृथकूपर्यादिसिद्धेनत्रैवृतेनचरोपयेत्।।९।।
Beneath talked about are the remedy ideas of VatajaVidradhi –
Lepa – Vata mitigating herbs are taken and their paste is made. This paste is combined with ghee, oil and fats and utilized on the abscess fashioned by vata. This paste ought to be comfortably heat and utilized thick.
Upanaha – Beneath talked about substances ought to be combined collectively to arrange a poultice for vatajavidradhi –
– Anupa mamsa – meat of animals residing in marshy areas
– Audakamamsa – meat of aquatic animals – animals residing in water,
– Kakolyadi Gana – herbs belonging to Kakolyadi Gana group
– Tarpana – corn flour
– Taila – oil
– Amla – bitter issues and
– Lavana – salt
Alternatively, poultice might be utilized utilizing –
– Vesavara – minced meat added with Sneha – fat, amla – sours and lavana – salt
– Krsara – rice cooked with pulses
– Paya – Milk or Payasa – candy milk pudding
The affected person also needs to be administered with swedana – sudation and raktamokshana – bloodletting accomplished constantly.
Regardless of treating vataja vidradhi with above mentioned measures, if the abscess develops indicators of ripening, it ought to be allowed to ripen rapidly by use of meals and herbs used for a similar objective.
Bhedana and Shodhana – After this, the vidradhi ought to be punctured – reduce open and cleansed.
Prakshalana and so forth. measures – Later, it ought to be washed with –
– Panchamula decoction added with extra of salt and
– Full of Bhadradarvadi Taila i.e. oil ready with herbs of Bhadradarvadi Gana group and Madhuka and
– Cleansed by dusting the powder of virechana varga – herbs belonging to purgative group, together with Trivrt – Operculina turpethum and
– Made to heal utilizing Prthakparnyadi Taila – oil ready utilizing Prthakparni and Trivrt
Pittaja Vidradhi Cikitsā
पैत्तिकंशर्करालाजामधुकैःसारिवायुतैः।।
प्रदिह्यात्क्षीरपिष्टैर्वापयस्योशीरचन्दनैः।।१०।।
पाक्यैःशीतकषायैर्वाक्षीरैरिक्षुरसैस्तथा।।
जीवनीयघृतैर्वाऽपिसेचयेच्छर्करायुतैः।।११।।
त्रिवृद्धरीतकीनांचचूर्णंलिह्यान्मधुद्रवम्।।
जलौकोभिर्हरेच्चासृक्पक्वंचापाट्यबुद्धिमान्।।१२।।
क्षीरवृक्षकषायेणप्रक्षाल्यौदकजेनवा।।
तिलैःसयष्टीमधुकैःसक्षौद्रैःसर्पिषायुतैः।।१३।।
उपदिह्यप्रतनुनावाससावेष्टयेत्व्रणम्।।
प्रपौण्डरीकमञ्जिष्ठामधुकोशीरपद्मकैः।।१४।।
सहरिद्रैःकृतंसर्पिःसक्षीरंव्रणरोपणम्।।
क्षीरशुक्लापृथक्पीसमङ्गारोनचन्दनैः।।१५।।
न्यग्रोधादिप्रवालेषुतेषांत्वक्ष्वथवाकृतम्।।
Beneath talked about are the ideas of treating Pittaja Vidradhi–
Pradeha – The beneath talked about herbs ought to be macerated with milk and the ready pastes is utilized on the abscess brought on by aggravated pitta –
- Sarkaradi Pradeha – paste of –
– Sarkara – sugar
– Laja –
– Madhuka – Glyzyrrhiza glabra
– Sariva – Hemidesimus indicus
- Payasyadi Pradeha – paste of –
– Payasya –
– Usira – Vetiveria zizanoides and
– Candana – Santalum album, sandalwood
Secana is pouring medicated liquids on the vidradhi. It ought to be accomplished utilizing –
– Jivaniya Gana Kashaya – decoction / infusion ready with herbs belonging to Jivaniya Gana group or
– Milk or
– Sugarcane juice or
– Jivaniya Ghrta – ghee ready with Jivaniya Gana group of herbs added with sugar
Trivrtadi Churna – Powder of Trivrit – Operculina tuprethum and Haritaki – Terminalia chebula ought to be given for licking combined with honey.
Raktamokshana – bloodletting ought to be accomplished utilizing leeches.
Patana and Prakshalana – The smart doctor ought to do patana – chopping open the ripe abscess. After this, he ought to do prakshalana– washing it with Panchavalkala Kashaya – decoction of bushes which yield milky sap or audaka vegetation – vegetation rising in water.
Upadeha / Upanaha – Poultice ready with tila – sesame seeds and yastimadhuka – Glyzyrrhiza glabra – added and combined with ghee and honey, ought to be utilized over the abscess which has been washed as talked about above after which a band of skinny material ought to be wrapped on the wound and tied.
Ghrta – Ghee ready with the beneath talked about herbs assist in therapeutic the wound –
Prapaundarikadi Ghrta – ghee ready with –
– Prapaundarika
– Manjistha
– Ushita
– Padmaka
– Haridra and
– Milk
Ksirasukladi Ghrta – ghee ready with –
– Ksirasukla,
– Prthakparni
– Samanga
– Rodhra
– Candana and
– Leaf buds of Nyagrodha and so forth. (Panchavalkala)
Karañjādi Ghrta
नक्तमालस्यपत्राणितरुणानिफलानिच।।१६।।
सुमनायाश्चपत्राणिपटोलारिष्टयोस्तथा।।
द्वेहरिद्रेमधूच्छिष्टंमधुकंतिक्तरोहिणी।।१७।।
प्रियङ्गःकुशमूलंचनिचुलस्यत्वगेवच।।
मञ्जिष्ठाचन्दनोशीरमुत्पलंसारिवेत्रिवृत्।।१८।।
एतेषांकार्षिकैर्भागैघृतप्रस्थंविपाचयेत्।।
दुष्टव्रणप्रशमनंनाडीव्रणविशोधनम्।।१९।।
सद्यश्छिन्नव्रणानांचकरञ्जाद्यमिदंशुभम्।।
दुष्टव्रणाश्चयेकेचिद्येचोत्सृष्टक्रियाव्रणाः।।२०।।
नाड्योगम्भीरिकायाश्चसद्यश्छिन्नास्तथैवच।।
अग्निक्षारकृताश्चैवयेव्रणादारुणाअपि।।२१।।
करञ्जाद्येनहविषाप्रशाम्यन्तिनसंशयः।।
The beneath talked about substances are cooked in a single prastha – 640 grams of ghee and medicated ghee ready, within the standard methodology of getting ready the ghee –
One karsa – 10 grams every of –
– Naktamala – Karanja – Pongamia pinnata,
– Leaves of Sumana, Patola and Arista,
– Haridra – Curcuma longa and Daruharidra – Berberis aristata,
– Madhuchista – bee wax,
– Madhuka – Glyzyrrhiza glabra,
– Tiktarohini – Picrorrhiza kurroa,
– Priyangu – Callicarpa macrophylla,
– Root of Kusa
– Bark of Nicula – Vetasa,
– Manjistha – Rubia cordifolia,
– Candana – Santalum album – sandalwood,
– Usira – Vetiveria zizanoides,
– Utpala –
– Two kinds of Sariva – Hemidesmus indicus and
– Trivrit – Operculina turpethum,
This ghee known as Karanjadi Ghrta.
Advantages – This ghee is helpful in –
– Mitigating dangerous (septic) ulcers,
– Cleanses sinus ulcers and freshly reduce wounds,
– Cures deep sinus ulcers and up to date wounds
– Cures burns brought on by fireplace and alkali are cured undoubtedly despite they being extreme sorts of burns
Kapha Vidradhi Cikitsā
इष्टकासिकतालोष्टगोशकृत्तुषपांशुभिः।।२२।।
मूत्रैरुष्णैश्चसततंस्वेदयेच्छ्लेष्मविद्रधिम्।।
कषायपानैर्वमनैरालेपैरुपनाहनैः।।२३।।
हरेदोषानभीक्ष्णंचाप्यलाब्वाऽसृक्तथैवच।।
आरग्वधकषायेणपक्वंचापाट्यधावयेत्।।२४।।
हरिद्रात्रिवृताशक्तुतिलैर्मधुसमायुतैः।।
पूरयित्वाव्रणंसम्यग्बध्नीयात्कीर्तितंयथा।।२५।।
ततःकुलत्थिकादन्तीत्रिवृच्छ्यामार्कतिल्वकैः।।
कुर्यात्तैलंसगोमूत्रंहितंतत्रससैन्धवम्।।२६।।
Beneath talked about are the ideas of treating Kaphaja Vidradhi –
Swedana – sudation ought to be accomplished by one of many beneath talked about issues made sizzling –
– Brick,
– Sand
– Stone
– Cow dung
– Husk
– Mud – mud
– Urines of animals and others
Kashaya pana–Decoctions ready with kapha mitigating herbs ought to be given for consuming in order to mitigate / remove aggravated kapha.
Vamana –Therapeutic emesis ought to be administered to expel severely aggravated doshas.
Alepa and Upanaha–Software of pastes and poultices ready with kapha mitigating medicines / herbs.
Raktamokshana – bloodletting ought to be accomplished utilizing alabu – gourd.
Patana – the ripe abscess ought to be reduce open. Later it ought to be washed with Aragwadha – Cassia fistula decoction.
Purana – The wound ought to be stuffed with the paste of the beneath talked about herbs combined with honey and later bandaged suitably as described beforehand –
– Haridra – Curcuma longa
– Trivrit – Operculina turpethum
– Saktu – corn flour
– Tila – sesame seeds
Taila – Medicated oil ready from the beneath talked about substances ought to be used –
– Kulathika –
– Danti – Baliospermum montanum
– Trivrt – Operculina turpethum
– Syama
– Arka – Caltropis gigantea and
– Tilvaka
– Gomutra – urine of cow
– Saindhava – rock salt
Rakta Vidradhi Chikitsa
पित्तविद्रधिवत्सर्वाःक्रियानिरवशेषतः।।
विद्रध्योःकुशलःकुर्याद्रक्तागन्तुनिमित्तयोः।।२७।।
वरुणादिगणक्वाथमपक्वेऽभ्यन्तरोत्थिते।।
ऊषकादिप्रतीवापंपिबेत्सुखकरंनरः।।२८।।
अनयोर्वर्गयोःसिद्धंसर्पिवैरेचनेनच।।
अचिराद्विद्रधिंहन्तिप्रातःप्रातर्निषेवितम्।।२९।।
एभिरेवगणैश्चापिसंसिद्धंस्नेहसंयुतम्।।
कार्यमास्थापनंक्षिप्रंतथैवाप्यनुवासनम्।।३०।।
पानालेपनभोज्येषुमधुशिगुगुमोऽपिवा।।
दत्तावापोयथादोषमपक्वंहन्तिविद्रधिम्।।३१।।
तोयधान्याम्लामूत्रैस्तुपेयोवाऽपिसुरादिभिः।।
यथादोषगणक्वाथैःपिबेद्वाऽपिशिलाजतु।।३२।।
प्रधानंगुग्गुलंचापिशुण्ठीचसुरदारुच।।
स्नेहोपनाहौकुर्याच्चसदाचाप्यनुलोमनम्।।३३।।
Beneath talked about are the ideas of treating Raktaja Vidradhi –
Pittaja Vidradhi Therapy – In Raktaja Vidradhi – abscesses brought on by aggravated blood and Agantuja Vidradhi – abscesses brought on by exterior brokers / elements – therapies prescribed for Pittaja Vidradhi ought to be adopted.
Kashaya pana – Within the unripe abscess and likewise in inner abscesses one ought to drink the decoction ready with Varunadi Gana group of herbs added with herbs of Usakadi Gana. This recipe offers consolation to the affected person.
Ghrta – Ghee ought to be processed and ready utilizing the herbs belonging to Varunadi Gana and Virecana Gana. This ghee, when used cures raktaja vidradhi.
Niruha Vasti and Anuvasana Vasti – Decoction of Varunadi Gana and Virecana Gana group of herbs added with oil ought to be used for administering decoction enema. In the identical manner, oil enema too ought to be rapidly accomplished.
Use of Madhusigru – Decoction ready with Madhusigru ought to be used after including appropriate herbs, for consuming objective, exterior software and likewise with meals. It could even be used with water, Dhanyamla, urine of animals or sura and so forth.
Shilajatu – Shilajatu is consumed together with decoctions ready with herbs which mitigate doshas.
Use of Guggulu and so forth – Guggulu – Commiphora mukul, Sunthi – Zingiber officinale and Suradaru – Cedrus deodara ought to be utilized in treating RaktajaVidradhi.
Different measures –Snehana – unctuous therapies, Upanaha – poultices and Anulomana – purgation ought to at all times be accomplished.
यथोद्दिष्टांसिरांविध्येत्कफजेविद्रधौभिषक्।।
रक्तपित्तानिलोत्थेषुकेचिद्वाहीवदन्तितु।।३४।।
As indicated in chapter 8 of Sarira Sthana, the doctor / surgeon ought to conduct siravedha – vein puncture of veins indicated in Kaphaja Vidradhi.
Sira Vyadha ought to be accomplished within the arms of Raktaja, Pittaja and Vataja Vidradhi, in response to the opinion of some students.
पक्वंवाबहिरुन्नद्धंभित्त्वाव्रणवदाचरेत्।।
स्रुतेषूर्ध्वमधोवाऽपिमैरेयाम्लसुरासवैः।।३५।।
पेयोवरुणकादिस्तुमधुशिमुद्रुमोऽपिवा।।
शिनुमूलजलेसिद्धंससिद्धार्थकमोदनम्।।३६।।
यवकोलकुलत्थानांयूषैर्भुञ्जीतमानवः।।
प्रातःप्रातश्चसेवेतमात्रयातैल्वकंघृतम्।।३७।।
त्रिवृतादिगणक्वाथसिद्धंवाऽप्युपशान्तये।।
The vidradhi ought to be punctured and reduce open when it’s ripened and bulged up. Later it ought to be handled like a vrana – wound.
Varunakadi Kashaya – decoction ready with herbs belonging to Varunakadi Gana or decoction of Madhusigru tree ought to be consumed when there may be exudation of pus, blood and so forth. in upward or downward path, in circumstances of vidradhi. These decoctions ought to be given combined with Maireya (fermented gruel), amla sura – bitter beer, or asava – fermented drink.
Weight loss plan – Rice ought to be ready with decoction of Sigru – Moringa oliefera (drumstick). The affected person ought to take this rice with Siddharthaka or with Yusa – soup ready with Yava – barley, Kola – jujube and Kulattha – horse gram.
Medicated Ghee – Each morning, the affected person ought to devour one in all these Ghrtas – ghee –
– Tilvaka Ghrta
– Ghrta ready with herbs belonging to Trivrtadi Gana
नोपगच्छेद्यथापाकंप्रयतेततथाभिषक्।।३८।।
पर्यागतेविद्रधौतुसिद्धिकान्तिकीस्मृता।।
The doctor ought to put all efforts to forestall the vidradhi from getting ripened. If he fails in doing so and if the abscess will get ripened, getting success in remedy of vidradhi can be uncertain.
प्रत्याख्यायतुकुर्वीतमज्जजातेतुविद्रधौ।।३९।।
स्नेहस्वेदोपपन्नानांकुर्याद्रक्तावसेचनम्।।
विद्रध्युक्तांक्रियांकुर्यात्पक्वेवाऽस्थितुभेदयेत्।।४०।।
निःशल्यमथविज्ञायकर्तव्यंप्रणशोधनम्।।
धावेत्तिक्तकषायेणतिक्तंसर्पिस्तथाहितम्।।४१।।
यदिमज्जपरिस्रावोननिवर्तेतदेहिनः।।
कुर्यात्संशोधनीयानिकषायादीनिबुद्धिमान्।।४२।।
प्रियङ्गुधातकीरोधकट्फलंतिनिसैन्धवम्।।
एतैस्तैलंविपक्तव्यंविद्रधिव्रणरोपणम्।।४३।।
MajjagataVidradhi – Earlier than commencing the remedy, the doctor ought to intimate the affected person and his attendants concerning the incurability, when the vidradhi – abscess is localized in majja – bone marrow. On this situation, the beneath talked about therapies ought to be adopted –
– Snehana – oleation
– Swedana – sudation,
– Raktamoksana – bloodletting / elimination of blood and
– Different therapies that are advocated for pakva vidradhi – ripened abscess ought to be adopted
Asthi Vidradhi – The bone could also be punctured and cleansed when the abscess is positioned within the bone.
The wound ought to be washed totally with Tikta Kashaya i.e. decoction ready with bitter tasting herbs and administered for oral consumption after figuring out that the vidradhi doesn’t have any overseas / dangerous supplies in them.
Tiktaghrta can be useful in treating this situation.
Sodhana Kashaya – Decoctions ready with herbs that are purgative in motion ought to be given by the smart doctor to the affected person for consuming when the stream of majja – bone marrow doesn’t stop.
Priyangvadi Taila – Oil ready with the beneath talked about herbs is helpful for therapeutic the wound of the abscess –
– Priyangu – Calicarpa macrophylla
– Dhataki – Woodfordia fruticosa,
– Rodhra – Cissampelos pareira
– Katphala
– Tini and
– Saindhava – rock salt
इतिसुश्रुतसंहितायांचिकित्सास्थानेविद्रधिचिकित्सितंनाम षोडशोऽध्यायः।।१६।।
Thus ends the sixteenth chapter by identify Vidradhi Cikitsita in Cikitsā Sthāna of Suśruta Samhita.