अथातो विद्रधिवृद्धिचिकित्सितं व्याख्यास्यामः । इतिहस्माहुरात्रेयादयो महर्षयः ।। १ ।।
We will now expound Vidradhi- Vruddhi chikitsa- treatment of Abscess and Scrotal enlargement; thus said atreya and other great sages. (1)
Vidradhi chikitsa – treatment of Abscess
सर्वमेव विद्रधिमामं शोफविधिना यथादोषमुपाचरेत् । प्रततं च शोणितमपहरेत् ।
पाकाभिमुखं चोपनाह्यपक्वं पाटयित्वा तणवच्चिकित्सेत् || २ ||
All varieties of abscess which are unripe should be treated by the same procedures as that of sopha (swelling) appropriate to the aggravated doshas; blood letting should be done often, those which are in the process of ripening, by resorting to application of (hot) poultice and those which are ripe, cutting them open and treating like a wound. (2)
आभ्यन्तरे तु विद्रधौ वरणादिक्वाथमूषकादिप्रतीवापं पिबेत् । आभ्यामेव च वर्गाभ्यां विरेचन द्रव्यैश्चपानाय सर्पिः प्रकल्पयेत् । आस्थापनमनुवासनं च। मधुशिग्रुम् च पानभोजनलेपनेषु । शिलाह्वयं वा कल्पविधानेनोपयुञ्जीत । गुग्गुलुं वा यथादोषं च सर्वशो गुल्मवदुपक्रमेत् ||३||
In cases of internal abscesses, drinking of the decoction of drugs of varanadigana mixed with (powder of) drugs of usakadigana (should be adhered to ), medicated ghee prepared from these groups of drugs and also from the drugs of virecana gana (purgative group) (chapter 14 of sutrasthana) should be used, and also for asthapana (decoction enema) and anuvasana (oil enema). Madhusigru should be used for preparing drinking water, foods and for external application; or silajatu or guggulu, should be used as described in the ( rasayana kalpa ( chapter 49 of uttarasthana) appropriate to the doshas involved. In all matters of the doshas the treatment (of internal abscess) should be similar to that of gulma (tumors of the abdomen). (3)
त्रिफलापिचुमन्दमधुककटुकापटोलानि शाणांशानि। त्रिवृत्त्रायमाणयोः कर्षम् । मसूर – पलं चैकध्यमष्टगुणेऽम्भसि साधयित्वा पूतं रसं घृतमूर्छितं पिबेत् । तेन विद्रधिगुल्मज्वरदाहशूलतृष्णाहृद्रोगभ्रमारतिमूर्छारक्तपित्तकामलाकुष्ठविसर्पाः प्रशाम्यन्ति ॥ ४ ॥
One sana each of triphala, picumanda, madhuka, katuka and patola, one karsa each of trivrit and trayamana and one pala of masura, are all cooked in eight times their quantity of water, decoction reduced (to a quarter) and filtered; by drinking this decoction mixed with ghee, abscess, abdominal tumor, fever, burning sensation, pain in the abdomen, thirst, heart disease, giddiness, restlessness, fainting, bleeding diseases, jaundices, leprosy (and other skin diseases) and herpes subside. ( 4 )
त्रायमाणाप्रस्थक्वाथे मुस्तकटुकातामलकीत्रायमाणाचन्दनदुरालभाजीवन्तीवीरोत्पलैः पालिकैर्घृतप्रस्थं क्षीरामलकरसप्रस्थद्वयोपेतं विपक्कं समानं पूर्वेण ॥ ५ ॥
One prastha of decoction of trayamana (powder of), one pala each of musta, katuka, tamlaki, traymana, chandana, duralabha, jivanti, vira and utpala; one prastha of ghee, two prastha of milk, and juice of amalaka, all are cooked and medicated ghee prepared. It is similar (in action) to the earlier one. (5)
द्राक्षामधूकखर्जूराभीरुविदारीपरूषकत्रिफलाक्वाथे क्षीरेक्षुधात्रीस्वरससमेतमभयागर्भं सर्पिर्विपाचयेत् ।
तच्छीतं मधुशर्करापादयुक्तं समानं पूर्वेण । भृशं च शृङ्गादिभिः शोणितमवसेचयेद्यथासन्नम् ।
बाहुमध्ये वा सिरां व्यधेत् । पच्यमानं च कोष्ठगतं बहिरुन्नतमुपनाहयेत् ||६ ॥
Draksa, madhuka, kharjura, abhiru, vidari, parusaka and triphala are made into a decoction, to this are added equal quantities of milk, juice of iksu and fresh juice of dhatri; (powder of) abhaya and ghee are mixed (in the usual proportion) and medicated ghee prepared; this recipe is also similar to the earlier ones in action.
In case of accumulation of large amount of blood inside, it should be removed in the nearby place by the use of horn etc or the vein in the centre of the arm should be cut (and blood let out).
The abscess of the abdomen which is in the stage of ripening and found bulging outwards should be given warm fomentations. (6)
तत्रैव च पिण्डिते शूले तत्पार्श्वपीडनेन लब्धसुप्तौ शस्त्रकर्मविधिनिर्दिष्टैश्च चिह्नः पक्वमुपलक्ष्य भित्त्वाव्रणवत्साधयेत् ।। ७ ।।
When the pain gets localised, the sides of the abscess should be squeezed in order to attain loss of sensation, and after determining the fully ripened stage by the signs of such a stage described in the procedure of surgical operation (chapter 38 of sutrasthana) the abscess should be cut open and then treated as a wound. (7)
आभ्यन्तर एव च पक्वमूर्ध्वमधो वा प्रवृत्तं पूयमुपद्रवान् परिरक्षन् उपेक्षेत दशाहमात्रम् ।।८।।
The pus (and blood) coming out of the body either from the upward or downward paths due to the bursting of a ripe internal abscess should be neglected (allowed to flow out and not stopped) for a period of ten days only, protecting the patient from any complications (secondary diseases) (that might arise during this period). (8)
असम्यग्वहति वा क्लेदे तन्निर्वाहणार्थमम्लसुरासवमैरेयोष्णोदकान्यतमेन वरणादिं मधुशिगुं वा पिबेत् । तन्मूलैर्वा कृतां यवागूं यवकोलकुलत्थयूषेण चाश्रीयात् । ऊर्ध्वं च दशाहात्तिल्वकघृतेन त्रायमाणाघृतेन वा यथाबलं शोधयेत् ।। ९ ।।
If the discharge flowing out is inadequate, in order to promote their flow, the patient should be made to drink the decoction of drugs of varanadi gana (chapter 16 of sutrasthana) or of madhusigru mixed with sour liquors such as sura, asava or maireya or even with hot water, or drink yavagu (gruel) boiled with the roots of these drugs; or eat (rice mess) mixed with the yusa (soup) of yava (barley), kola and kulattha (for ten days).
After ten days sodhana (purificatory therapies) should be done according to the strength of the patient by the using either tilvaka ghrta or trayamana ghrta. (9)
विशुद्धश्च तिक्तकमल्पम ल्पं सर्पिर्मधुनोपेतमुपयुञ्जीत । यथा च नोपैति पाकं तथा प्रयतितव्यम् ।
शीघ्रविदाहित्वात्तस्य विद्रधिरिति संज्ञा । पक्के तुपुनर्देविकी सिद्धिराशुकारितरश्च सर्वामयेभ्यो विद्रधिः । सति च प्रमेहेप्रमेहचिकित्सितमीक्षेत ॥ १० ॥
When the patient is purified thus, he should be administered small quantities, of tiktaka ghrta mixed with honey often.
All efforts should be made not to allow it (internal abscess) to ripen (to form pus); because of its tendency to form pus quickly, it is known as vidradhi.
Once the pus forms, the success of treatment depends upon the grace of god, because the abscess is very quick in its effect (of harming the patient) than all other diseases.
If there is prameha (diabetes ) in a patient of abscess ), then the treatment of diabetes should also perused (adopted). (10)
स्तनविद्रधिमपि व्रणविधानेनोपचरेत् । पच्यमानं यथेष्टभोजनेन पाचयेत् । न पुनरुपनाहयेत् । उपनद्धो हि स्तनो मृदुमांसतया शीघ्रमेव पक्वः सङ्कोथमवाप्यावदीर्येत । पक्कं च स्तनविद्रधिं स्तन्यवाहिनी: सिरा: सचूचुकं च कृष्णमण्डलं परिहरन् शस्त्रेणोपक्रमेत् । सर्वासु चामविदग्धपक्वव्रणावस्थासु स्तनं निर्दुहीत। दन्तादिविद्रधीनामपि यथास्वमेव वक्ष्यते लक्षणं साधनं च ।।११ ।।
Even the abscess of the breast, should be treated similar to that of a wound, the abscess during its stage of ripening should be made to ripen quickly by suitable foods liked (by the patient) but it should not be tied with poultices; by so doing, the breast composed of soft muscles, develops pus very quickly, decomposes and withers off; the ripened breast abscess should be operated upon by sharp instruments avoiding injury to milk ducts, veins, nipple and areola.
During all the stage (of the abscess ) such as unripe, ripening, ripened and ulcerated – the breast should be milked out.
The symptoms and management of abscess of teeth and others (of other organs) will be described in appropriate chapters, later on. (11)
॥ इतिविद्रधिचिकित्सा |
Thus ends the treatment of abscesses.
Vruddhi chikitsa – treatment of scrotal enlargement
वृद्धौ तु मारुतजे त्रिवृता स्निग्धमातुरं स्विन्नं च मिश्रकसुकुमारकतिल्वकैरण्डकोशाम्रफलस्नेहानामन्यतमेन विरेचयेत् । ततोऽनिलघ्नक्वाथकल्कैर्निरूहयेत् । निरूढं च मांसरसेनाशितं यष्टीमधुकतैलेनानुवासयेत्। स्वेदप्रलेपोपनाहांश्चप्रयुञ्जीत । पक्वं चभित्वाव्रणमिवचिकित्सेत् ||१२||
In vruddhi (enlargement of the scrotum) born from maruta (vata) the patient should be given (oleation therapy ) first using trivrit sneha (mixture of three fats) and sudation therapy. After these, he should be given virecana (purgation therapy) using any one of the recipes such as misraka (mixture of two fats) such as sukumaraka ghrta, tilvaka ghrta eranda phalasneha (castor oil) or kosamra phalasneha (oil of fruits of kosamra), then decoction enema with the decoction and paste of drugs which subdue vata. After decoction enema the patient should be made to eat food along with meat juice and then given an oil enema with yastimadhuka taila. Fomentation, warm application of paste of drugs and poultices should be done. (when the swelling becomes ripe by these methods), the ripe one should be cut open and treated just as a wound. (12)
पित्तवृद्धिं पित्तशोफवत् । पक्वं चपित्तव्रणवत् ।।१३।।
कफवृद्धिमपिकफशोफवत् । पिबेच्च पीतदारुकषायं मूत्रेण । कफग्रन्थिवच्च सर्वं विम्लापनवर्ज्यमाचरेत् । पक्वं च पाटितं श्रेष्मव्रणवत्। रक्तजं पित्तवृद्धिवत् । प्रततं चात्र रक्तमपहरेत् ॥ १४ ॥
Vruddhi due to pitta should be treated like a sopha (swelling) caused by pitta, when it is ripe, it is treated like a vrana (wound) cause by pitta.
Vruddhi due to kapha should be treated like sopha (swelling) caused by kapha. The patient should be drink a decoction pitadaru mixed with cows urine; all treatments except vimlapana (act of squeezing) prescribed for granthi (tumor) of kapha origin should be followed; that which is ripe should be cut open and treated like a wound of kapha origin.
That (vruddhi) due to rakta (blood) should be treated like vruddhi due to pitta, blood letting should be done often. (13-14)
मेदोवृद्दिं गवादिकरीषतुषकिण्वसुरसादिभिरुष्णरूक्षैर्मूत्रयुक्तैः स्वेदयित्वा पुनस्तद्विधैरेव सुखोष्णैः सोत्सेधं लेपयेत् ।
तद्वच्छिरोविरेकद्रव्यैर्वा । स्विन्त्रं चैवं फलसेवनीं परिहरन् वृद्धिपत्रेण विदार्यापनीयमेदः कासीससैन्धवमाक्षिकैः प्रतिसार्य सीव्येत् ।
ततः सुमनोग्रन्थिमनः शिलैलाभल्लातकैस्तैलमभ्यङ्गार्थंकुर्यात् । आव्रणसन्धानाच्चस्नेहस्वेदौ ।। १५ ।।
Vruddhi caused by medas (fat) should be given sudation with powder of dung of cow (and other animals), paddy husk, kinva (yeast), surasa etc. mixed with cows urine, made hot and dry; then the swelling should be given a coating by the same substances made comfortably warm, or by the drugs which are used for purgation to the head. After such sudation, the scrotum is to be slit using vruddhipatra (a sharp instrument) avoiding injury to the scrotal suture (raphae), the accumulation of fat removed, the area smeared with (a mixture of) kasisa, saindhava and maksika and then sutured. Medicated oil prepared with sumana granthi masassila, ela and bhallataka to be used for anointing; oleation and sudation therapy should be continued till the wound heals). (15)
मूत्रवृद्धिं स्त्रिग्धैः स्वेदयित्वा वस्त्रपट्टेन वेष्टयेत् । ततोऽधस्तात् सेवन्या दकोदरवव्रीहिमुखेन भित्वा नाड्यास्त्रावयेत् । ततः स्थगिकाबन्धं कुर्यात्। व्रणेच शोधनरोपणानि | ॥१६॥
Mutravruddhi (scrotal enlargement caused by accumulation of urine / hydrocele) should be given oleation and sudation therapies and then wrapped with a band of cloth. Afterwards, it should be pierced at the bottom with the vrihimukha yantra (trocer and canula) just like piercing dakodara (abdomen filled with water) and the fluid (urine ) drained through the tube. Then sthagika bandha ( a type of bandage) should be applied, methods of cleaning and healing the wound should be adopted. (16)
आन्त्रवृद्धिं फलकोशमसंप्राप्तं वातवृद्धिवदुपचरेत् । पुनर्नवशतपलं दशपलानि च पृथक् दशमूलपयस्याश्वगन्धाशतावर्येरण्डमूलान्यपां वहे ऽष्टांशावशेषं साधयेत् । पूतशीते च तस्मिन् निर्यूहे त्रिंशद्गुडपलान्येरण्डतैलप्रस्थं घृतद्विप्रस्थं क्षीरद्विप्रस्थं कल्कीकृतानि च द्विपलिकानि द्राक्षानागरपिप्पलीपिप्पलीमूलयवानीयवक्षारचित्रकमधुकसैन्धवान्यावाप्यैकध्यं विपचेत् । एतत् सर्वयन्त्रणास्वपरिक्लेशेन सुकुमाराख्यं सुकुमाराणामीश्वराणां नारीणां क्षीणरेतसामप्रजानामल्पाग्नीनां विषमाग्नीनां च कामतोन्नाने वा प्रयुक्तमलक्ष्मीघ्नं कान्तिकरं बल्यं बृंहणं वयस्थापनं वर्मविद्रधिप्लीहगुल्मोदावर्तशोफोदरार्शोमेढ्रयोनिरोगेषु महावातव्याधिषु चपरमौषधम् । गन्धर्वहस्तमूलतुलां यवाढकं नागरार्धकुडवं च सलिलद्रोणे पादशेषं विपचेत् । तेन द्विगुण-क्षीरेणैरण्डतैलप्रस्थं साधयेत् । कल्कपिष्टं चात्र दद्यात् पुनर्गन्धर्वहस्तमूलकुडवं शुण्ठीपलं च । एतत् गन्धर्वहस्ततैलं तुल्यं पूर्वेण । भवति चात्र ॥ १७ ॥
Antravruddhi (enlargement of scrotum caused by the intestines / scrotal hernia) in which the intestine has not come down to the scrotum should be treated just like vatavruddhi (scrotal enlargement caused by vata).
Sukumara ghrita
One hundred pala of punarnava, ten pala each of dashamoola, payasya, ashwagandha, satavari and eranda mula- are all boiled in one vaha of water, decoction reduced to oneeighth the quantity and filtered. To this decoction are added thirty pala of guda (jaggery), one prastha of eranda taila (castor oil), two prastha of ghee, two prastha of milk, and paste of two pala each of draksa, nagara, saindhava and pippalimula, yavani, yavakshara chitraka, and madhuka and medicated ghee prepared. This recipe known as Sukumara (ghrta) used in the desired manner or along with foods and drinks is beneficial to those persons of tender constitution who cannot withstand the strain of use of different kinds if instruments, the wealthy, women, those who have diminished semen, who have no offspring, who are of weak digestive activity, and of irregular digestive activity; it dispels evil (inauspiciousness) bestows good complexion, strength, plumpiness, retards aging, and is the best medicine for enlargement of scrotum, abscess, disease of spleen, abdominal tumor, upward movement of vata, dropsy, enlargement of the abdomen, haemorrhoids, disease of the penis, vagina and major diseases of the vata.
Gandharavahasta taila
One tula of roots of gandharvahasta, one adhaka of yava and half kudava of nagara are boiled in one drona of water and decoction reduced of one-fourth the quantity. To this are added milk, twice that quantity and one prastha of eranda taila and a paste of one kudava of root of gandharvahasta and one pala of sunthi; this recipe- Gandharvahasta taila is similar in action to the earlier one. (17)
Some verses more :
यायाद्वधर्म न चेच्छान्तिं स्त्रेहरेकानुवासनैः । बस्तिकर्म पुरः कृत्वा वक्षणस्थं ततो दहेत् ।। अग्निनामार्गरोधार्थं मरुतोऽर्धेन्दुवक्रया ||१८||
If the scrotal enlargement does not subside by oleation, sudation and oil enema therapies, then (decoction) enema therapy should be done first, then the swelling at the groins branded with fire in the shape of half moon, in order to close the passage for vata (there by to prevent the descent of the intestine into the scrotum). (18)
अङ्गुष्ठस्योपरिस्त्राव पीतं तन्तुसमं च यत् । उत्क्षिप्य सूच्या तत्तिर्यक् दहेच्छित्वा यतोगदः ।।१९।।
The yellow coloured snayu (tendon) resembling a thread located above the thumb of the same side, should be elevated with the help of a needle, cut obliquely and burnt sideways, for the (cure of) this disease. (19)
ततोऽन्यपार्श्वेऽन्यत्वाहुर्दहेद्वानामिकाङ्गुलेः ॥ २० ॥
Some others (authorities) say the cutting and burning of the tendon should be on the opposite side and be that of the ring finger. (20)
Note- According to the first opinion, if the scrotal enlargement is on the left side, the tendon on the left thumb should be selected and if it is on the right side, the tendon of the right thumb is for fire cautery. According to the second opinion, if the scrotal swelling is on the left side, the tendon on the right ring finger (opposite side) and viceversa should be selected.
गुल्मेऽन्यैर्वातकफजेप्लीहिचार्यविधिः स्मृतः । कनिष्ठिकानामिकयोर्विश्वभ्यांतुयतोगदः ॥ २१ ॥
Others (authorities) say that the same procedure should be followed in gulma (abdominal tumor) arising from vata and kapha together and also in diseases of the spleen, the tendon selected being those of the little finger, ring finger or of all the fingers of the same side depending upon the affected side of the disease. (21)
।। इतिपञ्चदशोऽध्यायः ।।
Thus ends the Fifteenth chapter.
