त्रयोदशोऽध्यायः अथातो लेख्यरोगप्रतिषेधं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the curative treatment of eye-diseases in which Scarification should be resorted to (Lekhya-Roga-Pratisedha). 1.
नव येऽभिहिता लेख्या: सामान्यस्तेष्वयं विधिः । स्त्रिग्धवान्तविरिक्तस्य निवातातपसद्मनि ॥ २ ॥ ( आप्तैर्दृढं गृहीतस्य वेश्मन्युत्तानशायिनः ॥ ) सुखोदकप्रतप्तेन सुसमाहितः । स्वेदयेद् वर्त्म निर्भुज्य वामाङ्गुष्ठाङ्गुलिस्थितम् ॥ ३ ॥ अङ्गुल्यङ्गुष्ठकाभ्यान्तु निर्भुग्नं वर्त्म यत्नतः । प्लोतान्तराभ्यां न यथा चलति स्त्रंसतेऽपि वा ॥ ४ ॥ ततः प्रमृज्य प्लोतेन वर्त्म शस्त्रपदाङ्कितम् । लिखेच्छस्त्रेण पत्रैर्वा ततो रक्ते स्थिते पुनः ॥ ५ ॥ स्विन्नं मनोहाकासीस-व्योषार्द्राञ्जनसैन्धवैः । श्लक्ष्णपिष्टैः समाक्षीकै : प्रतिसार्योष्णवारिणा ॥ ६ ॥ प्रक्षाल्य हविषा सिक्तं व्रणवत् समुपाचरेत् ॥ ७॥ स्वेदावपीडप्रभृतीस्त्र्यहादूर्ध्वं प्रयोजयेत् । व्यासतस्ते समुद्दिष्टं विधानं लेख्यकर्मणि ॥ ८ ॥ वाससा
The general course of treatment to be adopted in the nine kinds of eye diseases which are amenable to Scarifying (Lekhana) operation is as follows-The patient should be laid in a chamber not exposed to the sun and the gales of wind, after having been treated with proper emulsive measures (Sneha-karma)’ and subjected to a course of emetics and purgatives. The eyelid should be over-turned with the thumb and the index finger and should be very carefully fomented with a piece of linen soaked in lukewarm water and squeezed. The eye-lid should be covered with a piece of linen and over-turned with the thumb and the index finger at the time to guard against its movement and enclosing. The (part of the) eye-lid to be scraped, should be wiped with a linen and marked with a surgical instrument and the scraping should be effected there in with a scraping knife of any (rough) leaf according to the exigencies of the case. After the subsidence of the bleeding, the part should be fomented and then gently rubbed (Pratisarana) with a medicinal consisting of Manahsila (Realgar), Kasisa (Sulphate of iron), Trikatu, Anjana (black antimony), Saindhava Salt and Maksika finely pounded together. After this the part should be washed with lukewarm water and lubricated with clarified butter. The subsequent treatment there of should be like that of an ulcer (Vrana)². Fomentations, Avapida, etc. should also be employed after three days. Thus I have described to you the general measures to be observed in scraping an affected locality in the eye. 2-8.
असृगास्त्रावरहितं कण्डूशोफविवर्जितम् । समं नखनिभं वर्त्म लिखितं सम्यगिष्यते ॥ ९ ॥ रक्तमक्षि त्रवेत् स्कन्नं क्षताच्छस्त्रकृताद् ध्रुवम् । रागशोफपरित्रावास्तिमिरं व्याध्यनिर्जयः ॥ १० ॥ वर्त्म श्यावं गुरु स्तब्धं कण्डूहर्षोपदेहवत् । कुर्वीताप्रतिकारिणः । नेत्रपाकमुदीर्णं वा एतद् दुर्लिखितं ज्ञेयं स्नेहयित्वा पुनर्लिखेत् ॥ ११ ॥
Satisfactory and deficient scarificaton-Stoppage of bleeding,
1. It should be nofed that the patient should also be fomented (Sveda) after being treated with the emulsive measures. subsidence of the swelling and itching, a smooth level aspect of the part like the surface of a finger nail are the features, which mark a proper and satisfactory scarification. Redness of the eyes, swelling and discharge of blood from the operated locality, occurrence of Timira (blindness or darkness of vision), non-ameliorations of the disease under treatment, brownness, heaviness, numbness, itching, horripilation and coating (as if with foreign matter) of the eye-lids and a consequent high inflammation which attend an incomplete and unsatisfactory scarification, and this should be remedied by anointing and scarifying the affected part again. 9-11.
2. For the first seven dyas the treatment should be like that of an incidental ulcer (Sadyo-vrana) after this period, the case should be treated, if necessary, as a case of Sarira-Vrana.
व्यावर्तते यदा वर्त्म पक्ष्म चापि विमुह्यति । स्यात् सरुक् स्त्रावभूयिष्ठं तदतिस्त्रावितं विदुः ।
स्नेहस्वेदादिरिष्टः स्यात् क्रमस्तत्रानिलापहः ॥ १२॥
Excessive Scarification- Excessive discharge and pain in the locality together with an upturning of the eye-lids and spontaneous uprooting of the eye-lashes should be ascribed to excessive scraping. Fomentation, application of Sneha and employment of Vayu-subduing measures should be resorted to in such cases. 12.
वर्त्मावबन्धं क्लिष्टञ्च बहलं यच्च कीर्त्तितम् । पोथकीश्चाप्यवलिखेत् प्रच्छयित्वाऽग्रतः शनैः ॥ १३ ॥ लिखेत् तु मेधावी श्यावकर्दमवर्त्मनी । शर्कराञ्च तथैवोत्सङ्गिनीमपि । समं कुम्भीकिनीं कर्त्त (ल्प ) यित्वा तु शस्त्रेण लिखेत् पश्चादतन्द्रितः ॥ १४ ॥ भवेयुर्वर्त्मसु च याः पिडकाः कठिना भृशम् । ह्रस्वास्ताम्राश्च ताः पक्का भिन्द्याद् भिन्ना लिखेदपि ॥ १५ ॥ तरुणीश्चाल्पसंरम्भाः पिडका बाह्यवर्त्मजाः । विदित्वैताः स्वेदालेपनशोधनैः ॥ १६ ॥ प्रशमयेत्
In the following diseases of the eye, viz., Vartmavabandha, Klista-vartma, Bahala-vartma and Pothaki, the affected part should first be gently scraped and then scarified. In Syava-vartma and Kardama-vartma, the intelligent physician will gently scarify the aftected part neither deeply nor superficially. In cases of Utsangini, Sarkara and Kumbhikini, the seat of the disease should be first cut (with a knife) and then carefully scarified. An incision should be followed by a scarification in the case of small, very hard, supperated, copper-coloured, Pidakas (pustules) occurring on (the inner membrane of) the eye-lid. Small and slightly swelling Pidakas (pustules) occuring on the exterior surface of the eye-lid should be remedied with fomentations, plasters and the general corrective remedies. 13-16.
1. Dalhana says that some read ‘खेदयित्वा’ (fomenting) in place of ‘क्षेहयित्वा’ (anointing).
इति सुश्रुत संहितायामुत्तरतन्त्रे लेख्यरोगप्रतिषेधो नाम त्रयोदशोऽध्यायः ॥ १३ ॥
Thus ends the thirteenth chapter of the Uttara-Tantra in the Susruta Samhita which treats of the curative treatment of (eye) diseases amenable to scarfication.
