चतुर्दशोऽध्यायः अथातो भेद्यरोगप्रतिषेधं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the curative treatment of eye diseases which require surgical incisions (Bhedya-Roga-Pratisedha). 1
स्वेदयित्वा बिसग्रन्थिं छिद्राण्यस्य निराशयम् । पक्कं भित्वा तु शस्त्रेण सैन्धवेनावचूर्णयेत् ॥२॥
कासीसमागधीपुष्प नेपाल्येलायुतेन ततः क्षौद्रघृतं दत्त्वा सम्यग्बन्धमुपाचरेत् ॥ ३ ॥ तु।
Treatment of Visa granthi
Treatment of Visa-granthi – In case of suppurating Visagranthi, it should be first fomented, and its puncture-like holes should be completely incised (so as to remove any swelling in the affected part ). It should then be dusted with Saindhava, Kasisa, Magadhi, Puspanjana, Manah-sild and Ela pounded together¹. Honey and clarified butter should then be applied (over the dusted part) and it should be duly ( loosely) bandaged (for the complete union of the parts). 2-3.
रोचनाक्षारतुत्थानि पिप्पल्यः क्षौद्रमेव च । प्रतिसारणमेकैकं भिन्ने लगण इष्यते । महत्यपि च युञ्जीत क्षाराग्नी विधिकोविदः ॥ ४॥
1. Both Vrnda and Cakradatta read only the first two lines of the taxt and hold that the incision should be dusted with Saindhava only. Their commentators, however, accept rhe reading there to be Susruta’s. They supply the next two lines of Susruta, and notice the consequent alleration in the sense.
Lagana- An incision should be made into the affected part in a case of Lagana, and any of the following drugs, viz., Rocana, Yavaksara, Tuttha, Pippali and honey should be applied to the incised part; while in serious (lit-big) cases cauterization with alkali or with fire will be the remedy. 4.
Anjana
स्विन्नां भिन्नां विनिष्पीड्य भिषगञ्जननामिकाम् । शिलैलानतसिन्धूत्थैः सक्षौद्रैः प्रतिसारयेत् ॥ ५ ॥
रसाञ्जनमधुभ्यां वा भित्त्वा वा शस्त्रकर्मवित् । प्रतिसार्याञ्जनैर्युञ्यादुष्णैर्दीपशिखोद्भवैः ॥६॥
Anjana- In case of Anjana, the affected part should be duly fomented and if it spontaneously bursts open, it should be well pressed and rubbed (Pratisarana) with a plaster-compound of Manah-sila, Ela, Tagarapaduka and Saindhava, pasted together with honey. If, however, the surgeon wants to open it, it should be rubbed with honey and Rasanjana mixed together and then coated with a warm collyrium made the lamp-black collected from a burning lamp flame. 5-6.
Krimi granthi
सम्यस्विन्ने क्रिमिग्रन्थौ भिन्ने स्यात् प्रतिसारणम् । त्रिफलातुत्थकासीससैन्धवैस्तु भित्त्वोपनाहं कफजं पिप्पलीमधुसैन्धवैः । प्रच्छयेदपि॥८॥ रसक्रिया ॥ ७ ॥ लेखयेन्मण्डलाग्रेण समन्तात्
Krimi-granthi – In a case of Krimi-granthi, the affected part should be duly fomented after it has been incised and it should then be treated with the Rasa-kriya solution prepared with (the decoction of) Triphala (with the addtion of ) Tuttha’, Kasisa and Saindhava. In a case of Upanaha (in the eye) due to the action of the deranged Kapha, the affected part should be opened and rubbed with powdered Pippali and Saindhava mixed with honey. It should then be scraped with a Mandalagra instrument. The surrounding parts should also be gently scratched all around. 7-8.
1. Both Vrnda and Cakrapani read ‘Mutra’ (cow’s urine ) in place of Tuttha. Both of them also recommend the addition of Rasanjana in the compound.
संस्नेह्य पत्रभङ्गैश्च स्वेदयित्वा यथासुखम् । आपाकाद् विधिनोक्तेन पञ्च भेद्यानुपाचरेत् ॥ ९ ॥
सर्वेष्वेतेषु विहितं विधानं स्नेहपूर्वकम् । सम्पक्ने प्रयतो भूत्वा कुर्वीत व्रणरोपणम् ॥ १० ॥
In the foregoing five cases of incisable eye-disease, until the setting in of suppuration there in, the affected eye should first be treated with Sneha and then with light fomentation with (the help of) tender leaves (as a cover over the eye). In all the remedies to be adopted in the treatment of these (incisable eye) diseases, the application of a Sneha should be first adopted. In cases, however, where suppration had already set in, the remedies for the healing up of the ulcer, should be carefully adopted. 9-10.
इति सुश्रुत संहितायामुत्तरतन्त्रे भेद्यरोगप्रतिषेधो नाम चतुर्दशोऽध्यायः ॥ १४ ॥
Thus ends the fourteenth chapter of the Uttara-Tantra of the Susruta Samhita which deals with the curative treatment of (eye) diseases requiring incisions.
