एकोनविंशोऽध्यायः अथातो नयनाभिघातप्रतिषेधं व्याख्यास्यामः, भगवान् धन्वन्तरिः ॥ १ ॥ यथोवाच
Now we shall discourse on the medical treatment to be adopted in cases of hurt or injury to the eye (Nayanabhighata – Pratisedha). 1
अभ्याहते तु नयने बहुधा नराणां संरम्भरागतुमुलासु रुजासु धीमान् । नस्यास्यलेप’ परिषेचनतर्पणाद्यमुक्तं पुनः क्षतजपित्तजशूलपथ्यम् ॥ २ ॥ दृष्टिप्रसादजननं विधिमाशु कुर्यात् स्निग्धैर्हिमैश्च मधुरैश्च तथा प्रयोगैः ॥ ३॥ स्वेदाग्निधूमभयशोकरुजाभिघातैरभ्याहतामपि तथैव भिषक् चिकित्सेत् । सद्योहते नयन एष विधिस्तदूर्ध्वं स्यन्देरितो भवति दोषमवेक्ष्य कार्यः ॥ ४॥ अभ्याहतं नयनमीषदथास्यवाष्पसंस्वेदितं भवति तन्निरुजं क्षणेन ॥ ५ ॥
A violent and intolerable pain in the eye accompanied by redness and swelling therein, resulting from a blow or from any sort of hurt or injury to the organ, should be remedied with the application of medicinal Nasya (erhines), plasters, sprinkling and Tarpana (soothing measures), and other measures mentioned before, as well as the measures prescribed in cases of Pittaja and Raktaja Abhisyanda- lit. remedial to the pain (sula) caused by the deranged blood and Pitta in the locality. The affected eye (Drsti) should also be soothed with the help of cool, sweet and fatty drugs. This kind of treatment should also be followed in cases where the eye would be hurt or oppressed by (excessive) fomentation, smoke or glare-fire, or affected on account of feat mental agony, pain or injury. These measures should also be resorted to in the first stage (i.e., during the first week) of the hurt or injury in the eye. After this period the affected eye should be treated as a case of an Abhisyanda with due regard to the nature of the specific deranged bodily Dosa or Dosas involved in the case. A slight hurt in the eye may be instantaneously relieved by the application of warm breathfomentation. 2-5.
1. नस्यप्रलेपपरिषचनतर्पणाद्यमिति पाठान्तरम् ।
साध्यं क्षतं पटलमेकमुभे तु कृच्छ्रे त्रीणि क्षतानि पटलानि विवर्जयेत् तु ॥ ६ ॥ स्यात् पिच्चितञ्च नयनं ह्यति चावसन्नं स्त्रस्तं च्युतञ्च हतदृक् च भवेत् तु याप्यम् । विस्तीर्णदृष्टि तनुरागमसत्प्रदर्शि साध्यं यथास्थितमनाविलदर्शनञ्च ॥ ७॥
Prognosis- Any ulceration restricted to one Patala (coat) only of the eye may be easily cured; an ulcer invading two Patalas of the organ may be healed only with the greatest difficulty. While the one affecting three Patalas should be regarded as incurable. Palliative measures are all that are possible in cases of looseness, dislocation, sunkenness and the thrashed condition (Piccita) of the eye as well as in case of Hata-drsti (Loss of eye-sight ). Cases of wrong or erroneous vision, marked by the dilatation of the pupil, absence of any considerable redness and those cases where the eye (eye-ball) is in its proper place and is not affected in its power of vision prove amenable to medical treatment. 6-7.
प्राणोपरोधवमनक्षवकण्ठरोधैरुन्नम्यमाशु नयनं यदतिप्रविष्टम् ।
नेत्रे विलम्बिनि विधिर्विहितः पुरस्तादुच्छिङ्घनं शिरसि वार्यवसेचनञ्च ॥ ८ ॥
A sunken eye may be uplifted either by holding the breath (Prana-vayu) or by inducing vomiting or sneezing, or by throttling or obstructing the wind-pipe. Where the eyes would be found to be hanging down from the sockets, the measures and remedies prescribed before should, be resorted to, and the patient should be made to take in long breath of air (through the nostrils) and cold water should be poured on his head. 8.
Symptoms and treatment of Kukunaka
षट्सप्ततिर्नयनजा य इमे प्रदिष्टा रोगा भवन्त्यमहतां महताञ्च तेभ्यः । स्तन्यप्रकोपकफमारुतपित्तरक्तैर्बालाक्षिवर्त्मभव एव कुकूणकोऽन्यः ॥ ९ ॥ मृद्गाति नेत्रमतिकण्डुमथाक्षिकूटं नासाललाटमपि तेन शिशुः स नित्यम् । सूर्यप्रभां न सहते स्रवति प्रबद्धं तस्याहरेद्रुधिरमाशु विनिर्लिखेच्च । क्षौद्रायुतैश्च कटुभिः प्रतिसारयेत् तु मातुः शिशोरभिहितञ्च विधिं विदध्यात् ॥ १० ॥ तं वामयेत् तु मधुसैन्धवसम्प्रयुक्तैः पीतं पयः खलु फलैः खरमञ्जरीणाम् । स्यात् पिप्पलीलवणमाक्षिकसंयुतैर्वा नैनं वमन्तमपि वामयितुं यतेत ॥ ११ ॥
Symptoms and treatment of Kukunaka – The seventy-six kinds of eye diseases herein mentioned before, occur to adults as well as to infants, but a peculiar disease, due to the action of deranged Vayu, Pitta, Kapha and blood, sometimes manifests itself in (the inner lining of) the eye-lids of an infant and this is known as Kukunaka. Its exciting cause is the vitiated condition of the breast-milk of the mother. In this disease, there is excessive itching in the eyes, and the child frequently rubs his eyes, nose and forehead with his fist; there is constant lachrymation and the child cannot bear the least light of sun’s rays. The organ should, in such cases, be speedily bled (by applying leeches) and be scraped (with rough leaves). The organ should further be rubbed with Tri-katu and honey pasted together. The mother (or the nurse) should also be treated in the manner prescribed before (in cases of an affection of the breast-milk). Compounds of Saindhava salt, honey and powdered Khara-manjari (Apamarga) seeds, as well as those of powdered Pippali, saindaava-salt and honey with the vehicle of breastmilk should be given to the child for emetic purposes, but this should be discontinued as soon as vomiting would set in. 9-11.
दत्त्वा वचामशनदुग्धभुजे प्रयोज्यमूर्ध्वं ततः फलयुतं वमनं विधिज्ञैः ॥ १२ ॥
To a child who takes both breast-milk and other solid food, the emetic should be administered with the admixture of Vaca, and to a much older child (i.e. one who has given up taking breast-milk) the emetic should be given with the admixture of Madana fruit. 12.
जम्ब्वाम्रधात्र्यणुदलैः परिधावनार्थं कार्यं कषायमवसेचनमेव चापि । आश्च्योतने च हितमत्र घृतं गुडू ची – सिद्धं तथाऽऽहुरपि च त्रिफलाविपक्वम् ॥ १३ ॥
Decoction of the tender leaves of Jambu, Amra and Amalaki should be used for washing and sprinkling purpose. Clarified butter duly cooked with Tri-phala or with Guduci should be used duly cooked with Tri-phala or with Guduci should be dropped into the eye as an Ascyotana measure. 13.
नेपालजामरिचशङ्खरसाञ्जनानि सिन्धुप्रसूतगुडमाक्षिकसंयुतानि । स्यादञ्जनं मधुरसामधुकाम्रकैर्वा कृष्णायसं घृतपयोमधु वापि दग्धम् ॥ १४॥ व्योषं पलाण्डु मधुकं लवणोत्तमञ्च लाक्षाञ्च गैरिकयुतां गुटिकाञ्जनं वा । निम्बच्छदं मधुकदार्वि सताम्रलोध्रमिच्छन्ति चात्र भिषजोऽञ्जनमंशतुल्यम्॥ १५ ॥
Anjanas composed of Manah -sila, Marica, Sarmkha (conchshell), Rasanjana and Saindhava pounded together and pasted with honey and treacle should be applied to the affected organ. Compounds of Murva, honey and powdered copper should also be used as Anjana. The compound prepared by burning black iron (steel), clarified butter, milk and honey mixed together should be similarly used as an Anjana. As an alternative, the Gutikanjana made up of Trikatu, Palamdu (Onion), Yasti-madhu, Saindhava, Laksa (lac ) and Gairika ( earth) pasted together, should be used. The Anjana made of Nimba-leaves, Yasti-madhu, Darvi, 1 copper ( powdered) and Lodhra taken in equal parts and pounded together, is also effications. 14-15.
स्रोतोजशङ्खदधिसैन्धवमर्द्धपक्षं शुक्रं शिशोनुदति भावितमञ्जनेन ।
स्यन्दे कफादभिहितं क्रममाचरेच्च बालस्य रोगकुशलोऽक्षिगदं जिघांसुः ॥ १६ ॥
An Anjana prepared with Rasanjana (Antimony), Samkha, curd and Saindhava Kept together for a period of half a fortnight,² should be applied to the affected organ of the child in cases of Sukra, and the directions given under the head of Kaphaja-Abhisyanda should also be followed by experienced physicians in such cases of the eye-disease of children. 16.
समुद्र इव गम्भीरं नैव शक्यं चिकित्सितम् । वक्तुं निरवशेषेण श्लोकानामयुतैरपि ॥ १७॥
सहस्त्रैरपि च प्रोक्तमर्थमल्पमतिर्नरः । तर्कग्रन्थार्थरहितो नैव गृह्णात्यपण्डितः ॥ १८ ॥
1. “Darvi” generaly means Daru – haridra; but here, on the authority or Videha, Dalhana takes it to mean the two kinds of Haridra, viz., Haridra and Daru-haridra. 2. Method of preparing this Anjana, as explained by Dalhana on the authority of Videha, is as follows: Sankha (Conch-shell) and Saindhava should be first pasted together with curd (Dadhi) and then a quantity of Rasanjana should be soaked with this preparation for seven days and a half and Varti should then be prepared therewith and applied to the eye as an Anjana.
तदिदं बहुगूढार्थं चिकित्साबीजमीरितम् । कुशलेनाभिपन्नं तद् बहुधाऽभिप्ररोहति ॥ १९॥
तस्मान्मतिमता नित्यं नानाशास्त्रार्थदर्शिना । सर्वमूह्यमगाधार्थं शास्त्रमागमबुद्धिना ॥ २० ॥
Conclusion-The Science of medicine is as incomprehensible as the ocean. It cannot be fully described even in hundreds and thousands of verses. Dull people who are incapable of catching the real importance of the Science of reasoning would fail to acquire a proper insight into the Science of medicine if dealt with elaborately in thousands of verses. The occult principles (of the Science of medicine), as explained in these pages, would, therefore, sprout and grow and bear good fruits only under the congenial heat of a (medical) genius. A learned and experienced (medical) man would therefore try to understand the occult principles here in inculcated with due caution and with reference to other Sciences. 17-20.
इति सुश्रुत संहितायामुत्तरतन्त्रे नयनाभिघातप्रतिषेधनामेकोनविंशोध्याय ॥ १९ ॥
Thus ends the nineteenth chapter of the Uttara-Tantra in the Susruta Samhita with deals with the medical treatment to be adopted in cases of hurt or injury to the eye.