अथातः सन्धिसितारोगप्रतिषेधं व्याख्यास्यामः । स्माहुरात्रेयादयो इति ह महर्षयः ।
We shall now expound the chapter-Sandhi sita – sita roga practised-treatment of diseases of the fornices, sclera and cornea (of the eye ); thus said Atreya and other great sages.
Upanaha chikitsa
उपनाहं भिषक् स्विन्नं भिन्नं व्रीहिमुखेन च। लेखयेन्मण्डलाग्रेण ततश्च प्रतिसारयेत् ॥ १ ॥
पिप्पलीक्षौद्रसिन्धूत्थैर्बध्नीयात्पूर्ववत्ततः पटोलपत्रामलकक्वाथेनाश्च्योतयेच्च तम् ॥ २ ॥
The physician should give fomentation to Upanaha, then puncture it with vrhimukha sastra (trocar), scrape it with mandalagra (lance) and then apply the paste of pippali and saindhava mixed with honey, bind it as described earlier (vide, verses 3-9 of chapter 9 ). Later ascyotana (washing the eye) be made with the decoction of leaves of patola and amalaka. 1-2.
Parvani chikitsa
पर्वणी बडिशेनात्ता बाह्यसन्धित्रिभागतः । वृद्धिपत्रेण वर्ध्याऽर्धे स्यादश्रुगतिरन्यथा ॥ ३ ॥ चिकित्सा चार्मवत्क्षौद्रसैन्धवप्रतिसारिता ।
Parvani should be lifted up with badisa (forceps), then cut (excised) with vrddhi patra ( lancet ) at about threefourth part from the external joint, the excision made at half the length, otherwise there will be flow of tears; further treatment is similar to arma (verse-20-22 further); and pratisarana (applying the paste ) with honey and saindhava, should be done. 3-4a.
Puyalasa chikitsa
पूयालसे सिरां सिरां विध्येत्ततस्तमुपनाहयेत् ॥ ४ ॥
कुर्वीत चाक्षिपाकोक्तं सर्वं कर्म यथाविधि । सैन्धवार्द्रककासीसलोहताम्रैः सुचूर्णितैः ॥५॥
चूर्णाञ्जनं प्रयुञ्जीत सक्षौद्रैर्वा रसक्रियाम् ।
In Puyalasa, the vein should be cut ( to let out blood) then given fomentation and all the treatments prescribed for aksipaka (ch. 15/28-30a) as per procedure. Saindhava, ardraka, kasisa, iron and copper fillings all nicely powdered, and mixed with honey should be applied as collyrium, or rasakriya (thick decoction) of these drugs may be used (for this purpose). 4b-6a.
Krimigranthi chikitsa
कृमिग्रन्थिं करीषेण स्विन्नं भित्त्वा विलिख्य च ॥ ६ ॥ त्रिफलाक्षौद्रकासीससैन्धवैः प्रतिसारयेत् ।
Krmigranthi should be given fomentation with (warm) cowdung, then punctured and scraped, followed by application of powder of triphala, kasisa and saindhava mixed with honey. 6b-7a.
Sukti, Balasa grathita and pistaka chikitsa
पित्ताभिष्यन्दवच्छुक्तिं कफाभिष्यन्दवमन्मुक्त्वा बलासाह्वयपिष्टके ॥७॥
सिराव्यधमुपाचरेत् । बीजपूररसाक्तं च व्योषकट्फलमञ्जनम् ॥ ८ ॥
Sukti should be treated in the same manner as of pittabhisyanda (verse 2-5 of chapter 16 ) Balasagrathita and Pistaka should also be treated similar to kaphabhisyanda excluding venesection (vide chapter 16 ); (powder of) vyosa and katphala macerated with the juice of bijapura should be applied to the eye as collyrium. ‘7b-8.
जातीमुकुलसिन्धूत्थदेवदारुमहौषधैः शोफकण्डूघ्नमञ्जनम् ॥ ९ ॥
(Powder of) buds of jati, saindhava, devadaru and mahausadha, made into wick of ( nice paste) with prasanna ( scum of beer) and used as eyelash cures swelling and itching. 9.
पिष्टैः प्रसन्नया वर्तिः रक्तस्यन्दवदुत्पातहर्षजालार्जुनक्रिया
The treatment of sirotpata, siraharsa, sirajala and arjuna is similar to that of raktaja abhisyanda ( chapter 16). 10a.
सिरोत्पाते विशेषेण घृतमाक्षिकमञ्जनम् ॥ १० ॥
सिराहर्षे तु मधुना श्लक्ष्णघृष्टं रसाञ्जनम्। अर्जुने शर्करामस्तुक्षौद्रैराश्च्योतनं हितम् ॥ ११ ॥
स्फटिक कुङ्कुमं शङ्खो मधुकं मधुनाऽञ्जनम्। मधुना चाञ्जनं शङ्खः फेनो वा सितया सह ॥ १२ ॥
In sirotpata, especially. ghee and honey mixed together shold be used as collyrium; in siraharsa, rasanjana made into a fine paste with honey should be used; in arjuna, ascyotana (eye drops) with sugar, mastu, (water of curds) and honey is beneficial or sphatika, kumkuma, sankha and madhuka should be made into a paste and applied as collyrium or sankha and phena with either madhu (honey) or sita (sugar) may be used as collyrium. 10b-12.
Arma chikitsa
अर्मोक्तं पञ्चधा तत्र तनु धूमाविलं च यत् ।
रक्तं दधिनिभं यच्च शुक्रवत्तस्य भेषजम् ॥ १३ ॥
Among the five varieties of Arma decribed, that which is thin, turbid like smoke, red and which resembles curds, are to be treated in the same manner as of sukra (described further on). 13.
Sastra chikitsa – surgical treatment
उत्तानस्येतरत् स्विन्नं ससिन्धूत्थेन चाञ्जितम् । रसेन बीजपूरस्य निमील्याक्षि विमर्दयेत् ॥ १४ ॥
इत्थं संरोषिताक्षस्य प्रचलेऽर्माधिमांसके । घृतस्य निश्चलं मूर्ध्नि वर्त्मनोश्च विशेषतः ॥ १५ ॥
अपाङ्गमीक्षमाणस्य वृद्धेऽर्मणि कनीनकात् । बली स्याद्यत्र तत्रार्म बडिशेनावलम्बितम् ॥ १६ ॥
नात्यायतं मुचुण्ड्या वा सूच्या सूत्रेण वा ततः । समन्तान्मण्डलाग्रेण मोचयेदथ कनीनकमुपानीय छिन्द्यात्कनीनकं मोक्षितम् ॥ १७ ॥
चतुर्भागावशेषितम्। रक्षेद्वाहिनींश्चानुवाहिनीः ॥ १८ ॥
कनीनकव्यधादश्रु नाडी चाक्षिण प्रवर्तते । वृद्धेऽर्मणि तथाऽपाङ्गात्पश्यतोऽस्य कनीनकम् ॥ १९ ॥
The patient (of arma ) is made to lie with his face up, the eye is then given fomentation, sainndhava macerated with the juice of bijapura is applied as an eye-salve; the lids are the closed and massaged briskly, thus exciting the muscle growth of the arma, is made to move (loosened); the upper part of the lid is held motionless especially; the patient is asked to look towards the apanga (outer canthus), then the fold of the arma which hanging loosely more towards the kaninaka (inner canthus) is held with the forceps and cut, with a needle or mandalagra (lancet ), the muscle should be released from below, the cut end is next pulled towards the inner canthus, leaving a quarter of it (muscle) to remain in its place, the inner canthus and tear ducts being protected (not injured during cutting); injury to the inner canthus leads to profuse flow of tears through the tear ducts. In case the arma is more developed towards the outer canthus, the patient should to asked to look towards the inner canthus, and then the cutting done suitably. 14-19.
सम्यक् छिन्नं मधुव्योषसैन्धवप्रतिसारितम् । उष्णेन सर्पिषा सिक्तमभ्यक्तं मधुसर्पिषा ॥ २० ॥
बध्नीयात्सेचयेन्मुक्त्वा तृतीयादिदिनेषु च । करञ्जबीजसिद्धेन क्षीरेण क्वथितैस्तथा ॥ २१ ॥
सक्षौद्रैर्द्विनिशारोध्रपटोलीयष्टिकिंशुकैः कुरण्टमुकुलोपेतैर्मुञ्चेदेवाह्नि । सप्तमे ॥ २२ ॥
After the cutting has been done properly, the eye should be smeared with honey, vyosa and saindhava; next warm ghee is put in, then the eye is anointed with honey and ghee mixed together and bandaged. On the third day it is removed and eye washed with milk boiled with seeds of karanja (and bandaged). Next (on the fifth day) it should be washed with the decoction of the two nisa, rodhra, patoli, yasti, kimsuka, and buds of kuranta mixed with honey. On the seventh day the bandage should be removed finally. 20-22.
सम्यक् छिन्ने भवेत्स्वास्थ्यं हीनातिच्छेदजान् गदान् । सेकाञ्जनप्रभृतिभिर्जयेल्लेखनबृंहणैः ॥२३॥
Proper cutting leads to health ( normalcy of the eye); the diseases arising from inadequate or excess cutting should be treated by proper seka (pouring medicated liquids into the eye), use of collyrium, lekhana ( act of scraping) and brmhana (nourishing the eye). 23.
सितामनः शिलैलेयलवणोत्तमनागरम् । अर्धकर्षोन्मितं तार्क्ष्यं पलार्धं च मधुद्रुतम् ॥ २४ ॥
श्लेष्मतिमिरपिल्लशुक्रार्मशेषजित् । अञ्जनं
Anjana (eye-salve) prepared with sita (sugar), manassila, aileya, lavanottama and nagara — each half-karsa and tarksya half pala, and mixed with honey cures timira (blindness) caused by slesma ( kapha), pilla and sukra (both are eye diseases) and armasesa (residue of arma). 24-25a.
त्रिफलैकतमद्रव्यत्वचं शरावपिहितां दग्ध्वा कपाले चूर्णयेत्ततः । पृथक् शेषौषधरसैः पृथगेव च भाविता ॥ २६ ॥
सा मषी शोषिता पेष्या भूयो द्विलवणान्विता । त्रीण्येतान्यञ्जनान्याह लेखनानि परं निमिः ॥ २७ ॥
पानीयकल्किताम् ॥ २५ ॥
The skin (outer portion) of any one of the triphala, is macerated in water put inside an earthen saucer (covered wih another saucer, their edges saeled, both together are coated with mud, dried in sun and then placed inside heap of burning cowdung cakes) and cooked. Next it is powdered nicely and soaked in the decoction of the other two drugs (of triphala) seperately. This ash is then mixed with the two lavana, and macerated well. These three eye-salves are best lekhana (scraping the ulcer), says Nimi. 25b. 27.
सिराजाले सिरा यास्तु कठिना लेखनौषधैः । नसिद्ध्यन्त्यर्मवत्तासां पिटिकानां च साधनम् ॥ २८ ॥
In Sirajala, the veins which are hard and do not respond to drugs of scraping action, the treatment is the same as of arma (surgical treatment) so also for the Siraja pitaka. 28. Sukra chikitsa
दोषानुरोधाच्छुक्रेषु स्निग्धरूक्षा वरा घृतम् । तिक्तमूर्ध्वमसृक्स्त्रावो रेकसेकादि चेष्यते ॥ २९ ॥
In Sukra, depending on the predominance of the dosas the treatment should be either unctuous (with use of fats) or dry (without the use of fats ) either vara ghrta (triphala ghrta) or tikta ghrta (internally), blood letting, urdhva reka (purgation to the head), seka (pouring decoctions over the eyes etc. (nasal medication, applying collyrium) are beneficial. 29
त्रिस्त्रिवृद्वारिणा पकं क्षतशुक्रे घृतं पिबेत् । सिरयाऽनु हरेद्रक्तं जलौकोभिश्च लोचनात् ॥ ३० ॥ सिद्धेनोत्पलकाकोलीद्राक्षायष्टिविदारिभिः । ससितेनाजपयसा सेचनं सलिलेन वा ॥ ३१ ॥ रागाश्रुवेदनाशान्तौ परं लेखनमञ्जनम् ।
In ksata sukra, the patient must consume medicated ghee boiled three times in the decoction of trivrt then blood should be taken out from the eyes either by cutting the veins or by applying leeches; goat’s milk boiled with utpala, kakoli, draksa, yasti and vidari mixed with sugar or the decoction of these drugs should be poured into the eye, after the redness flow of tears and pain subside collyrium which has lekhana ( scraping) properly should be applied. 30-32a.
वर्तयो जातिमुकुललाक्षागैरिकचन्दनैः ॥ ३२ ॥ प्रसादयन्ति पित्तस्त्रं घ्नन्ति च क्षतशुक्रकम् ।
Medicinal wick prepared with the buds of jati, laksa, gairika and candana ( and its paste applied as eye-salve) mitigates (the increased) pitta and asra (blood) and cures ksatasukra. 32b-33a.
Danta varti
॥३३॥ दन्तैर्दन्तिवराहोष्ट्रगवाश्वाजखरोद्भवैः सशङ्खमौक्तिकाम्भोधिफेनैर्मरिचपादिकैः ।
क्षतशक्रमपि व्यापि दन्तवर्तिर्निवर्तयेत् ॥ ३४ ॥
Wick is prepared from (the ash of ) teeth of the elephant, boar, camel, cow, horse, goat and ass, sankha (conch shell) mauktika (pearls) and ambodhiphena (sea foam) added with one-fourth part of marica and applied to the eye as collyrium; this Dantavarti cures even ksata sukra (as well as suddha sukra) though wide. 33b-34.
तमालपत्रं गोदन्तशङ्खफेनोऽस्थि गार्दभम् । ताम्रं च वर्तिर्मूत्रेण सर्वशुक्रकनाशिनी ॥ ३५ ॥
Wick prepared from tamalapatra ( ash of ) cows tooth, sankha (conch) samudraphena ( sea foam ), ash of bones of a donkey and copper filings macerated with cow’s urine (and used as collyrium) cures all the varieties of sukra. 35.
रत्नानि दन्ताः शृङ्गाणि धातवस्त्र्यूषणं त्रुटि: । करञ्जबीजं लशुनो व्रणसादि च भेषजम् ॥ ३६ ॥ सव्रणाव्रणगम्भीरत्वक्स्थशुक्रघ्नमञ्जनम् ।
Gems (pearl, coral etc.), teeth ( of animals like elephant etc.), horn (of cow, goat etc.), dhatu (mineral ores such as gairika etc.), tryusana, truti, seeds of karanja; lasuna and drugs which cure ulcers, used as collyrium cure sukra, having ulcers, not having ulcer, deep seated and localised in the skin. 36-37a.
निम्नमुन्नमयेत्स्नेहपाननस्यरसाञ्जनैः सरुजं नीरुजं तृप्तिपुटपाकेन शुक्रकम् । ॥३७॥
Sukra which is depressed and painful should be lifted up by therapies such as drinking of fat, nasal medication and use of rasanjana, that which is painless by therapies, such as tarpana and putapaka (chapter 24 of sustrasthana). 37b-38a.
शुद्धशुक्रे निशायष्टींसारिवाशाबराम्भसा ॥ ३८ ॥ सेचनं रोधपोटल्या कोष्णाम्भोमग्नयाऽथवा ।
Suddha sukra should be treated by pouring the decoction of nisa, yasti, sariva and sabara over the eye, or mild fomentation with bolus of paste of rodhra warm or by expo38b-39a. sure to fire.
Mahanila gutika
बृहतीमूलयष्ट्याह्वताम्रसैन्धवनागरैः धात्रीफलाम्बुना पिष्टैर्लेपितं ताम्रभाजनम् ।
यवाज्यामलकीपत्रैर्बहुशो धूपयेत्ततः ॥ ४० ॥
तत्र कुर्वीत गुटिकास्ता जलक्षौद्रपेषिताः । महानीला इति ख्याताः शुद्धशुक्रहराः परम् ॥ ४१ ॥ ॥३९॥
Roots of brhati, yastyahva tamra, saindhava and nagara are macerated in the juice of dhatriphala and applied over a copper vessel; ( after drying ) it should be exposed many times to the smoke of yava, ajya ( ghee) and leaves of amalaki, then the paste is macerated with water and honey and rolled into pills; this known as Mahanila gutika (used as eye salve) is best to cure suddha sukra. 39b-41.
स्थिरे शुक्रे घने चास्य बहुशोऽपहरेदसृक् । शिरः कायविरेकांश्च पुटपाकांश्च भूरिशः ॥ ४२ ॥
In case of sukra being immobile and thick, the blood of the patient should be removed often, purgation to the head and the body and putapaka (eye drops) should be adiministered in large measure (many times). 42.
कुर्यान्मरिचवैदेहीशिरीषफलसैन्धवैः हर्षणं त्रिफलाक्वाथपीतेन लवणेन वा ॥ ४३ ॥
In sukra, harsana ( raising the veins) should be done by applying (the powder of ) marica, vaidehi, fruit of sirisa and saindhava or by lavana alone after the patient has consumed the decoction of triphala. 43.
कुर्यादञ्जनयोगौ वा श्लोकार्धगदिताविमौ । शङ्खकोलास्थिकतकद्राक्षामधुकमाक्षिकैः ॥४४॥ सुरादन्तार्णवमलैः शिरीषकुसुमान्वितैः ।
Or eye-salve prepared with drugs mentioned in the following half verses should be made use of; sankha, seed of kola, kataka, draksa, madhuka and maksika; sura, danta (cow’s tooth), arnava mala (sea foam) added with flower of sirisa. 44-45a.
धात्रीफणिज्जकरसे क्षारो लाङ्गलिकोद्भवः ॥ ४५ ॥ उषितः शोषितचूर्ण: शुक्रहर्षणमञ्जनम् ।
Ksara (alkali) obtained from langalika soaked in the juice of dhatri and phanijjaka dried and powdered, is a collyrium best to raise the sukra. 45b-46a.
मुद्रा वा निस्तुषाः पिष्टाः शङ्खौद्रसमायुताः ॥ ४६ ॥ सारोमधूकान्मधुमान् मज्जा वाऽक्षात्समाक्षिका |
Or mudga devoid of its husk, mixed with sankha and ksaudra (honey) and macerated or madhukasara mixed with honey or the marrow of aksa mixed with honey (act similarly). 46b-47a.
गोखराश्वोष्ट्रदशनाः शङ्खः फेनः समुद्रजः ॥४७॥ वर्तिरर्जुनतोयेन हृष्टशुक्रकनाशिनी ।
Wick prepared with the (ash of) teeth of the cow, ass, horse, and camel; sankha and samudraphena macerated with the decoction of arjuna, cures sukra which has been raised. 47b-48a.
उत्सन्नं वा सशल्यं वा शुक्रं वालादिभिर्लिखेत ॥ ४८ ॥
Sukra which is elevated or having a foreign body should be scraped with hair ( which are rough) etc. (leaves, barks or other rough materials). 48b.
सिराशुक्रे त्वदृष्टिघ्ने चिकित्सा व्रणशुक्रवत् ।
In Sirasukra which has not caused loss of vision, the treatment is the same as vranasukra. 49a.
पुण्ड्रयष्ट्याह्नकाकोलीसिंहीलोहनिशाञ्जनम् ॥ ४९ ॥ कल्कितं छागदुग्धेन सघृतैर्धूपितं यवैः । धात्रीपत्रैश्च पर्यायाद्वर्तिरत्राञ्जनं परम् ॥ ५० ॥
Pundra, yastahva, kakoli, simhi, loha, nisa and anjana made into a paste with goat’s milk is exposed to the fumes of yava and leaves of dhatri mixed with ghee alternately and made into wicks. Applied as eye-salve it is best in this disease. 49b-50.
Ajaka chikitsa
अशान्तावर्मवच्छस्त्रमजकाख्ये च योजयेत् । अजकायामसाध्यायां शुक्रेऽन्यत्र च तद्विधे ॥ ५१ ॥
वेदनोपशमं स्नेहपानासृक्स्रावणादिभिः । कुर्याद्वीभत्सतां जेतुं शुक्रस्योत्सेधसाधनम् ॥५२॥
If the disease does not subside, sastra chikitsa-surgical treatment as prescribed for arma should be done in Ajaka. In incurable ajaka, sukra and similar diseases, pain should be relieved by drinking of fat, blood letting etc. and other drastic measures to relieve the great swelling of sukra. 51-52.
नालिकेरास्थिभल्लाततालवंशकरीरजम् । भस्माद्भिः स्त्रावयेत्ताभिर्भावयेत्करभास्थिजम् ॥ ५३ ॥
चूर्ण शुक्रेष्वसाध्येषु तद्वैवर्ण्यघ्नमञ्जनम् । साध्येषु साधनायालमिदमेव च शीलितम् ॥ ५४ ॥
The ash of shell of nalikera; bhallata, tala and vamsa karira mixed with the ash of bones of the camel, should be wrinsed in water many times (as indicated in the preparation of alkalies (chapter 30 of sutrasthana) and then dried. Used as collyrium in the incurable sukra it removes the discolouration, and in the curable kind, this alone is enough to cure the disease, if used habitually. 53-54.
अजकां पार्श्वतोविध्वा सूच्या विस्त्राव्य चोदकम् । समं प्रीड्याङ्गुष्ठेन प्रीड्याङ्गुष्ठेन वसार्द्रेणानु पूरयेत् ॥ ५५ ॥
व्रणं गोमांसचूर्णेन वद्धं वद्धं विमुच्य च। सप्तरात्राद् व्रणे रूढे कृष्णभागे समे स्थिरे ॥ ५६ ॥
स्नेहाञ्जनं च कर्तव्यं नस्यं च क्षीरसर्पिषा । तथाऽपि पुनराधमाने भेदच्छेदादिकां क्रियाम् ॥ ५७ ॥
युक्त्या कुर्याद्यथा नातिच्छेदेन स्यान्निमज्जनम् ।। ५७ ।।
Ajaka should be pricked from the sides, by the needle, the watery fluid inside is squeezed out by kneading evenly with the thumb and moist cloth; then the ulcer should be filled with the powder of cow’s flesh and bandaged. This process of filling and bandaging, for seven days, when the ulcer heals and the black portion (cornea) becomes even and immovable, then snehanjana (eye-salve mixed with fats) should be done with milk and ghee. Even after these therapies, if if gets swollen, filled with fluid, then pricking or excision should be undertaken, as much as justified, since excess of treatment (pricking and excision) leads to sinking (blindness).
नित्यं च शुक्रेषु शृतं यथास्वं पाने च मर्शे च घृतं विदध्यात् । न हीयते लब्धबला तथाऽन्तस्तीक्ष्णाञ्जनैर्दृक् सततं प्रयुक्तैः ॥ ५८ ॥
In sukra, medicated ghee prepared with the appropriate drugs should be used daily for pana (consuming internally) and marsa (droping into the nose). The vision gaining strength by this method does not suffer from the effects of strong collyrium, though used continuously (habitually). 58½.
इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां
षष्ठे उत्तरस्थाने सन्धिसितासितरोगप्रतिषेधो नामैकादशोऽध्यायः ॥ ११ ॥
Thus ends the chapter-Sandhisitasita roga pratisedha -the eleventh in of Astanga hrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
