अथातो वर्त्मरोगप्रतिषेधं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।
We shall now expound the chapter-Vartmaroga_pratisedha-treatment of diseases of the eyelids; thus said Atreya and other great sages.
Vartma Chikitsa – Treatment of diseases of eyelids
कृच्छ्रोन्मीले पुराणाज्यं द्राक्षाकल्काम्बुसाधितम् ।
ससितं योजयेत्स्निग्धं नस्यधूमाञ्जनादि च ॥ १ ॥
For Krchronmila, old ghee, boiled with decoction and paste of draksa, added with sugar should be made use of as lubricating nasal drops, eye-salve etc.
कुम्भीकावर्त्म लिखितं सैन्धवप्रतिसारितम् । यष्टीधात्रीपटोलीनां क्वाथेन परिषेचयेत् ॥ २ ॥
Kumbhika vartma should be scraped, sprinkled with (fine powder of) saindhava and decoction of yasti, dhatri and patoli poured over it. 2.
Vartma lekhana vidhi – procedure of scraping the lids
निवातेऽधिष्ठितस्याप्तैः शुद्धस्योत्तानशायिनः । बहिः कोष्णाम्बुतप्तेन स्वेदितं वर्त्म वाससा ॥ ३ ॥
निर्भुज्य वस्त्रान्तरितं वामाङ्गुष्ठाङ्गुलीधृतम् । न स्स्रंसते चलति वा वर्मैवं सर्वतस्ततः ॥ ४ ॥
मलाग्रेण तत्तिर्यक् कृत्वा शस्त्रपदाङ्कितम् । लिखेत्तेनैव पत्रैर्वा शाकशेफालिकादिजैः ॥ ५ ॥
फेनेन तोयराशेर्वा पिचुना प्रमृजन्नसृक् । स्थिते रक्ते सुलिखितं सक्षौद्रैः प्रतिसारयेत् ॥ ६ ॥
यथास्वमुक्तरैनु च प्रक्षाल्योष्णेन वारिणा । घृतेन सिक्तमभ्यक्तं बधीयान्मधुसर्पिषा ॥ ७ ॥
ऊर्ध्वाधः कर्णयोर्दत्त्वा पिण्ढीं च यवसक्तुभिः । द्वितीयेऽहनि मुक्तस्य परिषेकं यथायथम् ॥ ८ ॥
कुर्याच्चतुर्थे नस्यादीन् मुञ्चेदेवाह पञ्चमे ।
The patient who has been purified (by emesis, purgation etc.) is made to lie in a room devoid of breeze, with his face up and surrounded by his well wishers. The lids are then given fomentation with warm water, held within the folds of a band of cloth, by the thumb and fingers of the left hand in such a way that if neither slips away nor makes any movement. Then with the mandalagra sastra (lancet), an incision shouldd be made horizontally, and then scraping done by its own edge, or with leaves of sephalika etc. (which are very rough); the exuding blood being washed by either phena (samudra phena/cuttle-fish), water or wet cloth. After the bleeding stops, the scraped place should be smeared with the powder of saindhava mixed with honey as described earlier; after some time it (lid) should be washed with warm water, bathed with ghee; a bolus of flour of yava mixed with honey and ghee, is inserted inside and the lids bandaged taking the tails of the bandage, above and below the ears. On the second day, it should be removed and bathing the eye done as described earlier. On the fourth day, nasal medication etc. should be done and from the fifth day, the bandage removed. 3-9a.
समं नखनिभं शोफकण्डूघर्षाद्यपीडितम् ॥ ९॥
विद्यात्सुलिखितं वर्त्म लिखेद् भूयो विपर्यये ।
रुकृपक्ष्मवर्त्मसदनस्त्रंसनान्यतिलेखनात् स्नेहस्वेदादिकस्तस्मिन्निष्टो वातहरः क्रमः । ॥१०॥
The lid becoming even, resembling the nail in shape, relieved of swelling, itching, friction and such other troubles should be considered as properly scraped, and in case of opposite symptoms if should be scraped again.
pain, weakness of the hairs and lids and drooping, result from excess scraping; for that, oleation,sudation etc. and methods of mitigating vata are desired. 9b-11a.
अभ्यज्य नवनीतेन श्वेतरोधं एरण्डमूलकल्केन पुटपाके प्रलेपयेत् ॥ ११ ॥ पचेत्ततः ।
स्विन्नं प्रक्षालितं शुष्कं चूर्णितं पोटलीकृतम् ॥ १२ ॥ स्त्रिया: क्षीरे छगल्या वा मृदितं नेत्रसेचनम् ।
A piece of svetarodhra anointed with butter is given a covering with the paste of roots of eranda, and cooked in the putapaka method. After it gets cooked, it is washed, dried, powdered and mecerated either with breast-milk, or goat’s milk, made into a ball (held inside cloth) and squeezed (so that drops of juice fall into the eye). 11b-13a.
शालितन्दुलकल्केन लिप्तं तद्वत् परिष्कृतम् ॥ १३ ॥
कुर्यान्नेत्रेऽतिलिखिते मृदितं दधिमस्तुना | केवलेनापि वा सेकं मस्तुना जाङ्गलाशिनः ॥ १४ ॥
The same (svetarodhra) placed inside the paste of flour of sali and cooked in the same way, macerated with dadhi mastu (water of curds / whey ) should be squeezed to the lid which has been over-scraped; or the eye may be bathed with mastu (whey) alone for the person who consumes meat of animals of desert-like lands. 13b-14.
पिटिका व्रीहिवक्त्रेण भित्त्वा तु कठिनोन्नताः । निष्पीडयेदनु विधिः परिशेषस्तु परिशेषस्तु पूर्ववत् ॥ १५ ॥
Hard and elevated eruptions should be pricked with Vrihimukha sastra (trocar) and their contents squeezed out. Afterwards pariseka (bathing the eye) done as described earlier. 15.
लेखने भेदने चायं क्रमः सर्वत्र वर्त्मनि ।
This is the procedure of lekhana (scraping) and bhedana (pricking, puncturing) in all the diseases of the eyelids. 16a.
Pittotklista and Raktotklista
पित्तास्त्रोत्क्लिष्टयोः स्वादुस्कन्धसिद्धेन सर्पिषा ॥ १६ ॥
सिराविमोक्षः स्निग्धस्य त्रिवृच्छ्रेष्ठं विरेचनम् । लिखिते स्रुतरक्ते च वर्त्मनि क्षालनं हितम् ॥ १७ ॥
यष्टीकषायः, सेकस्तु क्षीरं चन्दनसाधितम् ।
In pittotklista and raktotklista, venesection should be done after making the patient oleated with ghee prepared with drugs of sweet group (chapter 10 of sutrasthana) followed by purgation with trivrt. The lid is then scraped, and bleeding stopped; it is beneficial to wash the lid with the decoction of yasti and bathe it by pouring milk boiled with candana. 16b-18a.
Paksmasadana
पक्ष्मणां सदने सूच्या रोमकूपान् विकुट्टयेत् ॥ १८ ॥
ग्राहयेद्वा जलौकोभिः पयसेक्षुरसेन वा । वमनं, नावनं सर्पिः शृतं मधुरशीतलैः ॥ १९ ॥
In paksmasadana, the hair follicles should be pricked well with the needle or sized by leeches, emesis therapy using milk and sugercane juice and nasal medication with ghee procssed with drugs which are sweet and cold in potency should be done. 18b-19.
सञ्चूर्ण्य पुष्पकासीसं भावयेत्सुरसारसैः ।
ताम्रे दशाहं परमं पक्ष्मशाते तदञ्जनम् ॥ २० ॥
Paksmasata
Puspakasisa well powdered is soaked in the juice of surasa kept in a copper vessel. After ten days this if used as a colyrium is best in paksmasata. 20.
पोथकीर्लिखिताः शुण्ठीसैन्धवप्रतिसारिताः। उष्णाम्बुक्षालिताः सिञ्चेत् खदिराढकिशिग्रुभिः ॥ २१ ॥
अप्सिद्वैर्द्विनिशा श्रेष्ठामधुकैर्वा समाक्षिकैः ।
Pothaki should be scraped, smeared with sunthi and saindhava, washed with warm water, and sprinkled with water boiled with either khadira, adhaki, and sigru or with the two nisa, srestha and madhuka both mixed with honey. 21-22a.
kaphotklista
कफोत्क्लिष्टे विलिखिते सक्षौद्रैः प्रतिसारणम् ॥ २२ ॥
सूक्ष्मैः सैन्धवकासीसमनोह्वाकणतार्क्ष्यजैः । वमनाञ्जननस्यादि सर्वं च कफजिद्धितम् ॥ २३ ॥
In kaphotklista after doing the scraping nice powder of saindhava, kasisa, manohva, kana and tarksya mixed with honey should be applied; emesis, applying colyrium, nasal medication etc. and all other therapies mitigating kapha should be done. 22b-23.
कर्तव्यं दहेत् । लगणेऽप्येतदशान्तावग्निना
Even for lagana the same treatment should be done; if it does not subside then it should be burnt with fire ( cauterised). 24a.
[ स्विन्नां भित्त्वा विनिष्पीड्य भिषग (ड्योत्सङ्गां शिलैलासैन्धवनतैः सक्षौद्रैः चा) ञ्जननामिकाम् । प्रतिसारयेत् ॥ १ ॥]
(The physician should apply fomentation to Utsanga and Anjananamika, prick it, remove its contents and then apply the powder of sila, saindhava and nata added with honey).
Kukunaka
कुकूणे पीत्वा खदिर श्रेष्ठानिम्बपत्र शृतं घृतम् ॥ २४ ॥
धात्री वमेत्कृष्णायष्टीसर्षपसैन्धवैः । अभयापिप्पलीद्राक्षाक्वाथेनैनां मुस्ताद्विरजनीकृष्णाकल्केनालेपयेत्स्तनौ विरेचयेत् ॥ २५ ॥
धूयेत्सर्षपैः साज्यैः सुद्धां क्वाथं च पाययेत् ॥ २६ ॥
पटोलमुस्तमृद्वीकागुडूचीत्रिफलोद्भवम् शिशोस्तु लिखितं वर्त्म स्रुतासृग्वाऽम्बुजन्मभिः ॥२७॥
धात्र्यश्मन्तकजम्बूत्थपत्रक्लाथेन सेचयेत् ।
In Kukunaka, the nursing mother should be made to consume medicated ghee prepared with khadira, srestha and leaves of nimba; then emesis therapy administered using krsnsa, yasti, sarsapa and saindhava; and purgation therapy with the decoction of abhaya, pippali, and draksa. Her breasts should be smeared with the paste of musta, the two rajani and krsna and exposed to the fumes of sarsapa mixed with ghee. After purification she should be made to drink the decoction of patola, musta, mrdvika, guduci and triphala.
The eye lid of the child should be scraped or blood taken out by applying the leech; after that it should be bathed with the decoction of dhatri, asmantaka, and leaves of jambu. 24b-28a.
प्रायः क्षीरघृताशित्वाद्वालानां श्लेष्मजा गदाः ॥ २८ ॥
तस्माद्वमनमेवाग्रे सर्वव्याधिषु पूजितम् । सिन्धूत्थकृष्णापामार्गबीजाज्यस्तन्यमाक्षिकम् ॥ २९ ॥
चूर्णो वचाया: सक्षौद्रो मदनं मधुकान्वितम् । क्षीरंक्षीरान्नमन्त्रं च भजतः क्रमतः शिशोः ॥ ३० ॥
वमनं सर्वरोगेषु विशेषेण कुकूणके । सप्तलारससिद्धाज्यं योज्यं चोभयशोधनम् ॥ ३१ ॥
Because children are consuming milk and ghee (as food) they generally get affected by disease caused by kapha, hence in all diseases emesis therapy should be administered first.
(Powder of) saindhava, krsna and seeds of apamarga mixed with ghee, breast-milk and honey, powder of vaca mixed with honey; or madana and madhuka (mixed with honey) are best emetic recipe for children who consume breast-milk and those consume both milk and solid food and those cosnsuming only solid food, respectively, in all the diseases, especially in kukunaka.
Medicated ghee prepared from the decoction of saptala should be made use of to produce both the purifications (emesis and purgation). 28b-31.
kukunaka and pothaki
द्विनिशारोध्रयष्ट्याह्वरोहिणीनिम्बपल्लवैः कुकूणके हिता वर्तिः पिष्टैस्ताम्ररजोन्वितैः ॥ ३२ ॥
क्षीरक्षौद्रघृतोपेतं दग्धं वा लोहजं रजः। एलारसोनकतकशङ्घोषणफणिज्जकैः ॥३३॥
वर्तिः कुकूणपोथक्योः सुरापिष्टैः सकट्फलैः।
Wick prepared with macerating in water the two nisa, rodhra, yastyahva, rohini tender leaves of nimba and fine powder of copper or the powder of burnt iron (iron slag) mixed with milk, honey and ghee is beneficial in kukunaka (when applied as a collyrium to the eyes ). Wick prepared with ela, rasona, kataka, sankha, usana, phanijjaka, and katphala macerated with sura (beer) is beneficial in both kukunaka and pothaki. 32-34a.
Paksmarodha
पक्ष्मरोधे प्रवृद्धेषु शुद्धदेहस्य रोमसु ॥ ३४ ॥
उत्सृज्य द्वौ भ्रुवोऽघस्ताद्भागौ भागं च पक्ष्मतः। यवमात्रं यवाकारं तिर्यक् छित्वाऽऽर्द्रवाससा ॥ ३५ ॥
अपनेयमसृक् तस्मिन्नल्पीभवति शोणिते । सीव्येत्कुटिलया सूच्या मुद्गमात्रान्तरैः पदैः ॥ ३६ ॥
बध्वा ललाटे पट्टं च तत्र सीवनसूत्रकम् । नातिगाढश्लथं सूच्या निक्षिपेदथ योजयेत् ॥ ३७ ॥
मधुसर्पिः कवलिकां न चास्मिन् बन्धमाचरेत् । न्यग्रोधादिकषायैश्च सक्षीरैः सेचयेद्रुजि ॥ ३८ ॥
सूत्रमपनीयावचूर्णयेत् । पञ्चमे दिवसे गैरिकेण व्रणं युञ्यात्तीक्ष्णं नस्याञ्जनादि च ॥३९॥
In paksmarodha where the hair (eyelashes) have grown too much, the patient who has been purified (by emesis and purgation) is subjected to a surgical operation as follows a horizontal incision is made underneath the brow, of the size of a yava (barley) and resembling a yava (barley) in shape, at that place on the eyelid, leaving off two thirds part from above and one third part from the border line of the eyelashes; the exuding blood remved with the help of wet cloth; after the bleeding stops, the wound sutured with a curved needle making stitches, at the distance of the size of a green gram between them; a band of cloth should be tied on the forehead neither too tight nor too loose, and the suture either thread of cotton, silk or flax, fixed to the band on the forehead; a cotton wick soaked in honey and ghee is then placed over (the site of operations); bandaging should not be done in this condition. In case there is pain decoction of drugs of nyagrodbadi gana (chapter 15 of sutrasthana) mixed with milk should be poured on the place. On the fifth day the suture should be removed and powder of gairika be applied on the wound. Strong nasal medications and collyriums should be made use of. 34b-39.
दहेदशान्तौ निर्भुज्य वर्त्मदोषाश्रयां वलीम् । संदंशेनाधिकं पक्ष्म हृत्वा तस्याश्रयं दहेत् ॥ ४० ॥
सूच्यग्रेणाग्निवर्णेन, दाहो बाह्यालजेः पुनः । भिन्नस्य क्षारवह्निभ्यां सुच्छिन्नस्यार्बुदस्य च ॥ ४१ ॥
If the diseases does not subside (by the above treatment) the folds of the lid where in the dosas are localised should be bent outwards with the help of a forceps, the extra hair are cut off and their place of dwelling (growth) burnt (cauterised) with the tip of the needle heated redhot.
In Bahyalaji, cauterising should be done after puncturing. In Arbuda cauterising should be done with both alkalies and fire after excising it completely. 40-41.
इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने वर्त्मरोगप्रतिषेधो नाम नवमोऽध्यायः ॥ ९ ॥
Thus ends the chapter Vartmaroga pratisedha-the ninth in Uttarasthana of Astanga hrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
