अथातो विद्रधिवृद्धिचिकित्सितं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।
We will now expound the chapter Vidradhi-Vrddhi chikitsa – treatment of abscess and enlargement of the scrotum/ scrotal hernia); thus said atreya and other great sages.
Vidradhi Chikitsa – Abscess treatment
विद्रधिं सर्वमेवामं शोफवत्समुपाचरेत् ।
प्रततं च हरेद्रक्तं पक्के तु व्रणवत्क्रिया ॥ १ ॥
All types of Vidradhi (abscess) which are ama (unripe) should be treated similar to sopha (inflammatory swelling) blood-letting, being done repeatedly ; when these become pakva (ripe) treatment should be similar to an ulcer. 1.
Vataja vidradhi chikitsa
॥२॥ पञ्चमूलजलैधतं वातिकं लवणोत्तरैः ।
भद्रादिवर्गयष्ट्याह्वतिलैरालेपयेद्व्रणम् वैरेचनिकयुक्तेन त्रैवृतेन विशोध्य च । विदारीवर्गसिद्धेन त्रैवृतेनैव रोपयेत् ॥ ३ ॥
The vidradhi (abscess) of vata origin should be washed with the decoction of pancamula and a paste of drugs of bhadra daru varga (chapter 15 of sutrasthana), yastyahva, and tila added with more of lavana (salt) should be applied over it. It should be purified ( cleansed of pus ) by using trivrt sneha (mixture of three fats) boiled with drugs of virecanagana ( vide chapter 15 of sutrasthana) and made to heal by trivrt sneha itself boiled with drugs of vidari varga/ vidaryadi gana (chapter 15 of sutrasthana). 2-3.
Pittaja vidradhi chikitsa
क्षालितं क्षीरितोयेन लिम्पेद्यष्ट्यमृतातिलैः । पैत्तं घृतेन सिद्धेन मञ्जिष्ठोशीरपद्मकैः ॥ ४ ॥
रोपयेत् । पयस्याद्विनिशा श्रेष्ठायष्टीदुग्धैश्च न्यग्रोधादिप्रवालत्वक्फलैर्वा
The abscess of pitta origin should be washed with decoction of bark of trees having milky sap, applied over with the paste of yasti, amrta, and tila, it should be made to heal with the use of ghrta ( ghee ) boiled with manjistha, usira, payasya, the two nisa, srestha, yasti and dugdha (milk) or with tender sprouts, bark and fruits of nyagrodha etc. (nyagrodhadi gana (vide chapter 15 of sutrasthana). 4-5.
Kaphaja vidradhi chikitsa
कफजं पुनः ॥ ५ ॥
आरग्वधादिना धौतं सक्तुकुम्भनिशातिलैः । लिम्पेत्कुलत्थिकादन्तीत्रिवृच्छ्यामाग्नितिल्वकैः ॥ ६॥
ससैन्धवैः सगोमूत्रैस्तैलं कुर्वीत रोपणम् ।
The abscess of kapha origin should be washed with decoction of drugs of aragvadhadi gana (chapter 15 of sutrasthana), applied with the paste of saktu (cornflour), kumbha, nisa and tila; healed with the use of oil prepared with decoction of kulatthika, danti, trivrt, syama, agni and tilvaka, added with saindhava and gomutra (cow’s urine).6-7a.
रक्तागन्तूद्धवे कार्या पित्तविद्रधिवत्क्रिया ॥ ७ ॥
Treatment of abscesses arising from (vitiation of) blood and external causes is similar to that of abscess of pit origin.
Abhyantara vidrdhi chikitsa
वरुणादिगणक्वाथमपक्वेऽभ्यन्तरोत्थिते ऊषकादिप्रतीवापं पूर्वाहे विद्रधौ पिबेत् ॥ ८ ॥
When the internal abscess is in the unripe stage decoction of durgs of varunadi gana ( chapter 15 of sutrasthana) mixed with powder of drugs usakadi gana (chapter 15 of sutrasthana) should be consumed in the forenoon. 8.
घृतं विरेचनद्रव्यैः सिद्धं ताभ्यां च पाययेत् । निरूहं स्नेहबस्ति च ताभ्यामेव प्रकल्पयेत् ॥ ९ ॥
Medicated ghee prepared with drugs of purgative group and the two groups mentioned above should be consumed. Decoction enema and oleating enema also should be prepared from these drugs only. 9.
पानभोजनलेपेषु मधुशिग्रुः प्रयोजितः ।
दत्तावापो यथादोषमपक्कं हन्ति विद्रधिम् ॥ १० ॥
(Decoction of) Madhusigru added with paste (of the drugs mentioned above, made use of to prepare drinking water, appropriate to the dosa aggravated, food and for extrenal application) destroys the unripe abscess (cures without leading to suppuration). 10.
Trayantyadi kwatha
त्रायन्तीत्रिफलानिम्बकटुकामधुकं समम् । त्रिवृत्पटोलमूलाभ्यां चत्वारोंऽशाः पृथक् पृथक् ॥ ११ ॥
मसूरान्निस्तुषादष्टौ तत्क्वाथः सघृतो जयेत् । विद्रधीगुल्मवीसर्पदाहमोहमदज्वरान् ॥१२॥
तृणमूर्च्छाच्छर्दिहृद्रोगपित्तासृकुष्ठकामलाः
Equal aparts of trayanti, triphala, nimba, katuka and madhuka (all together one part ), four parts of trivrt and patola mula each seperately, and eight parts of dehusked masura made into decoction, mixed with ghee and consumed cures abscesses, abdominal tumour, visarpa ( herpes), burning sensation, unconsiciousness, toxicity, fever, thirst, fainting, vomitting, heart disease, bleeding disease, leprosy ( and other skin diseases) and jaundice. 11-13a.
Trayamanadi ghrita
कुडवं त्रायमाणायाः साध्यमष्टगुणेऽम्भसि ॥ १३ ॥
कुडवं तद्रसाद्धात्रीस्वरसात्क्षीरतो घृतात् । कर्षाशं कल्कितं तिक्तात्रायन्तीधन्वयासकम् ॥ १४ ॥
मुस्तातामलकीवीराजीवन्तीचन्दनोत्पलम् पचेदेकत्र संयोज्य तद्घृतं पूर्ववद्गुणैः ॥ १५ ॥
One kudava of trayamana is boiled in eight times and decoction reduced to quarter, To this, are added of water one kudava each of its own juice (of trayamana) and juice of dhatri, milk and ghee and paste of one karsa each of tikta, trayanti, dhanvayasaka, musta, tamalaki, vira, jivanti, candana and utpala and medicated ghee prepared which also posses qualities similar to the earlier formula. 13-15.
Draksadi ghrita
द्राक्षा मधूकं खर्जूरं विदारी सशतावरी । परूषकाणि त्रिफला तत्क्वाथे पाचयेद्धृतम् ॥ १६ ॥
क्षीरेक्षुधात्रीनिर्यासप्राणदाकल्कसंयुतम् ।
तच्छीतं शर्कराक्षौद्रपादिकं पूर्ववद्गुणैः ॥ १७॥
Medicated ghee is prepared with the decoction of draksa, madhuka, kharjura, vidari, satavari, parusaka and triphala, ksira ( milk ) iksurasa, dhatri rasa and paste of pranada (haritaki). After it cools, sugar and honey one fourth of the quantity of the preparations is added. This formula also possesses similar properties. 16-17.
हरेच्छृङ्गादिभिरसृक् सिरया वा यथान्तिकम् ।
Blood-letting should be done by using a srnga (sucking horn) etc. or by cutting the vein which is nearest. 18a.
विद्रधिं पच्यमानं च कोष्ठस्थं बहिरुन्नतम् ॥ १८ ॥
ज्ञात्वोपनाहयेत् शूले स्थिते तत्रैव पिण्डिते । तत्पार्श्वपीडनात्सुप्तौ दाहादिष्वल्पकेषु च ॥ १९ ॥
पक्व: स्याद्विद्रधिं भित्त्वा व्रणवत्तमुपाचरेत् । अन्तर्भागस्य चाप्येतच्चिह्नं पक्वस्य विद्रधेः ॥ २० ॥
The abscess which is situated in the abdomen undergoing ripening and found bulging outwards should be given a warm poultice and tied. When the pain subsides and the mass gets rounded, becomes painless when pressed from the sides, and burning sensation, etc, are slight, the abscess will have become ripe. It should then be cut (incised) and treated as an ulcer. These are the features of an internal abscess which is ripe. 18b-20.
पक्व: स्त्रोतांसि सम्पूर्य स यात्यूर्ध्वमधोऽवा । स्वयं प्रवृत्तं तं दोषमुपेक्षेत हिताशिनः ॥ २१ ॥
दशाहं द्वादशाहं वा रक्षन् भिषगुपद्रवान् । असम्यग्वहति क्लेदे वरुणादिं सुखाम्भसा ॥ २२ ॥
पाययेन्मधुशिग्रु वा यवागूं तेन वा कृताम् । शस्यते ॥ २३
यवकोलकुलत्थोत्थयूषैरन्नं च ॥
When the ripened abscess fills the channels with materials (like pus etc.) and they come out of the body on their own accord, either in upward or downward directions, it should be neglected (not stopped) by the person who desires good for the patient, for a period of ten or twelve days, protecting the patient all the time from complications/secondary diseases. If the discharge is not flowing out satisfactory, he should be given the (powder of drugs of) varunadi gana (chapter 15 of sutrasthana) with comfortables warm water or drink yavagu (thin gruel) prepared from madhusigru. He should consume his food (boiled rice) along with the soup of kulattha. 21-23.
ऊर्ध्वं दशाहात्त्रायन्तीसर्पिषा तैल्वकेन वा ।
शोधयेद्वलतः, शुद्धः सक्षौद्रं तिक्तकं पिबेत् ॥ २४ ॥ ,
After ten days, he should be purified (with purgations) using either trayantyadi ghrta (mentioned earlier) or tilvaka ghrita (vide verses 152-153 of chapter 3 of chikitsa sthana) considering his strength. After purification he should consume tiktaka ghrta ( verses 2-7 of chapter 19 of chikitsa sthana) mixed with honey. 24.
सर्वशो गुल्मवच्चैनं यथादोषमुपाचरेत् । सर्वावस्थासु सर्वासु गुग्गुलुं विद्रधीषु च ॥ २५ ॥ कषायैर्यौगिकैर्युञ्यात्स्वैः स्वैस्तद्वच्छिलाजतु ।
This (internal abscess) should be treated like gulma (abdominal tumour) in all the ways.
In all types of vidradhi (abscess) and in all their different stages. guggulu should be administered with appropriate decoctions (suitables to the aggravated dosas). Silajatu can 25-26a. also be used similarly.
पाकं च वारयेद्यत्नात्सिद्धिः पक्के हि दैविकी ॥ २६ ॥ अपि चाशु विदाहित्वाद्विद्रधिः सोऽभिधीयते ।
Suppuration (of the abscess) should be prevented by all efforts, once it becomes ripe, success in treatment is provi dential; because it produces quick suppuration it is called as ‘vidradhi’. 26b-27a.
सति चालोचयेन्मेहे प्रमेहाणां चिकित्सितम् ॥ २७ ॥
If it ( abscess ) manifests in patients of diabetes, the treatments mentioned so far should also be considered along with treatments of diabetes. 27b.
Stana vidradhi chikitsa
स्तनजे व्रणवत्सर्वं न त्वेनमुपनाहयेत् । पाटयेत्पालयन् स्तन्यवाहिनीः कृष्णचूचुकौ ॥ २८ ॥
सर्वास्वामाद्यवस्थासु निर्दुहीत च तत्स्तनम् । इति विद्रधिचिकित्सितम् ।
Abscess of the breast should be treated like a vrana (ulcer) but without applying warm poultices over it. It should be incised avoiding injury to the milk ducts, the black areola tand nipple. In all the stages commencing with the unripe, the affected breast should not be drained of its milk. 28-29a.
Thus ends the treatment of abscesses.
Treatment of enlargement of the scrotum – Vrddhi chikitsa
Vataja Scrotal Enlargement chikitsa
अथ वृद्धिचिकित्सितम् । शोधयेत्रिवृता स्त्रिग्धं वृद्धौ स्त्रेहैश्चलात्मके ॥ २९ ॥
कौशाम्रतिल्वकैरण्डसुकुमारकमिश्रकैः । ॥३०॥
ततोऽनिलघ्ननिर्यूहकल्कस्त्रेहैर्निरूहयेत् रसेन भोजितं यष्टितेलैनान्वासयेदनु।
स्वेदप्रलेपा वातघ्नाः पक्के भित्त्वा व्रणक्रियाम् ॥ ३१ ॥
Vrddhi (enlargement of the scrotum) arising from cala (vata) the patient should be given oleation therapy using trivrt sneha (mixture of three fats) followed by purifactory therapy using either the oil processed with kosamra, tilvaka and eranda, sukumaraka taila (described later in verse 41-46 ) or misraka sneha (described in verse 89-90 of chapter 14 of chikitsa sthana ).
Next, niruha basti (decoction enema ) administered using decoctions, paste and fats of drugs mitigating vata and made to take food along with meat soup.
Next, anuvasana basti ( lubricating enema) should be administered using yasti taila, fomentation and application of pastes which mitigate vata should be done next. When it becomes ripe, it should be cut (incised or punctured) and then treated as an ulcer. 29b-31.
Pittaja and raktaja vrddhi – Scrotal Enlargement treatment
पित्तरक्तोद्भवे वृद्धावामपक्के यथायथम् ।
शोफव्रणक्रियां कुर्यात् प्रततं च हरेतसृक् ॥ ३२॥
Vrddhi arising from pitta and rakta, should be treated in their ama (uripe) and pakva ( ripe ) stages just as treating a sopha (inflammatory swelling) and a vrana (ulcer) respectively. Blood should be let out frequently. 32.
Kaphaja vriddhi chikitsa
गोमूत्रेण पिबेत्कल्कं श्लैष्मिके पीतदारुजम् । विम्लापनादृते चास्य श्लेष्मग्रन्थिक्रमो हितः ॥ ३३॥
पक्के च पाटिते तैलमिष्यते व्रणशोधनम् । सुमनोरुष्कराङ्कोल्लसप्तपर्णेषु साधितम् ॥ ३४ ॥
पटोलनिम्बरजनीविडङ्गकुटजेषु च ।
In vrddhi arising from slesman (kapha) paste of pitadaru mixed with cows urine should be consumed. all the methods of treatments except vimlapana (kneading by hand) indicated for slesmagranthi (tumour of kapha origin) are beneficial. After it ripens and bursts use of medicated oil which cleanses the ulcer, prepared with sumana, aruskara, ankola, saptaparna, patola, nimba, rajani, vidanga and kutaja is desirable. 33-35a.
Medoja vyddhi cikitsa – scrotal enlargement due to accumilation of fat
मेदोजं मूत्रपिष्टेन सुस्विन्नं सुरसादिना ।। ३५ ।।
शिरोविरेकद्रव्यैर्वा वर्जयन् फलसेवनीम् । दारयेवृद्धिपत्रेण सम्यड्मेदसि सूद्धृते ॥३६॥ व्रणं माक्षिककासीससैन्धवप्रतिसारितम् । सीव्येदभ्यञ्जनं चास्य योज्यं मेदोविशुद्धये ॥ ३७॥
मनः शिलैलासुमनोग्रन्थिभल्लातकैः कृतम् । तैलमाव्रणसन्धानात्स्नेहस्वेदौ च शीलयेत् ॥ ३८ ॥
In vrddhi arising from medas (fat) the scrotum should be given fomentation (till perspiration appears) with drugs of either surasadigana or sirovireka (chapter 15 of sutrasthana) macerated with cows urine; next, avoiding the phala sevani (scrotal raphae), the scrotum should be incised with the vrddhipatra (lancet) till the fat is removed out completely the ulcer should then be covered with paste of honey., kasisa, and saindhava and sutured. It should be anointed with oil prepared with manassila, ela, sumana, granthi and bhallataka. Till the ulcer heels anointing it with oil and fomentation should be done. 35b-38.
Mutraja vrddhi cikitsa
मूत्रजं स्वेदितं स्निग्धैर्वस्त्रपट्टेन वेष्टितम् । विध्येदधस्तात्सेवन्याः स्त्रावयेच्च यथोदरम् ॥ ३९ ॥ व्रणं च स्थगिकाबद्धं रोपयेत्
Mutraja vrddhi (scrotal enlargement due to accumulation of urine/fluid/hydrocele) should be given fomentation, wrapped with cloth soaked in oil, punctured below near the suture (raphea) (with the help of a vrihimukha sastra-trocar and canula) and the fluid drained out just as in the case of udara (enlargement of the abdomen due to accumilation of fluid, described in chapter 15). The wound should be tied with sthagika bandha (kind of bandage vide chapter 29 of sutrasthana) and made to heal. 39-40a.
Antraja vrddhi chikitsa
अन्त्रहेतुके ।
फलकोशमसम्प्राप्ते चिकित्सा वातवृद्धिवत् ॥ ४० ॥
For antravrddhi (scrotal enlargement due to descent of the small intestine/scrotal hernia) when the intestine has not descended into the scrotum, treatment is similar to that of vatavrddhi (scrotal elargement arising from vata). 40b.
Sukumara ghrta
पचेत्पुनर्नवतुलां तथा दशपलाः पृथक् । दशमूलपयस्याश्वगन्धैरण्डशतावरी:
द्विदर्भशरकाशेक्षुमूलपोटगलान्विताः वहेऽपामष्टभागस्थे तत्र त्रिंशत्पलं गुडात् ॥ ४२ ॥
प्रस्थमेरण्डतैलस्य द्वौ घृतात्पयसस्तथा । आवपेद् द्विपलांशं च कृष्णातन्मूलसैन्धवम् ॥ ४३ ॥
यष्टीमधु (चित्र) कमृद्वीकायवानीनागराणि च (क्षारनागरम् ) । तत्सिद्धं सुकुमाराख्यं सुकुमारं रसायनम् ॥ ४४ ॥
वातातपाध्वयानादिपरिहार्येष्वयन्त्रणम् । प्रयोज्यं सुकुमाराणामीश्वराणां सुखात्मनाम् ॥ ४५ ॥
नृणां स्त्रीवृन्दभर्तृणामलक्ष्मीकलिनाशनम् सर्वकालोपयोगेन । कान्तिलावण्यपुष्टिदम् ॥ ४६ ॥ ।
वर्ध्मविद्रधिगुल्मार्शोयोनिमेढ्रानिलार्तिषु शोफोदरखुडप्लीहविड्विबन्धेषु चोत्तमम् ॥ ४७ ॥
One tula punarnava, ten pala each of dasamula, payasya, asvagandha, eranda, satavari, roots of the two darbha, sara, kasa, iksu, and potagala are boiled in one vaha of water and decoction reduced to one-eight part and filtered. To this are added thirty pala of guda (molasses), one prastha of eranda taila, two prastha each of ghrta ( ghee) and payas (milk) and paste of two pala each of krsna, its root (pippali mula), saindhava, yastimadhu, citraka, mrdvika, yavani and nagara, and ghrta prepared.
This formula known as Sukumara ghrta is rejuvinator for persons of tender constitution and possesses unlimited power in relieving the effects of breeze, sunlight long walk, riding on vehicles etc; suitable for administration to those who are of tender physique, wealthy, and desirous of comfort; who are husbanding a bevvy; it wards off inauspiciousness and dispels sorcery, furnishes good complexion, beauty and nourishment; by continuous use always it is the best medicine for vardhaman ( scrotal enlargement), abcess, abdominal tumour, haemorrhoids, disorder of vagina and penis, diseases of anila (vata) dropsy, enlargement of the abdomen, khuda (vatarakta / gout), diseases of the spleen and intestinal obstruction from faeces. 41-47.
Agnikarma in inguinal hernia – thermal cautery
यायाद्वधर्म न चेच्छान्तिं स्नेहरेकानुवासनैः । बस्तिकर्म पुरः कृत्वा वक्षणस्थं ततो दहेत् ॥ ४८ ।। अग्निना मार्गरोधार्थं मरुतः
If the vardhma (inguinal hernia) does not subside by oleation, purgation and lubricatory enema therapies; basti (decoction enema) should be administered first and then the mass in the groin should be branded with fire (cauterised) in order to clear the passage of maruta (vata). 48-49a.
अर्धेन्दुवक्रया । अङ्गुष्ठस्योपरि स्त्राव पीतं तन्तुसमं च यत् ॥ ४९ ॥
उत्क्षिप्य सूच्या तत्तिर्यग्दहेच्छित्त्वा यतो गदः। ततोऽन्यपार्श्वेऽन्ये वाहुर्दहेद्वाऽनामिकाङ्गुलेः ॥ ५० ॥
गुल्मेऽन्यैर्वातकफजे प्लीहि चायं विधिः स्मृतः ।
कनिष्ठिकानामिकयोर्विश्वाच्यां च यतो गदः ॥ ५१ ॥
The yellow tendon resembling a thread, situated over the thumb should be raised up by cutting, (its surrounding structures), and then branded ( with the fire ) using a needle curved like the half moon (which is made red hot) selecting the thumb of the opposite side. Others (athorities) say that branding should be done over the tendon above the ring finger (third finger). Some others say, that the same procedure should be done even in gulma (abdominal tumour) of vatakapha origin and enlargement of spleen, in visvaci (pain and rigidity of the arm/shoulder-arm syndrone) branding should be done between the little and ring fingers of the same side (of the affected arm). 49b-51.
Notes The above statement indicate the differences of opinion regarding the selection of the site and side for branding by fire. Experimental research only can help in confirming this procedure.
इति श्री वैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने विद्रधिवृद्धिचिकित्सितं नाम त्रयोदशोऽध्यायः ॥ १३॥
Thus ends the chapter, Vidradhi-vrddhi chikitsa-the thirteenth in chikitsasthana of Astangahrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
