अथातो विसर्पचिकित्सितं व्याख्यास्यामः । इतिह स्माहुरात्रेयादयो महर्षयः ।। १ ।।
We will now expound Visarpa chikitsam-treatment of Herpes; thus said Atreya and other great sages. (1)
VISARPA CHIKITSA – Ayurvedic Treatment of Herpes
पूर्वरूपेष्वेव सर्वविसर्पाणां लङ्घनं रूक्षणं सिरामोक्षणमुल्लेखनं विरेचनं च कुर्यात् । न तु कदाचिदपिस्नेहनम् ॥ २ ॥
In all varieties of visarpa, langhana (fasting) and other thinning therapies, ruksana (therapy which bring about dryness), siramoksa (venesection), ullekhana (emesis), viracana (purgation) should be done during their prodromal stage itself, but never snehana (lubricating therapies such as oleation etc). (2)
निरामेषु क्षीणकफेषु च शीतवीर्याणि सर्पींषि तिक्तकत्रायमाणाघृतादीनि पाने दद्यात् । तत्र मदनेन्द्रयवपटोलपिचुमन्दमधुकेक्षुरसान्वमनेऽवचारयेत् । द्राक्षात्रिवृत्त्रिफलात्रायमाणाविरेचने ।। ३ ।।
When not associated with (symptoms of) ama and when kapha is less, medicated ghee possessing cold potency, such as tiktaka ghrta, trayamna ghrta should be given to drink; madana, indrayava, patola, picumanda, madhuka and iksurasa should be used for producing vomiting; draksa, trivrit, triphala and trayamana for purgations. ( 3 )
मुस्तदेवदारुकुष्ठशताह्वावाराहीधान्याककृष्णगन्धावंशार्तगलान् लेपसेकेष्वनिलजे ह्रस्व – वढूवल्लीकण्टकपञ्चमूलानिच ॥४॥
For that (visarpa) born from vata; musta, devadaru, kustha, satahva, varahi, dhanyaka, krsnagandha sobhanjana, vamsa, atagala, hrasva panchamula, vadhra (brhat) panchamula, vallipanchamula and kantaki panchamula should be used for lepa (external application) and seka (pouring warm liquid over the part). (4)
पित्ते तु कमलोत्पलशैवालपङ्कदूर्वामृणालशृङ्गाटककशेरुकशर्कराहीबेरकुचन्दनमुक्तामणिगैरिकपयस्याप्रपौण्डरीकमधुकपद्मकघृतक्षीराणि न्यग्रोधादिंच ॥ ५ ॥
For that born from pitta; kamala, utpala, saivala, panka, durva, mrinala, Srngataka, kaseruka, sarkara, hribera, kuchandana, mukta, mani, gairika, payasya, prapaundarika, madhuka, padmaka, ghrta (ghee) kshira (milk) and drugs of nyagrodhadi gana (chapter 16 of sutrasthana) should be made use of (for external application and fomentation).
For that (visarpa) born from kapha; ajagandha, ashwagandha, sarala, kala, ekaisika, aguru, coca, rasna, vacha, sitasiva (misi), indravalli, cows urine, and drugs of varanadigana (chapter 16 of sutrasthana) should be made use of. (5)
श्रेष्मण्यजगन्धाश्वगन्धासरलकालकैषिकागरुचोचरास्त्रावचाशीतशिवेन्द्रवल्लीगोमूत्राणि वरणादिं चसंसर्गेयथादोषबलंविकल्पयेत् ||६||
In that variety caused by two doshas, treatment appropriate to the doshas should be adopted. (6)
तत्र कफस्थानाश्रिते सामे पित्तस्थानगते च रूक्षा विशीताः प्रलेपपरिषेकाः ॥७॥
When localised in the seats ( areas) of kapha, and has symptoms of ama; or in those localised in the seats of pitta, then external application and baths should be dry (nonunctous) and not very cold. (7)
पित्ते तनवः सुशीताः सघृता वस्त्रान्तरिताः क्षणे क्षणे चापनीयान्ये प्रयोज्याः ।।८।।
In case of (predominance) of pitta, they ( external application and bath) should be thin, very cold, mixed with ghee, applied over a sheet of cloth, removed and applied fresh minute after minute. (8)
द्वन्द्वजेषु यथायथं दोषांश्चिकित्सेत् । विशेषेणाग्निविसर्फे महातिक्तकं पिबेत् । ग्रन्थिविसर्फे रक्तपित्तसंसर्गमवेक्ष्य प्राग्लङ्घनादीनि विरेचनान्तानि शमनानि च योजयेत् । ततो वातश्लेष्महरं कर्म ॥ ९ ॥
For those (visarpa) produced by combination of two doshas, the doshas are to be treated appropriately; in agnivisarpa especially, drinking of mahatikta (ghrta) is ideal; for granthi visarpa, considering the associating of rakta and pitta samana (palliative) therapies commencing with fasting and ending with purgation should be adopted first and later on those therapies which subdue vata and kapha. (9)
शूले च तदा स्निग्धाम्लोष्णाभिरुत्कारिकाभिर्ग्रन्थीनामुपनाहनम् | वातकफविसर्पोक्तैश्चलेपस्तैरेव वा सिद्धेन तैलेन तोयेन वा परिषेकः । लिम्पेद्वा शुष्कमूलकस्य कल्केन नक्तमालत्वचो वा । बिभीतकेन वा विजयाक्षनागबलाग्निमन्थभूर्जग्रन्थिवंशपत्राणांवा ||१०||
When there is pain, the glandular enlargement should be given fomentation with warm poultices which are unctous, sour and hot; paste of drugs prescribed for visarpa arising from vata kapha should be applied externally; or the part bathed with either oil or water medicated with those drugs itself; or a coating of the paste of dry mulaka or a bark of naktamala; or with that of vibhitaka or with paste of vijaya ( haritaki), aksa, nagabala, agnimantha, bhurja granthi and vamsa patra. (10)
दन्तीचित्रकमूलत्वक्कासीसार्कस्नुही क्षीरभल्लातकास्थिभिरुष्णैर्लेपः शिलामपि भिनत्ति | दीर्घकालप्रसक्ते तु ग्रन्थौ त्रिफलांप्रयुञ्जीत | मधुपिप्पलीर्वा । मुस्तासक्तुभल्लातकानि वा | सीधुम धुशर्करान्वा । मातुलुङ्गरसानुविद्धांमदिरांवा | गिरिजतुंवागुल्मभेदनंवा | तप्तलोहोपलादिपीडनंवा । जत्रूर्ध्वगते तीक्ष्णधूमवमनानिच ।।११।।
Paste of danti, citramula, kasisa, sap of arka and snuhi; or bhallataka asthi applied hot, breaks up (makes an opening) even a stone (hence it is sure to make a hole in the glandular enlargements). For enlargement which is persisting since a long time, triphala should be administered with honey and pippal:; or musta, saktu and bhallataka; or sidhu, madhu, and sarkara or madira added with juice of matulunga; or the use of girijatu (silajatu); or the enlargement may be broken up by squeezing them with heated iron ball, stone etc. if glandular enlargement is localised on the areas above the shoulder, inhalation of strong fumes and administrations of strong emetic should be done. (11)
तथाप्यभेदे क्षारेणाग्निना वा दहेत् । पाटयित्वा वा शस्त्रेण परिशोधयेत् । विदग्धं वा रक्तमपनीयापनीय पुनः पुनः स्वेदयेत् । एवं पर्यायेण रक्तपित्ते वातश्रेष्मणि चोत्तिष्ठेत ॥ १२ ॥
Inspite of these, if the glandular enlargement are not punctured, they should be burnt either by caustic alkali or by fire, or cut open by a sharp instrument and then cleaned. That which is in the stage of ripening should be drained of its blood frequently and fomentation given repeatedly; in this manner treatment should be done for raktapitta and vatakapha alternately. (12)
सर्वस्मिन् विसर्पे पर्यागते विदारिते च व्रणवत् । तैलं च दार्वीविडङ्गकम्पिल्लकैः ग्रन्थिव्रणसाधनं साधयेत् ॥ १३ ॥
All types of visarpa which have over matured (ulcerated) and burst open, should be treated just like an ulcer; healing of glandular ulcers should be attempted by the use of oil prepared from darvi, vidanga and kampillaka. (13)
कर्दमके शीघ्रतरं सुतरां च वमनादीनि कृत्वा पुनर्जलौकोभिरसृगवसेचयेत् । असृक्प्रक्लेदाद्धि त्वङ्मांससिरास्नावसङ्क्लेदो भवति । पिबेच्च कषायं घनपटोलपिचुमन्दानाम् । मुस्तोशीरामलकसारिवाणाम् । चन्दनोत्पलयोः । पटोलादिवर्गस्य वा । घृतमिश्रं वा दार्वीत्वक्तिक्तापटोलयष्ट्याह्वारिष्टमसूरत्रिफलात्रायमाणानाम् ।।१४।।
Kardama visarpa should be treated very quickly by the administration of vamana (emesis) and other therapies to the maximum, blood letting should be done with the help of leeches; moistness (slimyness, greasiness ) develops in the skin, muscles, veins and tendons (nerves); only because of moistness ( slimyness) of the blood.
The patient should drink decoction of ghana, patola and picumanda, or of musta, usira, amalaka and sariva; or of chandana, and utpala; or of patoladivarga (chapter 16 of sutrasthana); of darvitvak, tikta, patola, yastyahva, arista, masura, triphala and trayamana, mixed with ghee. (14)
विरेकार्थं च त्रिवृच्चूर्णं सर्पिषापयसा द्राक्षारसेन घर्माम्भसा वा पाययेत् । त्रायमाणाशृतं पित्तोवृत्तौ क्षीरमिति । भवति चात्र ।। १५ ।।
For producing purgation, he should be made to drink powder of trivrit, along with either ghee, milk, juice of draksa or warm water; if pitta is aggravated greatly, he should drink milk boiled with trayamana.
Some verse more
श्रेष्ठास्त्रस्नुतिरेवात्र विसर्पो ह्यसृगाश्रयः । यच्चनासावसंसृष्टोरक्तपित्तेन जायते ॥१६॥
As visarpa is localised in the blood (arising from its vitiation) blood letting is the best treatment; it (visarpa) does not develop without the association of rakta and pitta (then also blood letting is ideal ). (16)
नघृतं बहुदोषाय देयं यन्त्र विरेचनम् । तेन दोषो ह्यपस्तब्धस्त्वग्रक्तपिशितंपचेत् ॥ १७ ॥
Even when the doshas are found to be greatly aggravated, no (medicated) ghee should be administered which does not produce purgation. By that (non-purgative ghee) the doshas, get blocked and cause cooking (destruction) of the skin, blood and muscles. (17)
॥ इतिविंशोऽध्यायः ॥
Thus ends the Twentieth chapter.
