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ashtanga hridayaVRANA PRATISEDHA - Treatment of ulcers - Ashtanga Hridaya Chapter 25

VRANA PRATISEDHA – Treatment of ulcers – Ashtanga Hridaya Chapter 25

अथातो व्रणप्रतिषेधं व्याख्यास्यामः ।

इति ह स्माहुरात्रेयादयो महर्षयः ।

We will now expound the chapter-Vrana pratisedhatreatment of ulcers; thus said Atreya and other great sages.

Vrana prakara – types of ulcer

व्रणो द्विधा निजागन्तुदुष्टशुद्धविभेदतः । शरीरोत्थैरागन्तुर्बाह्यहेतुजः ॥ १॥ शुद्धस्तैरनधिष्ठितः । निजो दोषैः दोषैरधिष्ठितो दुष्टः

Vrana are of two kinds viz, Nija (organic) and Agantu (traumatic); and dusta (vitiated, foul ) and suddha (unvitiated, clean ) ; nija is caused by dosas ( aggravated) in the body, agantu by external causes; dusta is that in which the dosas are localised and suddha is that which is free from localisation of the dosas. 1−2a.

Dusta vrana – vitiated ulcer

संवृतत्वं विवृतता काठिन्यं मृदुताऽति वा ॥ २ ॥

अत्युत्सन्नावसन्नत्वमत्यौष्ण्यमतिशीतता रक्तत्वं पाण्डुता कार्यं पूतिपूयपरिस्रुतिः ॥ ३॥

पूतिमांससिरास्नायुच्छन्नतोत्सङ्गिताऽतिरुक संरम्भदाहश्वयथुकण्ड्वादिभिरुपद्रुतः ॥४॥ विद्याद्दुष्टव्रणाकृतिम् । दीर्घकालानुबन्धश्च

Either contraction or expansion; hardness or softness; too much of elevation of depression; too much of warmth ( feeling of heat) or cold; too much of redness or paleness; black colouration, discharge of foul smelling pus; foul smelling muscle, veins, or tendons covering the ulcer at its top; severe pain, profound distress, burning sensation, swelling itching and other complication associating and persisting for a long time—are the feature of a dusta vrana (vitiated ulcer).

स पञ्चदशधा दोषैः सरक्तैः

It (vrana) is of fifteen kinds, caused by the dosas along with rakta (blood). 5b.

Vataja vrana

तत्र मारुतात् ॥ ५ ॥

श्यावः कृष्णोऽरुणो भस्मकपोतास्थिनिभोऽपि वा । मस्तुमांसपुलाकाम्बुतुल्यतन्वल्पसंस्स्रुतिः

निर्मांसस्तोदभेदाढ्यो रूक्षश्चटचटायते । ॥६॥

Vrana (ulcer) caused by maruta (vata ), is blue, blackish red or resembles ash or bones of th e pegion, exudes fluids which resembles water of curds, mutton wash or grain wash, thin and small in quantity; ulcer not showing (more of) muscle tissue with severe pricking and cutting-like pain, dryness and makes sound ( when manipulated). 6-7a.

Pittaja vrana

पित्तेन क्षिप्रजः पीतो नीलः कपिलपिङ्गलः॥७॥

मूत्रकिंशुकभस्माम्बुतैलाभोष्णबहुस्स्रुतिः क्षारोक्षितक्षतसमव्यथो । रागोष्मपाकवान् ॥ ८ ॥

Ulcer caused by pitta, develops quickly, is yellow, blue, brown or yellowish-brown, exudes fluid resembling urine, kimsuka, solution ash and oil, warm and large in quantity; pain resembles that caused by the smearing of caustic alkali (severe burning sensation), redness, feelling of great heat and undergoes ripening / suppuration. ‘7b-8.

Kaphaja vrana

कफेन पाण्डुः कण्डूमान् बहुश्वेतघनस्स्रुतिः । स्थूलौष्ठ: कठिनः स्नायुसिराजालततोऽल्परुक् ॥ ९ ॥

Ulcer caused by kapha is pale, has itching, large quantity of white, thick exudate; thick edges, hard with network of tendons and veins and has mild pain. 9.

Raktaja vrana

प्रवालरक्तो रक्तेन सरक्तं पूयमुगिरेत् । वाजिस्थानसमो गन्धे युक्तो लिङ्गैश्च पैत्तिकैः ॥ १०॥

Ulcer caused by rakta (blood is red like the coral, exudes pus mixed with blood, emits smell like that of a horse’s stable and has other feature of ulcer caused by pitta. 10.

द्वाभ्यां त्रिभिश्च सर्वेश्च विद्याल्लक्षणसङ्करात् ।

By the mixtrue of feature, presence of two and three dosas should be understood. 11a.

Suddha vrana – unvitiated ulcer

जिह्वाप्रभो मृदुः श्लक्षण: श्यावौष्ठपिटिकः समः ॥ ११

॥ किञ्चिदुन्नतमध्यो वा व्रणः शुद्धोऽनुपद्रवः ।

The ulcer which resembles the tongue (in colour), is soft, smooth, bluish in its edges, with eruptions ( granulations), even the floor slightly elevated and not accompanied with any complications-are the featrues of a suddhavrana ( ulcer unvitiated by the dosas etc.). 11b-12a.

Asadhya vrana – incurable ulcer

त्वगामिषसिरास्नायुसन्ध्यस्थीनि व्रणाशयाः ॥ १२॥ कोष्ठो मर्म च तान्यष्टौ दुःसाध्यान्युत्तरोत्तरम् ।

The skin, muscle, vein, tendons, bony joints, bones, viscera of the trunk and vital spots-these eight places of dwelling (sites) of the ulcers are very difficult to cure in their successive order. 12b-13a.

Susadhya vrana – easily curable ulcer

सुसाध्यः सत्त्वमांसाग्निवयोबलवति व्रणः ॥ १३ ॥

दीर्घस्त्रिपुटकश्चतुरस्त्राकृतिश्च यः । स्फिक्पायुमेद्रोष्ठपृष्ठान्तर्वक्त्रगण्डगः ॥ १४॥ वृत्तो तथा

Ulcers are easily curable which are present in persons who are strong in mind, muscle, digestive fire, age and strength; which are round, elongated with three folds and four sides in shape, present on the buttocks, rectum, penis, lips, back, interior of the mouth and cheeks. 13b-14.

Krcchrasadhya vrana – difficult to cure ulcer

कृच्छ्रसाध्योऽक्षिदशननासिकापाङ्गनाभिषु । सेवनीजठरश्रोत्रपार्श्वकक्षास्तनेषु च

Ulcer on the eyes, teeth, nose, outer angle of the eye, umbilicus, sutures, abodomen, ears, flanks, axillae and breasts are difficult to cure. 15.

फेनपूयानिलवहः भगन्दरोऽन्तर्वदनस्तथा ॥ १५ ॥

शल्यवानूर्ध्वनिर्वमी । कट्यस्यिसंश्रितः ॥ १६ ॥

कुष्ठिनां विषजुष्टानां शोषिणां मधुमेहिनाम् । व्रणा: कृच्छ्रेण सध्यन्ति येषां च स्युर्व्रणे व्रणाः ॥ १७॥

Those which exude froth, pus and air ( or gas), those having foreign body, which are elevated very much, which do not exude at all; rectal fiistula which has its mouth inside and invading the pelvic bone, ulcers of patients suffering from kustha (leprosy ), visa ( poison), sosa ( tuberculosis), madhumeha ( diabetes mellitus ) and those ulcers which de velop on another ( earlier) ulcer get cured with difficulty.

Asadhya vrana – incurable ulcer

नैव सिध्यन्ति वीसर्पज्वरातीसारकासिनाम् । पिपासूनामनिद्राणां श्वासिनामविपाकिनाम् ॥ १८ ॥

भिन्ने शिरः कपाले वा मस्तुलुङ्गस्य दर्शने ।

Ulcer in patients of visarpa (herpes), fever, dierrhoea, cough, severe thirst, who do not sleep at all, who are suffering from dyspnoea and indigestion, in whom the skull is fractured or the brain is visible do not get cured. 18-19a.

स्नायुक्लेदात्सिराच्छेदाद्गाम्भीर्यात्कृमिभक्षणात् ॥ १९ ॥

अस्थिमेदात्सशल्यत्वात्सविषत्वादतर्कितात् मिथ्याबन्धादतिस्नेहाद्रौक्ष्याद्रोमादिघट्टनात् ॥२०॥ ।

क्षोभादशुद्धकोष्ठत्वात्सौहित्यादतिकर्शनात् मद्यपानाद्दिवास्वप्नाद्य्ववायाद्रात्रिजागरात् ॥ २१ ॥

व्रणो मिथ्योपचाराच्च नैव साध्योऽपि सिध्यति ।

Even curable ulcers become incurable by exudation of tendons, cutting of the veins, increase of depth, devouring (destruction) by worms (bacteria etc.) fracture of bones, presence of foreign bodies and poisons, by too much of cutting ( excising during surgical operation ) improper bandaging, too much of anointing with fats or too much of dryness; friction by hair etc, too much of strain, impurity of the alimentary tract, too much of food, too much of debility, drinking wine, sleeping during day, copulation, keeping awake at nights and improper treatments. 19b-22a.

Healing ulcer

कपोतवर्णप्रतिमा यस्यान्ताः क्लेदवर्जिताः ॥ २२ ॥ स्थिराश्चिपिटिकावन्तो रोहतीति तमादिशेत् ।

An ulcer which has the colour resembling a pigeon, its interior free of exudations, static ( hard, immovable) dull and flat in appearance should be understood as “healing.”

Vrana chikitsa – Treatment of ulcer

अथात्र शोफावस्थायां यथासन्नं विशोधनम् ॥ २३ ॥ योज्यं शोफो हि शुद्धानां व्रणश्चाशु प्रशाम्यति ।

In the stage of swelling itself, purificatory therapy in the nearest route ( either emesis or purgation) should be administered; swelling or ulcer get cured quick in the person who has been purified. 23b-24a.

कुर्याच्छीतोपचारं च शोफवस्थस्य सन्ततम् ॥ २४ ॥ दोषाग्निरग्निवत्तेन प्रयाति सहसा शमम् ।

During the stage of swelling, cold therapies should be resorted to continuously, the agni (fire ) in the dosas is similar to fire (external fire) and gets subsided by this method immediately. 24b-25a.

शोफे व्रणे च कठिने विवर्णे वेदनान्विते ॥ २५ ॥

विषयुक्ते विशेषेण जलजाद्यैर्हरदसृक् । दुष्टास्त्रेऽपगते सद्यः शोफरागरुजां शमः ॥ २६ ॥

In swelling and ulcer which are hard, discoloured, painful and containing poison, blood should be taken out by using leeches; with the vitiated blood going out, swelling, redness and pain subside immediately. 25b-26.

हृते हृते च रुधिरे सुशीतैः स्पर्शवीर्ययोः । सुश्लक्ष्णैस्तदहः पिष्टैः शतधौतघृतोपेतैर्मूहुरन्यैरशोषिभिः क्षीरेक्षुस्वरसद्रवैः ॥ २७ ॥

प्रतिलोमं हितो लेपः सेकाभ्यङ्गाश्च तत्कृताः ॥ २८ ॥

After such removal of blood often, the ulcer should be covered with nice paste of drugs which are cold in potency and applied cold and prepared on the same day macerating with milk, sugarcane juice and such other liquids; satadhauta ghrta (ghee washed a hundred times in water or decoction of bark of trees having milky sap) should be applied often, rubbing it in the direction opposite of the hairs. Bathing the ulcer and anointing should also be done, by the same drugs. 27-28.

न्योग्रोधोदुम्बरा श्वत्थप्लक्षवेतसवल्कलैः । प्रदेहो भूरिसर्पिभिः शोफनिर्वापणः परम् ॥ २९ ॥

Pradeha (thick warm poultice) of the bark of nyagrodha, udumbara, asvattha; plaksa and vetasa added with more of ghee is best to relieve swelling. 29.

वातोल्बणानां स्तब्धानां कठिनानां महारुजाम्। स्स्रुतासृजां च शोफानां व्रणानामपि चेद्दशाम् ॥ ३० ॥

आनूपबेसवाराद्यैः स्वेदः, सोमास्तिलाः पुनः ।

भृष्टा निर्वापिताः क्षीरे तत्पिष्टा दाहरुग्धराः ॥ ३१ ॥

Ulcers which have predominance of vata, which are static, hard and very painful, swellings in which blood has been removed or ulcers of this kind, should be given fomentation with vesavara (minced meat cooked in oil) etc. of animals of marshy lands; seeds of uma and tila are fried, soaked in milk made into a paste and applied to the ulcer relieve bruning sensation and pain. 30-31.

स्थिरान् मन्दरुजः शोफान् स्नेहैर्वातकफापहैः । अभ्यज्य स्वेदयित्वा च वेणुनाड्या शनैः शनैः ॥ ३२ ॥

विम्लापनार्थं मृद्गीयात् तलेनाङ्गुष्ठकेन वा। यवगोधूममुद्रैश्च सिद्धपिष्टैः प्रलेपयेत् ॥ ३३ ॥

Swelling which are static and of dull pain should be anointed with oils which mitigate vata and kapha, exposed to the steam through the reeds of bamboo slowly, should be squeezed with the palm and the thumb to make it soft, applied with a paste of flour of yava, godhuma and mudga. 32-33.

विलीयते स चेन्नैवं ततस्तमुपनाहयेत् । अविदग्धस्तथा शान्तिं विदग्धः पाकमश्नुते ॥ ३४ ॥

सकोलतिलबल्लोमा दध्यम्ला: सक्तुपिण्डिका । सकिण्वकुष्ठलवणा कोष्णा शस्तोपनाहने ॥ ३५ ॥

If by this method the swelling does not become reduced, then upanaha ( application of warm poultice) should be done; by that the swelling subsides if it is unripe and forms pus; if it ripen kola, tila, valla, uma, dadhyamla (sour curds), saktupindaka (paste of corn flour kinva brewing yeast), kustha and lavana made into a paste is applied warm suitable for poultice. 34-35.

सुपक्के पिण्डिते शोफे पीडनैरुपपीडिते।

दारणं दारणार्हस्य सुकुमारस्य चेष्यते ॥ ३६ ॥ If the swelling is well ripened, collected together and squeezed mildly, it is desirable to cause its bursting, in those who are fit for it and who are of tender nature. 36. गुग्गुल्वतसिगोदन्तस्वर्णक्षीरीकपोतविद् ।

क्षारौषधानि क्षाराश्च पक्कशोफविदारणम् ॥ ३७ ॥

Guggulu, atasi, godanta, svarnaksiri, excreta of pigeon, drugs which have caustic property and caustic alkalies; these bring about bursting of the ripe sweling. 37.

पूयगर्भानणुद्वारान् सोत्सङ्गान्मर्मगानपि। निःस्नेहै: पीडनद्रव्यैः समन्तात्प्रतिपीडयेत् ॥ ३८ ॥

The swelling which is full of pus, has a narrow mouth, bulged up and located on a vital spot should be squeezed continuously with drugs of such action without the addition of fats. 38.

शुष्यन्तं समुपेक्षेत प्रलेपं पीडनं प्रति ।

न मुखे चैनमालिम्पेत् तथा दोषः प्रसिच्यते ॥ ३९ ॥

That swelling which is drying up should be neglected in respect of application of paste, its mouth not coated with the paste, for the dosas come out of it on their own accord. 39.

कलाययवगोधूममाषमुद्गहरेणवः

द्रव्याणां पिच्छिलानां च त्वङ्मूलानि प्रपीडनम् ॥ ४० ॥ Bark of the stem and roots of kalaya, yava, godhuma, masa, mudga, and harenu and drugs which are slimy-are good for squeezing (the swelling). 40.

सप्तसु क्षालनाद्येषु सुरसारग्वधादिकौ । भृशं दुष्टे व्रणे योज्यौ मेहकुष्ठव्रणेषु च ॥ ४१ ॥

In dusta vrana (vitiated ulcer) and those of diabetes and leprosy drugs of surasadi gana and aragvadhadi gana (chapter 15 of sutrasthana) should be made use of for the seven therapies such as ksalana etc, (ksalana, alepa, ghrta, taila, rasakriya, curna and varti) especially. 41.

अथवा क्षालनं क्वाथः पटोलीनिम्बपत्रजः।

अविशुद्धे, विशुद्धे तु न्यग्रोधादित्वगुद्भवः ॥ ४२ ॥

Ksalana (washing the ulcer ) can be done with the de coction of leaves of patoli and nimba when the ulcer is vitiated, and with that of the bark of drugs of nyagrodhadi gana (chapter 15 of sutrasthana) when the ulcer is not vitiated.

पटोलीतिलयष्ट्याह्वत्रिवृद्दन्तीनिशाद्वयम् ।

निम्बपत्राणि चालेपः सपटुव्रणशोधनः ॥ ४३ ॥

Paste of patoli, tila, yastyahva, trivrt, danti, the two nisa, and leaves of nimba added with patu (salt) applied over, cleanses it. 43.

व्रणान् विशोधयेद्वर्त्या सूक्ष्मास्यान् सन्धिमर्मगान् ।

त्रिवृतादन्तीलाङ्गलीमधुसैन्धवैः ॥ ४४ ॥ कृतया

Ulcers which have small opening and which are located on joints and vital spots should be cleaned (cleared of their contents) by inserting a varti (cotton wick) prepared with trivrt, danti, langali, madhu (honey) and saindhava. 44.

वाताभिभूतान् सात्रावान् धूपयेद्रुग्रवेदनान् । यवाज्यभूर्जमदनश्रीवेष्टकसुराह्वयैः ॥ ४५ ॥

Ulcers which have been vitiated by vata, which have exudation and severe pain should be fumigated with yava, bhurja, madana, Srivestha and surahva mixed with ghee. 45.

निर्वापयेद् भृशं शीतैः पित्तरक्तविषोल्बणान् ।

Those which are predominant with pitta, rakta (blood) and visa (poison) should be bathed with cold things (decoction, oils etc). 46a.

शुष्काल्पमांसे गम्भीरे व्रणे उत्सादनं हितम् ॥ ४६॥

न्यग्रोधपद्मकादिभ्यामश्वगन्धाबलातिलैः । अद्यान्मांसादमांसानि विधिनोपहितानि च ॥ ४७ ॥

मांसं मांसादमांसेन वर्धये शुद्धचेतसः ।

In those ulcers which have very little of dried-out muscle tissue, and the ulcer if deep seated, it is beneficial to elevate it, make it grow up by massaging with paste of drugs of nyagrodhadi gana and of padmakadi gana (chapter 15 of sutrasthana), asvagandha, bala and tila; the patient should eat meat of carnivorous animals prepared in the proper manner; muscle grows / develops by ingestion of meat especially of carnivorous animals and by pure ( pleasant) mind. 46b-48a.

उत्सन्नमृदुमांसानां व्रणानामवसादनम् ॥ ४८ ॥

जातीमुकुलकासीसमनोह्वालपुराग्निकैः उत्पन्नमांसान् कठिनान् कण्डयुक्तांश्चिरोत्थितान् ॥ ४९ ॥

व्रणान् सुदुःखशोध्यांश्च शोधयेत क्षारकर्मणा ।

Overgrowth of soft muscle tissue should be reduced by the use of paste of buds of jati, kasisa, manohva, pura and agnika; muscle which is elevated and ulcers in those who are difficult to be purified should be cleaned by ksarakarma alkaline cautery. 48b-50a.

स्त्रवन्तोऽश्मरिजा मूत्रं ये चान्ये रक्तवाहिनः ॥ ५० ॥

छिन्नाश्च सन्धयो येषां यथोक्तैर्ये च शोधनैः । शोध्यमाना न शुध्यन्ति शोध्याः स्युस्तेऽग्निकर्मणा ॥ ५१ ॥

Ulcers caused by asmari (renal calculii) which exude urine through them and others which exude blood, those ulcers located on the bony joints and have caused tearing, those ulcers which do not get cleaned by the usual methods of cleaning-all these should be cleaned by agnikarmathermal cautery. 50b-51.

For the healing of the ulcers the same drugs mentioned for massaging and raising up (vide verse no. 46b-48a) should be used. 52a.

शुद्धानां रोपणं योज्यमुत्सादाय यदीरितम् ।

अश्वगन्धा रुहा रोध्रं कट्फलं मधुयष्टिका ॥ ५२ ॥

समङ्गा धातकीपुष्पं परमं व्रणरोपणम् ।

(paste of) asvagandha, ruha ( vrksaruha), rodhra, katphala, madhuyasti, samanga and dhatakipuspa are best for healing the ulcer. 52b-53a.

अपेतपूतिमांसानां मांसस्थानामरोहताम् ॥ ५३ ॥

कल्कं संरोहणं कुर्यात् तिलानां मधुकान्वितम् । स्निग्धोष्णतिक्तमधुरकषायत्वैः स सर्वजित् ॥ ५४॥

स क्षौद्रनिम्बपत्राभ्यां युक्तः संशोधनं परम् । पूर्वाभ्यां सर्पिषा चासौ युक्तः स्यादाशुरोपणः ॥ ५५॥

The purified and foul smelling muscle tissue having been removed, if new muscle tissue is not seen growing in that place, then the paste of tila added with honey should be kept in that place which helps muscle growth. This being unctuous, hot, bitter, sweet, astringent, it cures all trobles; added with honey and leaves of nimba is a good pruifier, with these and ghee it heals the ulcers quickly. 53b-55.

Some तिलवधवकल्कं तु केचिदिच्छन्ति तद्विदः । that paste of say yava also acts like that of tila. 56a.

सास्रपित्तविषागन्तुगम्भीरान् सोष्मणो व्रणान् ॥ ५६ ॥

क्षीररोपणभैषज्य शृतेनाज्येन रोपणौषधसिद्धेन रोपयेत् । तैलेन कफवातजान्॥ ५७॥

Ulcers which are caused by blood, pitta, poison, external causes and which are deep seated should be made to heal by bathing it with lukewarm ghee boiled with milk and healing drugs; those which are caused by kapha and vata by oil boiled with milk and healing drugs. 56b-57.

काच्छीरोथ्राभयासर्जसिन्दूराञ्जनतुत्थकम् । चूर्णितं तैलमदनैर्युक्तं रोपणमुत्तमम् ॥ ५८ ॥

Kacchi (saurastra mrttika), rodhra, abhaya, sarja, sindura, anjana and tutthaka-powdered, mixed with oil and bees wax is good for healing ulcers. 58.

समानां स्थिरमांसानां त्वक्स्थानां चूर्ण इष्यते ।

ककुभोदुम्बराश्वत्थजम्बूकट्फलरोथ्रजैः त्वचमाशु निगृह्णन्ति त्वक्चूर्णैश्चर्णिता व्रणाः । ॥ ५९॥

For healing of ulcers which are even, with firm muscles and localised in the skin, powders (of healing drugs) are desirable; powder of bark of kakubha, udumbara, asvattha, jambu, katphala and rodhra dusted into the ulcers on the skin cures them quickly. 59-60a.

लाक्षामनोह्वामञ्जिष्ठाहरितालनिशाद्वयः सघृतक्षौद्रस्त्वग्विशुद्धिकरः परम् । प्रलेपः ॥६०॥

Application of cold paste of laksa manohva, manjistha, haritala and two nisa, added with ghee and honey is best to purify the skin. 60b-61a.

कालीयकलताम्रास्थिहेमकालारसोत्तमैः ॥ ६१॥ लेपः सगोमयरसः सवर्णकरणः परम् ।

Application of paste of kaliyaka, lata, amrasthi, hema (padmaka), kala (manjistha), rasottama (mercury) added with juice of fresh cowdung is best to bring up the normal colour of the skin. 61b-62a.

दग्धो वारणदन्तोऽन्तर्धूमं तैलं रसाञ्जनम् ॥ ६२ ॥ रोमसञ्जननो लेपस्तद्वत्तैलपरिप्लुता ।

चतुष्पान्नखरोमास्थित्वक्शृङ्गखुरजा मषी ॥ ६३ ॥

Tooth ot an elephant, burnt to ash in the internal method (putapaka method) oil and rasanjana is an application best for promoting growth of hair; similarly so the paste of ash of nails, hair, bones, skin, horn and hoof of quadrupeds added with oil. 62b-63.

व्रणिनः शस्त्रकर्मोक्तं पथ्यापथ्यान्नमादिशेत् ।

The do’s and dont’s prescribed for a person who has undergone surgical operation apply to the patient of ulcer also. 64a.

द्वे पञ्चमूले वर्गश्च वातघ्नो वातिके हितः ॥ ६४ ॥ न्यग्रोधपद्मकाद्यौ तु तद्वत्पित्तप्रदूषिते । आरग्वधादिः

In ulcers of vata origin, the drugs of the two pancamulas and those that mitigate vata are suitable. For that of pitta origin, drugs of nyagrodhadi and padmakadi gana (chapter 15 of sutrasthana ) and for that of kapha origin, the drugs of aragvadha gana and in ulcer of mixed origin with mixture of drugs. 64b-65.

एभि: प्रक्षालनं लेपो घृतं तैलं रसक्रिया । चूर्णो वर्तिश्च संयोज्या व्रणे सप्त यथायथम् ॥ ६६ ॥

These drugs should be made use of for praksalana (washing), lepa ( application of paste ), ghrta, taila, rasakriya (preparing medicated ghee, oil, solidified decoction) curna (powder) and varti ( wick smeared with paste of drugs) in the treatment of an ulcer appropriately. 66.

जातीनिम्बपटोलपत्रकटुकादार्वीनिशासरिवामञ्जिष्ठाभयसिक्थतुत्थमधुकैर्नक्ताह्वबी

न्वितैः सर्पिः साध्यमनेन सूक्ष्मवदना मर्माश्रिताः क्लेदिनो गम्भीराः सरुजो व्रणाः सगतयः शुद्ध्यन्ति रोहन्ति च ॥ ६७ ॥

Medicated ghee prepared with leaves of jati, nimba and patola, katuka, darvi, nisa, sariva, manjistha, abbaya, siktha, tuttha, madhuka and seeds of naktahva, cleanses and heals the ulcers which have small openings, situated on vital spots, which have exudation, deep seated, painful and having sinuses. 67.

इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने व्रणप्रतिषेधो नाम पञ्चविंशोऽध्यायः ॥ २५ ॥ Thus ends the chapter-Vrana pratisedha-the twenty fifth in Uttarasthana of Astangahrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.

श्लेष्मघ्नः कफे, मिश्रास्तु मिश्रजे ॥ ६५ ॥ षड्विशोऽध्यायः ।

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