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Sushruta SamhitaYoni vyapat Pratisedha - Therapeutics of the diseases of the female organ...

Yoni vyapat Pratisedha – Therapeutics of the diseases of the female organ of generation – Sushrutasamhita Uttaratantra Chapter 38

अष्टत्रिंशोऽध्यायः अथातो योनिव्यापत्प्रतिषेधं व्याख्यास्यामः, भगवान् धन्वन्तरिः ॥ १ ॥ यथोवाच

Now we shall discourse on the chapter which deals with (the symptoms and) the therapeutics of the diseases of the female organ of generation (Yoni-vyapat-Pratisedha). 1.

प्रवृद्धलिङ्गं पुरुषं याऽत्यर्थमुपसेवते । रूक्षदुर्बलबालायास्तस्या वायुः प्रकुप्यति ॥ २॥

स दुष्टो योनिमासाद्य योनिरोगाय कल्पते । त्रयाणामपि दोषाणां यथास्वं लक्षणेन तु ॥ ३ ॥

Causes- The bodily (as well as the local). Vayu of a girl of tender years, weak constitution or build and dry organic temperament, is deranged and aggravated in consequence of her excessive indulgence with a man of abnormally developed reproductive organ, and on getting into her organ of generation (yoni) gives rise to different local vaginal diseases which become manifest through the presence of the symptoms of the aggravation of the three specific Dosas. 2-3.

विंशतिर्व्यापदो योनेर्निर्दिष्टा रोगसंग्रहे । मिथ्याचारेण याः स्त्रीणां प्रदुष्टेनार्तवेन च । जायन्ते बीजदोषाच्च दैवाच्च शृणु ताः पृथक् ॥ ४ ॥

In the chapter on the enumeration of diseases, the diseases which affect the female organ of generation (yoni) have been classified into twenty different kinds’. The injudicious conduct of life which is usually found in females, menstrual disorders, the diseased or defective nature of the seed (of the parents of the girl), or any accidental causes may be fairly set down as causes of these female diseases. Now hear them discussed separately. 4.

1. The term “Yoni” is here used in a very comprehensive sense and means the whole female organ of generation, i.e. Uterus, Vagina, etc.

उदावर्ता तथा बन्ध्या विप्लुता च परिप्लुता । वातला चेति वातोत्थाः पित्तोत्था रुधिरक्षरा ॥ ५ ॥

वामिनी स्स्रंसिनी वापि पुत्रघ्नी पित्तला च या । अत्यानन्दा च या योनिः कर्णिनी चरणाद्वयम् ॥ ६ ॥

श्लेष्मला च कफाज् ज्ञेया षण्डी च फलिनी तथा । महती सूचीवक्त्रा च सर्वजेति त्रिदोषजा ॥ ७ ॥

Enumeration and Classification — Udavarta (dysmenorrhoea), Bandhya (Sterility ), Vipluta (introversion of the uterus), Paripluta (Retroversion or retroflexion of the uterus) and Vatala are the five kinds of Vataja vaginal diseases. Rudhiraksara (Menorrhoea), Vamini, Sramsini, Puttraghni and Pittala are the Pittaja one. Atyananda (nymphomania), Karnini, the two kinds of Carana and Slesmiki find their origin in Kapha and Sandi, Phalini, Mahati, Sucivaktra and Sarvaja are said to be due to the aggravation of the three Dosas. 5-7

Symptoms of the Vataja Yoni Vyapat

सा फेनिलमुदावर्ता रजः कृच्छ्रेण मुञ्चति । बन्ध्यां नष्टार्तवां विद्याद् विप्लुतां नित्यवेदनाम् ॥ ८ ॥

परिप्लुतायां भवति ग्राम्यधर्मे रुजा भृशम् । वातला कर्कशा स्तब्धा शूलनिस्तोदपीडिता । चतसृष्वपि चाद्यासु भवन्त्यनिलवेदनाः ॥ ९ ॥

Symptoms of the Vataja Types- An Udavarta yoni discharges painful and frothy menses and a Bandhya yoni is marked by the absence or suppression of the catamenial flow. A local pain is always complained of in a Vipluta yoni and in a Paripluta yoni an excessive local pain is experienced at the time of sexual intercourse. A Vatala yoni is marked by an aching and piercing pain in the organ which seems rough and numbed. The peculiar pain due to the derangement of the Vayu is also felt in the first four types of the series. 8-9.

1. These three lines correspond verbatim with three lines in the Caraka Samhita (vide Caraka Samhita, chapter XXX, Chikitsasthana).

Symptoms of the Pittaja Yoni Vyapat

सदाहं प्रकिरत्यस्त्रं यस्याः सा लोहितक्षरा । सवातमुगिरेद् बीजं वामिनी रजसा युतम् ।

प्रस्त्रंसिनी स्यन्दते तु क्षोभिता दुःप्रसूश्च या ॥ १० ॥

स्थितं स्थितं हन्ति गर्भं पुत्रघ्नी रक्तसंत्रवात् । अत्यर्थं पित्तला योनिर्दाहपाकज्वरान्विता ।

चतसृष्वपि चाद्यासु पित्तलिङ्गोच्छ्रयो भवेत् ॥ ११ ॥

Symptoms of the Pittaja types-Discharge of the menses with a burning sensation in the passage is the characteristic symptom of Lohitaksara or Rudhira-ksara Yoni. The Yoni from which the semen charged with the menstrual blood, is ejected with Vayu (Sound) is called Vamini; the coming out (prolapsus) of the organ ( uterus) when disturbed and a difficult or painful parturition are the symptoms of a Prasramsini yoni. The Yoni in the case of repeated abortions due to the excessive discharge of caatamenial blood during the period of gestation is called Puttraghni. An extremely burning sensation and suppuration in the organ attended with fever are the symptoms which mark a Pittala yoni. The four previous vaginal diseases are also marked by the specific symptoms of the aggravated Pitta. 10-11.

Symptoms of the Kaphaja Yoni Vyapat

अत्यानन्दा न सन्तोषं ग्राम्यधर्मेण गच्छति । कर्णिन्यां कर्णिका योनौ श्लेष्मासृग्भ्यां प्रजायते ॥ १२ ॥

मैथुनेऽचरणा पूर्वं पुरुषादतिरिच्यते । बहुशश्चातिचरणादन्या बीजं न विन्दति ॥ १३ ॥

श्लेष्मला पिच्छिला योनिः कण्डूयुक्ताऽतिशीतला । चतसृष्वपि चाद्यासु श्लेष्मलिङ्गोच्छ्रितिर्भवेत् ॥ १४ ॥

Symptoms of the Kaphaja types— An Atyananda yoni knows no satisfaction in matters of sexual pleasures. Haemorrhoid growths or polypii due to the aggravation of Kapha and vitiated blood appear on the living membrane of the organ in a Karnini yoni. In an Acarana Yoni a greater quantity of ovum is secreted before the completion of sexual act, and in the other i.e., in an Aticarana Yoni the semen is not retained in consequence of over-indulgence. A Slesmala yoni is very cold and slimy and has a local itching sensation. The first four kinds of this series of vaginal diseases (lit. diseased vagina) ae also characterised by the actions of the deranged and aggravated Kapha in the locality. 12-14.

Symptoms of the Tri-dosaja YoniVyapat

अनार्तवस्तना षण्डी खरस्पर्शा च मैथुने | अतिकायगृहीतायास्तरुण्याः फलिनी भवेत् ॥ १५ ॥

विवृताऽतिमहायोनिः सूचिवक्त्राऽतिसंवृता । सर्वलिङ्गसमुत्थानां सर्वदोषप्रकोपजा ॥ १६ ॥

चतसृष्वपि चाद्यासु सर्वलिङ्गोच्छ्रितिर्भवेत् । पञ्चासाध्या भवन्तीमा योनयः सर्वदोषजाः ॥ १७ ।

Symptoms of the Tri-dosaja Types- The Yoni of a woman marked bythe non-appearance of the menses, non-development of her breasts and the roughness of the vagina (Vaginal canal) which is felt at the time of coition is called a Sandi. A woman of tender years, who has just passed her girlhood, when ravished by a man with an abnormally developed genital organ, offers the illustration of a Phalini Yoni. An extremely dilated vagina is called Mahayoni, while an extremely constricted one is called a Sucivaktra (lit. a vagina with a needle-mouthed vulva). The Yoni marked with these symptoms of the aggravation of all the three Dosas is said to be a Sarvaja yoni. The four preceding kinds of vaginal malformations or diseases are also due to the concerted action of the three deranged Dosas in the locality and these last (five) kinds of Tridosaja vaginal diseases are incurable. 15-17.

प्रतिदोषन्तु साध्यासु स्नेहादिक्रम इष्यते । दद्यादुत्तरबस्तींश्च विशेषेण विशेषेण यथोदितान् ॥ १८ ॥ कर्कशां शीतलां स्तब्धामल्पस्पर्शाञ्च मैथुने । कुम्भीस्वेदैरुपचरेत् सानूपौदकसंयुतः ॥ १९ ॥ मधुरौषधसंयुक्तान् वेशवारांश्च योनिषु । निक्षिपेद् धारयेच्चापि पिचुतैलमतन्द्रितः ॥ २० ॥ धावनानि च पथ्यानि कुर्वीतापूरणानि च ॥ २१ ॥ ओषचोषान्वितासूक्तं कुर्याच्छीतं विधिं भिषक् । दुर्गन्धां पिच्छिलाञ्चापि चूर्णैः पञ्चकषायजैः । पूरयेद्राजवृक्षादि-कषायश्चापि धावनम् ॥ २२ ॥ योन्यान्तु पूयस्त्राविण्यां शोधनद्रव्यसंभृतैः । सगोमूत्रैः सलवणैः पिण्डैरापूरणं हितम् ॥ २३ ॥

Medical Treatment- The medical treatment of the curable types of vaginal diseases should begin with the administration of a Sneha according to the Dosa involved in each case and applications of properly charged vaginal enemas (Uttara-Basti) should be particularly resorted to. In cases where the Yoni (vagina) would feel cold, rough, numbed and be marked by diminished sensibility of its mucus membrane during sexual action it should be fomented, in the manner of Kumbhi-sveda, with the flesh of aquatic and Anupa animals; and drugs of the Madhura group mixed with Vesavara (all described before) should be applied (in the form of poultice) to the part, and plugs of oilsoaked cotton should be constantly retained in the Yoni (vagina). Proper vaginal lotions and washes as well as the measures of Purana i.e. medical injection (Prepared with the Vayu-subduing drugs) should also be employed; cooling measures should be adopted in the cases marked by dryness and sucking pain (Osa and Cosa) in the affected locality. The vagina should be filled up with the powders of the five officinal kinds of drug (Panca-kasaya) in a case, marked by fetor and slimy mucus secretion, and the decoction of the drugs of Rajavrksadi group should be used in washing. Pindas (balls) of disinfectant (Sodhona, lit, purifying) drugs pasted with cow’s urine and saturated with salt, should be inserted into the vagina marked by the discharge of pus. 18-23.

बृहतीफलकल्कस्य द्विहरिद्रायुतस्य च । कण्डूमतीमल्पस्पर्शां पूरयेद् धूपयेत् तथा ॥ २४ ॥

वर्तिं प्रदद्यात् कर्णिन्यां शोधनद्रव्यसंभृताम् ॥ २५ ॥

प्रस्त्रंसिनीघृताभ्यक्तां क्षीरस्विन्नां प्रवेशयेत् । पिधाय वेशवारेण ततो बन्धं समाचरेत् ॥ २६ ॥

A Yoni (Vagina) marked by an itching impaired sensibility should be fumigated with the vapour of Brhati and the two kinds of Haridra taken together, which should be as well inserted and retained in the vagina (in the shape of a plug). A plug or stick composed of a pasted of disinfectant (or Sodhana) drugs should be inserted into and retained in a Karnini yoni; and a prolapsing (Prasramsini) yoni should be fomented with hot milk and rubbed with clarified butter. It should then be restored to its proper place and, being pasted with Vesavara, should be duly bandaged. 24-26.

प्रतिदोषं विदध्याच्च सुरारिष्टासवान् भिषक् । प्रातः प्रातर्निषेवेत रसोनादुद्धृतं रसम् । क्षीरमांसरसप्रायमाहारं विदधीत च ॥ २७ ॥

Diet — Sura, asava, Arista (wines of medicinal drugs) should be prescribed according to the Dosa involved in each case and the patient should be made to take the expressed juice of garlic (Lasuna) every morning and her diet should consist mainly of milk, meat-soup etc. 27

शुक्रार्तवादयो दोषाः स्तनरोगाश्च कीर्तिताः । क्लैब्यस्थानानि मूढस्य गर्भस्य विधिरेव च ॥ २८ ॥

गर्भिणीप्रतिरोगेषु चिकित्सा चाप्युदाहृता । तां सर्वथा प्रयुञ्जीत योनिव्यापत्सु बुद्धिमान् ।

अपप्रजातारोगांश्च चिकित्सेदुत्तराद् भिषक् ॥ २९ ॥

We have already described the nature of the medical treatment and the remedial agents to be respectively pursued in and prescribed for diseases of the semen, menstrual complaints, affections of the mammae, impotency, cases of false presentatin of child and diseases during the period of pregnancy and motherhood, and all those may be employed with equal benefit in these diseases peculiar to the female sex. Other diseases (such as fever etc.) which may arise from immature delivery should be treated in the manner described in the respective treatment of those diseases in the Uttara Tantra. 28-29.

इति सश्रुत संहितायामुत्तरतन्त्रे योनिव्यापत्प्रतिषेधव्याख्यानामात्रिंशोऽध्यायः ॥ ३८ ॥

Thus ends the thirty-eight chapter of the Uttara Tantra in the Susruta Samhita which deals with the therapeutics of the female organ of generation.

Here ends the Kaumarabhrtya Tantra.


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