व्रणालेपनबन्धविध्यध्यायः
अथातो व्रणालेपनबन्धविधिमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
"Now, we shall expound the chapter on the method of wound application and bandaging."
"Thus said the venerable Dhanvantari."
This introduction sets the stage for discussing wound applications and bandaging techniques, as taught by Dhanvantari.
आलेप आद्य उपक्रमः , एष सर्वशोफानां सामान्यः प्रधानतमश्च, तं च प्रतिरोगं वक्ष्यामः- ततो बन्धः प्रधानं, तेन शुद्धिर्व्रणरोपणमस्थिसन्धिस्थैर्यं च ||३||
"Now, we shall expound the chapter on the method of wound application and bandaging. Thus said the venerable Dhanvantari. Application (Alepana) is the first treatment; it is common and most important for all swellings. We will explain it according to each disease. Next, bandaging is important, as it aids in cleansing, healing wounds, and stabilizing bones and joints."
This introduction sets the stage for discussing wound applications and bandaging techniques. It emphasizes the importance of Alepana (application) as the primary treatment for all swellings and details how bandaging aids in cleansing, healing, and stabilizing.
तत्र प्रतिलोममालिम्पेत् |
प्रतिलोमे हि सम्यगौषधमवतिष्ठतेऽनुप्रविशति रोमकूपान् स्वेदवाहिभिश्च सिरामुखैर्वीर्यं प्राप्नोति ||४||
"One should apply the medication against the direction of hair growth. When applied in this manner, the medicine adheres properly, penetrates the hair follicles, and through the sweat-carrying channels reaches the blood vessels to exert its effect."
This shloka advises that medicinal applications should be done against the direction of hair growth. This technique ensures that the medicine adheres well, penetrates the hair follicles, and through the sweat-carrying channels, reaches the blood vessels to exert its therapeutic effect.
न च शुष्यमाणमुपेक्षेत, अन्यत्र पीडयितव्यात् |
शुष्को ह्यपार्थको रुक्करश्च ||५||
"One should not neglect it when it is drying, except to apply pressure. A dried application is ineffective and causes roughness."
This shloka advises that a drying medicinal application should not be neglected, except when applying pressure to it. If allowed to dry out completely, the application becomes ineffective and can cause roughness to the skin.
स त्रिविधः- प्रलेपः, प्रदेह, आलेपश्च |
प्रलेपप्रदेहयोरन्तरं - तत्र प्रलेपः शीतस्तनुरविशोषी विशोषी वा; प्रदेहस्तूष्णः शीतो वा बहलोऽबहुरविशोषी च; मध्यमोऽत्रालेपः |
तत्र, रक्तपित्तप्रसादकृदालेपः; प्रदेहो वातश्लेष्मप्रशमनः शोधनो रोपणः शोफवेदनापहश्च; तस्योपयोगः क्षताक्षतेषु; यस्तु क्षतेषूपयुज्यते स भूयः ‘कल्क’ इति सञ्ज्ञां लभते निरुद्धालेपनसञ्ज्ञः; तेनास्रावसन्निरोधो मृदुता पूतिमांसापकर्षणमनन्तर्दोषता व्रणशुद्धिश्च भवति ||६||
"There are three types of applications: Pralepa, Pradeha, and Alepa. The difference between Pralepa and Pradeha is as follows: Pralepa is cool, thin, and non-drying or drying. Pradeha is warm or cool, thick, and non-drying. Alepa is intermediate. Alepa is beneficial for blood and Pitta disorders. Pradeha pacifies Vata and Kapha, cleanses, heals wounds, and reduces swelling and pain. It is used for injuries. When applied to injuries, it is often called 'Kalka', which is a restrictive application. It helps stop bleeding, softens the wound, removes putrid flesh, and cleanses the wound from inside."
This shloka categorizes medicinal applications into three types: Pralepa, Pradeha, and Alepa. It explains the differences between them, describing their properties and benefits for specific conditions. Alepa is effective for blood and Pitta disorders, Pradeha pacifies Vata and Kapha and aids in wound healing, and Alepa is intermediate in its effects. When applied to injuries, the preparation is often referred to as 'Kalka', which stops bleeding, softens the wound, removes putrid flesh, and cleanses the wound.
अविदग्धेषु शोफेषु हितमालेपनं भवेत् |
यथास्वं दोषशमनं दाहकण्डूरुजापहम् ||७||
त्वक्प्रसादनमेवाग्र्यं मांसरक्तप्रसादनम् |
दाहप्रशमनं श्रेष्ठं रुजाकण्डूविनाशनम् ||८||
मर्मदेशेषु ये रोगा गुह्येष्वपि तथा नृणाम् |
संशोधनाय तेषां हि कुर्यादालेपनं भिषक् ||९||
(षड्भागं पैत्तिके स्नेहं चतुर्भागं तु वातिके |
अष्टभागं तु कफजे स्नेहमात्रां प्रदापयेत्) ||१०||
"For non-inflamed swellings, application (Alepana) is beneficial as it pacifies the doshas according to their nature and alleviates burning sensation, itching, and pain. It is excellent for enhancing skin complexion and the condition of muscles and blood, as well as relieving burning sensation, pain, and itching. In treating diseases in vital and hidden areas of the body, physicians should use applications for cleansing. For Pitta disorders, use one-sixth part of oil; for Vata disorders, use one-fourth part of oil; for Kapha disorders, use one-eighth part of oil."
This shloka explains that Alepana (application) is effective for non-inflamed swellings, as it pacifies the doshas, alleviates burning, itching, and pain, and enhances the condition of the skin, muscles, and blood. It is also recommended for treating diseases in vital and hidden areas of the body. Specific proportions of oil should be used depending on the dosha involved: one-sixth part for Pitta, one-fourth part for Vata, and one-eighth part for Kapha disorders.
तस्य प्रमाणं महिषार्द्रचर्मोत्सेधमुपदिशन्ति ||११||
"The standard measure for it is the thickness of fresh buffalo hide."
This shloka specifies that the standard measure for the application or bandaging material is the thickness of fresh buffalo hide.
न चालेपं रात्रौ प्रयुञ्जीत , मा भूच्छैत्यविहतोष्मणस्तदनिर्गमाद्विकारप्रवृत्तिरिति ||१२||
प्रदेहसाध्ये व्याधौ तु हितमालेपनं दिवा |
पित्तरक्ताभिघातोत्थे सविषे च विशेषतः ||१३||
न च पर्युषितं लेपं कदाचिदवचारयेत् |
उपर्युपरि लेपं च न कदाचित् प्रदापयेत् ||१४||
ऊष्माणं वेदनां दाहं घनत्वाज्जनयेत् स हि |
न च तेनैव लेपेन प्रदेहं दापयेत् पुनः |
शुष्कभावात्स निर्वीर्यो युक्तोऽपि स्यादपार्थकः ||१५||
"One should not apply the paste at night, as the coldness and retained heat may lead to complications. It is beneficial to apply during the day, especially for conditions treatable with Pradeha, and particularly for Pitta, blood disorders, and venomous conditions. Never reapply an old paste, nor apply layers of paste. It generates heat, pain, and burning due to its density. Reapplying the same paste again for Pradeha is not advised, as it loses its potency when dried and becomes ineffective."
This passage provides specific guidelines for applying medicinal pastes. It advises against applying them at night due to potential complications from cold and retained heat. Daytime application is recommended, especially for Pradeha-treatable conditions, Pitta and blood disorders, and venomous conditions. Old paste should not be reused or layered, as it can cause heat, pain, and burning due to its density. Reapplying the same dried paste is ineffective as it loses its potency.
अत ऊर्ध्वं व्रणबन्धनद्रव्याण्युपदेक्ष्यामः; तद्यथा- क्षौमकार्पासाविकदुकूलकौशेयपत्रोर्णचीनपट्टचर्मान्तर्वल्कलालाबूशकललताविदलरज्जुतूलफलसन्तानिकालौहानीति ; तेषां व्याधिं कालं चावेक्ष्योपयोगः; प्रकरणतश्चैषामादेशः ||१६||
"Now, I will explain the materials used for wound bandaging, such as linen, cotton, wool, silk, bark, cloth, Chinese silk, leather, bark fibers, vine fibers, split bamboo, ropes, cotton wool, leaf fibers, and iron. Their use depends on the disease and the timing; and they should be chosen according to the specific situation."
This shloka outlines various materials used for bandaging wounds, including natural fibers, cloth, leather, and even iron. The choice of material depends on the disease, the timing, and the specific context in which it is being used.
तत्र कोशदामस्वस्तिकानुवेल्लितमु(प्र)तोलीमण्डलस्थगिकायमकखट्वाचीनविबन्धवितानगोफणाः पञ्चाङ्गी चेति चतुर्दश बन्धविशेषाः |
तेषां नामभिरेवाकृतयः प्रायेण व्याख्याताः ||१७||
"There are fourteen types of bandages: Kosha, Dama, Svastika, Anuvellita, Mu(pr)atoli, Mandala, Sthagika, Yamaka, Khatva, China, Vibhanda, Vitana, Gophana, and Panchangi. Their forms are generally described by their names."
This shloka lists fourteen types of bandages, each named according to its specific form and function. These names provide a general description of the bandage shapes and techniques.
तत्र कोशमङ्गुष्ठाङ्गुलिपर्वसु विदध्यात्, दाम सम्बाधेऽङ्गे, सन्धिकूर्चकभ्रूस्तनान्तरतलकर्णेषु स्वस्तिकं, अनुवेल्लितं शाखासु, ग्रीवामेढ्रयोः मु(प्र)तोलीं, वृत्तेऽङ्गे मण्डलम्, अङ्गुष्ठाङ्गुलिमेढ्राग्रेषु स्थगिकां, यमलव्रणयोर्यमकं, हनुशङ्खगण्डेषु खट्वाम्, अपाङ्गयोश्चीनं, पृष्ठोदरोरःसु विबन्धं, मूर्धनि वितानं, चिबुकनासौष्ठांसबस्तिषु गोफणां, जत्रुण ऊर्ध्वं पञ्चाङ्गीमिति; यो वा यस्मिन् शरीरप्रदेशे सुनिविष्टो भवति तं तस्मिन् विदध ्यात् ||१८||
"Kosha bandage is applied to the thumb joints; Dama to compressed parts; Svastika to joints, temples, brows, breasts, and ankles; Anuvellita to limbs; Mutoli to neck and genitalia; Mandala to circular parts; Sthagika to thumb, fingers, and genitalia tips; Yamaka to double wounds; Khatva to jaws, temples, and cheeks; China to the sides of the eyes; Vibhanda to the back, abdomen, and chest; Vitana to the head; Gophana to the chin, nose, lips, and bladder; Panchangi above the collarbone. Apply each type where it fits best on the body."
This shloka provides specific instructions on how to apply different types of bandages to various parts of the body. Each bandage type is tailored to specific areas and injuries to ensure effective treatment and support.
यन्त्रणमूर्ध्वमधस्तिर्यक् च ||१९||
"Bandaging should be done upwards, downwards, and across."
This concise shloka emphasizes the proper technique for bandaging, ensuring that the bandages are applied in upward, downward, and crosswise directions for effective support and coverage.
तत्र घनां कवलिकां दत्त्वा वामहस्तपरिक्षेपमृजुमनाविद्धमसङ्कुचितं मृदु पट्टं निवेश्य बध्नीयात् |
न च व्रणस्योपरि कुर्याद्ग्रन्थिमाबाधकरं च ||२०||
"Use a thick pad, wrap it smoothly with the left hand, without twisting or tightening, and use a soft cloth for bandaging. Do not tie knots directly over the wound, as it may cause discomfort."
This shloka provides instructions for bandaging wounds. It emphasizes using a thick pad and wrapping it smoothly with the left hand, ensuring the bandage is not twisted or tightened. A soft cloth should be used for bandaging, and knots should not be tied directly over the wound to prevent discomfort.
न च विकेशिकौषधे अतिस्निग्धे अतिरूक्षे विषमे वा कुर्वीत; यस्मादतिस्नेहात् क्लेदो, रौक्ष्याच्छेदो, दुर्न्यासाद्व्रणवर्त्मावघर्षणमिति ||२१||
"One should not use bandages that are too loose, excessively oily, overly dry, or uneven. Excessive oiliness causes excessive moisture, dryness causes cuts, and improper application leads to irritation around the wound edges."
This shloka advises against using bandages that are too loose, excessively oily, overly dry, or uneven. Excessive oiliness can lead to too much moisture, dryness can cause cuts, and improper application can cause irritation around the edges of the wound.
तत्र व्रणायतनविशेषाद्बन्धविशेषस्त्रिविधो भवति- गाढः, समः, शिथिल इति ||२२||
"There are three types of bandages based on the specific location of the wound: tight, moderate, and loose."
This shloka explains that bandages can be classified into three types according to the specific location of the wound: tight, moderate, and loose. The type of bandage chosen should correspond to the needs of the wound's location for optimal healing.
पीडयन्नरुजो गाढः सोच्छ्वासः शिथिलः स्मृतः |
नैव गाढो न शिथिलः समो बन्धः प्रकीर्तितः ||२३||
"A tight bandage causes pain; a loose bandage does not provide support. An ideal bandage is neither too tight nor too loose but moderate."
This shloka explains that a bandage that is too tight can cause pain, while a bandage that is too loose will not provide adequate support. Therefore, an ideal bandage is one that is applied with moderate tightness, ensuring it is effective without causing discomfort.
तत्र स्फिक्कुक्षिकक्षावङ्क्षणोरुशिरःसु गाढः, शाखावदनकर्णकण्ठमेढ्रमुष्कपृष्ठपार्श्वोदरोरःसु समः, अक्ष्णोः सन्धिषु च शिथिल इति ||२४||
"In areas like the buttocks, abdomen, armpits, groin, thighs, and head, a tight bandage is recommended. For limbs, face, ears, neck, genitals, scrotum, back, sides, abdomen, and chest, a moderate bandage is suggested. For the eyes and joints, a loose bandage is preferred."
This shloka advises specific bandaging techniques for different body parts: tight bandages for areas like the buttocks and abdomen, moderate bandages for limbs and the face, and loose bandages for the eyes and joints, ensuring proper support and healing for each area.
तत्र पैत्तिकं गाढस्थाने समं बध्नीयात्, समस्थाने शिथिलं, शिथिलस्थाने नैव; एवं शोणितदुष्टं च; श्लैष्मिकं शिथिलस्थाने समं, समस्थाने गाढं, गाढस्थाने गाढतरं; एवं वातदुष्टं च ||२५||
"In Pitta conditions, apply a moderate bandage to areas requiring a tight bandage, a loose bandage to areas requiring a moderate bandage, and no bandage to areas requiring a loose bandage. Similarly, for blood disorders. In Kapha conditions, apply a moderate bandage to areas requiring a loose bandage, a tight bandage to areas requiring a moderate bandage, and a very tight bandage to areas requiring a tight bandage. Similarly, for Vata disorders."
This shloka provides specific guidelines for bandaging based on the dosha involved. For Pitta and blood disorders, adjust the tightness of the bandage to be more moderate or loose. For Kapha and Vata disorders, the bandage should be tighter or very tight in the appropriate areas.
तत्र पैत्तिकं शरदि ग्रीष्मे द्विरह्नो बध्नीयात्, रक्तोपद्रुतमप्येवं; श्लैष्मिकं हेमन्तवसन्तयोस्त्र्यहात् , वातोपद्रुतमप्येवम् |
एवमभ्यूह्य बन्धविपर्ययं च कुर्यात् ||२६||
"For Pitta conditions during autumn and summer, bandage twice a day; the same applies for blood disorders. For Kapha conditions during winter and spring, bandage every three days; the same applies for Vata disorders. This is how the bandaging should be alternated as needed."
This shloka advises specific bandaging frequencies based on seasonal variations and the dosha involved. For Pitta conditions and blood disorders in autumn and summer, the bandage should be changed twice a day. For Kapha and Vata conditions in winter and spring, the bandage should be changed every three days, ensuring the appropriate care for each condition and season.
तत्र, समशिथिलस्थानेषु गाढं बद्धे विकेशिकौषधनैरर्थक्यं शोफवेदनाप्रादुर्भावश्च, गाढसमस्थानेषु शिथिलं बद्धे विकेशिकौषधपतनं पट्टसञ्चाराद्व्रणवर्त्मावघर्षणमिति; गाढशिथिलस्थानेषु समं बद्धे च गुणाभाव इति ||२७||
"When a tight bandage is applied to areas needing moderate or loose bandaging, it can cause discomfort, swelling, and pain. When a loose bandage is applied to areas needing tight or moderate bandaging, it may result in the bandage slipping and the medication not staying in place, causing irritation around the wound. Applying a moderate bandage to areas needing tight or loose bandaging results in a lack of effectiveness."
This shloka explains the consequences of improper bandaging: a tight bandage in areas needing moderate or loose bandaging causes discomfort, swelling, and pain; a loose bandage in areas needing tight or moderate bandaging results in the bandage slipping and medication not staying in place, causing irritation; and a moderate bandage in areas needing tight or loose bandaging leads to ineffectiveness.
अविपरीतबन्धे वेदनोपशान्तिरसृक्प्रसादो मार्दवं च ||२८||
"With a correctly applied bandage, pain subsides, blood is purified, and softness is maintained."
This shloka highlights the benefits of a properly applied bandage: it helps in reducing pain, purifying the blood, and maintaining the softness of the wound area, contributing to effective healing.
अबध्यमानो दंशमशकतृणकाष्ठोपलपांशुशीतवातातपप्रभृतिभिर्विशेषैरभिहन्यते व्रणः, विविधवेदनोपद्रुतश्च दुष्टतामुपैति, आलेपनादीनि चास्य विशोषमुपयान्ति ||२९||
"An uncovered wound is harmed by various factors like insect bites, grass, wood, stones, dust, cold, wind, and sunlight. It becomes painful and infected, and the applications like pastes and bandages dry out."
This shloka highlights the importance of covering wounds to protect them from various harmful elements such as insect bites, environmental factors, and physical irritants. An uncovered wound is vulnerable to infection and pain, and the medicinal applications may dry out and lose their effectiveness.
चूर्णितं मथितं भग्नं विश्लिष्टमतिपातितम् |
अस्थिस्नायुसिराच्छिन्नमाशु बन्धेन रोहति ||३०||
सुखमेवं व्रणी शेते सुखं गच्छति तिष्ठति |
सुखं शय्यासनस्थस्य क्षिप्रं संरोहति व्रणः ||३१||
"A wound caused by crushing, breaking, displacement, or severe impact, where bones, ligaments, or veins are severed, heals quickly with proper bandaging. Thus, the wound heals comfortably, allowing the patient to rest, move, and stay in bed comfortably, leading to faster recovery."
This shloka highlights the importance of proper bandaging for wounds caused by severe impact or displacement, ensuring quick healing. Proper bandaging helps the wound heal comfortably, allowing the patient to rest and move comfortably, leading to faster recovery.
अबन्ध्याः पित्तरक्ताभिघातविषनिमित्ता यदा शोफदाहपाकरागतोदवेदनाभिभूताः क्षाराग्निदग्धाः पाकात् प्रकुथितप्रशीर्णमांसाश्च भवन्ति ||३२||
"When wounds caused by Pitta, blood disorders, trauma, or venom are not bandaged, they are afflicted with swelling, burning, inflammation, redness, severe pain, and become filled with putrid and falling flesh due to improper healing from cauterization or burning."
This shloka explains that wounds caused by Pitta, blood disorders, trauma, or venom, if not properly bandaged, can suffer from severe swelling, burning, inflammation, redness, pain, and may become filled with putrid and decaying flesh due to improper healing from cauterization or burning.
कुष्ठिनामग्निदग्धानां पिडका मधुमेहिनाम् |
कर्णिकाश्चोन्दुरुविषे विषजुष्टाश्च ये व्रणाः ||३३||
मांसपाके न बध्यन्ते गुदपाके च दारुणे |
स्वबुद्ध्या चापि विभजेत्कृत्याकृत्यांश्च बुद्धिमान् ||३४||
देशं दोषं च विज्ञाय व्रणं च व्रणकोविदः |
ऋतूंश्च परिसङ्ख्याय ततो बन्धान्निवेशयेत् ||३५||
"Wounds caused by leprosy, burns, boils in diabetics, growths, bites by venomous creatures, and other infected wounds are not bandaged during the stages of flesh decay and severe anal abscesses. The wise should distinguish between necessary and unnecessary actions. An expert in wounds should consider the region, doshas, and the nature of the wound, as well as the seasons, and then apply the appropriate bandages."
This passage advises against bandaging wounds caused by leprosy, burns, boils in diabetics, growths, and venomous bites during the stages of flesh decay and severe anal abscesses. It emphasizes that the wise should differentiate between what is necessary and unnecessary. An expert should consider the region, doshas, wound nature, and seasons before applying the appropriate bandages.
ऊर्ध्वं तिर्यगधस्ताच्च यन्त्रणा त्रिविधा स्मृता |
यथा च बध्यते बन्धस्तथा वक्ष्याम्यशेषतः ||३६||
घनां कवलिकां दत्त्वा मृदु चैवापि पट्टकम् |
विकेशिकामौषधं च नातिस्निग्धं समाचरेत् ||३७||
प्रक्लेदयत्यतिस्निग्धा तथा रूक्षा क्षिणोति च |
युक्तस्नेहा रोपयति दुर्न्यस्ता वर्त्म घर्षति ||३८||
विषमं च व्रणं कुर्यात् स्तम्भयेत् स्रावयेत्तथा |
यथाव्रणं विदित्वा तु योगं वैद्यः प्रयोजयेत् ||३९||
पित्तजे रक्तजे वाऽपि सकृदेव परिक्षिपेत् |
असकृत् कफजे वाऽपि वातजे च विचक्षणः ||४०||
तलेन प्रतिपीड्याथ स्रावयेदनुलोमतः |
सर्वांश्च बन्धान् गूढान्तान् सन्धींश्च विनिवेशयेत् ||४१||
ओष्ठस्याप्येष सन्धाने यथोद्दिष्टो विधिः स्मृतः |
बुद्ध्योत्प्रेक्ष्याभियुक्तेन तथा चास्थिषु जानता ||४२||
उत्तिष्ठतो निषण्णस्य शयनं चाधिगच्छतः |
गच्छतो विविधैर्यानैर्नास्य दुष्यति स व्रणः ||४३||
ये च स्युर्मांससंस्था वै त्वग्गताश्च तथा व्रणाः |
सन्ध्यस्थिकोष्ठलप्राप्ताश्च सिरास्नायुगतास्तथा ||४४||
तथाऽवगाढगम्भीराः सर्वतो विषमस्थिताः |
नैते साधयितुं शक्या ऋते बन्धाद्भवन्ति हि ||४५||
"There are three types of bandaging techniques: upwards, downwards, and crosswise. I will now explain how to apply the bandages completely: Use a thick pad and wrap gently with a soft cloth, ensuring the medication is not too oily or too dry. Excessive oiliness causes soaking, dryness causes cuts, and improper application causes irritation around the wound edges. Incorrect bandaging can make the wound irregular, cause stiffness, or lead to drainage. The physician should apply the appropriate treatment according to the wound. For Pitta and blood-related wounds, bandage once, and for Kapha and Vata-related wounds, bandage multiple times. Press gently and drain in the direction of hair growth. All bandages should be secured well, including those for joints. The method described here is also applied for lip wounds and for securing bones. Whether standing, sitting, lying down, or traveling, the wound remains unaffected by these activities. Wounds located in muscles, skin, joints, bones, cavities, veins, and ligaments, or deep and unevenly situated wounds, cannot be effectively treated without bandaging."
This passage details various bandaging techniques and their applications for different types of wounds. It emphasizes the correct method of bandaging, the importance of using the right materials and techniques, and the benefits of proper bandaging for effective wound healing. It also highlights that wounds in specific areas and depths cannot be treated effectively without proper bandaging.
इति सुश्रुतसंहितायां सूत्रस्थाने व्रणालेपनबन्धविधिर्नामाष्टादशोऽध्यायः ||१८||
"Thus ends the eighteenth chapter named 'Vranalepanabandhavidhi' in the Sutra Sthana section of the Sushruta Samhita."
This closing statement signifies the end of the eighteenth chapter, which discusses the methods of wound application and bandaging in the Sushruta Samhita.