व्रणप्रश्नाध्यायः
अथातो व्रणप्रश्नमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
"Now we shall expound the chapter on questions related to wounds."
"As declared by the revered Dhanvantari."
This introductory verse sets the stage for the next chapter of the Sushruta Samhita, which will delve into the various aspects and inquiries related to wound management and treatment.
वातपित्तश्लेष्माण एव देहसम्भवहेतवः |
तैरेवाव्यापन्नैरधोमध्योर्ध्वसन्निविष्टैः शरीरमिदं धार्यतेऽगारमिव स्थूणाभिस्तिसृभिः अतश्च त्रिस्थूणमाहुरेके |
त एव च व्यापन्नाः प्रलयहेतवः |
तदेभिरेव शोणितचतुर्थैः सम्भवस्थितिप्रलयेष्वप्यविरहितं शरीरं भवति ||३||
"Vata, Pitta, and Kapha are the causes of the body's formation. When they are in balance, situated below, in the middle, and above, they hold the body like three pillars supporting a house. Therefore, some call it the 'three-pillared system'. When these three doshas become imbalanced, they cause destruction. Together with blood as the fourth element, these doshas are involved in the formation, sustenance, and destruction of the body."
This shloka emphasizes the critical role of the three doshas—Vata, Pitta, and Kapha—in maintaining the body's health and stability. It also highlights the importance of balance among these doshas and their association with blood in the body's lifecycle from formation to destruction.
भवति चात्र-
नर्ते देहः कफादस्ति न पित्तान्न च मारुतात् |
शोणितादपि वा नित्यं देह एतैस्तु धार्यते ||४||
"The body cannot exist without Kapha, nor without Pitta or Vata. Similarly, it cannot exist without blood; the body is always supported by these."
This shloka emphasizes the fundamental role of the three doshas—Vata, Pitta, and Kapha—along with blood, in maintaining the body's existence and health.
तत्र ‘वा’ गतिगन्धनयोः, इति धातुः, ‘तप’ सन्तापे, ‘श्लिष’ आलिङ्गने, एतेषां कृद्विहितैः प्रत्ययैर्वातः पित्तं श्लेष्मेति च रूपाणि भवन्ति ||५||
"Here, 'Va' denotes motion and smell, 'Tap' means heat, and 'Shlish' signifies embracing. From these root meanings, using grammatical affixes, the terms Vata, Pitta, and Shleshma (Kapha) are derived."
This shloka explains the etymology of the terms Vata, Pitta, and Kapha, emphasizing their fundamental characteristics—motion, heat, and cohesion, respectively.
दोषस्थानान्यत ऊर्ध्वं वक्ष्यामः- तत्र समासेन वातः श्रोणिगुदसंश्रयः; तदुपर्यधो नाभेः पक्वाशयः, पक्वामाशयमध्यं पित्तस्य; आमाशयः श्लेष्मणः ||६||
"Now, I shall describe the locations of the doshas: In brief, Vata is situated in the pelvis and rectum; its upper part is below the navel, in the large intestine. Pitta is located in the middle of the small intestine; and Kapha is located in the stomach."
This shloka explains the specific locations of the three doshas—Vata, Pitta, and Kapha—within the body. Understanding these locations is crucial for diagnosing and treating various health conditions.
अतः परं पञ्चधा विभज्यन्ते |
तत्र वातस्य वातव्याधौ वक्ष्यामः; पित्तस्य यकृत्प्लीहानौ हृदयं दृष्टिस्त्वक् पूर्वोक्तं च; श्लेष्मण उरः शिरः कण्ठो जिह्वामूलं सन्धय इति पूर्वोक्तं च; एतानि खलु दोषाणां स्थानान्यव्यापन्नानाम् ||७||
"Now, they are further divided into five types: For Vata, I shall explain the Vata disorders. For Pitta, the liver, spleen, heart, eyes, and skin have already been mentioned. For Kapha, the chest, head, throat, tongue root, and joints have already been mentioned. These are the locations of the doshas when they are not imbalanced."
This shloka introduces the further division of the doshas into specific types and their respective locations in the body when in a balanced state. It sets the stage for a more detailed discussion of the disorders associated with each dosha.
भवति चात्र-
विसर्गोदानविक्षेपैः सोमसूर्यानिला यथा |
धारयन्ति जगद्देहं कफपित्तानिलास्तथा ||८||
"Just as the Moon, Sun, and Wind sustain the world by providing moisture, heat, and movement, similarly, Kapha, Pitta, and Vata sustain the body."
This shloka draws a parallel between the natural elements that sustain the world and the doshas that sustain the body. It emphasizes the essential roles of Kapha, Pitta, and Vata in maintaining the body's health and balance.
तत्र जिज्ञास्यं किं पित्तव्यतिरेकादन्योऽग्निः? आहोस्वित् पित्तमेवाग्निरिति? |
अत्रोच्यते- न खलु पित्तव्यतिरेकादन्योऽग्निरुपलभ्यते, आग्नेयत्वात् पित्ते दहनपचनादिष्वभिप्रवर्तमानेऽग्निवदुपचारः क्रियतेऽन्तरग्निरिति; क्षीणे ह्यग्निगुणे तत्समानद्रव्योपयोगात् , अतिवृद्धे शीतक्रियोपयोगात् , आगमाच्च पश्यामो न खलु पित्तव्यतिरेकादन्योऽग्निरिति ||९||
"The question arises whether there is any fire other than Pitta? Or is Pitta itself the fire? It is said that no other fire apart from Pitta is found. Because Pitta has fiery properties, it performs actions like burning and digestion similar to fire; thus, it is called the inner fire. When the quality of fire is diminished, it is treated with substances having similar properties; when it is excessive, it is treated with cooling therapies. Hence, we observe that there is no fire apart from Pitta."
This shloka clarifies that Pitta, due to its fiery nature, is considered the internal fire responsible for burning and digestion. It highlights the importance of balancing Pitta to maintain proper digestive functions and overall health.
तच्चादृष्टहेतुकेन विशेषेण पक्वामाशयमध्यस्थं पित्तं चतुर्विधमन्नपानं पचति, विवेचयति च दोषरसमूत्रपुरीषाणि; तत्रस्थमेव चात्मशक्त्या शेषाणां पित्तस्थानानां शरीरस्य चाग्निकर्मणाऽनुग्रहं करोति, तस्मिन् पित्ते पाचकोऽग्निरिति सञ्ज्ञा; यत्तु यकृत्प्लीह्नोः पित्तं तस्मिन् रञ्जकोऽग्निरिति सञ्ज्ञा, स रसस्य रागकृदुक्तः; यत् पित्तं हृदयस्थं तस्मिन् साधकोऽग्निरिति सञ्ज्ञा, सोऽभिप्रार्थितमनोरथसाधनकृदुक्तः; यद्दृष्ट्यां पित्तं तस्मिन्नालोचकोऽग्निरिति सञ्ज्ञा, स रूपग्रहणाऽधिकृतः; यत्तु त्वचि पित्तं तस्मिन् भ्राजकोऽग्निरिति सञ्ज्ञा, सोऽभ्यङ्गपरिषेकावगाहालेपनादीनां क्रियाद्रव्याणां पक्ता छायानां च प्रकाशकः ||१०||
"The Pitta located in the middle of the stomach and intestines digests four types of food and drink and separates the doshas, rasa, urine, and feces. This Pitta, known as Pachaka Agni, aids in the digestive functions of the body. The Pitta located in the liver and spleen is known as Ranjaka Agni, responsible for imparting color to the rasa. The Pitta in the heart is known as Sadhaka Agni, which accomplishes the desired mental goals. The Pitta in the eyes is known as Alochaka Agni, responsible for vision. The Pitta in the skin is known as Bhrajaka Agni, which helps in the actions of massage, anointment, and application of external therapies, and provides radiance to the skin."
This shloka elaborates on the different types of Pitta located in various parts of the body, each with its specific function. Understanding these types of Pitta is crucial for comprehending their roles in maintaining the body's health and balance.
भवति चात्र-
पित्तं तीक्ष्णं द्रवं पूति नीलं पीतं तथैव च |
उष्णं कटुरसं चैव विदग्धं चाम्लमेव च ||११||
"Pitta is sharp, liquid, foul-smelling, blue, yellow, hot, pungent, and sour in nature."
This shloka describes the inherent qualities of Pitta, emphasizing its sharpness, liquidity, unpleasant smell, colors (blue and yellow), heat, and its pungent and sour tastes. These attributes help in understanding the nature of Pitta and its impact on the body.
अत ऊर्ध्वं श्लेष्मस्थानान्यनुव्याख्यास्यामः |
तत्र, आमाशयः पित्ताशयस्योपरिष्टात् तत्प्रत्यनीकत्वादूर्ध्वगतित्वात्तेजसः, चन्द्र इव आदित्यस्य , चतुर्विधस्याहारस्याधारः; स च तत्रौदकैर्गुणैराहारः प्रक्लिन्नो भिन्नसङ्घातः सुखजरो भवति ||१२||
"Now, I shall describe the locations of Kapha: The stomach is above the seat of Pitta due to its opposing nature and upward movement of Tejas, like the moon relative to the sun. It serves as the receptacle for four types of food. In the stomach, food is moistened by its aqueous qualities and broken down into a soft mass."
This shloka explains the location of Kapha in the stomach, its relationship with Pitta, and its role in the initial stages of digestion by moistening and breaking down food.
माधुर्यात् पिच्छिलत्वाच्च प्रक्लेदित्वात्तथैव च |
आमाशये सम्भवति श्लेष्मा मधुरशीतलः ||१३||
"Due to its sweetness, stickiness, and moistening nature, Kapha, which is sweet and cool, originates in the stomach."
This shloka describes the qualities of Kapha, emphasizing its sweet, sticky, and moistening nature, and its origin in the stomach. These characteristics play a crucial role in the initial stages of digestion and overall bodily functions.
स तत्रस्थ एव स्वशक्त्या शेषाणां श्लेष्मस्थानानां शरीरस्य चोदककर्मणाऽनुग्रहं करोति; उरःस्थस्त्रिकसन्धारणमात्मवीर्येणान्नरससहितेन हृदयावलम्बनं करोति; जिह्वामूलकण्ठस्थो जिह्वेन्द्रियस्य सौम्यत्वात् सम्यग्रसज्ञाने वर्तते; शिरःस्थः स्नेहसन्तर्पणाधिकृतत्वादिन्द्रियाणामात्मवीर्येणानुग्रहं करोत्; सन्धिस्थः श्लेष्मा सर्वसन्धिसंश्लेषात् सर्वसन्ध्यनुग्रहं करोति ||१४||
"Kapha, situated in its respective locations, supports the body's functions with its own strength. The Kapha in the chest supports the trikasandhi (three junctions) and the heart with its own vigor and the essence of food. The Kapha at the base of the tongue and in the throat, due to its gentle nature, plays a role in the proper perception of taste. The Kapha in the head, due to its unctuous and nourishing nature, supports the sensory organs with its own strength. The Kapha in the joints provides support to all joints through its cohesive properties."
This shloka elaborates on the specific roles of Kapha in various parts of the body, highlighting its supportive and nourishing functions essential for maintaining overall health and balance.
भवति चात्र-
श्लेष्मा श्वेतो गुरुः स्निग्धः पिच्छिलः शीत एव च |
मधुरस्त्वविदग्धः स्याद्विदग्धो लवण स्मृतः ||१५||
"Kapha is white, heavy, unctuous, and sticky. It is also cool and sweet when undigested, but when digested, it is considered salty."
This shloka describes the inherent qualities of Kapha, emphasizing its cool, heavy, and sticky nature. It also highlights the difference in taste when Kapha is in its raw versus digested state.
शोणितस्य स्थानं यकृत्प्लीहानौ, तच्च प्रागभिहितं; तत्रस्थमेव शेषाणां शोणितस्थानानामनुग्रहं करोति ||१६||
"The liver and spleen are the seats of blood, as previously mentioned. The blood located there supports the other locations of blood in the body."
This shloka highlights the primary locations of blood (Shoṇita) in the liver and spleen, emphasizing their role in supporting the distribution and maintenance of blood throughout the body.
भवति चात्र-
अनुष्णशीतं मधुरं स्निग्धं रक्तं च वर्णतः |
शोणितं गुरु विस्रं स्याद्विदाहश्चास्य पित्तवत् ||१७||
"Blood is slightly warm, sweet, unctuous, red in color, heavy, and has a mild smell. It causes burning sensations similar to Pitta."
This shloka describes the qualities of blood (Shoṇita), highlighting its slightly warm nature, sweetness, unctuousness, and characteristic red color. It also mentions its heavy nature and mild smell, and its similarity to Pitta in causing burning sensations.
एतानि खलु दोषस्थानानि; एषु सञ्चीयन्ते दोषाः |
प्राक् सञ्चयहेतुरुक्तः |
तत्र सञ्चितानां खलु दोषाणां स्तब्धपूर्णकोष्ठता पीतावभासता मन्दोष्मता चाङ्गानां गौरवमालस्यं चयकारणविद्वेषश्चेति लिङ्गानि भवन्ति |
तत्र प्रथमः क्रियाकालः ||१८||
"These are indeed the sites of the doshas, and in these, the doshas accumulate. The causes of their accumulation have been previously mentioned. The signs of accumulated doshas include stiffness and fullness in the abdomen, a yellowish complexion, reduced bodily heat, heaviness in the body, lethargy, and distaste for the causes of accumulation. This is the first stage of treatment."
This shloka details the primary sites where the doshas accumulate in the body and the signs of their accumulation. It also highlights the importance of recognizing these signs for timely treatment.
अत ऊर्ध्वं प्रकोपणानि वक्ष्यामः |
तत्र बलवद्विग्रहातिव्यायामव्यवायाध्ययनप्रपतनप्रधावनप्रपीडनाभिघातलङ्घनप्लवनतरणरात्रिजागरणभारहरण- गजतुरगरथपदातिचर्याकटुकषायतिक्तरूक्षलघुशीतवीर्यशुष्कशाकवल्लूरवरकोद्दालककोरदूषश्यामाकनीवार- मुद्गमसूराढकीहरेणुकलायनिष्पावानशनविषमाशनाध्यशनवातमूत्रपुरीषशुक्रच्छर्दिक्षवथूद्गारबाष्पवेगविघातादिभिर्विशेषैर्वायुः प्रकोपमापद्यते ||१९||
"Now, I shall describe the factors that aggravate the doshas: Excessive physical exertion, battles, overexertion, sexual activity, intense study, falling, running, pressure, trauma, fasting, swimming, sleeplessness, carrying heavy loads, excessive travel on elephants, horses, chariots, and walking long distances, consumption of pungent, astringent, bitter, dry, light, cold, and dry vegetables like Vallura, Varaka, Kodrava, Koraduska, Shyamaka, Nivara, Mudga, Masura, Adhaki, Harenuka, Kalaya, and Nispaava, irregular and improper eating habits, and suppression of natural urges like urine, stool, semen, vomiting, sneezing, belching, and tears can specifically aggravate Vata."
This shloka provides a detailed list of factors that can aggravate Vata dosha, emphasizing the importance of maintaining a balanced lifestyle to prevent the imbalance of doshas.
स शीताभ्रप्रवातेषु घर्मान्ते च विशेषतः |
प्रत्यूषस्यपराह्णे तु जीर्णेऽन्ने च प्रकुप्यति ||२०||
"Vata gets particularly aggravated during cold, cloudy, and windy weather, at the end of the summer, at dawn and dusk, and when food is fully digested."
This shloka outlines the specific conditions and times when Vata dosha is likely to become aggravated. It emphasizes the importance of being mindful of these factors to maintain the balance of Vata and prevent associated disorders.
क्रोधशोकभयायासोपवासविदग्धमैथुनोपगमनकट्वम्ललवण-तीक्ष्णोष्णलघुविदाहितिलतैलपिण्याककुलत्थसर्षपातसीहरितकशाक- गोधामत्स्याजाविकमांसदधितक्रकूर्चिकामस्तुसौवीरकसुराविकाराम्लफलकट्वरप्रभृतिभिःपित्तं प्रकोपमापद्यते ||२१||
"Pitta gets aggravated by anger, grief, fear, exertion, fasting, improper sexual activity, and by the consumption of pungent, sour, salty, sharp, hot, light, and burnt foods such as sesame oil, mustard, lentils, horse gram, radish, fish, meat of goats and sheep, curd, buttermilk, sour fruits, and fermented beverages."
This shloka lists the various emotional states and dietary factors that can lead to the aggravation of Pitta dosha. It emphasizes the importance of managing emotions and dietary habits to maintain the balance of Pitta.
तदुष्णैरुष्णकाले च घनान्ते च विशेषतः |
मध्याह्ने चार्धरात्रे च जीर्यत्यन्ने च कुप्यति ||२२||
"Pitta is particularly aggravated by hot substances, during hot seasons, at the end of summer, at midday and midnight, and when food is fully digested."
This shloka highlights specific conditions and times when Pitta dosha is likely to become aggravated. It emphasizes the importance of being mindful of these factors to maintain the balance of Pitta and prevent associated disorders.
दिवास्वप्नाव्यायामालस्यमधुराम्ललवणशीतस्निग्धगुरुपिच्छिलाभिष्यन्दिहायनकयवकनैषधेत्कट- माषमहामाषगोधूमतिलपिष्टविकृतिदधिदुग्धकृशरापायसेक्षुविकारानूपौदकमांसवसाबिसमृणाल- कसेरुकशृङ्गाटकमधुरवल्लीफलसमशनाध्यशनप्रभृतिभिः श्लेष्मा प्रकोपमापद्यते ||२३||
"Kapha gets aggravated by daytime sleep, lack of exercise, laziness, consumption of sweet, sour, salty, cold, unctuous, heavy, and sticky foods, such as hayana rice, barley, nishad rice, masha beans, maha masha beans, wheat, sesame products, curd, milk, krishara, rice pudding, sugarcane products, aquatic and marshy meat, fat, lotus stalks, water lilies, sugarcane molasses, sweet fruits, overeating, and eating at irregular times."
This shloka lists various factors that can lead to the aggravation of Kapha dosha, highlighting the importance of maintaining a balanced lifestyle and diet to prevent the imbalance of Kapha.
स शीतैः शीतकाले च वसन्ते च विशेषतः |
पूर्वाह्णे च प्रदोषे च भुक्तमात्रे प्रकुप्यति ||२४||
"Kapha is particularly aggravated by cold substances, during cold seasons and spring, in the forenoon and evening, and immediately after meals."
This shloka highlights specific conditions and times when Kapha dosha is likely to become aggravated. It emphasizes the importance of being mindful of these factors to maintain the balance of Kapha and prevent associated disorders.
पित्तप्रकोपणैरेव चाभीक्ष्णं द्रवस्निग्धगुरुभिराहारैर्दिवास्वप्नक्रोधानलातपश्रमाभिघाताजीर्णविरुद्धाध्यशनादिभिर्विशेषैरसृक् प्रकोपमापद्यते ||२५||
"By factors that aggravate Pitta, such as frequent consumption of liquid, oily, and heavy foods, daytime sleep, anger, exposure to fire and heat, exertion, trauma, indigestion, incompatible food combinations, etc., blood (Rakta) gets aggravated."
This shloka explains how various factors that aggravate Pitta also lead to the aggravation of blood (Rakta). It highlights the importance of avoiding these aggravating factors to maintain the balance of Rakta and prevent related disorders.
यस्माद्रक्तं विना दोषैर्न कदाचित् प्रकुप्यति |
तस्मात्तस्य यथादोषं कालं विद्यत् प्रकोपणे ||२६||
"Since the doshas never get aggravated without the involvement of blood, therefore, the time of its aggravation should be known according to the dosha."
This shloka emphasizes the integral relationship between blood (Rakta) and the doshas, highlighting the importance of understanding the timing of blood's aggravation in relation to the doshas.
तेषां प्रकोपात् कोष्ठतोदसञ्चरणाम्लीकापिपासापरिदाहान्नद्वेषहृदयोत्क्लेदाश्च जायन्ते |
तत्र द्वितीयः क्रियाकालः ||२७||
"Due to the aggravation of these, there arise abdominal pain, movement of gas, nausea, thirst, burning sensation, aversion to food, and heart discomfort. This is the second stage of treatment."
This shloka highlights the symptoms that arise from the aggravation of the doshas, such as abdominal pain, nausea, thirst, and heart discomfort. Recognizing these symptoms is crucial for timely intervention and treatment at the second stage.
अत ऊर्ध्वं प्रसरं वक्ष्यामः- तेषामेभिरातङ्कविशेषैः प्रकुपितानां किण्वोदकपिष्टसमवाय इवोद्रिक्तानां प्रसरो भवति |
तेषां वायुर्गतिमत्त्वात् प्रसरणहेतुः सत्यप्यचैतन्ये |
स हि रजोभूयिष्ठः; रजश्च प्रवर्तकं सर्वभावानाम् |
यथा- महानुदकसञ्चयोऽतिवृद्धः सेतुमवदार्यापरेणोदकेन व्यामिश्रः सर्वतः प्रधावति, एवं दोषाः कदाचिदेकशो द्विशः समस्ताः शोणितसहिता वाऽनेकधा प्रसरन्ति |
तद्यथा- वातः, पित्तं, श्लेष्मा, शोणितं, वातपित्ते, वातश्लेष्माणौ, पित्तश्लेष्माणौ, वातशोणिते, पित्तशोणिते, श्लेष्मशोणिते, वातपित्तशोणितानि, वातश्लेष्मशोणितानि, पित्तश्लेष्मशोणितानि, वातपित्तकफाः, वातपित्तकफशोणितानीति; एवं पञ्चदशधा प्रसरन्ति ||२८||
"Now, I shall describe the spread of the doshas: Due to specific factors, the aggravated doshas, like a mixture of yeast, water, and flour, start to spread. Because of Vata's movement, even though it is insentient, it propels the other doshas. It is mostly composed of Raja (activity); and Raja is the initiator of all functions. Just as an overflowing water reservoir breaks a dam and mixes with another body of water and spreads everywhere, similarly, the doshas sometimes spread singly, in pairs, collectively, or mixed with blood, in many ways. Thus, they can spread in fifteen different combinations: Vata, Pitta, Kapha, blood, Vata-Pitta, Vata-Kapha, Pitta-Kapha, Vata-blood, Pitta-blood, Kapha-blood, Vata-Pitta-blood, Vata-Kapha-blood, Pitta-Kapha-blood, Vata-Pitta-Kapha, and Vata-Pitta-Kapha-blood."
This shloka describes the spread of doshas, emphasizing the various ways they can combine and spread throughout the body, leading to different types of disorders.
कृत्स्नेऽर्धेऽवयवे वाऽपि यत्राङ्गे कुपितो भृशम् |
दोषो विकारं नभसि मेघवत्तत्र वर्षति ||२९||
नात्यर्थं कुपितश्चापि लीनो मार्गेषु तिष्ठति |
निष्प्रत्यनीकः कालेन हेतुमासाद्य कुप्यति ||३०||
"When a dosha becomes severely aggravated in an entire body part or half of it, it causes disorders like a cloud raining in the sky. Even if not excessively aggravated, it stays hidden in the pathways, and upon encountering a suitable cause, it aggravates again."
This shloka illustrates how severely aggravated doshas can cause disorders similarly to how clouds rain, and also highlights the dormant nature of doshas that may aggravate when triggered by specific causes.
तत्र वायोः पित्तस्थानगतस्य पित्तवत् प्रतीकारः, पित्तस्य च कफस्थानगतस्य कफवत्, कफस्य च वातस्थानगतस्य वातवत् ; एष क्रियाविभागः ||३१||
"In the case of Vata located in the seat of Pitta, it should be treated like Pitta. Pitta located in the seat of Kapha should be treated like Kapha. Kapha located in the seat of Vata should be treated like Vata. This is the division of treatment."
This shloka explains the approach to treating doshas when they are located in the seats of other doshas. It emphasizes the importance of addressing the doshas based on their location and the corresponding treatment principles.
एवं प्रकुपितानां प्रसरतां वायोर्विमार्गगमनाटोपौ, ओषचोषपरिदाहधूमायनानि पित्तस्य, अरोचकाविपाकाङ्गसादाश्छर्दिश्चेति श्लेष्मणो लिङ्गानि भवन्ति; तत्र तृतीयः क्रियाकालः ||३२||
"In this way, for the aggravated and spreading doshas, the signs are: for Vata, deviation from its normal pathways and sounds; for Pitta, burning, dryness, and smoke-like sensations; for Kapha, lack of taste, indigestion, heaviness of limbs, and vomiting. This is the third stage of treatment."
This shloka explains the specific signs of aggravated and spreading doshas for Vata, Pitta, and Kapha. Recognizing these signs is crucial for timely intervention at the third stage of treatment.
अत ऊर्ध्वं स्थानसंश्रयं वक्ष्यामः |
एवं प्रकुपितातांस्ताञ् शरीरप्रदेशानागम्य तांस्तान् व्याधीन् जनयन्ति |
ते यदोदरसन्निवेशं कुर्वन्ति तदा गुल्म विद्रध्युदराग्निसङ्गानाहविसूचिकातिसारप्रभृतीञ्जनयन्ति; बस्तिगताः प्रमेहाश्मरीमूत्राघातमूत्रदोषप्रभृतीन्; मेढ्रगता निरुद्धप्रकशोपदंशशूकदोषप्रभृतीन्; गुदगता भगन्दरार्शःप्रभृतीन्; वृषणगता वृद्धीः; ऊर्ध्वजत्रुगतास्तूर्ध्वजान्; त्वङ्मंसशोणितस्थाः क्षुद्ररोगान् कुष्ठानि विसर्पांश्च; मेदोगता ग्रन्थ्यपच्यर्बुदगलगण्डालजीप्रभृतीन्; अस्थिगता विद्रध्यनुशयीप्रभृतीन्; पादगताः श्लीपदवातशोणितवातकण्टकप्रभृतीन्; सर्वाङ्गगता ज्वरसर्वाङ्गरोगप्रभृतीन्; तेषामेवमभिसन्निविष्टानां पूर्वरूपप्रादुर्भावः ; तं प्रतिरोगं वक्ष्यामः |
तत्र पूर्वरूपगतेषु चतुर्थः क्रियाकालः ||३३||
"Now, I shall describe the localization of doshas: When they become aggravated and reach different body parts, they cause various diseases. When they localize in the abdomen, they cause diseases such as gulma (abdominal lumps), vidradhi (abscesses), agnisanga (obstruction of digestive fire), anaha (distention), visuchika (cholera), and atisara (diarrhea). When they localize in the bladder, they cause diseases like prameha (urinary disorders), asmari (stones), mutraghata (urinary obstruction), and mutradosha (urinary defects). When they localize in the genitals, they cause diseases like niruddhaprakasha (obstruction of the urethra), upadamsa (chancre), shukadosha (semen defects), and others. When they localize in the rectum, they cause diseases like bhagandara (fistula), arsha (hemorrhoids), and others. When they localize in the scrotum, they cause diseases like vruddhi (scrotal swelling). When they localize above the collarbone, they cause diseases affecting the upper body. When they localize in the skin, muscles, and blood, they cause minor diseases, skin diseases, and erysipelas. When they localize in fat, they cause diseases like granthi (nodules), apaci (inflammatory swelling), arbuda (tumors), galaganda (goiter), and alaji (abscesses). When they localize in bones, they cause diseases like vidradhi (abscesses) and anushayi (bone diseases). When they localize in the feet, they cause diseases like shlipada (filariasis), vatashonita (gout), vatakantaka (calcaneal spurs), and others. When they spread throughout the body, they cause fever and systemic diseases. The appearance of premonitory symptoms indicates the fourth stage of treatment."
This shloka explains the various diseases caused by the localization of aggravated doshas in different parts of the body, and the corresponding premonitory symptoms that indicate the need for specific treatments.
अत ऊर्ध्वं व्याधेर्दर्शनं वक्ष्यामः- शोफार्बुदग्रन्थिविद्रधिविसर्पप्रभृतीनां प्रव्यक्तलक्षणता ज्वरातीसारप्रभृतीनां च |
तत्र पञ्चमः क्रियाकालः ||३४||
"Now, I shall describe the manifestation of diseases: The clear symptoms of diseases like edema, tumors, nodules, abscesses, erysipelas, etc., and those of fever, diarrhea, and others. This is the fifth stage of treatment."
This shloka explains the fifth stage, where the diseases manifest with clear symptoms. Recognizing these symptoms is crucial for implementing the appropriate treatments.
अत ऊर्ध्वमेतेषामवदीर्णानां व्रणभावमापन्नानां षष्ठः क्रियाकालः, ज्वरातिसारप्रभृतीनां च दीर्घकालानुबन्धः |
तत्राप्रतिक्रियमाणेऽसाध्यतामुपयान्ति ||३५||
"Beyond this, when these diseases progress to ulceration, it marks the sixth stage of treatment. For fever, diarrhea, and similar conditions, prolonged persistence occurs. If left untreated, they become incurable."
This shloka describes the sixth stage, where diseases advance to a severe state, such as ulceration, and emphasizes the critical importance of timely intervention to prevent them from becoming incurable.
भवन्ति चात्र-
सञ्चयं च प्रकोपं च प्रसरं स्थानसंश्रयम् |
व्यक्तिं भेदं च यो वेत्ति दोषाणां स भवेद्भिषक् ||३६||
"One who knows the accumulation, aggravation, spread, localization, manifestation, and differentiation of the doshas becomes a physician."
This shloka emphasizes the comprehensive understanding required to become a proficient physician, highlighting the importance of knowing all stages of dosha dynamics.
सञ्चयेऽपहृता दोषा लभन्ते नोत्तरा गतीः |
ते तूत्तरासु गतिषु भवन्ति बलवत्तराः ||३७||
"Doshas removed during the accumulation phase do not progress further. If they proceed to later stages, they become more powerful."
This shloka emphasizes the importance of addressing doshas during their accumulation phase to prevent them from progressing to more severe stages, where they become harder to treat.
सर्वैर्भावैस्त्रिभिर्वाऽपि द्वाभ्यामेकेन वा पुनः |
संसर्गे कुपितः क्रुद्धं दोषं दोषोऽनुधावति ||३८||
"In combination, whether by all three, two, or even one, an aggravated dosha will further aggravate another dosha."
This shloka explains how doshas, when aggravated in combinations, can cause further aggravation of each other, highlighting the complex interplay between the doshas in the development of disorders.
संसर्गे यो गरीयान् स्यादुपक्रम्यः स वै भवेत् |
शेषदोषाविरोधेन सन्निपाते तथैव च ||३९||
"In the case of combined doshas, the dominant one should be primarily treated. In the case of multiple doshas, treat according to the non-antagonistic one."
This shloka highlights the principle of treating combined or multiple doshas by focusing on the dominant dosha or the one that is non-antagonistic, ensuring effective management of the imbalance.
वृणोति यस्माद्रूढेऽपि व्रणवस्तु न नश्यति |
आदेहधारणात्तस्माद्व्रण इत्युच्यते बुधैः ||४०||
"Because, even when healed, the object of the wound does not perish, since it is retained in the body, therefore, it is called 'wound' by the wise."
This shloka explains the concept of a "wound" (व्रण) by highlighting that even when a wound heals, the impact or object causing the wound remains within the body, giving it the name "wound" as understood by the wise.
इति सुश्रुतसंहितायां सूत्रस्थाने व्रणप्रश्नाध्यायो नामैकविंशोध्यायः ||२१||
"Thus ends the twenty-first chapter named 'Vrana Prashna' in the Sutra Sthana of the Sushruta Samhita."
This shloka marks the conclusion of the twenty-first chapter of the Sushruta Samhita, highlighting the importance of understanding the various aspects of wounds, their causes, and treatments as discussed in this chapter.