विपरीताविपरीतव्रणविज्ञानीयाध्यायः
अथातो विपरीताविपरीतव्रणविज्ञानीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
"Now, we shall expound the chapter on the recognition of proper and improper wounds."
"As declared by the venerable Dhanvantari."
This Shloka introduces a chapter dedicated to understanding the characteristics of proper and improper wounds. It highlights the importance of accurate recognition and diagnosis of wounds to ensure effective treatment and patient care, as taught by the revered sage Dhanvantari.
फलाग्निजलवृष्टीनां पुष्पधूमाम्बुदा यथा |
ख्यापयन्ति भविष्यत्त्वं तथा रिष्टानि पञ्चताम् ||३||
"Just as fruit, fire, rainfall, flowers, smoke, and clouds predict their future states, so do omens indicate impending doom."
This Shloka compares the predictability of natural phenomena like fruit ripening, fire burning, rainfall, blooming flowers, rising smoke, and forming clouds to the way omens can foreshadow future events, particularly negative ones. It highlights the belief in the significance of omens in understanding and predicting future occurrences.
तानि सौक्ष्म्यात् प्रमादाद्वा तथैवाशु व्यतिक्रमात् |
गृह्यन्ते नोद्गतान्यज्ञैर्मुमूर्षोर्न त्वसम्भवात् ||४||
ध्रुवं तु मरणं रिष्टे... |५|
"Due to subtlety, negligence, or sudden occurrence, omens are not perceived by the ignorant, nor do they affect those who are not dying. But when omens appear, death is certain."
This Shloka explains that omens can be missed due to their subtle nature, lack of awareness, or sudden occurrence. It emphasizes that those who are ignorant or not near death may not recognize or be affected by these omens. However, the appearance of omens is a definite indicator of impending death.
... ब्राह्मणैस्तत् किलामलैः |
रसायनतपोजप्यतत्परैर्वा निवार्यते ||५||
"It is said that these omens can be averted by pure Brahmins who are dedicated to the practices of alchemy, austerity, and recitation of mantras."
This Shloka continues the discussion on omens, suggesting that they can be counteracted by pure and knowledgeable Brahmins through the dedicated practices of alchemy (rasayana), austerity (tapas), and the recitation of mantras (japa). It emphasizes the importance of spiritual practices in mitigating the effects of negative omens.
नक्षत्रपीडा बहुधा यथा कालं विपच्यते |
तथैवारिष्टपाकं च ब्रुवते बहवो जनाः ||६||
"As the afflictions of the stars mature over time, so do the omens develop, as many people believe."
This Shloka draws a parallel between the maturation of astrological afflictions and the development of omens. It suggests that just as the negative influences of stars or planetary positions affect individuals over time, the impact of omens also gradually unfolds, as understood by many people.
असिद्धिमाप्नुयाल्लोके प्रतिकुर्वन् गतायुषः |
अतोऽरिष्टानि यत्नेन लक्षयेत् कुशलो भिषक् ||७||
"In this world, one who treats those with a shortened lifespan without recognizing the omens will face failure. Therefore, a skillful physician should carefully observe the omens."
This Shloka emphasizes the importance of recognizing and interpreting omens in medical practice. It warns that failing to acknowledge these signs when treating patients with a shortened lifespan can lead to unsuccessful outcomes. Hence, a knowledgeable and skillful physician must be diligent in observing and understanding omens to ensure effective treatment and care.
गन्धवर्णरसादीनां विशेषाणां स्वभावतः |
वैकृतं यत् तदाचष्टे व्रणिनः पक्वलक्षणम् ||८||
"The natural characteristics of smell, color, taste, and others, when altered, indicate the signs of suppuration in a wound."
This Shloka highlights how changes in the natural properties of smell, color, taste, and other characteristics can signal the presence of suppuration (the process of pus formation) in a wound. These signs are crucial for diagnosing the condition of a wound and determining the appropriate treatment.
कटुस्तीक्ष्णश्च विस्रश्च गन्धस्तु पवनादिभिः |
लोहगन्धिस्तु रक्तेन व्यामिश्रः सान्निपातिकः ||९||
लाजातसीतैलसमाः किञ्चिद्विस्राश्च गन्धतः |
ज्ञेयाः प्रकृतिगन्धाः स्युः ... |१०|
"The smell which is pungent, strong, and foul is associated with Vata and other doshas. A metallic smell mixed with blood indicates a Sannipata condition (a combined aggravation of all three doshas). The natural smells are like those of fried rice and linseed oil, with slight variations in odor."
These Shlokas describe the different types of smells associated with wounds and their underlying causes. Understanding these variations helps in diagnosing the condition of the wound and determining the appropriate treatment.
... रतोऽन्यद्गन्धवैकृतम् ||१०||
मद्यागुर्वाज्यसुमनापद्मचन्दनचम्पकैः |
सगन्धा दिव्यगन्धाश्च मुमूर्षूणां व्रणाः स्मृताः ||११||
श्ववाजिमूषिकध्वाङ्क्षपूतिवल्लूरमत्कुणैः |
सगन्धाः पङ्कगन्धाश्च भूमिगन्धाश्च गर्हिताः ||१२||
"Any other abnormal smells are considered significant. Wounds of those near death are said to have fragrances like alcohol, ghee, flowers, lotus, sandalwood, and champaka. However, wounds with smells like those of dogs, horses, mice, vultures, putrid substances, bedbugs, mud, and earth are considered objectionable."
These Shlokas provide insights into the different smells associated with wounds and their implications. Pleasant fragrances are linked to wounds of those near death, while unpleasant smells are regarded as undesirable and indicative of poor prognosis.
कुङ्कुमध्यामकङ्कुष्ठसवर्णाः पित्तकोपतः |
न दह्यन्ते न चूष्यन्ते भिषक् तान् परिवर्जयेत् ||१३||
कण्डूमन्तः स्थिराः श्वेताः स्निग्धाः कफनिमित्ततः |
दूयन्ते वाऽपि दह्यन्ते भिषक् तान् परिवर्जयेत् ||१४||
कृष्णास्तु ये तनुस्रावा वातजा मर्मतापिनः |
स्वल्पामपि न कुर्वन्ति रुजं तान् परिवर्जयेत् ||१५||
"Wounds that are yellowish-red or crimson in color due to aggravated Pitta, which neither burn nor secrete, should be avoided by the physician. Wounds that are itchy, firm, white, and oily due to aggravated Kapha, which either spread or burn, should also be avoided by the physician. Wounds that are black, with thin secretions due to aggravated Vata, which affect vital parts, and cause minimal pain, should be avoided by the physician."
These Shlokas describe different types of wounds based on the aggravation of doshas (Pitta, Kapha, and Vata) and their characteristics. They emphasize that physicians should be cautious with these wounds and avoid treating them if they exhibit these specific traits.
क्ष्वेडन्ति घुर्घुरायन्ते ज्वलन्तीव च ये व्रणाः |
त्वङ्मांसस्थाश्च पवनं सशब्दं विसृजन्ति ये ||१६||
ये च मर्मस्वसम्भूता भवन्त्यत्यर्थवेदनाः |१७|
"Wounds that produce whistling or gurgling sounds and seem to burn, which exhale air with noise from the skin and muscle tissues due to aggravated Vata, should be avoided by the physician. Wounds that occur in vital parts and cause extreme pain should also be avoided by the physician."
These Shlokas describe certain types of wounds that exhibit specific symptoms such as unusual sounds, burning sensations, and extreme pain. The physician is advised to be cautious and avoid treating these wounds due to their complexity and potential complications.
दह्यन्ते चान्तरत्यर्थं बहिः शीताश्च ये व्रणाः ||१७||
दह्यन्ते बहिरत्यर्थं भवन्त्यन्तश्च शीतलाः |१८|
"Wounds that burn excessively inside and are cold externally should be avoided by the physician. Wounds that burn excessively externally and are cold inside should also be avoided by the physician."
These Shlokas describe wounds with contradictory sensations of burning and coldness, either internally or externally. Physicians are advised to be cautious and avoid treating such complex wounds due to their unusual symptoms and potential complications.
शक्तिध्वजरथाः कुन्तवाजिवारणगोवृषाः ||१८||
येषु चाप्यवभासेरन् प्रासादाकृतयस्तथा |
चूर्णावकीर्णा इव ये भान्तिचानवचूर्णिताः ||१९||
"Wounds that resemble spears, banners, chariots, lances, horses, elephants, and bulls, as well as those that appear like the shapes of palaces, should be avoided. Also, wounds that look as if they are scattered with powder but are not actually powdered should be avoided."
These Shlokas use symbolic imagery to describe the appearances of certain wounds that should be avoided by physicians due to their complexity or negative prognosis. The comparison to various objects and shapes highlights the importance of careful observation and judgment in wound treatment.
प्राणमांसक्षयश्वासकासारोचकपीडिताः |
प्रवृद्धपूयरुधिरा व्रणा येषां च मर्मसु ||२०||
"Wounds in patients suffering from breathlessness, cough, and anorexia, with diminished vitality and muscle tissue, and those with excessive pus and blood at vital points, should be avoided."
This Shloka describes the conditions of wounds in patients who are experiencing severe symptoms such as breathlessness, cough, anorexia, reduced vitality, and muscle tissue loss. It also mentions wounds with excessive pus and blood at vital points, advising physicians to avoid treating these complex and high-risk wounds.
क्रियाभिः सम्यगारब्धा न सिद्ध्यन्ति च ये व्रणाः |
वर्जयेत्तानपि प्राज्ञः संरक्षन्नात्मनो यशः ||२१||
"Wounds that do not heal despite proper treatment should also be avoided by a wise physician, thus preserving their own reputation."
This Shloka emphasizes the importance of a physician's judgment in recognizing wounds that are resistant to treatment. By avoiding such wounds, a physician can maintain their reputation and ensure that they provide effective care to patients.
इति सुश्रुतसंहितायां सूत्रस्थाने विपरीताविपरीतव्रणविज्ञानीयो नामाष्टाविंशतितमोऽध्यायः ||२८||
"Thus ends the twenty-eighth chapter named 'Recognition of Proper and Improper Wounds' in the Sutrasthana of the Sushruta Samhita."
This Shloka signifies the conclusion of the twenty-eighth chapter in the Sutrasthana section of the Sushruta Samhita, which focuses on understanding the characteristics of proper and improper wounds. It highlights the importance of accurate recognition and diagnosis of wounds to ensure effective treatment and patient care.