अग्रोपहरणीयाध्यायः
अथातोऽग्रोपहरणीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
"Now, we shall expound the chapter on the best (materials) for treatments."
"As spoken by the revered Dhanvantari."
This introductory passage sets the stage for discussing the best materials and substances for medical treatments in Ayurveda, as taught by Dhanvantari.
त्रिविधं कर्म- पूर्वकर्म, प्रधानकर्म, पश्चात्कर्मेति; तद्व्याधिं प्रत्युपदेक्ष्यामः ||३||
"There are three types of actions: preparatory actions (Purvakarma), main actions (Pradhanakarma), and post-actions (Pashchatkarma). We shall describe these in relation to diseases."
This verse introduces the classification of medical actions into three categories: preparatory, primary, and post-treatment actions, emphasizing a structured approach to disease management.
अस्य तु शास्त्रस्य शस्त्रकर्मप्राधान्याच्छस्त्रकर्मैव तावत् पूर्वमुपदेक्ष्यामस्तत्सम्भारांश्च ||४||
"Given that surgical procedures hold primary importance in this science, we shall first describe the surgical procedures and their components."
This verse highlights the significance of surgical actions within the science of Ayurveda and indicates that the description of surgical procedures and their requisite materials will be provided first.
तच्च शस्त्रकर्माऽष्टविधं; तद्यथा- छेद्यं, भेद्यं, लेख्यं, वेध्यम्, एष्यम्, आहार्यं, विस्राव्यं, सीव्यमिति ||५||
"There are eight types of surgical procedures: excision (Chedya), incision (Bhedya), scarification (Lekhya), puncturing (Vedhya), probing (Eshya), extraction (Aharya), draining (Visravya), and suturing (Sivya)."
This verse categorizes the various surgical procedures practiced in Ayurveda, providing a foundational understanding of the different types of operations and techniques.
ततः प्रशस्तेषु तिथिकरणमुहूर्तनक्षत्रेषु दध्यक्षतान्नपानरत्नैरग्निं विप्रान् भिषजश्चार्चयित्वा, कृतबलिमङ्गलस्वस्तिवाचनं लघुभुक्तवन्तं प्राङ्मुखमातुरमुपवेश्य , यन्त्रयित्वा, प्रत्यङ्मुखो वैद्यो मर्मसिरास्नायुसन्ध्यस्थिधमनीः परिहरन्, अनुलोमं शस्त्रं निदध्यादापूयदर्शनात् , सकृदेवापहरेच्छस्त्रमाशु च; महत्स्वपि च पाकेषु द्व्यङ्गुलान्तरं त्र्यङ्गुलान्तरं वा शस्त्रपदमुक्तम्
||७||
"Then, on an auspicious day, during a favorable tithi (lunar day), karaṇa (half lunar day), muhūrta (moment), and nakṣatra (constellation), having worshipped the sacred fire, Brahmins, and physicians with curd, rice, grains, water, and jewels, and after offering sacrificial offerings and auspicious chants, the physician should seat the patient facing the east, having had a light meal, and restrain him with surgical instruments. The physician, facing the west, avoiding the vital points (marmas), veins (sirās), ligaments (snāyus), joints (sandhis), bones (asthis), and arteries (dhamanīs), should apply the surgical instrument in the direction of hair growth as soon as pus is seen, and swiftly remove the instrument at once; for large abscesses too, the surgical incision should be made at a distance of two to three finger-breadths."
This verse describes the detailed procedure a physician should follow for performing a surgical operation, highlighting the importance of auspicious timing, proper preparation, and surgical precision.
तत्रायतो विशालः समः सुविभक्तो निराश्रय इति व्रणगुणाः ||८||
"The qualities of a good wound are: it should be elongated, wide, level, well-distributed, and without any cavities."
This verse describes the ideal characteristics of a wound, emphasizing the importance of proper shape, distribution, and absence of cavities for effective healing.
भवतश्चात्र-
आयतश्च विशालश्च सुविभक्तो निराश्रयः |
प्राप्तकालकृतश्चापि व्रणः कर्मणि शस्यते ||९||
"The wound that is elongated, wide, well-distributed, without any cavities, and made at the appropriate time is considered suitable for the procedure."
This verse highlights the importance of specific characteristics of a wound for it to be deemed suitable for a medical procedure, emphasizing shape, distribution, absence of cavities, and timing.
शौर्यमाशुक्रिया शस्त्रतैक्ष्ण्यमस्वेदवेपथु |
असम्मोहश्च वैद्यस्य शस्त्रकर्मणि शस्यते ||१०||
"Courage, cleanliness, sharpness of instruments, absence of sweat, absence of trembling, and absence of confusion in the physician are essential for surgical procedures."
This verse emphasizes the importance of the physician's qualities and the condition of the surgical instruments for performing successful surgeries.
एकेन वा व्रणेनाशुध्यमाने नाऽन्तरा बुद्ध्याऽवेक्ष्यापरान् व्रणान् कुर्यात् ||११||
भवति चात्र-
यतो यतो गतिं विद्यादुत्सङ्गो यत्र यत्र च |
तत्र तत्र व्रणं कुर्याद्यथा दोषो न तिष्ठति ||१२||
"If a single wound is not healing, the physician should, using his intelligence, examine and make more wounds in between. It is said that wherever there is movement and wherever there is swelling, there, the physician should make incisions so that the dosha (impurity) does not remain."
These verses emphasize the importance of thorough examination and the creation of additional incisions to ensure that impurities do not remain in the body, thereby promoting proper healing.
तत्र भ्रूगण्डशङ्खललाटाक्षिपुटौष्ठदन्तवेष्टकक्षाकुक्षिवङ्क्षणेषु तिर्यक् छेद उक्तः ||१३||
(चन्द्रमण्डलवच्छेदान् पाणिपादेषु कारयेत् |
अर्धचन्द्राकृतींश्चापि गुदे मेढ्रे च बुद्धिमान्) ||१४||
अन्यथा तु सिरास्नायुच्छेदनम्, अतिमात्रं वेदना, चिराद्व्रणसंरोहो, मांसकन्दीप्रादुर्भावश्चेति ||१५||
"In regions like the eyebrows, cheeks, temples, forehead, eye sockets, lips, gums, armpits, abdomen, and groin, a transverse incision is recommended. Incisions resembling the shape of the crescent moon should be made on the hands and feet, and semi-circular incisions in the anal and genital regions by a wise physician. Otherwise, it may lead to the cutting of veins and ligaments, excessive pain, delayed wound healing, and the development of fleshy growths."
These verses describe the appropriate types of incisions for various body parts and emphasize the importance of careful surgical techniques to avoid complications.
मूढगर्भोदरार्शोऽश्मरीभगन्दरमुखरोगेष्वभुक्तवतः कर्म कुर्वीत ||१६||
"In cases of obstructed labor, abdominal diseases, hemorrhoids, urinary stones, fistula-in-ano, and oral diseases, the procedure should be performed on an empty stomach."
This verse emphasizes the importance of an empty stomach before performing surgical procedures for specific medical conditions to ensure better outcomes.
ततः शस्त्रमवचार्य,शीताभिरद्भिरातुरमाश्वास्य, समन्तात् परिपीड्याङ्गुल्या, व्रणमभिमृद्य(ज्य), प्रक्षाल्य कषायेण प्रोतेनोदकमादाय , तिलकल्कमधुसर्पिःप्रगाढामौषधयुक्तां नातिस्निग्धां नातिरूक्षां वर्तिं प्रणिदध्यात्; ततः कल्केनाच्छाद्य, घनां कवलिकां दत्त्वा, वस्त्रपट्टेन बध्नीयात्; वेदनारक्षोघ्नैर्धूपैर्धूपयेत्, रक्षोघ्नैश्च मन्त्रै रक्षां कुर्वीत ||१७||
"After applying the surgical instrument, soothing the patient with cold water, and pressing the wound all around with fingers, and rubbing the wound, washing with a decoction, taking clean water, he should place a wick smeared with a paste of sesame, honey, and ghee that is neither too oily nor too dry and is well mixed with medicines. Then, covering the wound with a paste, applying a thick covering, tying with a cloth bandage, he should fumigate with fumigations that alleviate pain and ward off evil spirits, and protect with protective chants."
This verse describes the detailed post-surgical care process, including cleaning, soothing, applying medicinal pastes, bandaging, and using protective measures like fumigation and chants to ensure proper healing and protection.
ततो गुग्गुल्वगुरुसर्जरसवचागौरसर्षपचूर्णैर्लवणनिम्बपत्रविमिश्रैराज्ययुक्तैर्धूपयेत् | आज्यशेषेण चास्य प्राणान् समालभेत ||१८||
"Then, fumigate the wound with a mixture of powdered guggulu (Commiphora mukul), aguru (Aquilaria agallocha), resin of sal tree (Shorea robusta), vachā (Acorus calamus), white mustard seeds, and salt mixed with clarified butter and neem leaves. Thereafter, apply the remaining clarified butter to revive the patient's life force."
This verse describes the use of specific herbal and medicinal fumigations and the application of clarified butter as part of the post-surgical care to ensure proper healing and rejuvenation of the patient.
उदकुम्भाच्चापो गृहीत्वा प्रोक्षयन् रक्षाकर्म कुर्यात्; तद्वक्ष्यामः- ||१९||
कृत्यानां प्रतिघातार्थं तथा रक्षोभयस्य च |
रक्षाकर्म करिष्यामि ब्रह्मा तदनुमन्यताम् ||२०||
नागाः पिशाचा गन्धर्वाः पितरो यक्षराक्षसाः |
अभिद्रवन्ति ये ये त्वां ब्रह्माद्या घ्नन्तु तान् सदा ||२१||
पृथिव्यामन्तरीक्षे च ये चरन्ति निशाचराः |
दिक्षु वास्तुनिवासाश्च पान्तु त्वां ते नमस्कृताः ||२२||
पान्तु त्वां मुनयो ब्राह्मया दिव्या राजर्षयस्तथा |
पर्वताश्चैव नद्यश्च सर्वाः सर्वे च सागराः ||२३||
अग्नी रक्षतु ते जिह्वां प्राणान् वायुस्तथैव च |
सोमो व्यानमपानं ते पर्जन्यः परिरक्षतु ||२४||
उदानं विद्युतः पान्तु समानं स्तनयित्नवः |
बलमिन्द्रो बलपतिर्मनुर्मन्ये मतिं तथा ||२५||
कामांस्ते पान्तु गन्धर्वाः सत्त्वमिन्द्रोऽभिरक्षतु |
प्रज्ञां ते वरुणो राजा समुद्रो नाभिमण्डलम् ||२६||
चक्षुः सूर्यो दिशः श्रोत्रे चन्द्रमाः पातु ते मनः |
नक्षत्राणि सदा रूपं छायां पान्तु निशास्तव ||२७||
रेतस्त्वाप्याययन्त्वापो रोमाण्योषधयस्तथा |
आकाशं खानि ते पान्तु देहं तव वसुन्धरा ||२८||
वैश्वानरः शिरः पातु विष्णुस्तव पराक्रमम् |
पौरुषं पुरुषश्रेष्ठो ब्रह्माऽऽत्मानं ध्रुवो भ्रुवौ ||२९||
एता देहे विशेषेण तव नित्या हि देवताः |
एतास्त्वां सततं पान्तु दीर्घमायुरवाप्नुहि ||३०||
स्वस्ति ते भगवान् ब्रह्मा स्वस्ति देवाश्च कुर्वताम् |
(स्वस्ति ते चन्द्रसूर्यौ च स्वस्ति नारदपर्वतौ) |
स्वस्त्यग्निश्चौव वायुश्च स्वस्ति देवाः सहेन्द्रगाः ||३१||
पितामहकृता रक्षा स्वस्त्यायुर्वर्धतां तव |
ईतयस्ते प्रशाम्यन्तु सदा भव गतव्यथः ||३२||
इति स्वाहा |
एतैर्वेदात्मकैर्मन्त्रैः कृत्याव्याधिविनाशनैः |
मयैवं कृतरक्षस्त्वं दीर्घमायुरवाप्नुहि ||३३||
"Taking water from a pot, sprinkle it around and perform the protection ritual; this will be described:"
"To counteract spells and ward off dangers, I shall perform the protection ritual, let Brahma approve of it:"
"Serpents, demons, celestial musicians, ancestors, yakshas, and rakshasas who attack you, may Brahma and other deities always destroy them:"
"Those nocturnal beings who wander on earth and in the atmosphere, those who reside in the directions and places, let them protect you, those who are venerated:"
"May the sages, divine Brahmins, royal sages, mountains, rivers, and all oceans always protect you:"
"May the fire protect your tongue, the wind protect your life breaths, and Soma protect your breath of exhalation and inhalation; let Parjanya protect you:"
"May the lightnings protect your breath of exhalation, thunder protect your equalizing breath, Indra protect your strength, the lord of strength and Manu protect your mind:"
"May the celestial musicians protect your desires, Indra protect your essence, Varuna the king protect your wisdom, and the ocean protect your navel:"
"May the sun protect your eyes, the moon protect your ears and the directions, the stars always protect your form, and the nights protect your shadow:"
"May the waters always nourish your semen, your hair, and the herbs; may the sky protect your openings, and the earth protect your body:"
"May the cosmic fire protect your head, Vishnu protect your valor, the best of men protect your masculinity, Brahma protect your self, and Dhruva protect your eyebrows:"
"These eternal deities particularly in your body, may they always protect you, and may you obtain long life:"
"May the blessed Brahma and the gods grant you auspiciousness, may the moon and the sun bless you with auspiciousness, may Narada and Parvata bless you:"
"May the protection performed by the ancestors increase your lifespan, may your ailments always be pacified, and may you always be free from pain:"
"Thus, may it be true; with these Vedic mantras that destroy spells and diseases, I have thus protected you, may you obtain long life."
These verses describe the protection rituals and mantras used to ward off evil spirits, spells, and diseases. The rituals invoke the blessings and protection of various deities, natural elements, and ancestors, emphasizing the importance of divine protection and auspiciousness for the well-being and longevity of the patient.
ततः कृतरक्षमातुरमागारं प्रवेश्य, आचारिकमादिशेत् ||३४||
"Then, having performed the protection ritual, the patient should be led into the house, and the attendant should be instructed accordingly."
This verse emphasizes the importance of guiding the patient into a safe and protected environment after performing the necessary protection rituals. The attendant is to be given proper instructions to ensure the patient's well-being.
ततस्तृतीयेऽहनि विमुच्यैवमेव बध्नीयाद्वस्त्रपट्टेन; न चैनं त्वरमाणोऽपरेद्युर्मोक्षयेत् ||३५||
"Then, on the third day, after untying the bandage, bind it again with a cloth bandage in the same manner; do not untie it in a hurry on the next day."
This verse emphasizes the importance of proper wound care, advising to re-bandage the wound on the third day without haste and ensuring the bandage is applied correctly to promote healing.
द्वितीयदिवसपरिमोक्षणाद्विग्रथितो व्रणश्चिरादुपसंरोहति, तीव्ररुजश्च भवति ||३६||
"If the bandage is removed on the second day, the wound becomes complicated, heals slowly, and causes intense pain."
This verse advises against removing the bandage on the second day, as it can lead to complications, delayed healing, and increased pain. Proper wound care and timing are emphasized to ensure effective healing and reduce discomfort.
अत ऊर्ध्वं दोषकालबलादीनवेक्ष्य कषायालेपनबन्धाहाराचारान् विदध्यात् ||३७||
"After that, considering the doshas, timing, strength, and other factors, one should apply decoctions, poultices, bandages, diet, and regimen accordingly."
This verse emphasizes the importance of taking into account the individual's doshas (bodily humors), appropriate timing, and the patient's strength while deciding on the application of medicinal decoctions, poultices, bandages, diet, and overall regimen to ensure proper healing.
न चैनं त्वरमाणः सान्तर्दोषं रोपयेत्; स ह्यल्पेनाप्यपचारेणाभ्यन्तरमुत्सङ्गं कृत्वा भूयोऽपि विकरोति ||३८||
"One should not hastily heal a wound with internal impurities; even with slight negligence, it can lead to internal pus formation and cause further complications."
This verse emphasizes the importance of not rushing the healing process for wounds that contain internal impurities. Proper care and attention are necessary to prevent internal pus formation and avoid further complications.
भवन्ति चात्र-
तस्मादन्तर्बहिश्चैव सुशुद्धं रोपयेद्व्रणम् |
रूढेऽप्यजीर्णव्यायामव्यवायादीन् विवर्जयेत् |
हर्षं क्रोधं भयं चापि यावत् स्थैर्योपसम्भवात् ||३९||
"Therefore, one should thoroughly cleanse and heal the wound both internally and externally. Even after healing, one should avoid improper digestion, excessive exercise, and sexual activities. Joy, anger, and fear should also be avoided until stability and recovery are achieved."
This verse emphasizes the importance of cleansing and healing the wound thoroughly both internally and externally. It also advises avoiding activities and emotions that may hinder the healing process, such as improper digestion, excessive exercise, sexual activities, joy, anger, and fear, until complete stability and recovery are achieved.
हेमन्ते शिशिरे चैव वसन्ते चापि मोक्षयेत् |
त्र्यहाद्द्व्यहाच्छरद्ग्रीष्मवर्षास्वपि च बुद्धिमान् ||४०||
"In the Hemanta (early winter), Shishira (late winter), and Vasanta (spring) seasons, the bandage should be changed after three days; during Sharad (autumn), Grishma (summer), and Varsha (rainy) seasons, the bandage should be changed after two days."
This verse provides guidelines on the frequency of changing bandages according to the different seasons. It emphasizes the importance of adjusting medical care to the seasonal conditions to ensure proper healing and prevent complications.
अतिपातिषु रोगेषु नेच्छेद्विधिमिमं भिषक् |
प्रदीप्तागारवच्छीघ्रं तत्र कुर्यात् प्रतिक्रियाम् ||४१||
"In severe diseases, the physician should not follow this method; instead, immediate action should be taken, like extinguishing a burning house."
This verse advises that in cases of severe diseases, the physician should not adhere to the usual method but should act swiftly and decisively, similar to how one would urgently address a fire in a burning house.
या वेदना शस्त्रनिपातजाता तीव्रा शरीरं प्रदुनोति जन्तोः |
धृतेन सा शान्तिमुपैति सिक्ता कोष्णेन यष्टीमधुकान्वितेना ||४२||
"The pain caused by the impact of surgical instruments that intensely afflicts the body can be soothed by applying a warm solution mixed with licorice and ghee."
This verse emphasizes the importance of using warm medicinal solutions, specifically those containing licorice and ghee, to soothe and alleviate the intense pain caused by surgical procedures.