The 12th chapter of Uttaratantra of Sushruta Samhita is named as Raktabhisyanda Pratisedha Adhyaya. This chapter deals with the treatment of Abhisyanda of Rakta Origin.
अथातो रक्ताभिष्यन्दप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound Raktabhisyanda Pratisedha – treatment of Abhisyanda (conjunctivitis) caused by blood; as revealed by the venerable Dhanvantari.
(In this chapter treatment of diseases caused by blood such as Abhisyanda, Adhimantha, Sirotpata, Sirotpata, Siraharsa, Arjun, Avranasukra, Savranasukra, Ajaka, Sasophapaka, Puyalasa, Praklinnavartma and Aklinnavartma have been described).
मन्थं स्यन्दं सिरोत्पातं सिराहर्षं च रक्तजम् |
एकेनैव विधानेन चिकित्सेच्चतुरो गदान् ||३||
व्याध्यार्तांश्चतुरोऽप्येतान् स्निग्धान्कौम्भेन सर्पिषा |
रसैरुदारैरथवा सिरामोक्षेण योजयेत् ||४||
विरिक्तानां प्रकामं च शिरांस्येषां विशोधयेत् |
वैरेचनिकसिद्धेन सितायुक्तेन सर्पिषा ||५||
(मज्ज्ञा वा तद्विमिश्रेण मेदसा तच्छृतेन वा) |
All the below mentioned conditions produced by vitiated rakta – blood should be treated alike (by one method itself) by an intelligent physician –
– Adhimantha,
– Abhisyanda,
– Sirotpata and
– Siraharsa
Snehana – In these diseases snehana should be administered with one of the below mentioned used in more quantity –
– Kumbhi Sarpi – one hundred years old ghee or
– Meat soup added with ghee
Siravedha – Venepuncture should be done after Snehana.
The patient should be given purification with more purgation. Following this, head purgation should also be done. For this, ghee boiled with herbs meant for purging the head should be used. Alternatively marrow or fats other than ghee boiled with the same herbs (head purging) should be used.
ततः प्रदेहाः परिषेचनानि नस्यानि धूमाश्च यथास्वमेव |
आश्च्योतनाभ्यञ्जनतर्पणानि स्निग्धाश्च कार्याः पुटपाकयोगाः ||६||
After this, the below mentioned therapies in their unctuous form should be administered –
– Pradeha,
– Pariseka,
– Nasya,
– Dhuma,
– Ascotana,
– Anjana,
– Tarpana and
– Putapaka
नीलोत्पलोशीरकटङ्कटेरीकालीययष्टीमधुमुस्तरोध्रैः |
सपद्मकैर्धौतघृतप्रदिग्धैरक्ष्णोः प्रलेपं परितः प्रकुर्यात् ||७||
For applying around the eyes, ghee washed many times with the decoction of the below mentioned ingredients should be used –
– Nilotpala,
– Usira,
– Kantakateri,
– Kaliya,
– Yastimadhuka,
– Musta,
– Rodhra and
– Padmaka
रुजायां चाप्यतिभृशं स्वेदाश्च मृदवो हिताः |
अक्ष्णोः समन्ततः कार्यं पातनं च जलौकसाम् ||८||
घृतस्य महती मात्रा पीता चार्तिं नियच्छति |
पित्ताभिष्यन्दशमनो विधिश्चाप्युपपादितः ||९||
Below mentioned treatments help in relieving severe pain –
– mild fomentation around the eyes,
– leech application or
– drinking ghee in maximum dose
Treatments indicated in the treatment of Pittaja Abhisyanda are indicated in this condition too.
कशेरुमधुकाभ्यां वा चूर्णमम्बरसंवृतम् |
न्यस्तमप्स्वान्तरिक्षासु हितमाश्च्योतनं भवेत् ||१०||
The powder of Kaseru and Mahduka is kept in a cloth bag. This bag is kept soaked in rain water. Ascyotana done with this water is beneficial.
पाटल्यर्जुनश्रीपर्णीधातकीधात्रिबिल्वतः |
पुष्पाण्यथ बृहत्योश्च बिम्बीलोटाच्च तुल्यशः ||११||
समञ्जिष्ठानि मधुना पिष्टानीक्षुरसेन वा |
रक्ताभिष्यन्दशान्त्यर्थमेतदञ्जनमिष्यते ||१२||
Flowers of the below mentioned should be taken in equal quantities –
– Patala,
– Arjuna,
– Sriparni,
– Dhataki,
– Dhatri,
– Bilva,
– Brhati,
– Bimbilota and
– Manjistha
They should all be macerated either with honey or sugarcane juice and should be applied as anjana. This cures Abhisyanda of Rakta origin – vitiated blood (Raktaja Abhisyanda).
चन्दनं कुमुदं पत्रं शिलाजतु सकुङ्कुमम् |
अयस्ताम्ररजस्तुत्थं निम्बनिर्यासमञ्जनम् ||१३||
त्रपु कांस्यमलं चापि पिष्ट्वा पुष्परसेन तु |
विपुला याः कृता वर्त्यः पूजिताश्चाञ्जने सदा ||१४||
Below mentioned ingredients are taken in equal quantities –
– Candana,
– Kumuda Patra – lotus petals,
– Silajatu,
– Kumkuma,
– Powder of Ayah (loha), Tamra and Tuttha
All these are macerated in the sap of Nimba and used as collyrium.
Other recipe –
Lead and slag of bronze are powdered well. This powder is macerated with honey and made into wicks. This is used as collyrium and applied to the eyes. This is a praised recipe.
Sirotpata Cikitsa
स्यादञ्जनं घृतं क्षौद्रं सिरोत्पातस्य भेषजम् |
तद्वत्सैन्धवकासीसं स्तन्यघृष्टं च पूजितम् ||१५||
मधुना शङ्खनैपालीतुत्थदार्व्यः ससैन्धवाः |
रसः शिरीषपुष्पाच्च सुरामरिचमाक्षिकैः ||१६||
युक्तं तु मधुना वाऽपि गैरिकं हितमञ्जने |
Below mentioned are the best Anjanas to be used in Sirotpata –
– Anjana i.e. Srotanjana, Ghee and Honey well macerated in breast milk or
– Saindhava lavana and Kasisa well macerated in in breast milk
All of the below mentioned ingredients macerated well can also be used as collyrium –
– Sankha,
– Naipali – Mmanassila,
– Tuttha,
– Darvi,
– Saindhava lavana,
– Juice of Sirisa flowers,
– Sura,
– Marica and
– Makshika – Madhu
Alternatively, Gairika well macerated with honey is also beneficial as a collyrium.
Siraharsa Cikitsa
सिराहर्षेऽञ्जनं कुर्यात् फाणितं मधुसंयुतम् ||१७||
मधुना तार्क्ष्यजं वाऽपि कासीसं वा ससैन्धवम् |
वेत्राम्लस्तन्यसंयुक्तं फाणितं च ससैन्धवम् ||१८||
In Siraharsa, below mentioned collyrium recipes are useful –
– Phanita – molasses mixed with honey or
– Tarksyaja – Rasanjana mixed with honey or
– Kasisa mixed with Saindhaval Lavana and honey, or
– Vetramla – Amlavetasa with Phanita and Saindhava lavana mixed in breast milk
Arjuna cikitsa
पैत्तं विधिमशेषेण कुर्यादर्जुनशान्तये |
इक्षुक्षौद्रसितास्तन्यदार्वीमधुकसैन्धवैः ||१९||
सेकाञ्जनं चात्र हितमम्लैराश्च्योतनं तथा |
सितामधुककट्वङ्गमस्तुक्षौद्राम्लसैन्धवैः ||२०||
बीजपूरककोलाम्लदाडिमाम्लैश्च युक्तितः |
एकशो वा द्विशो वाऽपि योजितं वा त्रिभिस्त्रिभिः ||२१||
स्फटिकं विद्रुमं शङ्खो मधुकं मधु चैव हि |
शङ्खक्षौद्रसितायुक्तः सामुद्रः फेन एव वा ||२२||
द्वाविमौ विहितौ योगावञ्जनेऽर्जुननाशनौ |
सैन्धवक्षौद्रकतकाः सक्षौद्रं वा रसाञ्जनम् ||२३||
कासीसं मधुना वाऽपि योज्यमत्राञ्जने सदा |
All the pitta mitigating treatments should be adopted for the cure of Arjuna disease.
For Seka and Anjana,Iksu, Ksaudra, Sita, Stanya, Madhuka and Saindhava are used.
Ascyotana done with sour liquids like sura, kanjika, aranala etc is beneficial in Arjuna.
Below mentioned can be used once, twice or thrice in a day –
– Sita,
– Madhuka,
– Katvanga,
– Mastu,
– Kshaudra,
– Amla – sour liquids and
– Saindhava
Below mentioned collyrium recipes are the best to cure Arjuna –
– Sphatika, Vidruma, Sankha, Madhuka and Madhu combined together
– Sankha, Ksaudra, Sita and Samudraphena used together
Below mentioned collyrium preparations can always be used –
– collyrium made with Saindhava, Ksaudra and Kataka or
– collyrium made with Rasanjana mixed in Kshaudra or
– collyrium prepared with Kasisa mixed in Kshaudra
Lekhyanjana
लोहचूर्णानि सर्वाणि धातवो लवणानि च ||२४||
रत्नानि दन्ताः शृङ्गाणि गणश्चाप्यवसादनः |
कुक्कुटाण्डकपालानि लशुनं कटुकत्रयम् ||२५||
करञ्जबीजमेला च लेख्याञ्जनमिदं स्मृतम् |
Lekhyanjana i.e. scarifying collyrium is prepared from the below mentioned ingredients –
– powder or ash of lohas i.e. metals like iron, gold, copper etc.
– dhatus i.e. mineral ores like manassila, gairika, haritala etc.
– lavana i.e. salts like saindhava, samudra, bida etc.
– ratnas i.e. precious stones and gems like vaidurya, vajra, marakata etc.
– danta – teeth or tusks and
– srnga – horns of animals and
– things like Kasisa etc. comprising of Avasadana Gana
Another Lekhyanjana is prepared from the below mentioned ingredients –
– shell of hen’s egg,
– lasuna,
– katutraya,
– karanja bija and
– ela
पुटपाकावसानेन रक्तविस्रावणादिना ||२६||
सम्पादितस्य विधिना कृत्स्नेन स्यन्दघातिना |
In this disease also, the therapies such as bloodletting ending with putapaka which are described in the treatment of Abhisyanda shall be properly administered.
Avrana Sukra Cikitsa
अनेनापहरेच्छुक्रमव्रणं कुशलो भिषक् ||२७||
The above methods itself shall be adopted to treat Avrana Sukra.
Savrana Sukra Cikitsa
उत्तानमवगाढं वा कर्कशं वाऽपि सव्रणम् |
शिरीषबीजमरिचपिप्पलीसैन्धवैरपि ||२८||
शुक्रस्य घर्षणं कार्यमथवा सैन्धवेन तु |
कुर्यात्ताम्ररजःशङ्खशिलामरिचसैन्धवैः ||२९||
अन्त्याद्द्विगुणितैरेभिरञ्जनं शुक्रनाशनम् |
कुर्यादञ्जनयोगौ वा सम्यक् श्लोकार्धिकाविमौ ||३०||
शङ्खकोलास्थिकतकद्राक्षामधुकमाक्षिकैः |
क्षौद्रदन्तार्णवमलशिरीषकुसुमैरपि ||३१||
क्षाराञ्जनं वा वितरेद्बलासग्रथितापहम् |
मुद्गान् वा निस्तुषान् भृष्टान् शङ्खक्षौद्रसितायुतान् ||३२||
मधूकसारं मधुना योजयेच्चाञ्जने सदा |
बिभीतकास्थिमज्जा वा सक्षौद्रः शुक्रनाशनः ||३३||
शङ्खशुक्तिमधुद्राक्षामधुकं कतकानि च |
द्वित्वग्गते सशूले वा वातघ्नं तर्पणं हितम् ||३४||
Savrana Sukra might be superficial, deep or rough. In either case, it should be rubbed with the powder of the below mentioned –
- Powder of Sirisa Bija, Marica, Pippali and Saindhava or
- Saindhava, powder of Tamra, Sankha, Manassila, Marica and Saindhava (the last two should be taken double in quantity)
They should be rubbed into the eye.
Collyrium prepared with the herbs mentioned in the below mentioned half verses should be used –
- Collyrium prepared with –
– Sankha,
– Kolasthi,
– Kataka,
– Draksa,
– Madhuka and
– Maksika
- Collyrium prepared with –
– Kshaudra – honey,
– Danta – tusk,
– Arnavamala – Samudraphena and
– Sirisa Kusuma
- Ksaranjana which is used in the treatment of Balasagrathita can be used.
- Mudga – green gram should be de-husked and fried. It is added with ash of Sankha – conch and mixed with honey and sugar. This recipe is used as Anjana.
- Madhuka Kshira – latex of Madhuka tree should be added with honey and always used as a collyrium. Alternatively, the seed or kernel of Vibhitaki mixed in honey should be applied as a collyrium in Sukra – corneal ulcer.
When the disease is present in two Patalas (layers) and has pain, the below mentioned should be used as Tarpana, which is very beneficial in these conditions –
– Ash of Sankha and Sukti,
– Madhu – honey,
– Draksha,
– Madhuka and
– Kataka
वंशजारुष्करौ तालं नारिकेलं च दाहयेत् |
विस्राव्य क्षारवच्चूर्णं भावयेत्करभास्थिजम् ||३५||
बहुशोऽञ्जनमेतत्स्याच्छुक्रवैवर्ण्यनाशनम् |३६|
The below mentioned ingredients should be burnt and made into ash –
– Vamsankura,
– Aruskara,
– Tala and
– Narikela
This ash should be mixed with the ash of camel bones and dissolved in water. This water is filtered many times and the alkali is prepared. This recipe should be used as a collyrium. It removes the discoloration of the cornea.
Ajaka Cikitsa
अजकां पार्श्वतो विद्ध्वा सूच्या विस्राव्य चोदकम् ||३६||
व्रणं गोमांसचूर्णेन पूरयेत् सर्पिषा सह |
बहुशोऽवलिखेच्चापि वर्त्मास्योपगतं यदि ||३७||
Firstly, the Ajaka should be punctured with a needle from its side. The fluid inside it is drained out. After this, the wound should be filled with the powder of cow’s flesh added and mixed in ghee. If the Ajaka is very close to the eyelid, it should be scraped many times.
Sasopha and Asopha paka cikitsa
सशोफश्चाप्यशोफश्च द्वौ पाकौ यौ प्रकीर्तितौ |
स्नेहस्वेदोपपन्नस्य तत्र विद्ध्वा सिरां भिषक् ||३८||
सेकाश्च्योतननस्यानि पुटपाकांश्च कारयेत् |
Siravedha i.e. venepuncture should be done after snehana – oleation and swedana – sudation in both kinds of Aksipaka i.e. one with swelling and the other without swelling.
Then the physician should administer the below mentioned therapies –
– Pariseka,
– Ascyotana,
– Nasya and
– Putapaka
सर्वतश्चापि शुद्धस्य कर्तव्यमिदमञ्जनम् ||३९||
ताम्रपात्रस्थितं मासं सर्पिः सैन्धवसंयुतम् |
मैरेयं वाऽपि दध्येवं दध्युत्तरकमेव वा ||४०||
घृतं कांस्यमलोपेतं स्तन्यं वाऽपि ससैन्धवम् |
मधूकसारं मधुना तुल्यांशं गैरिकेण वा ||४१||
सर्पिःसैन्धवताम्राणि योषित्स्तन्ययुतानि वा |
Below mentioned collyrium should be used after administering proper purificatory therapies.
– Saindhava lavana and Ghee should be added to the ghee kept for one month in a copper vessel.
– Maireya – beer, Dadhi – curd and Dadhyttara – whey are kept in a copper vessel. Saindhava lavana is added to it and may be used as a collyrium.
Also the below mentioned recipes may be used as collyrium –
– ghee added with flux of kamsya i.e. bronze,
– breast milk added with saindhava lavana,
– madhuka sara added with equal quantity of honey and gairika or
– ghee added with powder of saindhava lavana and tamra – copper and woman’s milk
दाडिमारेवताशमन्तकोलाम्लैश्च ससैन्धवाम् |
रसक्रियां वा वितरेत्सम्यक्पाकजिघांसया ||४२||
Below mentioned ingredients are pounded –
– Dadima,
– Aragwadha,
– Ashmanta,
– Kola,
– Kanji and
– Saindhava Lavana
The resultant paste is boiled with water and decoction is prepared with it. The decoction is filtered and Rasakriya is prepared with it.
The physician may adopt Rasakriya therapy also in order to relieve suppuration.
मासं सैन्धवसंयुक्तं स्थितं सर्पिषि नागरम् |
आश्च्योतनाञ्जनं योज्यमबलाक्षीरसंयुतम् ||४३||
Nagara and Saindhava Lavana are soaked in ghee for one month. This ghee is mixed with woman’s milk and used in the form of Ascyotana and Anjana.
जात्याः पुष्पं सैन्धवं शृङ्गवेरं कृष्णाबीजं कीटशत्रोश्च सारम् |
एतत् पिष्टं नेत्रपाकेऽञ्जनार्थं क्षौद्रोपेतं निर्विशङ्कं प्रयोज्यम् ||४४||
Paste of the below mentioned is prepared –
– flowers of Jati,
– Saindhava,
– Srngavera,
– Krsna Bija – Pippali,
– Kitasatru – Vidanga
This paste is mixed with honey. In conditions of Netrapaka – suppuration of the eyes, it should be applied as a collyrium without hesitation.
Puylasa cikitsa
पूयालसे शोणितमोक्षणं च हितं तथैवाप्युपनाहनं च |
कृत्स्नो विधिश्चेक्षणपाकघाती यथाविधानं भिषजा प्रयोज्यः ||४५||
Bloodletting and application of warm poultice are beneficial in treating Puyalasa. The physician should administer all therapies which cure suppuration of eyes (ulcers) according to their procedure.
कासीससिन्धुप्रभवार्द्रकैस्तु हितं भवेदञ्जनमेव चात्र |
क्षौद्रान्वितैरेभिरथोपयुञ्ज्यादन्यत्तु ताम्रायसचूर्णयुक्तैः ||४६||
Collyrium should be prepared by mixing Kasisa, Saindhava and Ardraka with honey and applied.
Similarly, the collyrium prepared with powder of Tamra – copper and Ayas – iron should also be mixed with honey and applied.
Praklinna Vartma Cikitsa
स्नेहादिभिः सम्यगपास्य दोषांस्तृप्तिं विधायाथ यथास्वमेव |
प्रक्लिन्नवर्त्मानमुपक्रमेत सेकाञ्जनाश्च्योतननस्यधूमैः ||४७||
The physician should treat Praklinna Vartma by administering Pariseka, Anjana, Nasya and Dhuma after eliminating the aggravated doshas through oleation and other therapies in a satisfactory way.
मुस्ताहरिद्रामधुकप्रियङ्गुसिद्धार्थरोध्रोत्पलसारिवाभिः |
क्षुण्णाभिराश्च्योतनमेव कार्यमत्राञ्जनं चाञ्जनमाक्षिकं स्यात् ||४८||
Decoction of the below mentioned ingredients should be prepared –
– Musta,
– Haridra,
– Madhuka,
– Priyangu,
– Siddhartha,
– Rodhra,
– Utphala and
– Sariva
Ascyotana should be done with this decoction.
Along with this, the collyrium prepared from Rasanjana and Maksika may be used.
पत्रं फलं चामलकस्य पक्त्वा क्रियां विदध्यादथवाऽञ्जनार्थे |
वंशस्य मूलेन रसक्रियां वा वर्तीकृतां ताम्रकपालपक्वाम् ||४९||
रसक्रियां वा त्रिफलाविपक्वां पलाशपुष्पैः खरमञ्जरेर्वा |
Rasakriya i.e. thick decoction should be prepared from water boiled with leaves and fruits of Amalaka. This is used as a collyrium.
Roots of Vamsa are boiled in a copper vessel so as to prepare its thick decoction. This is made into wicks. This may be used as a collyrium.
Also, thick decoction prepared by boiling the below mentioned in water may be used as collyrium –
– Triphala or
– Flowers of Palasa or
– Kharamanjari
Pratyanjana Pacifying Collyrium
पिष्ट्वा छगल्याः पयसा मलं वा कांसस्य दग्ध्वा सह तान्तवेन ||५०||
प्रत्यञ्जनं तन्मरिचैरुपेतं चूर्णेन ताम्रस्य सहोपयोज्यम् |
Ash is prepared by burning together goat excreta and slag (waste) of copper wire. To this, Marica is added and macerated in goat’s milk. This should be used as Pratyanjana – pacifying collyrium. Similarly, anjana prepared with copper powder / ash may be used as Pratyanjana.
समुद्रफेनं लवणोत्तमं च शङ्खोऽथ मुद्गो मरिचं च शुक्लम् ||५१||
चूर्णाञ्जनं जाड्यमथापि कण्डूमक्लिन्नवर्त्मान्युपहन्ति शीघ्रम् |
Nice powder of the below mentioned ingredients is prepared –
– Samudraphena,
– Lavanottama – Saindhava lavana,
– Sankha – conch,
– Mudga,
– Sukla Marica – seeds of Sobhanjana
This powder is used as Curnanjana – powder collyrium. It cures sluggishness, itching and Aklinna Vartma quickly.
Praklinna vartma cikitsa
प्रक्लिन्नवर्त्मन्यपि चैत एव योगाः प्रयोज्याश्च समीक्ष्य दोषम् ||५२||
सकज्जलं ताम्रघटे च घृष्ठं सर्पिर्युतं तुत्थकमञ्जनं च ||५३||
After having considered the nature of the doshas, the above mentioned formulae should be used even in the treatment of Praklinna Vartma.
Kajjala i.e. lamp back is macerated on a copper pot along with ghee and tuttha. This should be used as a collyrium.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे रक्ताभिष्यन्दप्रतिषेधो नाम द्वादशोऽध्यायः ||१२||
Thus ends the twelfth chapter byname Raktabhisyanda Pratisedha in Uttara Sthana of Susruta Samhita.
