Sushruta Samhita Chikitsasthana Chapter 2 Sadyovraņa Cikitsitam (Treatment of Accidental Wounds)

 

The 2d bankruptcy of Chikitsasthana of Sushruta Samhita is called as Sadyovraņa Cikitsitam Adhyaya. This bankruptcy offers with Treatment of Accidental Wounds.

अथातोसद्यौव्रणचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।

We will now expound the bankruptcy – Sadyovrana Cikitsita- remedy of unintended wounds; as printed by means of the venerable Dhañvañtari.

धन्वन्तरिर्धर्मभृतांवरिष्ठोवाग्विशारदः।।
विश्वामित्रसुतंशिष्यमृर्षिसुश्रुतमन्वशात्।।३।।

Sage Dhañvañtari regarded as as the manager amongst the ones upholding dharma – righteousness and upholders of righteousness and a fluent vagvisharada – exponent thus suggested his disciple Sushruta, the son of Sage Visvamitra.

नानाधारामुखैःशस्त्रैर्नानास्थाननिपातितैः।।
नानारूपाव्रणायेस्युस्तेषांवक्ष्यामिलक्षणम्।।४।।

In this bankruptcy, I can describe –

• the options of various sorts of wounds,
• that have came about on other portions of the frame which might be
• brought about by means of guns with more than a few kinds of edges

Agantu & Doshaja Vraņaākrti – shapes of wounds brought about by means of trauma and by means of doshas

आयताश्चतुरस्त्राश्चत्र्यस्त्रामण्डलिनस्तथा।।
अर्धचन्द्रप्रतीकाशाविशालाःकुटिलास्तथा।।५।।
शरावनिम्नमध्याश्चयवमध्यास्तथाऽपरे।।
एवंप्रकाराकृतयोभवन्त्यागन्तवोव्रणाः।।६।।
दोषजावास्वयंभिन्ना,नतुवैद्यनिमित्तजाः।।

Below discussed are the other shapes of Agantu Vrana i.e. wounds brought about accidentally or trauma and in addition of Doshaja Vrana i.e. endogenous wounds brought about by means of the doshas that have go off all by means of themselves. These don’t seem to be the shapes of the injuries executed by means of a doctor i.e. they aren’t the shapes of surgical wounds –

• lengthy
• sq. – having 4 edges,
• triangular – having 3 edges,
• spherical
• semi lunar – resembles half-moon,
• vast,
• abnormal / curved,
• saucer formed with melancholy on the centre,
• saucer formed with elevation on the centre

Accidental wounds are of innumerable shapes

भिषग्व्रणाकृतिज्ञोहिनमोहमधिगच्छति।।७।।
भृशंदुर्दर्शरूपेषुव्रणेषुविकृतेष्वपि।।
अनन्ताकृतिरागन्तुःसभिषग्भिःपुरातनैः।।८।।
मासतोलक्षणतःषड्विधःपरिकीर्तितः।।

If a doctor has superb wisdom concerning the other shapes of wounds, he’s going to by no means transform at a loss for words when he encounters wounds which seem dreadful and strange.

According to the traditional physicians, the unintended wounds are of innumerable shapes. Based on their options, a majority of these wounds are labeled in short into six sorts.

Sad-vidha   vrana – six sorts of wounds

छिन्नंभिन्नंतथाविद्धंक्षतंपिच्चितमेवच।।९।।
घृष्टमाहुस्तथाषष्ठंतेषांवक्ष्यामिलक्षणम्।।

The six sorts of wounds are as under discussed –

• Chinna (minimize wounds),
• Bhinna (puncture wounds),
• Viddha (puncture wounds),
• Ksata (overwhelmed wounds),
• Piccita (contused wounds) and
• Ghrsta (lacerated wounds)

The options of those other sorts of wounds will likely be described by means of me now.

Chinna – minimize / incised wound 

तिरश्चीनऋजुर्वाऽपियोव्रणश्चायतोभवेत्।।१०।।
गात्रस्यपातनंचापिछिन्नमित्युपदिश्यते।।

Chinna Vranas are minimize or incised wounds. They are –

• Oblique or
• Straight or
• Broad / large and comprises
• Falling off of a part of the frame

Bhinna – punctured wounds of viscera 

कुन्तशक्त्यृष्टिखङ्गाग्रविषाणादिभिराशयः।।११।।
हतःकिञ्चित्स्त्रवेत्तद्धिभिन्नलक्षणमुच्यते।।

Bhinna Vranas are the ones wounds brought about by means of puncture of inner organs. It contains of visceral organs of the chest and stomach (asaya) which might be punctured by means of the end of the under discussed –

• Kunta – dagger,
• Sakti – spear,
• Rsti – lance,
• Khadga – sword,
• Visana – horns of animals and so forth.

These wounds additionally exude little amount of fluids.

स्थानान्यामाग्निपक्वानांमूत्रस्यरूधिरस्यच॥१२॥
हृदुण्डुकःफुप्फुसश्चकोष्ठइत्यभिधीयते॥

Kostha – viscera throughout the chest and stomach hollow space – contains of seats of –

• Ama – undigested meals
• Agni – digestive hearth,
• Pakva – digested meals,
• Mutra – urine,
• Rudhira – blood,
• Hrdaya – middle,
• Unduka – caecum and
• Pupphusa – lungs

 Koşthabheda lakṣaṇa – options of puncture of the stomach

तस्मिन्भिन्नेरक्तपूर्णेज्वरोदाहश्चजायते।।१३।।
मूत्रमार्गगुदास्येभ्योरक्तंघ्राणाच्चगच्छति।।
मूश्विासतृडाघ्मानमभक्तच्छन्दएवच।।१४।।
विण्मूत्रवातसङ्गश्चस्वेदास्रावोऽक्षिरक्तता।।
लोहगन्धित्वमास्यस्यगात्रदौर्गन्ध्यमेवच।।१५।।
हृच्छूलंपार्श्वयोश्चापि

Below discussed are the indicators of Kostha Bheda – puncture of kostha –

• Filling of kostha with blood
• Fever
• Burning sensation,
• Bleeding from urinary tract, anus, mouth and nostril,
• Fainting,
• Dyspnoea,
• Thirst,
• Flatulence,
• Not having need for meals,
• Non removing of faeces, urine and fart / flatus,
• Sweating,
• Reddish colouration of the eyes,
• Smell of iron coming from the mouth,
• Body emits dangerous odor,
• Pain within the area of the center and flanks

विशेषंचात्रमेॠणु||
आमाशयस्थेरुधिरेरुधिरंछर्दयेत्पुनः।।१६।।
आध्मानमतिमात्रंचशूलंचभृशदारुणम्।।
पक्वाशयगतेचापिरुजोगौरवमेवच।।१७।।
शीतताचाप्यधोनाभेःखेभ्योरक्तस्यचागमः।।
अभिन्नेऽप्याशयेऽन्त्राणांखैःसूक्ष्मैरन्त्रपूरणम्।।१८।।
पिहितास्येघटेयद्वल्लक्ष्यतेतस्यगौरवम्।।

Now the particular signs are being stated by means of me, concentrate to the similar –

Organ during which blood has amassed	Symptoms
Amashaya – abdomen	Vomiting of blood, Profound flatulence, Excruciating ache
Pakvashaya – huge gut	Pain, Feeling of heaviness, Coldness of the stomach under the navel area Bleeding from orifices, basically anus

Just like a pot whose mouth has been closed with a lid will get stuffed with water and turns into heavy with the water getting into into it in the course of the small pores on its aspects, there can be filling of intestines with blood despite those organs no longer being punctured and this occurs in the course of the minute pores of the intestines.

 Viddha vrana – punctured wound 

सूक्ष्मास्यशल्याभिहतंयदङ्गंत्वाशयाद्विना।।१९।।
उण्डितंनिर्गतंवातद्विद्धमितिनिर्दिशेत्।।

A wound is known as as Viddha Vrana when any weapon or international frame injures any a part of the frame except for the hole viscera, by means of getting into via small openings and bulges up the frame, even after the international frame has pop out.

Kșata vrana – overwhelmed wound

नातिच्छिन्नंनातिभिन्नमुभयोर्लक्षणन्वितम्।।२०।।
विषमंव्रणमङ्गेयत्तत्क्षतंत्वभिनिर्दिशेत्।।

A wound qualifies to be known as as Ksata Vrana if it satisfies the under discussed prerequisites –

• The wound has no longer a great deal / critically minimize the frame section (does no longer minimize the frame section into two), and
• does no longer in truth puncture the frame section, however
• has the indicators of each and
• the wound is abnormal in form and degree

Piccita vrana – contused wound

प्रहारपीडनाभ्यांतुयदङ्गपृथुतांगतम्।।२१।।
सास्थितत्पिच्चितंविद्यान्मज्जरक्तपरिप्लुतम्।।

Piccita Vrana – contused wound is when –

• because of assault / attack by means of cane and so forth or because of compression (pressed, squeezed),
• if any a part of the frame will get unfold out being overwhelmed along side bone provide inside of it and
• is full of bone marrow and blood

Ghrsta vrana – abrasion

विगतत्वग्यदङ्गंहिसंघर्षादन्यथाऽपिवा।।२२।।
उषात्रावान्वितंतत्तुघृष्टमित्युपदिश्यते।।

A wound is described as Ghrsta Vrana – abrasive wound when –

• any a part of the frame loses its pores and skin both because of rubbing / friction on arduous or tough surfaces (or attack by means of weapon) or differently, and is
• accompanied with burning sensation and watery exudation

Sāmāñya cikitsā – common remedy

छिन्नेभिन्नेतथाविद्धेक्षतेवाऽसृगतिस्त्रवेत्।।२३।।
रक्तक्षयानुजस्तत्रकरोतिपवनोभृशम्।।
स्नेहपानंहितंतत्रतत्सेकोविहितस्तथा।।२४।।
वेशवारैःसकशरैःसुस्निग्धैश्चोपनाहनम्।।
धान्यस्वेदांश्चकुर्वीतस्निग्धान्यालेपनानिच।।२५।।
वातघ्नौषधसिद्धश्चस्नेहर्बस्तिर्विधीयते।।

When there may be over the top bleeding in any more or less wounds i.e. chinna, bhinna, viddha or ksata, vata gets annoyed because of lack of blood. This annoyed vata produces serious ache.

The under discussed remedy concept will have to be followed to regard this situation –

• snehana and swedana is recommended
• upanaha – heat poultices will have to be executed with vesavara or krsara added with fat,
• swedana – with baked or fried corns,
• software of unctuous pastes at the section,
• unctuous enemas with oil ready from the herbs which mitigate vata,

पिच्चितेचविघृष्टेचनातिस्रवतिशोणितम्।।२६।।
अगच्छतिभृशंतस्मिन्दाहःपाकश्चजायते।।
तत्रोष्मणोनिग्रहार्थंतथादाहप्रपाकयोः।।२७।।
शीतमालेपनंकार्यपरिषेकश्चशीतलः।।
षट्स्वेतेषुयथोक्तेषुछिन्नादिषुसमासतः।।२८।।
ज्ञेयंसमर्पितंसर्वसद्योव्रणचिकित्सितम्।।

Blood does no longer go with the flow out a great deal in case of piccita and ghrsta kinds of wounds. Due to the stasis of blood inside of, there can be serious burning sensation and suppuration (pus formation).

Treatment – Paste of herbs will have to be implemented chilly or chilly medicinal liquids will have to be poured at the affected section / portions in an effort to mitigate the warmth of the wound. These remedies may even lend a hand in overcoming the burning sensation and suppuration.

Thus, remedy briefly for the six sorts of unintended wounds akin to chinna and so forth. had been described.

Višeșa cikitsā – particular remedies

Chinna vrana cikitsa: Treatment of minimize wounds

अतऊर्ध्वप्रवक्ष्यामिछिन्नानांतुचिकित्सितम्।।२९।।
येव्रणाविवृताःकेचिच्छिरःपाविलम्बिनः।।
तान्सीव्येद्विधिनोक्तोनबध्नीयाद्गाढमेवच।।३०।।

After this, I can describe intimately the remedy of Chinna Vrana i.e. minimize or incised wounds.

The under discussed sorts of minimize wounds will have to be sutured within the means described previous in bankruptcy 25 of Sutra Sthana Section –

• wounds found in head and flanks,
• wounds that have open mouths

After suturing, those wounds will have to be bandaged tightly.

कर्णस्थानादपहृतंस्थापयित्वायथास्थितम्।।
सीव्येद्यथोक्तंतैलेनस्रोतश्चाभिप्रतर्पयेत्।।३१।।

Below discussed is briefly the control of the ear which has transform displaced –

• it will have to get replaced to its same old website, and
• sutured correctly and
• anointed i.e. dressed with medicated oil and later,
• the orifice of the ear too will have to be stuffed with oil

कृकाटिकान्तेछिन्नेतुगच्छत्यपिसमीरणे।।
सम्यङ्गिनिवेश्यबन्धीयात्सीव्येच्चापिनिरन्तरम्।।३२।।
आजेनसर्पिषाचैवंपरिषेकंतुकारयेत्।।
उत्तानोऽन्नंसमशीयाच्छयीतचसुयन्त्रितः।।३३।।

Below discussed is the control when there’s a minimize wound on the finish (border) of Krkatika with air popping out of it –

• the krkatika will have to be restored in its same old website (position) correctly and
• steady suture will have to be executed adopted by means of –
• bandaging after which
• the world will have to be bathed with goat’s ghee

The affected person will have to be instructed to take meals whilst mendacity along with his face up (supine) and sleep smartly restrained.

शाखासुपतितांस्तिर्यक्प्रहारान्विवृतान्भृशम्।।
सीव्येत्सम्यङ्गिवेश्याशुसन्ध्यस्थीन्यनुपूर्वशः।।३४।।
बद्ध्वावेल्लितकेनाशुततस्तैलेनसेचयेत्।।
चर्मणागोफणाबन्धःकार्योयोवाहितोभवेत्।।३५।।

In the injuries going on at the extremities, if the cuts are indirect and if there may be formation of a large hole within the minimize, the surgeon / doctor will have to push the bone and joints inside of, position them of their puts after which suture the sound. After suturing, he will have to do the bandaging adopting the Vellitaka form of bandage and shower where with oil. Gophana Bandha form of bandage will likely be executed the use of leather-based or whichever is at ease.

पृष्ठेव्रणोयस्यभवेदुत्तानंशाययेत्तुतम्।।
अतोऽन्यथाचोरसिजेशाययेत्पुरुषंव्रणे।।३६।।

Positioning of the affected person within the wounds of again and chest –

• if the wound is within the again, the individual will have to be positioned in supine place with the affected person dealing with upwards / ceiling
• if the wound is within the chest, he will have to be positioned in vulnerable place i.e. the affected person dealing with downward

छिन्नांनिःशेषतःशाखांदग्ध्वातैलेनबुद्धिमान्।।
बध्नीयात्कोशबन्धनप्राप्तंकार्यंचरोपणम्।।३७।।

When the extremity i.e. higher or decrease limb has been utterly separated from the frame, the smart doctor / surgeon will have to do the under stated sorts of remedy –

• first, he will have to burn the wound the use of hearth i.e. rods heated on hearth, after which
• follow oil or gauze soaked in oil on it after which
• follow kosa form of bandage following which
• he will have to do ropana – measures which might heal the wound

Cañdanādi taila 

चन्दनंपद्यकंरोधमुत्पलानिप्रियङ्गवः।।
हरिद्रामधुकंचैवपयःस्यादत्रचाष्टमम्।।३८।।
तैलमेभिर्विपक्वंतुप्रधानंव्रणरोपणम्।।

The under discussed 8 elements will have to be cooked with oil in an effort to get ready the medicated oil i.e. Candanadi Taila in the standard means –

• Candana
• Padmaka
• Rodhra
• Utpala
• Priyangu
• Haridra
• Madhuka and
• Milk

This oil is alleged to be the most efficient for therapeutic the injuries.

चन्दनंकर्कटाख्याचसहेमांस्याह्वयाऽमृता।।३९।।
हरेणवोमृणालंचत्रिफलापद्मकोत्पले।।त्र
योदशाङ्गंत्रिवृतमेतद्वापयसाऽन्वितम्।।४०।।
तैलंविपकंसेकार्थेहितंतुव्रणरोपणे।।

The under discussed 13 elements / herbs are taken –

• Candana,
• Karkatasringi
• Two Saha – Masaparni and Mudgaparni
• Jatamansi
• Amrta
• Harenu
• Mrnala
• Triphala – Haritaki, Bibhitaki and Amalaki
• Padmaka
• Utpala

These herbs are cooked with Trivrt Sneha i.e. oil, ghee and muscle fats, added with milk and medicated oil ready.

This oil turns out to be useful for bathing the wound and in addition to heal it.

Bhinna vraņa cikitsā – remedy of puncture wounds

अतऊर्ध्वंप्रवक्ष्यामिभिन्नानांतुचिकित्सितम्।।४१।।
भिन्नंनेत्रमकर्मण्यमभिन्नंलम्बतेतुयत्।।
तन्निवेश्ययथास्थानमव्याविद्धसिरंशनैः।।४२।।
पीडयेत्पाणिनासम्यक्पद्मपत्रान्तरेणतु।।
ततोऽस्यतर्पणंकार्यनस्यंचानेनसर्पिषा।।४३।।

After this, the remedy of puncture wounds will likely be described by means of me.

When the attention has been punctured and no longer doing its standard purposes of seeing issues, when it’s placing unfastened, it will have to be gently driven again and positioned in its standard position whilst taking care that it’s siras i.e. veins / blood vessels don’t seem to be broken.

After this, the attention must be massaged with the palm of the doctor. While doing so, petals of padma (lotus flower) will have to be positioned between the hand of the doctor and eye of the affected person.

After massaging, Tarpana will have to be executed to the attention by means of filling the attention with ghee and so forth. The similar ghee will have to be used for nasya – instilled into the nostril additionally.

आजघृतंक्षीरपात्रंमधुकंचोत्पलानिच।।
जीवकर्षभकोचैवपिष्टवासर्पिर्विपाचयेत्।।४४।।
सर्वनेत्राभिघातेतुसर्पिरेतत्प्रशस्यते।।

Medicated ghee will have to be ready by means of cooking the under discussed with cow’s ghee –

• One patra (adhaka) amount of every of goat’s ghee (ready from goat’s milk) and cow’s milk
• Madhuka
• Utpala
• Jivaka and
• Rshabhaka

Note – Madhuka, Utpala, Jivaka and Rshabhaka will have to be taken in equivalent amounts.

This ghee is extremely recommended in treating a wide variety of accidents of the eyes.

Koşthabheda cikitsā – remedy of visceral wounds

उदरान्मेदसोवर्तिर्निर्गतायस्यदेहिनः।।४५।।
कषायभस्ममृत्कीर्णाबद्ध्वासूत्रेणसूत्रवित्।।
अग्नितप्तेनशस्त्रेणछिन्द्यान्मधुसमायुतम्।।४६।।
बद्ध्वाव्रणंसुजीर्णेऽन्नेसर्पिषःपानमिष्यते।।
स्नेहपानाइतेचापिपयःपानंविधीयते।।४७।।
शर्करामधुयष्टिभ्यांलाक्षयावाश्वदंष्ट्रया।।
चित्रासमन्वितंचैवरुजादाहविनाशनम्।।४८।।
आटोपोमरणंवास्याच्छूलोवाऽच्छिद्यमानया।।
मेदोग्रन्यौतुयत्तैलंवक्ष्यतेतच्चयोजयेत्।।४९।।

When because of the puncture, the medovarti i.e. pancreas has pop out of the stomach, the doctor / surgeon will have to smear powder of astringent herbs, ash or dust. After making use of any such, it will have to be tied with threads all spherical, minimize the use of a heated sharp device like scalpel or lancet. Following this, honey is implemented on it and bandaging is finished over the wound.

After that, he will likely be given meals which has been cooked smartly for consuming and ghee for ingesting. Ghee will have to be given for ingesting after the ate up meals has been totally digested. Administration of ghee will likely be executed even with out following laws of abhyantara Sneha – inner oleation. After the affected person has ate up ghee, he will have to be given milk for ingesting. The milk must be blended with Sarkara – sugar, Madhuyashti – Glyzyrrhiza glabra, Laksa – lac, Svadamshtra – Tribulus terristris and Citra – Plumbago zeylanica.

This will relieve ache and burning sensation. Flatulence, demise or ache would possibly happen if reducing isn’t executed. In this situation, the medicated oil described for treating Medogranthi i.e. fatty tumours previous (bankruptcy 18) will likely be used.

Koșthaśalyāharaņa– disposing of international our bodies from the stomach 

त्वचोऽतीत्यसिरादीनिभित्त्वावापरिहृत्यवा।।
कोष्ठेप्रतिष्ठितंशल्यंकुर्यादुक्तानुपद्रवान्।।५०।।
तत्रान्तर्लोहितंपाण्डुशीतपादकराननम्।।
शीतोच्छवासंरक्तनेत्रमानद्धंचविवर्जयेत्।।५१।।

Cutting the stomach or different strategies will have to be followed to take away the international our bodies that have entered the stomach reducing in the course of the pores and skin, veins and so forth and lodged throughout the stomach. Later the headaches enumerated previous (bankruptcy 26 of Sutra Sthana) will have to be handled.

The doctor / surgeon will have to reject the affected person (will have to no longer deal with) if he has advanced the under discussed signs / headaches –

• Internal bleeding,
• Pallor,
• Coldness of arms, ft and face,
• Cold breath,
• Redness of the eyes and
• Flatulence

Raktapūrņakoştha cikitsā – inner haemorrhage and its remedy

आमाशयस्थेरुधिरेवमनंपथ्यमुच्यते।।
पक्वाशयस्थेदेयंचविरेचनमसंशयम्।।२।।
आस्थापनंचनिःस्नेहंकार्यमुष्णैर्विशोधनैः।।
यवकोलकुलत्थानांनि : स्नेहेनरसेनच।।५३।।
भुञ्जीतान्नंयवागूवापिबेत्सैन्धवसंयुताम्।।
अतिनिःउतरक्तोवाभिन्नकोष्ठःपिबेदसृक्।।५४।।

Treatments for haemorrhage going on in amashaya (abdomen) –

• Vamana – emesis treatment is alleged to be the most efficient remedy

Treatments for haemorrhage going on in pakvashaya (huge gut) –

• Virechana – purgation treatment
• Asthapana Vasti – decoction enemas with out including Sneha – fat and ready from purgative herbs will have to be administered heat

Foods – meals ready with yava – barley and kola – jujube will have to be served along side kulattha yusa – horse gram soup or meat soup or yavagu – thick gruel added with saindhava lavana – rock salt.

The affected person will likely be given with blood of animals for ingesting if he has serious bleeding or if his organs are punctured.

स्वमार्गप्रतिपन्नास्तुयस्यविण्मूत्रमारुताः।।
व्युपद्रवःसभिन्नेऽपिकोष्ठेजीवतिमानवः।।५५।।

The particular person would live to tell the tale despite his stomach organs being punctured if –

• his faeces, urine and fart / flatus are observed to be shifting in their very own channels,
• when there are not any headaches

Nişkrāñtāñtra cikitsā – remedy of protrusion / prolapse of intestines

अभिन्नमंत्रंनिष्क्रान्तंप्रवेश्यंनान्यथाभवेत्।।
पिपीलिकाशिरोग्रस्तंतदप्येकेवदन्तितु।।५६।।
प्रक्षाल्यपयसादिग्धंतृणशोणितपांशुभिः।।
प्रवेशयेत्कृत्तनखोघृतेनाक्तंशनैःशनैः।।५७।।
प्रवेशयेत्क्षीरसिक्तंशुष्कमन्त्रंघृताप्लुतम्।।
अङ्गल्याऽभिमृशेत्कण्ठंजलेनोद्वेजयेदपि।।५८।।
हस्तपादेषुसंगृह्यसमुत्थाप्यमहाबलाः।।
भवत्यन्तःप्रवेशस्तुयथानिथुनुयुस्तथा।।५९।।
तथाऽन्त्राणिविशन्त्यन्तःस्वांकलांपीडयन्तिच।।
व्रणाल्पत्वाद्बहुत्वाद्वादुष्प्रवेशंभवेत्तुयत्।।६०।।
तदापाट्यप्रमाणेनभिषगन्त्रंप्रवेशयेत्।।
यथास्थानंनिविष्टेचव्रणंसीव्येदतन्द्रितः।।६१।।
स्थानादपेतमादत्तेप्राणान्गुपितमेववा।।
वेष्टयित्वातुपट्टेनघृतसेकंप्रदापयेत्।।६२।।
घृतंपिबेत्सुखोष्णंचचित्रातैलसमन्वितम्।।
मृदुक्रियार्थंशकृतोवायोश्चाधःप्रवृत्तये।।६३।।
ततस्तैलमिदंकुर्याद्रोपणार्थंचिकित्सकः।।
त्वचोऽश्वकर्णधवयोर्मोचकीमेषशृङ्गयोः।।६४।।
शल्लक्यर्जुनयोश्चापिविदार्याःक्षीरिणांतथा।।
बलामूलानिचाहृत्यतैलमेतैर्विपाचयेत्।।६५।।
व्रणंसंरोपयेत्तेनवर्षमात्रंयतेतच।।

The gut which has protruded out of the stomach and no longer been punctured, the doctor / surgeon shall push the gut again via the similar orifice in which it’s sticking out and will have to no longer be allowed to stay out of doors for a very long time.

According to the opinion of others, the section sticking out will have to be washed with water. Grass, blood and sand adhering to it will have to be got rid of (via washing) and held tight by means of the heads of giant sized ants. Later they want to be driven inside of gently, by means of the doctor / surgeon. The doctor will have to have pared his nails carefully earlier than touching the gut. He will have to additionally smear his arms with ghee. Doing so, he will have to push the gut inside of. The doctor will have to squeeze the neck of the affected person along with his arms and in addition will have to be nervous by means of sprinkling water on his face. In order to make the gut get again into the stomach, robust individuals will have to elevate the affected person up by means of maintaining his arms and ft and shake him. When executed so, the gut displaces its personal membranes whilst getting into in.

When the intestinal mass sticking out out is huge and when the wound is small it could get tough to push the gut into the stomach. Then the surgeon will have to minimize a portion of the sticking out stomach, to a required period after which push it inside of. The wound will have to be correctly sutured with none laxity as soon as the gut has been positioned in its right kind place by means of pushing it in. when improperly positioned or twisted whilst hanging, the gut takes away existence. After suturing, the stomach will likely be wrapped with a band of leather-based or thick fabric. Ghee will have to be poured in this. Also, the affected person is given ghee to drink. This ghee will have to be added with oil of Citra – Eranda, Ricinus communis (castor oil) and served scorching.

In order to melt the faeces and lend a hand motion of flatus downward the affected person will have to be given heat ghee blended with eranda taila (castor oil) to drink.

The under discussed oil will likely be ready and used for wound therapeutic. The oil will have to be processed with barks of the under discussed bushes / herbs –

• Asvakarna,
• Dhava,
• Mocaki,
• Mesasringi,
• Sallaki,
• Arjuna,
• Vidari,
• Trees yielding milky sap and
• Roots of Bala

This oil would heal the injuries. The particular person will have to steer clear of bodily actions, copulation and so forth. and lead a existence with restraint, for a duration of 1 12 months.

Nirastamuşka – prolapse of testes

पादौनिरस्तमुष्कस्यजलेनप्रोक्ष्यचाक्षिणी।।६६।।
प्रवेश्यतुन्नसेवन्यामुष्कीसीव्येत्ततःपरम्।।
कार्योगोफणिकाबन्धःकट्यामावेश्यचन्त्रकम्।।६७।।
नकुर्यात्स्नेहसेकंचतेनक्लिद्यतिहिव्रणः।।
कालानुसार्यागुर्वेलाजातीचन्दनपाकैः।।६८।।
शिलादाळमृतातुत्यैस्तैलंकुर्वीतरोपणम्।।

When the scrotum will get torn because of attack or damage by means of guns and when on account of that the testes are sticking out out of the scrotum partially, the doctor / surgeon will have to do the remedy as stated under –

• The sticking out testes and the orifice in which the testes is sticking out will have to be sprinkled with water and
• The testes will have to be driven inside of, close to the sevani i.e. scrotal raphae and later
• The scrotum will have to be sutured and
• Gophanika form of bandage will have to be implemented and
• Tie it to a regulate / thread fixed around the waist

Anointing and pouring liquids over where will have to be have shyed away from. Doing so would possibly create moistness within the wound.

Medicated oil ready with under discussed herbs heals the wound –

• Kalanusarya
• Aguru
• Ela
• Jati
• Candana
• Padmaka
• Manassila
• Darvi
• Amrta
• Tuttha and
• Taila

Śirassalya – international our bodies within the cranium

शिरसोऽपहृतेशल्येबालवर्तिर्निवेशयेत्।।६९।।
बालवामदत्तायांमस्तुलुङ्गंव्रणात्स्रवेत्।।
हन्यादेनंततोवायुस्तस्मादेवमुपाचरेत्।।७।।
व्रणेरोहतिचैकैकंशनैर्बालमपक्षिपेत्।।

After disposing of the international our bodies from the pinnacle (cranium) wicks fabricated from hairs will have to be inserted. If the hair wick isn’t inserted into the wound, mastulunga i.e. mind subject would go with the flow out in the course of the wound (opening). As a end result, vata would get annoyed and ultimately kill the individual. Therefore, it will have to be handled within the described method. The wicks of hairs that have been inserted should be got rid of separately after the wound has healed.

Sarira salya – international our bodies in different portions

गात्रादपहतेऽन्यस्मात्स्नेहवर्तिप्रवेशयेत्।।७१।।
कृतेनिःशोणितेचापिविधिःसद्यःक्षतेहितः।।

In the opposite portions of the frame, when the international our bodies are discovered, they will have to be got rid of and the wound will have to be cleared of blood. Later, wicks lubricated with oil or ghee will have to be inserted within the wound. Here additionally the remedies advocated for worrying wounds will have to be followed beneficially.

दूरावगाढाःसूक्ष्माःस्युर्येव्रणास्तान्विशोणितान्।।७२।।
कृत्वासूक्ष्मेणनेत्रेणचक्रतैलेनतर्पयेत्।।

When the injuries are deep and feature small openings, the blood in them will have to be cleared and stuffed with Cakra taila i.e. contemporary oil extracted from the mill. The oil filling will have to be executed with the assistance of a nozzle of a tubular device used for wound washing.

समङ्गांरजनीपद्मांत्रिवर्गतुत्थमेवच।।७३।।
विडङ्गकटुकोपथ्यागुडूचींसकरञ्जिकाम्।।
संहृत्यविपचेत्कालेतैलंरोपणमुत्तमम्।।७४।।

Medicated oil ready with the under discussed herbs –

• Samanga,
• Rajani,
• Padma,
• Trivarga (Triphala),
• Tuttha
• Vidanga
• Katuka
• Pathya
• Guduchi and
• Karanjaka

When used at right kind time, this medicated oil is helping perfect in therapeutic.

तालीशंपद्मकंमांसीहरेण्वगुरुचन्दनम् ||
हरिद्रेपद्मबीजानिसोशीरंमधुकंचतैः।।७५।।
पक्वंसद्योव्रणेषूक्तंतैलंरोपणमुत्तमम्।।

Medicated oil is ready the use of the under discussed herbs,

• Talisa
• Padmaka
• Mamsi
• Harenu
• Aguru
• Candana
• Haridra and Daruharidra
• Seeds of Padma,
• Usira and
• Madhuka

This is the most efficient oil for therapeutic the injuries.

Kşata, piccita and ghrsta vrana cikitsā – remedy of overwhelmed, contused and lacerated wounds

क्षतेक्षतविधिकार्यःपिच्चितेभग्नवद्विधिः।।७६।।
घष्टेरुजोनिगृह्माशुचूर्णरुपचरेवणम्।।

Treatment described in bankruptcy 23 for Ksata will have to be executed for Ksataja Vrana i.e. overwhelmed wounds additionally.

Similarly, the similar remedies advocated for Bhagna – fracture of bones will likely be followed for Piccita Vrana i.e. contused wounds.

Pain will have to be mitigated briefly and the wound will have to be handled by means of dusting the powder of medicinal herbs in case of Ghrsta Vrana – lacerated wounds.

Dronīvāsa – hanging in bathtub

विश्लिष्टदेहंपतितंमथितंहतमेवच।।७७।।
वासयेत्तैलपूर्णायांद्रोण्यांमांसरसाशनम्।।
अयमेवविधि : कार्यःक्षीणेमर्महतेतथा।।७८।।

Below discussed individuals will have to be made to lie for some days in a bath of oil and be served with meals along side meat soup –

• Those having displacement of frame portions,
• Those who’ve fallen from peak,
• Those who’ve been twisted of their frame portions and
• Those who’ve been hit on their marmas i.e. important or deadly spots,

Similar remedy will have to be executed for many who are emaciated and people who had been hit on important / deadly spots.

रोपणेसपरीषेकेपानेचव्रणिनांसदा।।
तैलंघृतंवासंयोज्यंशरीरतूंनवेक्ष्यहि।।७९।।

For the aim of therapeutic the injuries and for pouring on them, medicated oil or ghee will have to be made use of. This will have to be executed after having regarded as the situation of the frame and the season. This will have to all the time be adopted whilst treating the wounded individuals.

घृतानियानिवक्ष्यामियत्नतःपित्तविद्रधौ।।
सद्योव्रणेषुदेयानितानिवैद्येनजानता।।८।।

A smart doctor will have to employ the medicated ghee that I’m going to explain within the remedy of Pittaja Vidradhi (in bankruptcy 16) in treating the unintended wounds additionally.

सद्यःक्षतव्रणंवैद्यःसशूलंपरिषेचयेत्।।
सर्पिषानातिशीतेनबलातैलेनवापुनः।।८१।।

For unintended wounds which might be painful, the doctor will have to do pariseka – i.e. pour heat medicated liquids in streams over the injuries. It will have to be executed both with ghee or the use of Bala Taila after making them quite heat.

Samañgādi Taila

समङ्गांरजनीपद्मांपथ्यांतुत्थंसुवर्चलाम्।।
पद्मकंरोघ्रमधुकंविडङ्गानिहरेणुकाम्।।८२।।
तालीशपत्रंनलदंचन्दनंपद्मकेशरम्।।
मञ्जिष्ठोशीरलाक्षाश्चक्षीरिणांचापिपल्लवान्।।८३।।
प्रियालबीजंतिन्दुक्यास्तरुणानिफलानिच।।
यथालाभंसमाहृत्यतैलमेभिर्विपाचयेत्।।८४।।
सद्योव्रणानांसर्वेषामदुष्टानांतुरोपणम्।।

The under discussed herbs, as many as to be had, are amassed and used for getting ready medicated oil –

• Samanga,
• Rajani
• Padma
• Pathya
• Tuttha
• Suvarchala
• Padmaka
• Rodhra
• Madhuka
• Vidanga
• Harenuka
• Talisapatra
• Nalada
• Candana
• Padmakesara
• Manjistha
• Usira
• Laksa
• Young leaves of Panchavalkala
• Priyala Bija
• Unripe culmination of Tinduki

This medicated oil is alleged to be the most efficient to heal a wide variety of non-vitiated unintended wounds.

कषायमधुराःशीताःक्रियाःस्निग्धाश्चयोजयेत्।।८५।।
सद्योव्रणानांसप्ताहंपश्चात्पूर्वोक्तमाचरेत्।।

Below discussed are the foundations of treating unintended wounds –

• They will have to be handled with astringent and candy tasting herbs and with
• Cold and unctuous measures and later,
• Treatments described previous in bankruptcy 1 will have to be followed

Dustavrana Cikitsa – remedy of septic wounds

दुष्टव्रणेषुकर्तव्यमूर्ध्वंचाधश्चशोधनम्।।८६।।
विशोषणंतथाऽऽहारःशोणितस्यमोक्षणम्।।
कषायंराजवृक्षादौसुरसादौचधावनम्।।८७।।
तयोरेवकषायेणतैलंशोधनमिष्यते।।
क्षारकल्पेनवातैलंक्षारद्रव्येषुसाधितम्।।८८।।

Dushta Vrana i.e. septic wounds will have to be in the beginning handled with –

• Upward and downward purification strategies i.e. vamana and virechana
• Foods which reason thinning of frame and
• Bloodletting

The wounds will have to be washed with the Kashaya of herbs belonging to both Rajavriksadi Gana workforce of herbs or Surasadi Gana workforce of herbs.

Oil ready with the similar herbs will have to be used for cleaning the wound.

Ksara – oil or oil ready with Ksara will have to be used for the aim.

Dravañtyādi Taila 

द्रवन्तीचिरबिल्वश्चदन्तीचित्रकमेवच।।
पृथ्वीकानिम्बपत्राणिकासीसंतुत्थमेवच।।८९।।.
त्रिवृत्तेजोवतीनीलीहरिद्रेसैन्धवंतिलाः।।
भूमिकदम्बःसुवहाशुकाख्यालाङ्गलाह्वया।।९०।।
नैपालीजालिनीचैवमदयन्तीमृगादनी।।
सुधामूर्वार्ककीटारिहरितालकरञ्जिकाः।।९१।।
यथोपपत्तिकर्तव्यंतैलमेतैस्तुशोधनम्।।
घृतंवायदिवाप्राप्तकल्काःसंशोधनास्तथा।।९२।।

The under discussed herbs, as many as to be had will likely be amassed and medicated oil or ghee ready –

• Dravanti,
• Cirabilva,
• Danti,
• Citraka
• Prthvika
• Nimbapatra,
• Kasisa
• Tuttha
• Trivrt
• Tejovati
• Nili
• Haridra
• Daruharidra
• Saindhava
• Tila
• Bhumikadamba
• Suvaha
• Sukavrksa
• Langalaka
• Nepali (Manassila)
• Jalini
• Madayanti
• Mrgadani
• Sudha
• Murva
• Arka
• Kitari (Vidanga)
• Haritala and
• Karanjika

The paste of the similar herbs can be implemented. All those are regarded as as excellent for Sodhana – cleaning the wound.

सैन्धवत्रिवृदेरण्डपत्रकल्कस्तुवातिके।।
त्रिवृद्धरिद्रामधुककल्कःपैत्तेतिलैयुतः।।९३।।
कफजेतिलतेजोह्वादन्तीस्वर्जिकचित्रकाः।।
दुष्टव्रणविधिःकार्योमेहकुष्ठव्रणेष्वपि।।९४।।

Wounds with	Medicine
Symptoms of Vata	Paste of Saindhava, Trivrt and Eranda patra
Symptoms of Pitta	Paste of Trivrt, Haridra and Madhuka
Symptoms of Kapha	Paste of Tila, Tejohva, Danti, Svarjika and Citraka
Due to diabetes and pores and skin illnesses	Treatment prescribed for Dusta Vrana – septic wounds

षड्विधःप्राक्प्रदिष्टोयःसद्योव्रणविनिश्चयः।।
नातःशक्यंपरंवक्तुमपिनिश्चितवादिभिः।।९५।।
उपसगैर्निपातैश्चतत्तुपण्डितमानिनः।।
केचित्संयोज्यभाषन्तेबहुधामानगर्विताः।।९६।।
बहुतद्भाषितंतेषांषट्स्वेष्वेवावतिष्ठते।।
विशेषाइवसामान्येषट्त्वंतुपरमंमतम्।।९७।।

There are most effective six sorts of Sadyovrana – unintended wounds, as described by means of me up to now and not anything or no different kind will also be added to this by means of any discriminating particular person.

Some individuals will have immense delight and claim themselves as realized and in consequence, by means of including both suffixes or prefixes to those phrases, would possibly describe some extra sorts of wounds. Many of the ones sorts discussed by means of them would even be integrated below those six sorts of Sadyovrana most effective similar to the Visesa (peculiars, specials) merge with the Samanya (generals). Thus, the classification into six sorts is the most efficient classification and ultimate one too.

इतिसुश्रुतसंहितायांचिकित्सास्थानेसद्योव्रणचिकित्सितं नामद्वितीयोऽध्यायः।।२।।

Thus ends the second one bankruptcy by means of identify Sadyovrana Cikitsita in Cikitsā Sthāna of Suśruta Samhita.