The 25th chapter of Uttara Sthanam of Ashtanga Hridayam is named as Vrana Pratishedha. This chapter deals with the explanation of ‘Treatment of ulcers.’
The topics covered in this chapter include –
Dustavrana (vitiated Ulcer)
- Vrana Prakara – kinds of ulcer
- Vrana Prakara – kinds of ulcer
- Vataja Vrana
- Pittaja Vrana
- Kaphaja Vrana
- Raktaja Vrana
- Dvandvaja and Tridoshaja Vrana
- Shuddha Vrana – non-vitiated ulcer
- Dussadhya Vrana – incurable ulcer
- Susadhya Vrana – easily curable ulcer
- Krichrasadhya Vrana – difficult to cure ulcers
- Asadhya Vrana – incurable ulcer
- Healing ulcer
- Vrana Cikitsa – treatment of ulcers
- Intervention during the presence of swelling
- Bloodletting
- Application of medicinal pastes and other procedures
- Nyagrodhadi Pralepa
- Treatment of Vata predominant ulcers
- Treatment of Vata predominant ulcers
- Upanaha
- Darana
- Gugguluvadi Lepa in pakva shopha
- Pidana
- Treatment of swelling which is drying
- Kshalana and other procedures
- Patoladi alepa
- Trivritadi Varti
- Yavadi dhupana
- Shita Nirvapa
- Treatment of ulcers having dried our muscles
- Treatment of ulcers caused by Ashmari
- Ropana
- Ashvagandhadi lepa
- Tiladi lepa
- Tila Yava Lepa
- Laxadi Pralepa
- Kaliyakadi Pralepa
- Romasanjanana
- Shastrakarma vidhi in vrana
- Formulations for doshaja vranas
Pledge by the author(s)
अथातो व्रणप्रतिषेधो व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
Athāto vraṇa pratiṣedho vyākhyāsyāma: – After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘Treatment of ulcers.
iti ha smāhu: ātreyādayo maharṣaya: – Thus, say (pledge) Atreya and other sages.
Vrana Prakara: Kinds of ulcer
व्रणो द्विधा निजागन्तुदुष्टशुद्धविभेदतः ।
निजो दोषैः शरीरोत्थैरागन्तुर्बाह्यहेतुजः ॥ १ ॥
दोषैरधिष्ठितो दुष्टः शुद्धस्तैरनधिष्ठितः ।
Vrana are of two kinds-viz, organic and traumatic and vitiated/foul and unvitiated /lean. Nija vrana is caused by doshas (aggravated) in the body, Agantu vrana by external causes; Dusta is that in which the doshas are localized and Shuddha is that which is free from localization of the doshas.
Dustavrana (vitiated Ulcer)
Vrana Prakara: Kinds of ulcer
संवृतत्वं विवृतता काठिन्यं मृदुताऽति वा ॥ २ ॥
अत्युत्सन्नावसन्नत्वमत्यौष्ण्यमतिशीतता ।
रक्तत्वं पाण्डुता कार्ष्ण्यं पूतिपूयपरिस्रुतिः ॥ ३ ॥
पूतिमांससिरास्नायुच्छन्नतोत्सङ्गिताऽतिरुक् ।
संरम्भदाहश्वयथुकण्ड्वादिभिरुपद्रुतः ॥ ४ ॥
दीर्घकालानुबन्धश्च विद्याद्दुष्टव्रणाकृतिम् ।
Either contraction or expansion; excessive hardness or softness; too much of elevation or depression; too hot or cold, too much of redness or paleness; black coloration, discharge of foul-smelling pus; foul smelling muscle, veins, ligaments surrounded by swelling and severe pain, profound distress, burning sensation, swelling, itching and other complications associating and persisting for a long time are the features of a Dusta Varna (vitiated ulcer).
स पञ्चदशधा दोषैः सरक्तै:
It (Vrana) is of fifteen kinds, caused by the Doshas along with Rakta (blood).
Vataja Vrana
स्तत्रमारुतात् ॥ ५ ॥
श्यावःकृष्णोऽरुणोभस्मकपोतास्थिनिभोऽपिवा ।
मस्तुमांसपुलाकाम्बुतुल्यतन्वल्पसंस्रुतिः ॥ ६ ॥
निर्मांसस्तोदभेदाढ्योरूक्षश्चटचटायते ।
Vrana caused by Vata is blue, blackish red or resembles ash or bones of the pigeon, exudes fluids which resembles water of curds, mutton wash or grain wash, thin, small in quantity; ulcer not showing more of muscle tissue with severe pricking pain and cutting-like pain, dryness and makes sound (when manipulated).
Pittaja Vrana
पित्तेन क्षिप्रजः पीतो नीलः कपिलपिङ्गलः ॥ ७ ॥
मूत्रकिंशुकभस्माम्बुतैलाभोष्णबहुस्रुतिः ।
क्षारोक्षितक्षतसमव्यथो रागोष्मपाकवान् ॥ ८ ॥
Ulcer caused by Pitta, develops quickly, is yellow, blue, brown or yellowish-brown, exudes fluid resembling urine, kiṃśuka – Butea monosperma, solution of ash and oil, warm and large in quantity; pain resembles that caused by the smearing of caustic alkali (severe burning sensation), redness, feeling of great heat and undergoes ripening / suppuration.
Kaphaja Vrana
कफेन पाण्डुः कण्डूमान् बहुश्वेतघनस्रुतिः ।
स्थूलौष्ठः कठिनः स्नायुसिराजालततोऽल्परुक् ॥ ९
Ulcer caused by Kapha is pale, has itching, large quantity of white, thick exudates, thick edges, hard with a network of tendons and veins and has mild pain.
Raktaja Vrana
प्रवालरक्तो रक्तेन सरक्तं पूयमुद्गिरेत् ।
वाजिस्थानसमो गन्धे युक्तो लिङ्गैश्च पैत्तिकैः ॥१०॥
Ulcer caused by Rakta (blood) is red like the coral, exudes pus mixed with blood, emits smell like that of a horse’s stables and has other features of ulcer caused by Pitta.
Dvandvaja and Tridoshaja Vrana
द्वाभ्यां त्रिभिश्च सर्वैश्च विद्याल्लक्षणसङ्करात् ।
By the mixture of features, presence of two doshas and three doshas should be understood.
Shuddha Vrana: Non-vitiated ulcer
जिह्वाप्रभो मृदुः श्लक्ष्णः श्यावौष्ठपिटिकः समः॥११॥
किञ्चिदुन्नतमध्यो वा व्रणः शुद्धोऽनुपद्रवः ।
The ulcer which resembles the tongue (in color), is soft, smooth, bluish in its edges with eruptions (granulations), even, the floor slightly elevated and not accompanied with complications are features of a Shuddhavrana (ulcer unvitiated by the Doshas etc.).
Dussadhya Vrana: Incurable ulcer
त्वगामिषसिरास्नायुसन्ध्यस्थीनि व्रणाशयाः ॥१२॥
कोष्ठो मर्म च तान्यष्टौ दुःसाध्यान्युत्तरोत्तरम् ।
The skin, muscle, vein, tendons, bony joints, bones, viscera of the trunk and vital spots these eight are places of dwelling (site) of the Ulcers are very difficult to cure in their successive order.
Susadhya Vrana: Easily curable ulcer
सुसाध्यः सत्त्वमांसाग्निवयोबलवति व्रणः ॥ १३ ॥
वृत्तो दीर्घस्त्रिपुटकश्चतुरश्राकृतिश्च यः ।
तथा स्फिक्पायुमेढ्रौष्ठपृष्ठान्तर्वक्त्रगण्डगः ॥ १४ ॥
Ulcers are easily curable, which are present in persons who are strong in mind, muscle, digestive fire, age; which are round, elongated with three folds and four sides in shape, present on the buttocks, rectum, penis, lips, back interior of the mouth and cheeks.
Krichrasadhya Vrana: Difficult to cure ulcers
कृच्छ्रसाध्योऽक्षिदशननासिकापाङ्गनाभिषु ।
सेवनीजठरश्रोत्रपार्श्वकक्षास्तनेषु च ॥ १५ ॥
Ulcers on the eyes, teeth, nose, outer angle of the eye, umbilicus, sutures, abdomen, ears, flanks, axillae and breasts are difficult to cure.
फेनपूयानिलवहः शल्यवान् ऊर्ध्वनिर्वमी ।
भगन्दरोऽन्तर्वदनस्तथा कट्यस्थिसंश्रितः ॥ १६ ॥
कुष्ठिनां विषजुष्टानां शोषिणां मधुमेहिनां ।
व्रणाः कृच्छ्रेण सिध्यन्ति येषां च स्युर्व्रणे व्रणाः ॥१७॥
Those which exude froth, pus and air (or gas), those having foreign body, which are elevated very much, which do not exude at all; bhagandaro – rectal fistula which has its mouth inside and invading the pelvic bone, ulcers of patients suffering from skin diseases, affected by poison, tuberculosis and diabetes mellitus and those ulcers which develops on another (earlier) ulcer get cured with difficulty.
Asadhya Vrana: Incurable ulcer
नैव सिध्यन्ति वीसर्पज्वरातीसारकासिनाम् ।
पिपासूनामनिद्राणां श्वासिनामविपाकिनाम् ॥ १८ ॥
भिन्ने शिरःकपाले वा मस्तुलुङ्गस्य दर्शने ।
Ulcer in patients of herpes, fever, diarrhoea, cough, severe thirst, who do not sleep at all, who are suffering from dyspnea and indigestion, in whom the skull is fractured or the brain is visible do not get cured.
Asadhya Vrana: Incurable ulcer
स्नायुक्लेदात्सिराछेदाद्गाम्भीर्यात्कृमिभक्षणात् ॥ १९ ॥
अस्थिभेदात्सशल्यत्वात्सविषत्वादतर्कितात् ।
मिथ्याबन्धादतिस्नेहाद्रौक्ष्याद्रोमादिघट्टनात् ॥ २० ॥
क्षोभादशुद्धकोष्ठत्वात्सौहित्यादतिकर्शनात् ।
मद्यपानाद्दिवास्वप्नाद्व्यवायाद्रात्रिजागरात् ॥ २१ ॥
व्रणो मिथ्योपचाराच्च नैव साध्योऽपि सिध्यति ।
Even curable become incurable by exudation of tendons, cutting of the veins, increase of depth, devouring (description) by worms (bacteria etc.), fracture of bones, presence of foreign bodies and poisons, unexpectedly, improperly binding it, excessive unctuousness, dryness surrounded by body hairs by too much of strain, impurity of the alimentary tract, too much of food, too much of debility, drinking wine, sleeping during day, copulation, keeping awake at nights and improper treatments of ulcers.
Healing ulcer
कपोतवर्णप्रतिमा यस्यान्तः क्लेदवर्जिताः ॥२२॥
स्थिराश्चिपिटिकावन्तो रोहतीति तमादिशेत् ।
An ulcer which has the color resembling a pigeon, its interior free of exudations, static (hard, immovable) containing skin flakes should be understood as “healing”.
Vrana Chikitsa: Treatment of ulcers
अथात्र शोफावस्थायां यथासन्नं विशोधनम् ॥ २३ ॥
योज्यं शोफो हि शुद्धानां व्रणश्चाशु प्रशाम्यति ।
In the stage of swelling itself, prefatory therapy in the nearest route (either emesis or purgation) should be administered; swelling or ulcer get cured quickly in the person who has been purified.
Intervention during the presence of swelling
कुर्याच्छीतोपचारं च शोफावस्थस्य सन्ततम् ॥२४॥
दोषाग्निरग्निवत्तेन प्रयाति सहसा शमम् ।
During the stage of swelling, cold therapies should be resorted to continuously; the agni (fire) in the Doshas is similar to fire (external fire) and gets subsided by this method immediately.
Bloodletting
शोफे व्रणे च कठिने विवर्णे वेदनान्विते ॥ २५ ॥
विषयुक्ते विशेषेण जलजाद्यैर्हरेदसृक् ।
दुष्टास्रेऽपगते सद्यः शोफरागरुजां शमः ॥ २६ ॥
In swelling and ulcer which are hard, discolored, painful and containing poison, especially blood should be taken out by using leeches; with the vitiated blood going out, swelling, redness and pain subside immediately.
Application of medicinal pastes and other procedur
हृते हृते च रुधिरे सुशीतैः स्पर्शवीर्ययोः ।
सुश्लक्ष्णैस्तदहःपिष्टैः क्षीरेक्षुस्वरसद्रवैः ॥ २७ ॥
शतधौतघृतोपेतैर्मुहुरन्यैरशोषिभिः ।
प्रतिलोमं हितो लेपः सेकाभ्यङ्गाश्च तत्कृताः ॥ २८ ॥
After such removal of blood often, the ulcer should be covered with nice paste of herbs which are cold in touch and potency and applied cold and prepared on the same day macerating with milk, sugarcane juice and such other liquids; Shatadhauta Ghrita (ghee washed hundred times in water or decoction of bark of trees having milky sap) should be applied often and also, the other non-drying things, rubbing it in the direction opposite of the hairs is beneficial, so as the anointing, bathing the ulcer and massage should be done, by the same herbs.
Nyagrodhadi Pralepa
न्यग्रोधोदुम्बराश्वत्थप्लक्षवेतसवल्कलैः ।
प्रदेहो भूरिसर्पिर्भिः शोफनिर्वापणः परम् ॥ २९ ॥
Thick warm poultice of the bark of nyagrodha – Ficus bengalensis, udumbara – Ficus racemosa, aśvattha – Ficus religiosa, plakṣa – Ficus lacor and vetasa – Salix caprea added with more of ghee is best to relieve swelling.
Treatment of Vata predominant ulcers
वातोल्बणानां स्तब्धानां कठिनानां महारुजाम् ।
स्रुतासृजां च शोफानां व्रणानामपि चेदृशाम् ॥ ३० ॥
आनूपवेसवाराद्यैः स्वेदः सोमास्तिलाः पुनः ।
भृष्टा निर्वापिताः क्षीरे तत्पिष्टा दाहरुघराः ॥ ३१
Ulcers which have predominance of Vata, which are static, hard and severely painful, swellings in which blood has been removed or ulcers of this kind, should be given fomentation with veshavara (minced meat cooked in oil) etc. of animals of marshy lands. Seeds of Linum usittaissimum and tilāḥ – Sesamum indicum are fried, soaked in milk made into a paste (and applied to the ulcer) to relieve burning sensation and pain.
Treatment of Vata predominant ulcers
स्थिरान् मन्दरुजः शोफान् स्नेहैर्वातकफापहैः ।
अभ्यज्य स्वेदयित्वा च वेणुनाड्या शनैः शनैः ॥३२॥
विम्लापनार्थं मृद्नीयात्तलेनाङ्गुष्ठकेन वा ।
यवगोधूममुद्गैश्च सिद्धपिष्टैः प्रलेपयेत् ॥३३॥
Swelling which are static and of dull pain should be anointed with oils which mitigate Vata and Kapha, after massaging, exposed to the steam through the reeds of Bamboo slowly, should be squeezed with the palm and the thumb to make it soft, applied with a paste of flour of Hordeum vulgare, godhūma – Triticum aestivum and mudgaiśca – Vigna radiata.
Upanaha
विलीयते स चेन्नैवं ततस्तमुपनाहयेत् ।
अविदग्धस्तथा शान्तिं विदग्धः पाकमश्नुते ॥३४॥
सकोलतिलवल्लोमा दध्यम्ला सक्तुपिण्डिका ।
सकिण्वकुष्ठलवणा कोष्णा शस्तोपनाहने ॥३५॥
If by this method, the swelling does not get reduced, then upanaha (application of warm poultice) should be done; by that the swelling subsides if it is unripe and forms pus, if it he ripens, sakola – Ziziphus mauritiana, tila – Sesamum indicum, Valla – legumes, umā – Linum ustitissimum, sour curds paste of corn flour brewing yeast kuṣṭha – Saussurea lappa and salt and made into a paste is applied warm suitable for poultice.
Darana
सुपक्वे पिण्डिते शोफे पीडनैरुपपीडिते ।
दारणं दारणार्हस्य सुकुमारस्य चेष्यते ॥ ३६ ॥
If the swelling is well ripened, collared together and squeezes mildly, it is desirable to cause its burning, in those who are fit for it and who are of tender nature.
Gugguluvadi Lepa in Pakva Shopha
गुग्गुल्वतसिगोदन्तस्वर्णक्षीरीकपोतविट् ।
क्षारौषधानि क्षाराश्च पक्वशोफविदारणम् ॥ ३७ ॥
Guggulu – Commiphora mukul, atasi – Linum usitatissimum, teeth of cow or Arsenii trisulphidum, svarṇakṣīrī – Panicum sumatrense, kapotaviṭ – excreta of pigeon, medicines which have caustic property and caustic alkalies; these bring about bursting of the ripened swelling.
Pidana
पूयगर्भानणुद्वारान् सोत्सङ्गान् मर्मगानपि ।
निःस्नेहैः पीडनद्रव्यैः समन्तात्प्रतिपीडयेत् ॥ ३८ ॥
The swelling which is full of pus, has a narrow mouth, bulged up and located on a vital spot should be continuously squeezed with herbs of such action without the addition of fats.
Treatment of swelling which is drying
शुष्यन्तं समुपेक्षेत प्रलेपं पीडनं प्रति ।
न मुखे चैनमालिम्पेत्तथा दोषः प्रसिच्यते ॥ ३९ ॥
That swelling which is drying up should be neglected in respect of application of paste and squeezing, its mouth not coated with the paste, for the doshas come out of it on their own accord.
कलाययवगोधूममाषमुद्गहरेणवः ।
द्रव्याणां पिच्छिलानां च त्वङ्मूलानि प्रपीडनम् ॥४०॥
Bark of the stem and roots of kalāya – Lathyrus sativus, yava – Hordeum vulgare, godhūma – Triticum aestivum, māṣa – Vigna mungo, mudga – Vigna radiata and hareṇavaḥ – Pisum sativum and herbs which are slimy are good for squeezing (the swelling).
Kshalana and other procedures
सप्तसु क्षालनाद्येषु सुरसारग्वधादिकौ ।
भृशं दुष्टे व्रणे योज्यौ मेहकुष्ठव्रणेषु च ॥ ४१ ॥
In Dusta Varna (Vitiated ulcer) and those of diabetes, kuṣṭha – skin disease and ulcers, herbs of Surasadi Gana and Aragvadhadi Gana (chapter 15 of Sutrasthana) should be made use of, the seven therapies such as Kshalana etc. (Kshalana – washing, Alepa – paste application, Ghrita, Taila, Rasakriya, Churna and Varti) especially.
अथवा क्षालनं क्वाथः पटोलीनिम्बपत्रजः ।
अविशुद्धे विशुद्धे तु न्यग्रोधादित्वगुद्भवः ॥ ४२ ॥
Washing the ulcer can be done with the decoction of leaves of Trichosanthes dioica and nimba – Azadirachta indica. When the ulcer is vitiated, and with that of the bark of herbs of NyagrodhadiGana (chapter 15 of Sutrasthana) when the ulcer is not vitiated.
Patoladi alepa
पटोलीतिलयष्ट्याह्वत्रिवृद्दन्तीनिशाद्वयम् ।
निम्बपत्राणि चालेपः सपटुर्व्रणशोधनः ॥ ४३ ॥
Paste of paṭolī – Trichosanthes dioica, tila – Sesamum indicum, yaṣṭyāhva – Glycyrrhiza glabra, trivṛt – Operculina turpethum, dantī – Baliospermum montanum, the two Nisha –
– Haridra – Curcuma longa
– Daruharidra – Berberis aristata
and leaves of Azadirachta indica added with Salt applied over, cleanses the ulcers / wounds.
Trivritadi Varti
व्रणान् विशोधयेद्वर्त्या सूक्ष्मास्यान् सन्धिमर्मगान् ।
कृतया त्रिवृतादन्तीलाङ्गलीमधुसैन्धवैः ॥ ४४ ॥
Ulcers which have small opening and which are located on joints and vital sports should be cleaned (cleared of their contents) by inserting a varti (cotton wick) prepared with trivṛtā – Operculina turpethum, dantī – Baliospermum montanum, lāṅgalī – Gloriosa superba, honey and rock salt.
Yavadi dhupana
वाताभिभूतान् सास्रावान् धूपयेदुग्रवेदनान् ।
यवाज्यभूर्जमदनश्रीवेष्टकसुराह्वयैः ॥ ४५ ॥
Ulcers which have been vitiated by Vata, which have exuded and severe pain should be fumigated with yava – Hordeum vulgare, bhūrja – Betula utilis, madana – Randia dumetorum., exudates of Pinus roxburghii, surāhvayaiḥ – Cedrus deodara mixed with ghee.
Shita Nirvapa
निर्वापयेद्भृशं शीतैः पित्तरक्तविषोल्बणान् ।
Those which are predominant with Pitta, blood and poison should be bathed with cold things (decoction, oils etc.).
Treatment of ulcers having dried out muscles
शुष्काल्पमांसे गम्भीरे व्रण उत्सादनं हितम् ॥ ४६ ॥
न्यग्रोधपद्मकादिभ्यामश्वगन्धाबलातिलैः ।
अद्यान् मांसादमांसानि विधिनोपहितानि च ॥ ४७ ॥|
मांसं मांसादमांसेन वर्धते शुद्धचेतसः ।
In those ulcers which have very little of dried out muscle tissue, and the ulcer if deep seated, it is beneficial to elevate it, make it grow up by massaging with paste of herbs of nyagrodha – Nyagrodhadi Gana and of Padmakadi Gana (chapter 15 of Sutrasthana), aśvagandhā – Withania somnifera, balā – Sida cordifolia and tilaiḥ – Sesamum indicum, the patient should eat meat of amāṃsāni – carnivorous animals prepared in the proper manner; muscle grows / develops by ingestion of meat especially of carnivorous animals and by pure (pleasant) mind.
Treatment of ulcers having dried out muscles
उत्सन्नमृदुमांसानां व्रणानामवसादनम् ॥ ४८ ॥ जातीमुकुलकासीसमनोह्वालपुराग्निकैः ।
उत्सन्नमांसान् कठिनान् कण्डूयुक्तांश्चिरोत्थितान् ॥ ४९ ॥
व्रणान् सुदुःखशोध्यांश्च शोधयेत्क्षारकर्मणा ।
Overgrowth of soft muscle tissue over the ulcers should be reduced by the use of paste of buds of jātī – Jasminum grandiflorum, kāsīsa – ferrous sulphate, manohvāla – realgar, pura – Commiphora mukul and agnikaiḥ – Plumbago zeylanica; muscle which is elevated, hard associated with itching and long standing (chronic) and ulcers in those which are difficult to be purified should be cleaned by Kshara karma (alkaline cautery).
Treatment of ulcers caused by Ashmari
स्रवन्तोऽश्मरीजा मूत्रं ये चान्ये रक्तवाहिनः ॥५०॥
छिन्नाश्च सन्धयो येषां यथोक्तैर्ये च शोधनैः ।
शोध्यमाना न शुध्यन्ति शोध्याः स्युस्तेऽग्निकर्मणा ॥५१॥
Ulcers caused by renal calculi which exude urine through them and others which exude blood, those ulcers located on the bony joints and have caused tearing, those ulcers which do not get cleaned by the usual methods of cleaning all these should be cleaned in those fit to be cleansed by Agnikarma – thermal cautery.
Ropana
शुद्धानां रोपणं योज्यमुत्सादाय यदीरितम् ।
For the healing of the ulcers the same herbs mentioned for massaging and rising up (vide verse no. 46b-48a) should be used in those cleansed.
Ashvagandhadi lepa
अश्वगन्धा रुहा लोध्रं कट्फलं मधुयष्टिका ॥५२॥
समङ्गा धातकीपुष्पं परमं व्रणरोपणम् ।
Aśvagandhā – (Paste of) Withania somnifera, ruhā – (vrksaruha) – Dendrophthoe falcata, lodhraṃ – Symplocos racemosa, kaṭphalaṃ – Myrica nagi, madhuyaṣṭikā – Glyccrhiza glabra, samaṅgā – Rubia cordifolia and flowers of Woodfordia fruticosa are best for healing the ulcer.
Tiladi lepa
अपेतपूतिमांसानां मांसस्थानामरोहताम् ॥५३॥
कल्कं संरोहणं कुर्यात्तिलानां मधुकान्वितम् ।
स्निग्धोष्णतिक्तमधुरकषायत्वैः स सर्वजित् ॥५४॥
स क्षौद्रनिम्बपत्राभ्यां युक्तः संशोधनं परम् ।
पूर्वाभ्यां सर्पिषा चासौ युक्तः स्यादाशु रोपणः ॥५५॥
The putrefied and foul-smelling muscle tissue having been removed, if new muscle tissue is not been growing if new muscle tissue is not been growing in that place, then the paste of tilānāṃ – Sesamum indicum added with honey should be kept in that place which helps muscle growth. This being unctuous, hot, bitter, sweet, astringent, it cures all troubles; added with honey and leaves of nimba yuktaḥ – Azadirachta indica is a good purifier, ghee processed with above herbs, these heals the ulcers quickly.
Tila Yava Lepa
तिलवद्यवकल्कं तु केचिदिच्छन्ति तद्विदः ।
Some say that paste of tilavat – Sesamum indicum also acts like that of yava – Hordeum vulgare.
Ropana
सास्रपित्तविषागन्तुगम्भीरान् सोष्मणो व्रणान् ॥५६॥
क्षीररोपणभैषज्यशृतेनाज्येन रोपयेत् ।
रोपणौषधसिद्धेन तैलेन कफवातजान् ॥५७॥
Ulcers which are caused by blood and Pitta, poison, external causes and which are deep seated should be made to heal by bathing it with lukewarm ghee boiled with milk and healing herbs; those which are caused by Kapha and Vata by oil boiled with healing herbs.
Ropana
काच्छीलोध्राभयासर्जसिन्दूराञ्जनतुत्थकम् ।
चूर्णितं तैलमदनैर्युक्तं रोपणमुत्तमम् ॥ ५८ ॥
Kācchī – Saurastra mrittika, lodhra – Symplocos racemosa, abhayā – Terminalia chebula, sarja – Resin of Vateria indica, sindūra – red oxide of lead, añjana – antimony sulphide and tutthakam – copper sulphate powdered, mixed with oil and beeswax is good for healing ulcers.
समानां स्थिरमांसानां त्वक्स्थानां चूर्ण इष्यते ।
ककुभोदुम्बराश्वत्थजम्बूकट्फललोध्रजैः ॥ ५९ ॥
त्वक्चूर्णैश्चूर्णिता व्रणाः त्वक्चूर्णैश्चूर्णिता व्रणाः ।
For healing of ulcers which are even, with firm muscles and localised in the skin, powders (of healing herbs) are desirable; powder of bark of kakubha – Terminalia alata, udumbara – Ficus racemosa, aśvattha – Ficus religiosa, jambū – Syzygium cumini, kaṭphala – Myrica nagi and lodhrajaiḥ – Symplocos racemosa
निगृह्णन्ति त्वचमाशु त्वक् चूर्णै: चूर्णिता व्रणाः –
Dusted into the ulcers and on the skin cures them quickly.
Lakshadi Pralepa
लाक्षामनोह्वामञ्जिष्ठाहरितालनिशाद्वयैः ॥ ६० ॥
प्रलेपः सघृतक्षौद्रस्त्वग्विशुद्धिकरः परम् ।
Application of cold paste of lākṣā – Laccifer lacca, manohvā – realgar, mañjiṣṭhā – Rubia cordifolia, haritāla – arsenic trisulphide and two nisha-
– Haridra – Curcuma longa
– Daruharidra – Berberis aristata,
added with ghee and honey is best to purify the skin.
Kaliyakadi Pralepa
कालीयकलताम्रास्थिहेमकालारसोत्तमैः ॥ ६१ ॥
लेपः सगोमयरसः सवर्णकरणः परम् ।
Application of paste of kālīyaka – Berberis aristata, Lata – Hiptage benghalensis, seeds of Mangifera indica, (Padmaka) – Prunus cerasoides, (Manjishta) - Rubia cordifolia rasottamaiḥ – Purified Mercury, added with juice of fresh cow dung is best to bring up the normal color of the skin.
Romasanjanana
दग्धो वारणदन्तोऽन्तर्धूमं तैलं रसाञ्जनम् ॥६२॥
रोमसञ्जननो लेपस्तद्वत्तैलपरिप्लुता ।
चतुष्पान्नखरोमास्थित्वक्शृङ्गखुरजा मषी ॥६३
Application of paste of an elephant tusk burnt to ash in the internal method (putapaka method), oil and rasanjana; is an application best for promoting growth of hair; similarly, so the paste of ash of nails, hair, bones, skin, horn and hoof of catuṣpān – quadrupeds added with oil.
Shastrakarma vidhi in vrana
व्रणिनः शस्त्रकर्मोक्तं पथ्यापथ्यान्नमादिशेत् ।
The do’s and don’ts of diet prescribed for a person who has undergone surgical operation apply to the patient of ulcer also.
Formulations for doshaja vranas
द्वे पञ्चमूले वर्गश्च वातघ्नो वातिके हितः ॥ ६४ ॥
न्यग्रोधपद्मकाद्यौ तु तद्वत्पित्तप्रदूषिते ।
आरग्वधादिः श्लेष्मघ्नः कफे मिश्रास्तु मिश्रजे ॥६५॥
In Ulcer of Vata origin, the herbs of the two pancamulas –
– Bilva – Aegle marmelos
– Agnimantha – Premna mucronata
– Shyonaka – Oroxylum indicum
– Patala – Stereospermum suaveolens
– Gambhari – Gmelina arborea
– Shalaparni – Desmodiumgangeticum
– Prishniparni – Urariapicta
– Brihati – Solanum indicum
– Kantakari – Solanum xanthocarpum
– Gokshura – Tribulus terrestris
and those group of herbs that mitigate Vata are suitable. Similarly, for that of Pitta origin, herbs of nyagrodhadi and padmakadi gana (chapter 15 of Sutrasthana); and for that of Kapha origin, the herbgs of aragvadha gana which mitigate Kapha and in ulcer of mixed origin with mixture of herbs.
Formulations for doshaja vranas
एभिः प्रक्षालनं लेपो घृतं तैलं रसक्रिया ।
चूर्णो वर्तिश्च संयोज्य व्रणे सप्त यथायथम् ॥ ६६ ॥
These herbs should be made use of for washing, application of paste, preparation of medicated ghee, medicated oil, solidified decoction, powder and wick smeared with paste of herbs should be used in the treatment of seven kinds of ulcer as per the condition.
Jatyadi ghrita
जातीनिम्बपटोलपत्रकटुकादार्वीनिशासारिवा |
मञ्जिष्ठाभयसिक्थतुत्थमधुकैर्नक्ताह्वबीजान्वितैः |
सर्पिः साध्यमनेन सूक्ष्मवदना मर्माश्रिताः क्लेदिनो |
गम्भीराः सरुजो व्रणाः सगतयः शुध्यन्ति रोहन्ति च ॥ ६७ ॥
Medicated ghee prepared with leaves of jātī – Jasminum grandiflorum, nimba – Azadirachta indica, paṭola – Trichosanthes dioica, kaṭukā – Picrorhiza kurroa, dārvī – Berberis aristata, niśā – Curcuma longa, sārivā – Hemidesmus indicus, mañjiṣṭhā – Rubia cordifolia, abhaya – Terminalia chebula, siktha – beeswax, Purified copper sulphate, madhukai: – Glycyrrhiza glabra and seeds of naktāhva – Pongamia pinnata cleanses and heals the ulcers which have small openings, situated on vital spots which have exudation, deep seated, painful and having sinuses.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने व्रणप्रतिषेधो नाम पञ्चविंशोऽध्याय: ॥ १ ॥
Thus, ends the chapter – Vrana Pratishedha- the twentyfifth in Uttarasthana of Astanga Hridaya Samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
