The seventeenth chapter of Chikitsasthana of Sushruta Samhita is known as as Dvivraniya Cikitsitam Adhyaya. This chapter offers with Therapy of Erysipelas, Sinus Ulcer and Ailments of The Breast.
अथातोविसर्पनाडीस्तनरोगचिकित्सितंव्याख्यास्यामः॥१॥
यथोवाचभगवान्धन्वन्तरिः।।२।।.
We are going to now expound the Visarpa-Nadi roga and Stana roga cikitsita therapy of Erysipelas, Sinus ulcer and Ailments of the breast, as revealed by the venerable Dhanvantari
Visarpa – Erysipelas
साध्याविसर्यालयआदितोयेनसन्निपातक्षतजौहिसाध्यौ।।
साध्येषुतत्पध्यगणैर्विदध्यादतानिसेकांशतथोपदेहान्॥३॥
मुस्ताशताडासुरदारुकुष्ठवाराहिकुस्तुम्बुरुकृष्णागन्याः।।
बातात्मकेचोष्णगणाःप्रयोज्या:सेकेषुलेषेषुतथाशतेषु।।४।।
यत्पञ्चमूलखलुकण्टकाख्यमल्यंमहच्चाप्यथवल्लिर्जच।।
तच्चोपयोज्यंभिषजाप्रदेहेसेकेघृतेचापितथैवतैले॥५॥
The primary three sorts of Visarpa are curable i.e.
– Vataja Visarpa
– Pittaja Visarpa
– Kaphaja Visarpa
The opposite two kinds of Visarpa are incurable i.e.
– Sannipataja Visarpa and
– Ksataja Visarpa
The curable kinds of Visarpa must be handled utilizing the beneath talked about strategies –
– ingesting of medicated ghee,
– taking bathtub with medicated decoctions and
– making use of pastes ready utilizing herbs which mitigate explicit doshas (concerned within the causation of the illness)
Vätaja visarpa
Beneath talked about substances must be used to arrange kashaya – decoctions which can be utilized for bathing, pastes for exterior software and medicated ghee for inner utilization in sufferers affected by Vataja kind of Visarpa –
– Mustā,
– Satánvā,
– Suradāru,
– Kustha,
– Vārāhikanda,
– Kustumburu,
– Krsnagandha (sobhanjana) and
– Pippalyadi Gana group of herbs and
– Usna Gana i.e. herbs belonging to Bhadradarvadi and Pippalyadi Gana group of herbs
The doctor ought to use the beneath talked about herbs for offering heat poultice, bathing and for preparation of medicated oil and ghee –
– Herbs belonging to Kantakſ Pañcamúla group,
– Herbs belonging to Alpa (hrasva) Pañcamüla group,
– Herbs belonging to Mahat Pancamüla group and
– Herbs belonging to Valli Pañcamüla group
Pittaja Visarpa
कसेरुशृङ्गाटकपशगुन्द्राःसशैवलाःसोत्पलकर्दमाश्च।।
वस्त्रान्तराःपित्तकृतेविसर्पलेपाविधेयाःसघृताःसुशीताः।।६।।
हीवेरलामज्जकचन्दनानिस्रोतोजमुक्तामणिगैरिकाश्च।।
क्षीरेणपिष्टाःसघृताःसुशीतालेपाःप्रयोज्यास्तनवःसुखाय।।७।।
प्रपौण्डरीकंमधुकंपयस्यामञ्जिष्ठिकापाकचन्दनेच।।
सुगन्धिकाचेतिसुखायलेपःपैत्तेविसर्पभिषजाप्रयोज्यः।।८।।
न्यग्रोधवर्ग:परिषेचनंचघृतंचकुर्यात्स्वरसेनतस्य।।
शीतैःपयोभिश्चमधूदकैश्चसशर्करैरिक्षुरसैश्चसेकान्।।९।।
For therapy of Visarpa brought on by Pitta, paste of the beneath talked about must be ready –
– Kaseruka,
– Karnataka,
– Padma,
– Gundra,
– Saivala,
– Utpala and
– Kardama (slush)
This paste must be added with ghee and unfold over a pad of sterile fabric. This must be utilized chilly on the lesion.
Paste of the beneath talked about herbs must be macerated with the milk, blended with ghee and utilized chilly and skinny on the lesion brought on by Pittaja Visarpa to offer consolation –
– Hrībera,
– Lämajjaka,
– Cañdana,
– Srotoñjana,
– Muktä,
– Maņi and
– Gairika
To supply consolation to the affected person of Pittaja Visarpa, the paste of the beneath talked about must be utilized over the lesions –
– Prapaundarīka,
– Madhuka,
– Payasyä,
– Mañjisthä,
– Padmaka and
– Candana and
– Sugandhika (utpala sārivā)
Nyagrodhädi Gana group of herbs must be used for making ready water which can be utilized for bathing functions.
Ghee ready from the recent juice of the identical herbs i.e. Nyagrodhadi Gana group of herbs must be used for Seka i.e. irrigation or showering (or chilly compress), with chilly milk, honey water, sugar water or sugarcane juice.
Gauryadi ghrta (Haridrādi ghrta)
घृतस्यगौरीमधुकारविन्दरोधाम्बुराजादनगैरिकेषु।।
तथर्षभेपद्मकसारिवासुकाकोलिमेदाकुमुदोत्पलेषु।।१०।।
सचन्दनायांमधुशर्करायांद्राक्षास्थिरापृश्रिशताह्वयासु।।
कल्कीकृतासूदकमत्रदत्त्वान्यग्रोधवर्गस्यतथास्थिरादेः।।११।।
गणस्यबिल्वादिकपञ्चमूल्याश्चतुर्गुणंक्षीरमथापितद्वत्।।
प्रस्थंविपक्वंपरिषेचनेनपैत्तीनिहन्यात्तुविसर्पनाडीः॥१२॥
विस्फोटदुष्टव्रणशीर्षरोगान्पाकंतथाऽऽस्यस्यनिहन्तिपानात्।।
ग्रहार्दितेशोषिणिचापिबालेघृतंहिगौर्यादिकमेतदिष्टम्।।१३।।
Paste of the beneath talked about herbs is ready –
– Gauri (haridrā),
– Madhuka,
– Aravinda (padma),
– Rodhra,
– Ambu (välaka)
– Rājādana,
– Gairika,
– Rsabhaka, Padmaka,
– Sāriva,
– Kākoli,
– Meda,
– Kumuda,
– Utpala,
– Candana,
– Madhusarkara (solidified honey),
– Drāksa,
– Sthira (salaparni),
– Prsniparni and
– Satähvaya (satapuspa)
Decoction of the beneath talked about must be taken in 4 elements every
– Nyagrodhadi Gana group of herbs,
– Sthiradi Gana group of herbs,
– Bilvadi Pancamula group of herbs
Milk – taken in 4 elements
Ghee – is taken in a single prastha i.e. 640 grams amount
All of the above talked about substances are taken collectively and medicated ghee ready. This ghee is understood by the title Gauryadi Ghrta.
Advantages –
This Gauryadi Ghrta when used for bathing the lesion cures –
– erysipelas brought on by pitta and
– sinus ulcers brought on by pitta
It cures the beneath talked about situations / ailments when used internally –
– eruptions of smallpox
– septic ulcers
– ailments of the pinnacle
– ulcers of the mouth,
– possession by evil spirits in kids and
– consumption
Kaphaja visarpa
अजाऽश्वगन्धासरलासकालासैकषिकाचाप्यथवाऽजशृङ्गी।।
गोमूत्रपिष्टोविहितःप्रदेहोहन्याद्विसर्पकफजसशीघ्रम्।।१४।।
कालानुसार्यागुरुचोचगुञ्जारास्रावचाशीतशिवेन्द्रपर्यः।।
पालिन्दिमुञ्जातमहीकदम्बाहिताविसर्पेषुकफात्मकेषु।।१५।।
Beneath talked about substances are macerated in gomutra – urine of cow and their paste is ready –
– Aja (ajagandha),
– Asvagandha,
– Sarala (trivrt),
– Kala (kāsamarda),
– Ekaisika (śatāvarī) and
– Ajaśrñgi
This paste utilized heat cures Visarpa brought on by kapha shortly.
Paste of the beneath talked about herbs is useful for software in Visarpa of Kapha origin –
– Kālānusārya,
– Aguru,
– Coca,
– Guñjā,
– Räsnā,
– Vacā,
– Sītaśiva (satapuspa bheda),
– Indraparņi (iñdravāruņi or lāñgalaki)
– Palinda,
– Muñjāta and
– Mahikadamba (bhūkadamba)
गुणस्तुयोज्योवरुणप्रवृत्तःक्रियासुसर्वासुविचक्षणेन।।
संशोधनंशोणितमोक्षणंचश्रेष्ठंविसर्पेषुचिकित्सितंहि।।१६।।
सर्वांश्चपक्वान्परिशोध्यधीमान्व्रणक्रमेणोपचरेद्यथोक्तम्।।
Use of herbs belonging to the Varunadi Gana group is claimed to be the perfect for all functions like exterior software, bathing and making ready ghee and so on. within the therapy of all kinds of Visarpa. Likewise, in all kinds of Visarpa, administration of purificatory therapies and bloodletting are the perfect.
The clever doctor ought to clear the Visarpa as soon as it has change into ripe i.e. as soon as it has shaped into ulcers. Following this, he ought to undertake remedies advocated for ulcers.
Nadi vrana – Sinus ulcers
नाडीत्रिदोषप्रभवानसिध्येच्छेषाश्चतस्त्र:खुलयलसाध्याः।।१७।।
Sannipataja Nadi Vrana i.e. sinus ulcers produced by simultaneous aggravation of all of the tridoshas collectively doesn’t reply to any therapy. Alternatively, the remaining 4 kinds of Nadi Vrana i.e. Vataja, Pittaja, Kaphaja and Salyaja Nadi Vrana are curable with issue.
Vätaja Nādi Vrana
तत्रानिलोत्थामुपनाह्यपूर्वमशेषतःपूयगतिविदार्य।।
तिलैरपामार्गफलैश्चपिष्टवाससैन्धवैर्बन्धनमत्रकुर्यात्।।१८।।
प्रक्षालनेचापिसदाव्रणस्ययोज्यंमहद्यत्खलुपञ्चमूलम्।।
हिंस्रांहरिद्राकटुकोबलाचगोजिह्निकांचापिसबिल्वमूलाम्।।१९।।
संहृत्यतैलंविपचेद्णस्यसंशोधनपूरणरोपणंच।।
Upanaha (heat poultice fomentation) ought to firstly be given for Nadi Vrana produced by vata. Following this, the channel (tract) of pus must be totally minimize open. The opening must be stuffed with paste of tila – sesame, fruits (seeds) of Apamarga and Saindhava – rock salt and bandaged. For laundry the ulcer, the decoction ready utilizing herbs belonging to Brhat / Mahat Pancamula ought to all the time be used.
Decoction and paste must be ready from the beneath talked about herbs –
– Himsra,
– Haridra,
– Katuka,
– Bala,
– Gojihva and
– Root of Bilva
Medicated oil must be ready from this decoction and paste.
This medicated oil must be used for cleaning and therapeutic the ulcer.
Pittaja nādi vrana
पित्तात्मिकाप्रागुपनाह्यधीमानुत्कारिकाभिःसपयोघृताभिः।।२०।।
निपात्यशस्त्रंतिलनागदन्तीयष्टयाह्वकल्कैःपरिपूरयेत्ताम्।।
प्रक्षालनेचापिससोमनिम्बानिशाप्रयोज्याकुशलेननित्यम्।।२१।।
In Pittaja Nadivrana fomentation must be given first by the clever doctor. He ought to do this by utilizing utkarika (pan cake) added with milk and ghee. Following this, he ought to minimize open the sinus with the assistance of a pointy instrument and clear it. Within the cleaned sinus paste of tila, nagadanti and yasti must be crammed.
Decoction of Soma (somalata), Nimba and Nisa must be used for laundry the wound every day.
श्यामात्रिभण्डीत्रिफलासुसिद्धहरिद्रयोरोधकवृक्षयोश्च।।
पतंसदुग्धंव्रणतर्पणेनहन्याद्गतिकोष्ठगताऽपियास्यात्।।२२।।
Ghee must be ready with the beneath talked about substances –
– Syāma,
– Tribhandi (trivrt),
– Triphalā,
– Haridrā,
– Rodhra and
– Vrkşaka (kutaja) and
– Milk
This ghee is crammed into the sinus. When performed, this recipe cures the ulcer although current within the belly viscera.
Kaphaja Nādi Vrana
नाडीकफोत्थामुपनाह्यसम्यक्कुलत्थसिद्धार्थकसक्तुकिण्वैः।।
मृदूकृतामेष्यगतिंविदित्वानिपातयेच्छस्त्रमशेषकारी।।२३।।
दद्याद्रणेनिम्बातिलान्संदन्तीन्सुराष्ट्रजासैन्धवसंप्रयुक्तान्।।
प्रक्षालनेचापिकरञ्जनिम्बजात्यक्षपीलुस्वरसाःप्रयोज्याः।।२४।।
सुवर्चिकासैन्धवचित्रकेषुनिकुम्भतालीतलरूपिकासु।।
फलेष्वपामार्गभवेषुचैवकुर्यात्समूत्रेषुहितायतैलम्।।२५।।
In Kaphaja Nadi Vrana, fomentation must be given first. It must be given with heat poultice ready from Kulattha, Siddhartaka, Saktu (corn flour) and Kinva (yeast).
After the ulcer has been made tender thereby, it must be probed by way of the pus channel, totally minimize open utilizing a pointy instrument. The wound must be stuffed with the paste of Nimba, Tila, Danti, Surastraja (Mrittika) and Saindhava.
Recent juice or decoction of Karanja, Nimba, Jati, Aksa and Pilu must be used every day for laundry.
Medicated oil must be ready with the beneath talked about substances –
– Suvarcikā,
– Saiñdhava,
– Citraka,
– Nikumbha,
– Tälītala (root of musalī),
– Rūpikā (svetärka) and
– Apāmārga phala together with goműtra and tila taila
This oil is used for therapeutic.
Salyaja nädi vrana
नाडीतुशल्यप्रभवांविदार्यनिहत्यशल्यंप्रविशोध्यमार्गम्।।
संशोधयेत्क्षौद्रघृतप्रगाढस्तिलैस्ततोरोपणमाशुकुर्यात्।।२६।।
कुम्भीकखजूंरकपित्थबिल्ववनस्पतीनांचशलाटुवर्गः।।
कृत्वाकषायंविपचेत्तुतैलमावाप्यमुस्तासरलाप्रियङ्गः।।२७।।
सुगन्धिकामोचरसाहिपुष्यंरोधंविदध्यादपिधातकीच।।
एतेनशल्यप्रभवातुनाडीरोहेदद्रणोवासुखमाशुचैव।।२८।।
Firstly, the Nadi Vrana brought on by Salya (overseas physique) must be minimize open. The overseas physique inside it must be eliminated and the sinus is cleaned. Cleansing must be performed utilizing the paste of tila added with extra honey and ghee after which made to heal shortly.
Decoction is ready utilizing the tender fruits of the beneath stated –
– Kumbhika,
– Kharjura,
– Kapittha,
– Bilva and
– Vanaspati Varga (Pancavalkala)
Paste must be ready with the beneath talked about herbs –
– Musta,
– Sarala,
– Priyangu,
– Sugandhika (Utpala Sariva),
– Mocarasa,
– Ahipuspa (Nagakesara),
– Rodhra and
– Dhataki
Medicated oil is ready by processing the oil with the decoction and paste defined above.
The sinus ulcers brought on by salya – overseas our bodies heal shortly and simply by utilizing this oil.
Kşāra sūtra prayoga – use of alkali thread
कशदुर्बलभीरूणांनाडीमर्माश्रिताचया।।
क्षारसूत्रेणतांच्छिन्द्यान्नतुशस्त्रेणबुद्धिमान्।।२९।।
एषण्यागतिमन्विष्यक्षारसूत्रानुसारिणीम्।।
सूचीनिदध्याद्गत्यन्तेतथोन्नम्याशुनिहरेत।।३०।।
सूत्रस्यान्तंसमानीयगाढंबन्धंसमाचरेत्।।
ततःक्षारबलंवीक्ष्यसूत्रमन्यत्प्रवेशयेत्।।३१।।
क्षाराक्तंमतिमान्वैद्योयावन्नछिद्यतेगतिः।।
भगन्दरेऽप्येषविधिःकार्योवैद्येनजानता।।३२।।
अर्बुदादिषुचोत्क्षिप्यमूलेसूत्रंनिधापयेत्।।
सूचीभिर्यववक्राभिराचितान्वासमन्ततः।।
मूलेसूत्रेणबन्धीयाच्छिन्नेचोपचरेद्रणम्।।३३।।
The smart doctor / surgeon ought to minimize open the sinus utilizing Ksara Sutra (threads soaked in caustic alkalies) and never by utilizing sharp devices within the beneath talked about situations –
– in individuals who’re emaciated,
– in individuals who’re weak,
– in individuals who’re frightened and
– in ulcers current in very important organs
With the assistance of a probe, the doctor / surgeon ought to probe the sinus. Then he ought to introduce a blunt needle having an alkali thread until the needle reaches the tip of the sinus.
Then the needle is lifted up following which the entrance tip (finish) of the thread is pulled out and a decent knot is tied. One other ksara sutra could also be inserted after having eliminated the primary thread by the doctor after having thought-about the energy of the alkali, till the sinus will get minimize.
The clever doctor ought to undertake the identical process of doing ksara sutra in situations like bhagandara (fistula in ano), arbuda (malignant tumour) and so on.
A ksara sutra could also be wound across the base of the arbuda and tied, after lifting it from its base. The thread could also be handed by way of the needle which has a gap within the entrance, inserted on the base of the arbuda after which tied. After the tumour cuts off, the ensuing ulcer could also be handled like another wound.
Varti prayoga – inserting medicinal wicks
याद्विव्रणीयेऽभिहितास्तुवर्त्यस्ताःसर्वनाडीषुभिषग्विदध्यात्।।
घोण्टाफलत्वग्लवणानिलाक्षापूगीफलंचालवणंचपत्रम्।।३४।।
स्नुह्यर्कदुग्धेनतुकल्कएषवीकृतोहन्त्यचिरेणनाडीः।।
In all kinds of sinus ulcers, the doctor / surgeon ought to make use of the vartis i.e. medicinal wicks as described in Dvivraniya Adhyaya (chapter 1).
Paste of the beneath talked about substances must be ready –
– Bark of Ghonta phala (badari phala),
– Lavanas (all salts),
– Laksa,
– Pugiphala,
– Leaves of alavana (kākamardanikā)
The paste is ready by macerating the above stated substances within the milky sap of Snuhi and Arka. Threads must be produced from this. Alternatively, robust cotton threads must be soaked within the combination of the above stated substances and made into wicks.
When used, these vartis i.e. wicks cures the sinus ulcers shortly.
विभीतकाम्रास्थिवटप्रवालाहरेणुकाशङ्खिनिबीजमस्यः।।३५।।
वाराहिकन्दश्चतथाप्रदेयोनाडीषुतैलेनचमिश्रयित्वा।।३६।।
Ash must be ready from the beneath talked about substances –
– Vibhitaka,
– Amra seed kernel,
– Tender leaves of Vata,
– Harenuka,
– Sankhini seeds and
– Varahikanda
The resultant ash must be blended with oil and used to remedy the sinus ulcers.
धत्तूरजंमदनकोद्रवजंचबीजंकोशातकीशुकनसामृगभोजिनीच।।
अङ्कोटबीजकुसुमंगतिषुप्रयोज्यंलाक्षोदकाहृतमलासुविकृत्यचूर्णम्।।३७।।
Powder of the beneath talked about substances is ready –
– Seeds of Dhattūra,
– Madana,
– Kodrava,
– Kośātakī,
– Sukanāsā,
– Mrgabhojini (iñdravāruni)
– Flower and seeds of Añkoțaki
The sinus must be cleansed with decoction / resolution of laksa. After cleansing the sinus, the above talked about powder could also be used.
तथाचगोमांसमसीहितायकोष्ठाश्रितस्यादरतोदिशन्ति।।
वर्तीकृतंमाक्षिकसंप्रयुक्तंनाडीनमुक्तंलवणोत्तमंवा।।३८।।
Ash of cow meat is ready. It’s added with honey and lavanottama / saindhava lavana (rock salt) and made into wicks. These wicks could also be used for treating the sinuses current within the kostha – belly organs.
दुष्टवणेयद्विहितंचतैलंतत्सर्वनाडीषुभिषग्विदध्यात्।।
चूर्णीकृतैरथविमिश्रितमेभिरेवतैलंप्रयुक्तमचिरेणगतिंनिहन्ति।।३९।।
एष्वेवमूत्रसहितेषुविधायतैलंतत्साधितंगतिमपोहतिसप्तरात्रात्।।
In all kinds of nadi varana i.e. sinus ulcers, the medicated oils which have been described within the context of treating dusta vrana i.e. septic ulcers (chapter 2/89) must be used.
Alternatively, powder of the herbs talked about therein (within the above stated context) must be used after including honey, saindhava – rock salt and oil. This powder cures the sinus ulcers shortly.
Additionally, oil cooked with the identical herbs talked about above must be used after including gomutra – urine of cow. This recipe cures the sinus inside every week.
पिण्डीतकस्यतुवराहविभावितस्यमूलेषुकन्दशकलेषुचसौवहेषु।।४०।।
तैलंकृतंगतिमपोहतिशीघ्रमेतत्कन्देषुचामरवरायुधसाह्वयेषु।।
Oil is cooked with Pinditaka and roots and tubers of Varahi. When used, this oil cures sinus ulcers.
Alternatively, the medicated oil ready with tubers of Sauvaha (gandhanakuli) also needs to be used within the therapy of nadi vrana. This oil additionally cures the sinus ulcers shortly.
Sinus ulcers are additionally cured by utilizing the medicated oil ready with amaravara ayudha sahvaya i.e. Vajrakanda.
भल्लातकार्कमरिचैलवणोत्तमेनसिद्धंविडङ्गरजनीद्वयचित्रकैश्च।।४१।।
स्यान्मार्कवस्यचरसेननिहन्तितैलंनाडीकफानिलकृतामपचीव्रणांश्च।।
Oil must be ready with the beneath talked about substances –
– Bhallātaka,
– Arka,
– Marica,
– Lavaņottama (saindhava),
– Vidañga,
– The 2 Rajanī (haridrā),
– Citraka and
– Mārkava (bhrñgarāja) juice
This medicated oil when used cures the sinus ulcers, apaci (goitre, lymphadenitis) and wounds produced by kapha and vata.
Stana roga – ailments of the breast
Stañya dusti – vitiation of breast milk
स्तन्येगतेविकृतिमाशुभिषक्तुधात्रींपीतांघृतंपरिणतेऽहनिवामयेत्तु।।४२।।
निम्बोदकेनमधुमागधिकायुतेनवान्तागतेऽहनिचमुद्गरसाशनास्यात्।।
एवंत्र्यहंचतुरहंषडहंवमेद्वासर्पिःपिबेत्रिफलयासहसंयुतंवा।।४।।
भार्गीबचामतिविषांसुरदारुपाठांमुस्तादिकंमधुरसांकटुरोहिणींच।।
धात्रीपिबेत्तुपयसःपरिशोधनार्थमारग्वधादिषुवरंमधुनाकषायम्।।४४।।
सामान्यमेतदुपदिष्टमतोविशेषाहोषान्पयोनिपतितान्शमयेद्यथास्वम्।।
The doctor ought to conduct the beneath talked about remedies when the stanya – breast milk has change into irregular (vitiated by the doshas) –
– the mom ought to firstly be made to drink ghee at night time
– the following morning she must be made to vomit by ingesting the decoction of Nimba added with honey and powder of Magadhi (pippali – lengthy pepper)
– she must be allowed to take meals together with soup of mudga – inexperienced gram after she has correctly vomited
The vomiting is induced on this method for 3, 4 or six days repeatedly.
She could also be requested to drink the ghee boiled and ready with the beneath talked about substances so as to purify the milk –
– Triphala,
– Bharangi,
– Vaca,
– Ativisa,
– Suradaru,
– Patha,
– Mustadi Gana group of herbs and
– Katurohini
Alternatively, she might drink the decoction of ‘Aragvadhadi Gana’ group of herbs added with milk.
That is the overall methodology of therapy. After this, particular (particular) strategies of therapy must be adopted to mitigate the vitiation of particular doshas.
Stana vidradhi – abscess of the breast
रोगंस्तनोत्थितमवेक्ष्यभिषग्विदध्याद्यद्विद्रधावभिहितंबहुशोविधानम्।।५।।
संपच्यमानमपितंतुविनोपनाहै:संभोजनेनखलुपाचयितुंयतेत।।
शीघ्रंस्तनोहिमृदुमांसतयोपनद्धःसर्वंप्रकोथमुपयात्यवदीर्यतेच।।४६।।
The doctor / surgeon ought to undertake completely different strategies of remedies described in therapy of Vidradhi i.e. abscesses in Vidradhi Chikitsa chapter after fastidiously diagnosing the breast abscess.
Despite the abscess present process paka i.e. suppuration, it must be handled with out utilizing upanaha i.e. heat poultices. It ought to in truth be handled with solely meals which promote suppuration. This must be performed as a result of the breasts are composed of soppy muscle tissue and therefore putrefaction shortly develops in them, destroying and tearing them.
पक्वेतुदुग्धहरिणीःपरिहृत्यनाडीःकृष्णंचचूचुकयुगंविदधीतशस्त्रम्।।
आमेविदाहिनितथैवगतेचपाकंधात्र्याःस्तनौसततमेवचनिर्दुहीत।।४७।।
The abscess must be opened with a pointy instrument after it turns into ripe. It must be performed whereas fastidiously defending the dugdha harini i.e. lactiferous ducts and the black nipples from damage.
The milk must be taken out from the breasts of the mom or moist nurse consistently throughout ama (unripe), vidahi (ripening) and pakva (ripe) phases.
इतिसुश्रुतसंहितायांचिकित्सास्थानेविसर्पनाडीस्तनरोगचिकित्सितंनामसप्तदशोऽध्यायः।।१७।।
Thus ends the seventeenth chapter by title Visarpa-Nādi-Sthana roga cikitsita in cikitsā sthāna of Suśruta samhita.