The 18th chapter of Chikitsasthanam of Ashtanga Hridayam is known as as Visarpa Chikitsitam Adhyayah. This chapter offers with the reason of ‘treatment of herpes’.
The matters coated on this chapter embody –
- Remedy rules in herpes
- Formulations to induce emesis in herpes
- Formulations to induce purgation in herpes
- Palliative therapy
- Bloodletting in herpes
- Medicated ghee in nirama stage of herpes
- Indications for exterior therapy in herpes
- Vataja Visarpa Cikitsa
- Pittaja Visarpa Cikitsa
- Sleshmika Visarpa Cikitsa
- Kaphaja Visarpa Cikitsa
- Administration of Vata related to ama localized in seats of kapha or pitta
- Administration of Visarpa brought on by mixture of doshas
- Agni Visarpa Cikitsa
- Granthi Visarpa Cikitsa
- Medicinal pastes, eating regimen and therapies to interrupt the tumor
- Suppuration and excision of tumors
- Bloodletting
- Remedy of exterior and inner wound
- Significance of Virecana Ghrta
Pledge by the writer(s)
अथातो विसर्पचिकित्सितं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘treatment of herpes’.Thus say (pledge) Atreya and different sages.
Remedy rules in herpes
आदावेव विसर्पेषु हितं लङ्घनरूक्षणम् ।
रक्तावसेको वमनं विरेकः स्नेहनं न तु ॥ १ ॥
In herpes it’s useful to manage langhana (thinning the physique with fasting and so forth.), ruksana (inflicting dryness)rakta avaseko – blood-letting,vamanaṃ – emesis, virekaḥ – and purgation therapies at first of therapy itself, however not snehana (oleation remedy).
Formulations to induce emesis in herpes
प्रच्छर्दनं विसर्पघ्नं सयष्टीन्द्रयवं फलम् ।
पटोलपिप्पलीनिम्बपल्लवैर्वा समन्वितम् ॥ २ ॥
Emesis achieved by utilizing Randia dumetorum along with Glycyrrhiza glabra, Randia spinosa and indrayava – seeds of Holarrhena antidysenterica blended with Trichosanthes dioica, Piper longum ,leaves of Azadirachta indica destroys visarpa.
Formulations to induce purgation in herpes
रसेन युक्तं त्रायन्त्या द्राक्षायास्त्रैफलेन वा ।
विरेचनं त्रिवृच्चूर्णं पयसा सर्पिषाऽथवा ॥ ३ ॥
योज्यं कोष्ठगते दोषे विशेषेण विशोधनम् ।
Purgation ought to be achieved by utilizing powder of Operculina turpethum blended with the juice/ decoction of both Gentiana kurroo, Vitis vinifera, triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellirica, Amalaki – Emblica officinalis); or milk or ghee ought to be added particularly when the doshas, are lodged within the alimentary tract, particularly for the aim of cleaning them (doshas).
Palliative therapy
अविशोध्यस्य दोषेऽल्पे शमनं चन्दनोत्पलम् ॥४॥
मुस्तनिम्बपटोलं वा पटोलादिकमेव वा ।
शारिवामलकोशीरमुस्तं वा क्वथितं जले ॥ ५ ॥
For individuals who’re unfit for purifactory therapies and when the doshas are delicate, samana (palliative remedy) is good. Santalum album, Nymphaea alba, Cyperus rotundus, Azadirachta indica candana – and Trichosanthes dioica; or Trichosanthes dioica and others (Patoladi gana) (vide chapter 15 of sutrasthana); or Hemidesmus indicus, Emblica officinalis, Vetiveria zizoanioides and Cyperus rotundus boiled with water ought to be administered.
Palliative therapy
दुरालभां पर्पटकं गुडूचीं विश्वभेषजम् ।
पाक्यं शीतकषायं वा तृष्णाविसर्पवान् पिबेत् ॥ ६ ॥
दार्वीपटोलकटुकामसूरत्रिफलास्तथा ।
सनिम्बयष्टीत्रायन्तीः क्वथिता घृतमूर्छिताः ॥ ७ ॥
Affected person of visarpa having thirst ought to drink both the decoction or chilly infusion of Fagonia cretica, Fumaria parviflora, Tinospora cordifolia, and Zingiber officinalis; or decoction of Cedrus deodara, Trichosanthes dioica, Picrorrhiza kurroa, Lens culinaris, triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellerica & Amalaki – Emblica officinalis), Azadirachta indica, Glycyrrhiza glabra Gentiana Kurroa processed with ghee.
Bloodletting in herpes
शाखादुष्टे तु रुधिरे रक्तमेवादितो हरेत्।
त्वङ्मांसस्नायुसङ्क्लेदो रक्तक्लेदाद्धि जायते॥८॥
When the blood will get vitiated within the sakhas (tissues), blood-letting itself ought to be achieved, first, as a result of enhance of moisture within the pores and skin, muscle groups, tendons and so forth., happens resulting from enhance of moisture within the blood itself.
Medicated ghee in nirama stage of herpes
निरामे श्लेष्मणि क्षीणे वातपित्तोत्तरे हितम्।
घृतं तिक्तं महातिक्तं शृतं वा त्रायमाणया॥९॥
When there aren’t any signs of ama, when kapha has decreased however vata and pitta are predominant, then both tiktakaghrta, mahatiktaghrta (chapter 19 of cikitsasthan) of that ready by the decoction of Gentiana kurroo are useful.
Indications for exterior therapy in herpes
निर्हृतेऽस्रे विशुद्धेऽन्तर्दोषे त्वङ्मांससन्धिगे।
बहिःक्रियाः प्रदेहाद्याः सद्यो विसर्पशान्तये॥१०॥
After blood-letting when the inside (of the alimentary canal) turns into cleared, and the doshas are discovered localised within the pores and skin, muscle groups, and joints, then exterior therapies reminiscent of pradeha (software of heat poultice) and so forth. subside visarpa quickly.
Vataja Visarpa Chikitsa
शताह्वा मुस्तवाराही वंशार्तगलधान्यकम् ।
सुराह्वा कृष्णगन्धा च कुष्ठं चालेपनं चले ॥ ११ ॥
In visarpa arising from Vata software of paste of śatāhvā – Anethum sowa, musta – Cyperus rotundus, vārāhī – Dioscorea bulbifera, vaṃśa – Bambusa arundinacea, ārtagala – Nila Saireyaka – Barleria strigose, dhānyakam – Coriandrum sativum, surāhvā – Cedrus deodara, kṛṣṇagandhā ca – Moringa oleifera kuṣṭhaṃ – and Saussurea lappa is good.
Pittaja Visarpa Chikitsa: Nyagrodhadi Lepa
न्यग्रोधादिगणः पित्ते तथा पद्मोत्पलादिकम् ।
न्यग्रोधपादास्तरुणाः कदलीगर्भसंयुताः ॥ १२ ॥
बिसग्रन्थिश्च लेपः स्याच्छतधौतघृताप्लुतः ।
पद्मिनीकर्दमः शीतः पिष्टं मौक्तिकमेव वा ॥ १३ ॥
शङ्खः प्रवालं शुक्तिर्वा गैरिकं वा घृतान्वितम् ।
In that arising from pitta, paste of both the herbs of nyargodhadi gana (chapter 15 of sutrasthana) padma utpalādikam – or padmotpaladi and so forth. (chapter 20 cikitsthana of astangasangraha) is useful.
So additionally the paste of tender aerial roots of Ficus bengalensis, the pith of Musa paradisiaca, and Nelumbium speciosum, bathed with satadhauta ghrta (ghee washed in water for hundred occasions) or the slush / mud of lotus lake or paste of mauktika (pearls) conch, coral, oyster shell or of gairika (purple ochre) blended with ghee and utilized chilly are additionally useful.
Sleshmika Visarpa Chikitsa: Triphaladi Lepa
त्रिफलापद्मकोशीरसमङ्गाकरवीरकम् ॥ १४ ॥
नलमूलान्यनन्ता च लेपः श्लेष्मविसर्पहा ।
Paste of triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellerica & Amalaki – Emblica officinalis), padmaka – Prunus puddum, uśīra – Vetiveria zizanioides, samaṅgā – Rubia cordifolia, karavīrakam – Nerium indicum, nalamūlāni – Arundo donax, and Hemidesmus indicus utilized externally cures visarpa arising from Kapha.
Kaphaja Visarpa Chikitsa
धवसप्ताह्वखदिरदेवदारुकुरण्टकम् ॥ १५ ॥
समुस्तारग्वधं लेपो वर्गो वा वरुणादिकः ।
आरग्वधस्य पत्राणि त्वचः श्लेष्मातकोद्भवाः ॥१६॥
इन्द्राणिशाकं काकाह्वा शिरीषकुसुमानि च ।
Software of paste of dhava – Anogeissus latifolia, saptāhva – Alstonia scholaris, khadira – Acacia catechu, devadāru – Cedrus deodara, kuraṇṭakam – Barleria prionitis, musta – dhava – Cyperus rotundus āragvadhaṃ – and Cassia fistula or of herbs of Varunadi gana (chapter 15 of sutrasthana) or of the leaves of āragvadhasya – Cassia fistula, bark of śleṣmātaka udbhavāḥ – Cordia dichotama, indrāṇi śākaṃ – leaves of Citrullus colocynthis, kākāhvā – Solanum nigrum and flowers of Albizia lebbeck (cures visarpa of Kapha origin).
Kaphaja Visarpa Chikitsa
सेकव्रणाभ्यङ्गहविर्लेपचूर्णान् यथायथम् ॥१७॥
एतैरेवौषधैः कुर्याद्वायौ लेपा घृताधिकाः ।
Recipes for bathing, anointing, fumigating, topical software of paste and powder for dusting the wound ought to be ready by these herbs solely. The pastes talked about for the therapy of visarpa of vata origin ought to be blended with extra amount of ghee.
Administration of Vata related to ama localized in seats of kapha or pitta
कफस्थानगते सामे पित्तस्थानगतेऽथवा ॥ १८ ॥
अशीतोष्णा हिता रूक्षा रक्तपित्ते घृतान्विताः ।
अत्यर्थशीतास्तनवस्तनुवस्त्रान्तरास्थिताः ॥ १९ ॥
योज्याः क्षणे क्षणेऽन्येऽन्ये मन्दवीर्यास्त एव च ।
When vayu related to ama, is discovered lodged both within the seat of kapha or of pitta it’s useful to make use of it neither chilly nor scorching (in different phrases, barely heat) and dry (with out addition of fat). In case of aggravation of rakta (blood) and pitta, it ought to be blended with ghee, made very chilly, skinny hid inside skinny fabric, utilized recent, minute after minute (each time). For the reason that similar paste is utilized time and again turns into weak in motion.
Administration of Visarpa brought on by mixture of doshas
संसृष्टदोषे संसृष्टमेतत्कर्म प्रशस्यते ॥ २० ॥
In visarpa arising from the mix of the doshas, it’s ultimate to mix the therapy suitability.
Agni Visarpa Chikitsa: Shata Dhauta Ghrita
शतधौतघृतेनाग्निं प्रदिह्यात्केवलेन वा ।
सेचयेद्घृतमण्डेन शीतेन मधुकाम्बुना ॥ २१ ॥
सिताम्भसाऽम्भोदजलैः क्षीरेणेक्षुरसेन वा ।
पानलेपनसेकेषु महातिक्तं परं हितम् ॥ २२ ॥
Agni visarpa ought to be bathed with satadhauta ghrta (ghee washed 100 occasions) or with plain ghee, or sprinkled with the scum of ghee or chilly decoction of Glycyrrhiza glabra, resolution of sugar, decoction of Cyperus rotundus, milk or juice of sugarcane all made chilly. mahatiktakaghrta (chapter 19 of cikitsa sthana) is greatest for ingesting, exterior software and bathing the pores and skin.
Granthi Visarpa Chikitsa
ग्रन्थ्याख्ये रक्तपित्तघ्नं कृत्वा सम्यग्यथोदितम् ।
कफानिलघ्नं कर्मेष्टं पिण्डस्वेदोपनाहनम् ॥ २३ ॥
For granthi visarpa therapies prescribed for raktapitta (chapter 2 of cikitsa sthana) ought to be achieved first, adopted by therapies which mitigate kapha and Vata reminiscent of pinda sveda – and upanaha (chapter 17 of sutrasthana).
Granthi Visarpa Chikitsa: Dashamoola Taila Sechana
ग्रन्थिविसर्पशूले तु तैलेनोष्णेन सेचयेत् ।
दशमूलविपक्वेन तद्वन्मूत्रैर्जलेन वा ॥ २४ ॥
In case of ache in granthi visarpa, the pores and skin ought to be bathed with heat oil ready with dashamula, likewise with cow urine or water boiled with dashamula.
Granthi Visarpa Chikitsa
सुखोष्णया प्रदिह्याद्वा पिष्टया कृष्णगन्धया ।
नक्तमालत्वचा शुष्कमूलकैः कलिनाऽथवा ॥ २५ ॥
Software of heat paste of both Moringa oleifera, naktamāla tvacā – bark of Pongamia pinnata, śuṣkamūlakaiḥ – dried Raphanus sativus or Terminalia bellerica ought to be achieved.
Medicinal pastes, eating regimen and therapies to interrupt the tumor
दन्ती चित्रकमूलत्वक् सौधार्कपयसी गुडः ।
भल्लातकास्थि कासीसं लेपो भिन्द्याच्छिलामपि ॥२६॥
बहिर्मार्गाश्रितं ग्रन्थिं किं पुनः कफसम्भवम् ।
दीर्घकालस्थितं ग्रन्थिमेभिर्भिन्द्याच्च भेषजैः ॥ २७ ॥
मूलकानां कुलत्थानां यूषैः सक्षारदाडिमैः ।
गोधूमान्नैर्यवान्नैर्वा ससीधुमधुशार्करैः ॥ २८ ॥
सक्षौद्रैर्वारुणीमण्डैर्मातुलुङ्गरसान्वितैः ।
त्रिफलायाः प्रयोगैश्च पिप्पल्याः क्षौद्रसंयुतैः ॥ २९ ॥
देवदारुगुडूच्योश्च प्रयोगैर्गिरिजस्य च ।
मुस्तभल्लातसक्तूनां प्रयोगैर्माक्षिकस्य च ॥ ३० ॥
धूमैर्विरेकैः शिरसः पूर्वोक्तैर्गुल्मभेदनैः ।
तप्तायोहेमलवणपाषाणादिप्रपीडनैः ॥ ३१ ॥
Paste of dantī – Baliospermum montanum, citrakamūla tvak – bark of Plumbago zeylanica, milky sap of Euphorbia neriifolia, arka payasī – and latex of Calotropis gigantea, jaggery, bhallātaka asthi – Semecarpus anacardium seed kāsīsaṃ – and ferrous sulphate breaks even the stone; what then to say – of exterior tumor arising from kapha? Even the tumor which is lengthy standing ought to be damaged up with these herbs; With the usage of soup of both mulaka – Raphanus sativus or Dolichos biflorus added with alkali and Punica granatum ,mess ready with from godhuma – Triticum aestivum or mess ready with Hordeum vulgare adopted by drink of sidhu blended with honey and sugar, with honey and varuni manda together with juice of Citrus medica. Administration of triphala (Haritaki – Terminalia chebula Vibhitaki – Terminalia bellerica & Amalaki – Emblica officinalis) and Piper longum blended with honey, of Cedrus deodara and Tinospora cordifolia or use of of asphaltum Cyperus rotundus, Semecarpus anacardium and saktu – roasted flour of cereals with honey; by fumigation (of the affected half), purgative remedy for the pinnacle, (that’s nasya – nasal remedy), beforehand talked about measures for opening the tumor by touching the tumor with heated plaque of with iron or gold, salt stone and so forth.
Suppuration and excision of tumors
आभिः क्रियाभिः सिद्धाभिर्विविधाभिर्बले स्थितः ।
ग्रन्थिः पाषाणकठिनो यदि नैवोपशाम्यति ॥ ३२ ॥
अथास्य दाहः क्षारेण शरैर्हेम्नाऽपि वा हितः ।
पाकिभिः पाचयित्वा वा पाटयित्वा तमुद्धरेत् ॥३३॥
If the exhausting and deep rooted tumor doesn’t break even by these completely different sorts of therapy of confirmed efficacy and stays stony exhausting, it ought to then be burnt (cauterised) both with ksara (alkalies) or purple scorching arrow or rod of gold; Or it ought to be made to endure suppuration by herbs which promote pus formation after which excised and eliminated.
Bloodletting
मोक्षयेद्बहुशश्चास्य रक्तमुत्क्लेशमागतम् ।
पुनश्चापहृते रक्ते वातश्लेष्मजिदौषधम् ॥ ३४ ॥
The blood which is vitiated and arising from the tumor ought to be let loose in massive amount; after eradicating the blood, medicines which mitigate Vata and Kapha ought to be administered.
Remedy of exterior and inner wound
प्रक्लिन्ने दाहपाकाभ्यां बाह्यान्तर्व्रणवत्क्रिया ।
दार्वीविडङ्गकम्पिल्लैः सिद्धं तैलं व्रणे हितम् ॥ ३५ ॥
दूर्वास्वरससिद्धं तु कफपित्तोत्तरे घृतम् ।
When the tumor turns into enormously moist from burning (cauterisation) and suppuration, therapy ought to be like these of exterior and inner wounds. Oil ready with Berberis aristata, Embelia ribes, and Mallotus philippensis is sweet for the wound (therapeutic). Ghee ready with recent juice of Cynodon dactylon is sweet for the wound which has predominance of Kapha and Pitta.
Bloodletting
एकतः सर्वकर्माणि रक्तमोक्षणमेकतः ॥ ३६ ॥
विसर्पो न ह्यसंसृष्टः सोऽस्रपित्तेन जायते ।
If all the opposite therapy are at one facet, blood-letting alone is on the different. Visarpa doesn’t happen with out being related to rakta-pitta (bleeding illness), blood alone is the seat of it (visarpa). Therefore, blood-letting ought to be achieved many occasions/ in massive portions.
Significance of Virechana Ghrita
न घृतं बहुदोषाय देयं यन्न विरेचनम् ।
तेन दोषो ह्युपस्तब्धस्त्वग्रक्तपिशितं पचेत् ॥३८॥
No medicated ghee which isn’t a purgative ought to be given to the affected person (of visarpa), who has nice enhance of doshas; if achieved so, it (ghee) obstructs the doshas and cooks (destroys) the pores and skin, blood and muscle tissues.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने विसर्पचिकित्सितं नामाष्टादशोऽध्याय: ॥ १८ ॥
Thus, ends the chapter visarpa cikitsa- the eighteenth in cikitsitasthana of asthangahrsaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
