The 14th chapter of Uttara Sthanam of Ashtanga Hridayam is called as Linganasha Pratishedha. This chapter offers with the reason of ‘Treatment of blindness’.
The subjects coated on this chapter embody –
– Vyadhana in Linganasha
– Indicators of improperly fashioned Linganasha
– Linganasha fashioned from Kapha
– Avartaki and different issues of imaginative and prescient
– Contraindications for puncturing
– Vyadhana Vidhi (strategies of puncturing), Cataract operation
– Durvadi Mukhalepa
– Sarshapadi Mukhalepa
– Payasyadi Lepa
– Lodhradi Kshira Aschyotana
– Vataghna Lepa
– Adhakyadi Varti
– Pindanjana
Pledge by the creator(s)
अथातो लिङ्गनाशप्रतिषेधं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
Athāto liṅganāśa pratiṣedhaṃ vyākhyāsyāma: – After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘treatment of blindness’.
iti ha smāhu: ātreyādayo maharṣaya: – Thus, say (pledge) Atreya and different sages.
Vyadhana in Linganasha
विध्येत्सुजातं निष्प्रेक्ष्यं लिङ्गनाशं कफोद्भवम् ।
आवर्तक्यादिभिः षड्भिर्विवर्जितमुपद्रवैः ॥ १ ॥
Linganasha (blindness attributable to opacity of the lens / cataract) which is of Kapha origin, which has developed absolutely (ripened), turns into opaque, which has prompted full lack of imaginative and prescient, which isn’t having six problems such because the Avartaki and so on. needs to be punctured (couching performed).
Indicators of Improperly Fashioned Linganasha
सोऽसञ्जातो हि विषमो दधिमस्तुनिभस्तनुः ।
शलाकयाऽवकृष्टोऽपि पुनरूर्ध्वं प्रपद्यते ॥२॥
करोति वेदनां तीव्रां दृष्टिं च स्थगयेत्पुनः ।
श्लेष्मलैः पूर्यते चाशु सोऽन्यैः सोपद्रवश्चिरात्॥३॥
It (Linganasha), when not absolutely fashioned, is uneven, resemble the water of curds (in color), skinny; when pressed laborious by a metallic rod it once more strikes upwards, causes extreme ache and hinders imaginative and prescient; once more (even after puncturing) will get crammed rapidly by ingestion of meals which enhance Kapha and even others (Vata and Pitta), turns into related to problems which persists for lengthy.
Linganasha fashioned from Kapha
श्लैष्मिको लिङ्गनाशो हि सितत्वाच्छ्लेष्मणः सितः ।
तस्यान्यदोषाभिभवाद्भवत्यानीलता गदः ॥ ४ ॥
Linganasha born from Kapha is white. Due to the white shade, it’s prompted attributable to Kapha. When it’s dominated by different doshas, it attains bluishness.
Avartaki and different issues of imaginative and prescient
तत्रावर्तचला दृष्टिरावर्तक्यरुणासिता ।
शर्करार्कपयोलेशनिचितेव घनाति च ॥ ५ ॥
राजीमती दृङ्निचिता शालिशूकाभराजिभिः ।
विषमच्छिन्नदग्धाभा सरुक् छिन्नांशुका स्मृता॥६॥
दृष्टिः कांस्यसमच्छाया चन्द्रकी चन्द्रकाकृतिः ।
छत्राभा नैकवर्णा च छत्रकी नाम नीलिका ॥७॥
Avartaki is that, during which the imaginative and prescient (much less) is unsteady like a whirl and barely pink or black in shade. Sharkara is that during which, the imaginative and prescient (lens) seems as if smeared with milky sap of Calotropis gigantea and is thick / laborious. In Rajimati, the imaginative and prescient (lens) seems as if studded by spikes of paddy grains. If the imaginative and prescient (much less) is uneven (irregular), torn (discontented), burnt like, and is painful is named Chinnamshuka. In Chandriki, the imaginative and prescient (much less) resembles the bell-metal in shade and moon-like (in look). Chatraki is that during which the lesion resembles an umbrella, has many colours and is blue.
Contraindications for puncturing
न विध्येदसिरार्हाणां न तृट्पीनसकासिनाम् ।
नाजीर्णिभीरुवमितशिरःकर्णाक्षिशूलिनाम् ॥ ८ ॥ Puncturing (couching of the much less) shouldn’t be performed in individuals who’re unsuitable for venesection, who’re affected by thirst, persistent nasal catarrh, cough, not in indigestion, worry, vomiting and ailments (ache) of the pinnacle, ears and eyes.
Vyadhana Vidhi (Strategies of puncturing), Cataract operation
अथ साधारणे काले शुद्धसम्भोजितात्मनः ।
देशे प्रकाशे पूर्वाह्णे भिषग्जानूच्चपीठगः ॥९॥
यन्त्रितस्योपविष्टस्य स्विन्नाक्षस्य मुखानिलैः ।
अङ्गुष्ठमृदिते नेत्रे दृष्टौ दृष्ट्वोत्प्लुतं मलम्॥१० ॥
स्वां नासां प्रेक्षमाणस्य निष्कम्पं मूर्ध्नि धारिते ।
कृष्णादर्धाङ्गुलं मुक्त्वा तथार्धार्धमपाङ्गतः ॥११॥
तर्जनीमध्यमाङ्गुष्ठैः शलाकां निश्चलं धृताम् ।
दैवच्छिद्रं नयेत्पार्श्वादूर्ध्वमामन्थयन् इव ॥१२॥
सव्यं दक्षिणहस्तेन नेत्रं सव्येन चेतरत् ।
विध्येत्सुविद्धे शब्दः स्यादरुक् चाम्बुलवस्रुतिः॥१३॥
Subsequent, through the temperate season, the affected person who has been cleansed, comforted with good meals and who has managed his senses, needs to be made to take a seat in a spot having good mild, within the morning and restrained (held tight by attendants). Then the doctor sitting on a seat of the peak of the knee, ought to first give fomentation to the eyes by blowing air (into the eyes) from his mouth, then rub the eyes with the thumb. After seeing that, the attention wastes have been eliminated, the pinnacle of the affected person needs to be held tight, not permitting its shaking; he needs to be requested to repair his gaze on (the tip of) his personal nostril. Then leaving half angula (1 cm) of area from the border of the black portion (cornea) and 1 / 4 angula (0.5 cm) from the outer canthus, holding the metallic rod tight between the center finger, index finger and the thumb, draw the pure aperture (pupil) to the perimeters, twisting from above after which puncture (push the much less outdoors) utilizing the precise hand for the left eye and the left hand for the opposite eye. When correctly punctured (pushed outdoors), there shall be a sound produced, there shall be no ache and slight movement of water.
Vyadhana Vidhi (strategies of puncturing), Cataract operation
सान्त्वयन्नातुरं चानु नेत्रं स्तन्येन सेचयेत् ।
शलाकायास्ततोऽग्रेण निर्लिखेन्नेत्रमण्डलम् ॥१४॥
अबाधमानः शनकैर्नासां प्रति नुदंस्ततः ।
उच्छिङ्घनाच्चापहरेद्दृष्टिमण्डलगं कफम् ॥१५॥
स्थिरे दोषे चले वाति स्वेदयेदक्षि बाह्यतः ।
अथ दृष्टेषु रूपेषु शलाकामाहरेच्छनैः ॥१६॥
घृताप्लुतं पिचुं दत्त्वा बद्धाक्षं शाययेत्ततः ।
विद्धादन्येन पार्श्वेन तमुत्तानं द्वयोर्व्यधे ॥१७॥
निवाते शयनेऽभ्यक्तशिरःपादं हिते रतम् ।
After that the affected person is made snug, the eyes full of breast milk, then the areas of the attention scratched with the tip / edge of the metallic rod, with out inflicting ache, slowly pushing the grime (mucous) within the course of the nostril (downward) after which take away the Kapha (soiled mucus) collected on the realm of imaginative and prescient (surrounding the pupil). When the doshas are both very static (adhering quick), or very unsteady (transferring rapidly), the eyes needs to be given fomentation from outdoors. Subsequent, when the affected person begins to see the objects, the metallic rod needs to be withdrawn slowly, a swab soaked in ghee put into the attention and the attention is bandaged. Then, he’s made to sleep on the other aspect of the operated eye and along with his face up, when each eyes are operated, ought to sleep in a room devoid of breeze, along with his heads and ft anointed and with different appropriate issues.
Routine after Vyadhana Vidhi (puncturing), Cataract operation
क्षवथुं कासमुद्गारं ष्ठीवनं पानमम्भसः ॥१८॥ अधोमुखस्थितिं स्नानं दन्तधावनभक्षणम् ।
सप्ताहं नाचरेत्स्नेहपीतवच्चात्र यन्त्रणा ॥ १९ ॥
For seven days, he ought to keep away from sneezing, coughing, belching, expectoration, consuming water, mendacity along with his face down, taking bathtub, cleansing (brushing) the tooth, consuming meals; his management is by (adopting) the routine prescribed for sneha paana (chapter 16 of Sutrasthana).
Routine after Vyadhana Vidhi (puncturing) / Cataract operation
शक्तितो लङ्घयेत्सेको रुजि कोष्णेन सर्पिषा ।
सव्योषामलकं वाट्यमश्नीयात्सघृतं द्रवम् ॥२०॥
विलेपीं वा त्र्यहाच्चास्य क्वाथैर्मुक्त्वाऽक्षि सेचयेत् ।
वातघ्नैः सप्तमे त्वह्नि सर्वथैवाक्षि मोचयेत्॥२१॥
He needs to be made to quick relying on his energy. In case of ache, the attention needs to be bathed with heat ghee, drink vatya (gruel ready from ready from barley) combined with powder of Trikatu (Pippali – Piper longum, Maricha – Piper nigrum & Shunti – Zingiber officinale) āmalakaṃ – Emblica officinalis and ghee or drink skinny gruel. After three days, the bandage (of the attention) is eliminated and the attention bathed with the decoction of herbs mitigating Vata. On the seventh day, the bandage needs to be discontinued as soon as for all.
Routine after Vyadhana Vidhi (puncturing)/Cataract operation
यन्त्रणामनुरुध्येत दृष्टेरास्थैर्यलाभतः ।
रूपाणि सूक्ष्मदीप्तानि सहसा नावलोकयेत् ॥२२॥|
Seeing needs to be restricted. This needs to be practiced until steadiness is attained. Issues that are very minute and vibrant shouldn’t be seen instantly.
Problems of improper Vyadhana (Puncturing)/ Cataract operation
शोफरागरुजादीनामधिमन्थस्य चोद्भवः ।
अहितैर्वेधदोषाच्च यथास्वं तान् उपाचरेत् ॥२३॥
Swelling, redness, ache and so on. of Adhimantha (one other eye illness) come up from improper puncturing and by enhance of doshas, these needs to be handled appropriately.
Durvadi Mukhalepa
कल्किताः सघृता दूर्वायवगैरिकशारिवाः ।
मुखालेपे प्रयोक्तव्या रुजारागोपशान्तये ॥ २४ ॥
Dūrvā – Cynodon dactylon, yava – Hordeum vulgare, gairika – pink ochre, śārivāḥ – Hemidesmus indicus, made into paste and added with ghee needs to be used as mukhalepa (utilized over the face and eyes additionally) to alleviate ache and redness.
Sarshapadi Mukhalepa
ससर्षपास्तिलास्तद्वन्मातुलुङ्गरसाप्लुताः ।
Equally, sasarṣapā – Brassica juncea and tilā: – Sesamum indicum macerated with the juice of mātuluṅga – Citrus medica (could also be utilized).
Payasyadi Lepa
पयस्याशारिवापत्रमञ्जिष्ठामधुयष्टिभिः ॥२५॥
अजाक्षीरयुतैर्लेपः सुखोष्णः शर्मकृत्परम् ।
Payasyā – Ipomoea paniculata, śārivā – Hemidesmus indicus, patra – Cinnamomum tamala, mañjiṣṭhā – Rubia cordifolia, madhuyaṣṭibhiḥ – Glycyrrhiza glabra are made right into a paste and utilized with goat milk and utilized heat is finest to offer consolation.
Lodhradi Kshira Aschyotana
लोध्रसैन्धवमृद्वीकामधुकैश्छागलं पयः ॥२६॥
शृतमाश्च्योतनं योज्यं रुजारागविनाशनम् ।
मधुकोत्पलकुष्ठैर्वा द्राक्षालाक्षासितान्वितैः ॥२७॥
Goat milk boiled with lodhra – Symplocos racemosa, saindhava – rock salt, mṛdvīkā – Vitis vinifera and madhukai – Glycyrrhiza glabra used as aschyotana (bathing the eyes) cures ache and redness; equally, madhuka – Glycyrrhiza glabra, utpala – Nymphaea alba, kuṣṭhai – Sausurrea lappa, drākṣā – Vitis vinfera, lākṣā – Laccifer lacca and sugar.
Vataghna Lepa
वातघ्नसिद्धे पयसि शृतं सर्पिश्चतुर्गुणे ।
पद्मकादिप्रतीवापं सर्वकर्मसु शस्यते ॥२८॥
Medicated ghee ready with decoction of herbs mitigating Vata, 4 elements of milk and paste of herbs of Padmakadi Gana (chapter 15 of Sutrasthana) is finest for all therapies (of the attention).
Vataghna Lepa
सिरां तथानुपशमे स्निग्धस्विन्नस्य मोक्षयेत् ।
मन्थोक्तां च क्रियां कुर्याद्वेधे रूढेऽञ्जनं मृदु॥२९॥
If the troubles don’t subside, the veins needs to be minimize (and blood set free) after giving oleation and sudation therapies to the affected person; the remedy advocated for Adhimantha also needs to be performed. After the puncture heals, delicate collyrium needs to be utilized.
Adhakyadi Varti
आढकीमूलमरिचहरितालरसाञ्जनैः ।
विद्धेऽक्ष्णि सगुडा वर्तिर्योज्या दिव्याम्बुपेषिता ॥३०॥
Roots of Cajanas cajana, marica – Piper nigrum, haritāla – arsenic trisulphide and aqueous extract of Berberis aristata combined with guda (jaggery) macerated in rain water and made into wicks. This (utilized to the eyes as collyrium) is useful to the operated eye.
Pindanjana
जातीशिरीषधवमेषविषाणिपुष्पवैडूर्यमौक्तिकफलं पयसा सुपिष्टम् ।
आजेन ताम्रममुना प्रतनु प्रदिग्धं सप्ताहतः पुनरिदं पयसैव पिष्टम् ॥३१॥
पिण्डाञ्जनं हितमनातपशुष्कमक्ष्णि विद्धे प्रसादजननं बलकृच्च दृष्टेः ।
स्रोतोजविद्रुमशिलाम्बुधिफेनतीक्ष्णैरस्यैव तुल्यमुदितं गुणकल्पनाभिः ॥३२॥
Puṣpa jātī – Flower of Jasminum grandiflorum, śirīṣa – Albizia lebbeck, dhava – Anogeissus latifolia, meṣa viṣāṇi – Meshavishana, vaidurya (cat’s eye) and pearl macerated with goat milk to kind a pleasant paste which is utilized over skinny sheet of copper and saved for seven days. Subsequent, it’s taken out, macerated with goat milk solely and dried with out exposing it to daylight. This Pindanjana, is nice when utilized as collyrium for the eyes operated upon, bestows readability and energy of the imaginative and prescient. Collyrium of lead sulphide, coral, (Manassila) – realgar, seafoam and (Maricha) Piper nigrum comparable (with the above recipe) in actions and mode of preparation.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने लिङ्गनाशप्रतिषेधं नाम चतुर्दशोऽध्याय: ॥१४॥
Thus, ends the chapter – Linganasha Pratishedha – the fourteenth in Uttarasthana of Astanga Hridaya Samhita composed by Srimad Vagbhata, Son of Sri Vaidyapati Simhagupta.
