The thirteenth chapter of Cikitsasthanam of Ashtanga Hridayam is called as Vidradhi Vrddhi cikitsitam Adhyayah. This chapter offers with the reason of ‘treatment of abscess and enlargement of scrotum’.
The subjects coated on this chapter embody –
• Sodhana – purifactory remedy
• Vataja Vidradhi Cikitsa
• Pittaja Vidradhi Cikitsa
• Kaphaja Vidradhi Cikitsa
• Abhyantara Vidradhi Cikitsa
• Trayantyadi Kwatha
• Trayamanadi Ghrta
• Draksadi Ghrta
• Raktamoksana – bloodletting
• Treating ripened and unripe abscess situated within the stomach
• Therapy of ripe abscess
• Purification with medicated ghee
• Use of Guggulu
• Definition of Vidradhi
• Therapy of Vidradhi in diabetics
• Stana Vidradhi Cikitsa
• Vrddhi Cikitsa – remedy of enlargement of the scrotum
• Vataja Vrddhi Cikitsa
• Pittaja and Raktaja Vrddhi Cikitsa
• Kaphaja Vrddhi Cikitsa
• Medoja Vrddhi Cikitsa – Scrotal enlargement attributable to accumulation of fats
• Mutraja Vrddhi Cikitsa
• Antraja Vrddhi Cikitsa
• Sukumara Ghrta
• Agnikarma – thermal cautery
Pledge by the creator(s)
अथातो विद्रधिवृद्धिचिकित्सितं व्याख्यास्याम: 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 abscess and enlargement of scrotum’. Thus say (pledge) Atreya and different sages.
Shodhana: Purifactory remedy
विद्रधिं सर्वमेवामं शोफवत्समुपाचरेत् ।
प्रततं च हरेद्रक्तं पक्वे तु व्रणवत्क्रिया ॥ १ ॥
All kinds of abscesses that are unripe ought to be handled just like sopha; Blood-letting being executed repeatedly; when these turn out to be ripetreatment ought to be just like an ulcer.
Vataja Vidradhi Chikitsa
पञ्चमूलजलैर्धौतं वातिकं लवणोत्तरैः ।
भद्रादिवर्गयष्ट्याह्वतिलैरालेपयेद्व्रणम् ॥ २ ॥
वैरेचनिकयुक्तेन त्रैवृतेन विशोध्य च ।
विदारीवर्गसिद्धेन त्रैवृतेनैव रोपयेत् ॥ ३ ॥
The vidradhi (abscess) of vata origin ought to be washed with the decoction of pancamula and a paste of herbs of bhadra daru varga (chapter 15 of sutrasthana), yaṣṭyāhva – Glycyrrhiza glabra, tila – and Sesamum indicum added with extra of lavana (salt) ought to be utilized over it. Ulcer ought to be purified (cleansed of pus) through the use of trivrt sneha (combination of three fat), boiled with herbs of virechana gana (vide chapter 15 of sutrasthana) and made to heal by trivrt Sneha itself boiled with herbs of vidari varga/ vidaryadi gana (chapter 15 ofsutrasthana).
Pittaja Vidradhi Chikitsa
क्षालितं क्षीरितोयेन लिम्पेद्यष्ट्यमृतातिलैः ।
पैत्तं घृतेन सिद्धेन मञ्जिष्ठोशीरपद्मकैः ॥ ४ ॥
पयस्याद्विनिशाश्रेष्ठायष्टीदुग्धैश्च रोपयेत् ।
न्यग्रोधादिप्रवालत्वक्फलैर्वा
The abscess of pitta origin ought to be washed with decoction of bark of bushes having milky sap, utilized over with the paste of yaṣṭi – Glycyrrhiza glabra, amṛtā – Tinospora cordifolia, and tila – Sesamum indicum. It ought to be made to heal with the usage of ghee boiled with mañjiṣṭhā – Rubia cordifolia, uśīra – Vetiveria zizanioides, padmaka – Prunus cerasoides, payasyā – Lilium polyphyllum, dvi niśā – Curcuma longa and Berberis aristata, śreṣṭhā – Aquilaria agallocha, yaṣṭī – Glycyrrhiza glabra and milk or with tender sprouts, bark and fruits of nyagrodha and so forth. (nyagrodhadi gana, vide chapter 15 of sutrasthana)
Kaphaja Vidradhi Chikitsa
कफजं पुनः ॥ ५ ॥
आरग्वधादिना धौतं सक्तुकुम्भनिशातिलैः ।
लिम्पेत्कुलत्थिकादन्ती त्रिवृच्छ्यामाग्नितिल्वकैः॥६॥
ससैन्धवैः सगोमूत्रैस्तैलं कुर्वीत रोपणम् ।
The abscess of kapha origin ought to be washed with decoction of herbs of aragvadhadi gana (chapter 15 of sutrasthana), utilized with the paste of corn flour, kumbha – Careya arborea, niśā – Curcuma longa, and tila – Sesamum indicum, healed with the usage of oil ready with decoction of kulattha – Dolichos biflorus, dantī – Baliospermum montanum, trivṛt – Operculina turpethum, śyāmā – Ipomoea turpethum, agni – Plumbago zeylanica, tilvaka – and Symplocos racemosa, added with rock salt and cow’s urine.
Kaphaja Vidradhi Chikitsa
रक्तागन्तूद्भवे कार्या पित्तविद्रधिवत्क्रिया ॥ ७ ॥
Therapy of abscesses arising from (vitiation of) blood and exterior causes is just like that of abscess of pitta origin.
Abhyantara Vidradhi Chikitsa
वरुणादिगणक्वाथमपक्वेऽभ्यन्तरोत्थिते ।
ऊषकादिप्रतीवापं पूर्वाह्णे विद्रधौ पिबेत् ॥ ८ ॥
When the interior abscess is within the unripe stage, decoction of herbs of varunadi gana (chapter 15 of sutrasthana) combined with powder of herbs of usakadi gana (chapter 15 of sutrasrhana) ought to be consumed within the forenoon.
Abhyantara Vidradhi Chikitsa
घृतं विरेचनद्रव्यैः सिद्धं ताभ्यां च पाययेत् ।
निरूहं स्नेहवस्तिं च ताभ्यामेव प्रकल्पयेत् ॥ ९ ॥
Medicated ghee ready with herbs of purgative group and the 2 teams talked about above ought to be consumed. Decoction enema and oleation enema additionally ought to be ready from these herbs solely.
पानभोजनलेपेषु मधुशिग्रुः प्रयोजितः ।
दत्तावापो यथादोषमपक्वं हन्ति विद्रधिम् ॥ १० ॥
Decoction of madhuśigruḥ – Moringa oleifera added with paste (of the herbs talked about above), acceptable to the dosha aggravated, drink, meals and for exterior utility, destroy the unripe abscess (cures with out resulting in suppuration).
Trayantyadi Kwatha
त्रायन्तीत्रिफलानिम्बकटुकामधुकं समम् ।
त्रिवृत्पटोलमूलाभ्यां चत्वारोंऽशाः पृथक् पृथक् ॥ ११ ॥
मसूरान्निस्तुषादष्टौ तत्क्वाथः सघृतो जयेत् ।
विद्रधिगुल्मवीसर्पदाहमोहमदज्वरान् ॥ १२ ॥
तृण्मूर्छाछर्दिहृद्रोगपित्तासृक्कुष्ठकामलाः ।
Equal components of trāyantī – Gentiana kurroo, triphalā – Terminalia chebula, Terminalia bellirica and Emblica officinalis, nimba – Azadirachta indica, kaṭukā – Picrorhiza Kurroa, madhuka – and Glycyrrhiza glabra (all collectively one half), 4 components of trivṛt – Operculina turpethum and roots of paṭola – Trichosanthes dioica every individually, eight components of masūra – Lens culinaris ought to be de-husked and made into decoction, combined with ghee and consumed cures vidradhi – abscess, gulma – stomach tumor, vīsarpa – herpes, dāha – burning sensation, moha – unconsciousness, mada – toxicity, jvara – fever, tṛṭ – thirst, mūrchā – fainting, chardi – vomiting, hṛdroga – coronary heart illness, pittāsṛk – bleeding illness, kuṣṭha – pores and skin ailments, kāmalā – and jaundice.
Trayamanadi Ghrita
कुडवं त्रायमाणायाः साध्यमष्टगुणेऽम्भसि ॥ १३ ॥
कुडवं तद्रसाद्धात्रीस्वरसात्क्षीरतो घृतात् ।
कर्षांशं कल्कितं तिक्तात्रायन्तीधन्वयासकम् ॥१४॥
192 grams of trāyamāṇa – Gentiana kurroo is boiled in eight instances of water and decoction diminished to quarter, to this, are added, 192 ml every of its juice (of trayamana – Gentiana kurroo)dhātrī svarasāt – and juice of Emblica officinalis, milk, ghee and paste of karṣāṃśaṃ – one karsa (12 grams) every of tiktā – Swertia chirata, trāyantī – Gentiana kurroo dhanvayāsaka – Alhagi camelorum, mustā – Cyperus rotundus, tāmalakī – Phyllanthus niruri, vīrā – Vetiveria zizanioides, jīvantī – Leptadenia reticulata, candana – Santalum album, utpalam – Nymphaea stellata and medicated ghee ready by combining all these collectively. This ghee additionally possesses qualities of the sooner method.
Drakshadi Ghrita
द्राक्षा मधूकं खर्जूरं विदारी सशतावरी ।
परूषकाणि त्रिफला तत्क्वाथे पाचयेद्घृतम्॥१६॥
क्षीरेक्षुधात्रीनिर्यासप्राणदाकल्कसंयुतम् ।
तच्छीतं शर्कराक्षौद्रपादिकं पूर्ववद्गुणैः ॥ १७ ॥
Medicated ghee is ready with the decoction of drākṣā – Vitis vinifera, madhūkaṃ – Madhuca longifolia, kharjūraṃ – Phoenix dactylifera, vidārī – Pueraria tuberosa, śatāvarī – Asparagus racemosu, parūṣakāṇi – Grewia asiatica, triphalā – Terminalia chebula, Terminalia belliricaand Emblica officinalis, kṣīra – milk, juice of ikṣu – Saccharum officinarum juice of dhātrī – Emblica officinalis and paste of prāṇadā – Terminalia chebula. When it will get cooled, sugar and honey, one fourth the amount of the preparation is added. This method additionally possesses comparable properties.
Raktamokshana: Blood letting
हरेच्छृङ्गादिभिरसृक् सिरया वा यथान्तिकम् ।
Blood-letting ought to be executed through the use of a srnga (sucking horn) and so forth. or by chopping the vein which is nearest to the location of illness manifestation.
Treating ripened and unripe abscess situated within the stomach
विद्रधिं पच्यमानं च कोष्ठस्थं बहिरुन्नतम् ॥१८॥
ज्ञात्वोपनाहयेत् शूले स्थिते तत्रैव पिण्डिते ।
तत्पार्श्वपीडनात् सुप्तौ दाहादिष्वल्पकेषु च ॥१९॥
पक्वः स्याद्विद्रधिं भित्त्वा व्रणवत्तमुपाचरेत् ।
अन्तर्भागस्य चाप्येतच्चिह्नं पक्वस्य विद्रधे: ॥२०॥
The abscess which is located within the stomach understanding ripening, and located bulging outwards ought to be given a heat poultice and tied. When the ache subsides and the mass will get rounded, it turns into painless when pressed from the edges, and burning sensation and so forth. signs turn out to be gentle. When the abscess ripens, it ought to be lower (incised) and handled as an ulcer. These are the options of an inner abscess which is ripe.
Therapy of ripe abscess
पक्वः स्रोतांसि सम्पूर्य स यात्यूर्ध्वमधोऽथवा ।
स्वयम्प्रवृत्तं तं दोषमुपेक्षेत हिताशिनः ॥ २१ ॥
दशाहं द्वादशाहं वा रक्षन् भिषगुपद्रवात् ।
असम्यग्वहति क्लेदे वरुणादिं सुखाम्भसा॥२२॥
पाययेन्मधुशिग्रुं वा यवागूं तेन वा कृताम् ।
यवकोलकुलत्थोत्थयूषैरन्नं च शस्यते ॥ २३ ॥
When the ripened abscess fills channels with supplies (like pus and so forth.) they usually come out of physique on their very own accord, both in upward or downward instructions, it ought to be uncared for (not stopped) by the one that needs good for the affected person, for a interval of ten days or twelve days, defending the affected person on a regular basis from the complication/ secondary ailments. If the discharge will not be flowing out passable, he ought to be given the (powder of herbs of) varunadi gana (chapter 15 of sutrasthana) with snug heat water or drink skinny gruel ready from Moringa oleifera. He ought to devour his meals (cooked rice) together with the soup yava – of Hordeum vulgare, kola – Ziziphus jujube, or kulattha – Dolichos biflorus.
Purification with medicated ghee
ऊर्ध्वं दशाहात्त्रायन्तीसर्पिषा तैल्वकेन वा ।
शोधयेद्बलतः शुद्धः सक्षौद्रं तिक्तकं पिबेत् ॥ २४ ॥
After ten days, he ought to be purified (with purgations) utilizing both trayantyadi ghrta (talked about earlier) or tilvaka ghrita (vide verses 152-153 of chapter 3 of cikitsita sthana), contemplating his power. After purification, he ought to devour tiktaka ghrta (verses 2-7 of chapter 19 of cikitsita sthana), combined with honey.
Use of Guggulu
सर्वशो गुल्मवच्चैनं यथादोषमुपाचरेत् ।
सर्वावस्थासु सर्वासु गुग्गुलुं विद्रधीषु च ॥ २५ ॥
कषायैर्यौगिकैर्युञ्ज्यात् स्वैः स्वैस्तद्वच्छिलाजतु ।
This (inner abscess) ought to be handled like gulma (stomach tumor) in all of the methods based on concerned doshas, in all kinds of vidardhi (abscess) and in all their totally different levels, guggulu – Commiphora mukul ought to be administered with acceptable decoctions (appropriate to the aggravated doshas), Asphaltum punjabinum will also be used equally.
Definition of Vidradhi
पाकं च वारयेद्यत्नात्सिद्धिः पक्वे हि दैविकी ॥२६॥
अपि चाशु विदाहित्वाद्विद्रधिः सोऽभिधीयते ।
Suppuration (of the abscess) ought to be prevented by all efforts, as soon as it turns into ripe, success in remedy is providential as a result of it produces fast suppuration, it’s referred to as as Vidradhi.
Therapy of Vidradhi in diabetics
सति चालोचयेन्मेहे प्रमेहाणां चिकित्सितम् ॥२७॥
If it (abscess) manifests in sufferers of diabetes, the therapies talked about up to now ought to be thought-about together with therapies of diabetes.
Stana Vidradhi Chikitsa
स्तनजे व्रणवत्सर्वं न त्वेनमुपनाहयेत् ।
पाटयेत्पालयन् स्तन्यवाहिनीः कृष्णचूचुकौ ॥२८॥
सर्वास्वामाद्यवस्थासु निर्दुहीत च तत् स्तनम् ।
अथ वृद्दिचिकित्सितम्
Abscess of the breast ought to be handled like an ulcer however with out making use of heat poultices over it. It ought to be incised avoiding damage to the milk ducts, the black areola and nipple. All of the levels commencing with the unripe, the affected breast ought to be drained of its milk. Thus ends the remedy of abscesses.
Vriddhi Chikitsa: Therapy of enlargement of the scrotum
Vataja Vriddhi Chikitsa
शोधयेत्त्रिवृता स्निग्धं वृद्धौ स्नेहैश्चलात्मके ॥ २९ ॥
कौशाम्रतिल्वकैरण्डसुकुमारकमिश्रकैः ।
ततोऽनिलघ्ननिर्यूहकल्कस्नेहैर्निरूहयेत् ॥ ३० ॥
रसेन भोजितं यष्टितैलेनान्वासयेदनु ।
स्वेदप्रलेपा वातघ्नाः पक्वे भित्त्वा व्रणक्रियाम् ॥ ३१ ॥
In enlargement of the scrotum arising from cala (vata), the affected person ought to be given oleation remedy with fats ready with Operculina turpethum adopted by purifactory remedy utilizing both the oil processed with Schleichera oleosa, tilvaka – Symplocos racemosa, eraṇḍa – Ricinus communis, sukumaraka taila (described later in verse 41-46) or misraka sneha (described later in verse 89-90 of chapter 14 of cikistsita sthana). Subsequent, decoction enema administered utilizing vata mitigating decoctions, paste and fat and made to take meals together with meat soup. Subsequent, lubricating enema ought to be administered utilizing yasti taila (oil of Glycyrrhiza glabra), fomentation and utility of pastes which mitigate vata ought to be executed subsequent. When it turns into ripe, it ought to be lower (incised or punctured) after which handled as an ulcer.
Pittaja and Raktaja Vriddhi Chikitsa
पित्तरक्तोद्भवे वृद्धावामपक्वे यथायथम् ।
शोफव्रणक्रियां कुर्यात्प्रततं च हरेदसृक् ॥ ३२ ॥
Vrddhi arising from pitta and raktha, ought to be handled of their unripe and ripe levels simply as treating an inflammatory swelling and an ulcer respectively. Blood ought to be let loose ceaselessly.
Kaphaja Vriddhi Chikitsa
गोमूत्रेण पिबेत्कल्कं श्लैष्मिके पीतदारुजम् ।
विम्लापनाद्ऋते चास्य श्लेष्मग्रन्थिक्रमो हितः॥३३॥ पक्वे च
पाटिते तैलमीष्यते व्रणशोधनम् ।
सुमनोऽरुष्कराङ्कोल्लसप्तपर्णेषु साधितम् ॥ ३४ ॥
पटोलनिम्बरजनीविडङ्गकुटजेषु च ।
In vrddhi arising from kapha, paste of pītadāru – Berberis aristate combined with cow urine ought to be consumed. All of the strategies of therapies besides vimlapana (kneading by hand) indicated for slesmagranthi (tumor of kapha origin) are helpful. After it ripens and bursts use of medicated oil which cleanses the ulcer, ready with sumana – Mesua ferrea, aruṣkara – Semecarpus anacardium, aṅkolla – Alangium salvifolium, saptaparṇa – Alstonia scholaris, paṭola – Trichosanthes dioica, nimba – Azadirachta indica, rajanī – Curcuma longa, viḍaṅga – Embelia ribes and kuṭaja – Holarrhena antidysenterica is fascinating.
Medoja Vriddhi Chikitsa: Scrotal enlargement attributable to accumulation of fats
मेदोजं मूत्रपिष्टेन सुस्विन्नं सुरसादिना ॥ ३५ ॥
शिरोविरेकद्रव्यैर्वा वर्जयन् फलसेवनीम् ।
दारयेद्वृद्धिपत्रेण सम्यङ्मेदसि सूद्धृते ॥ ३६ ॥
व्रणं माक्षिककासीससैन्धवप्रतिसारितम् ।
सीव्येदभ्यञ्जनं चास्य योज्यं मेदोविशुद्धये ॥ ३७ ॥
मनःशिलैलासुमनोग्रन्थिभल्लातकैः कृतम् ।
तैलमाव्रणसन्धानात् स्नेहस्वेदौ च शीलयेत्॥३८॥
In vrddhi arising from medas (fats), the scrotum ought to be given fomentation (until perspiration seems) with herbs of both surasadi gana or herbs for Nasya (chapter 15 of sutrasthana), macerated with cows urine; Subsequent, avoiding the scrotal raphae, the scrotum ought to be incised with the vrddhipatra (lancet) until the fats is eliminated out utterly. The ulcer ought to be coated with paste of – honey, inexperienced vitriol, and rock salt. After eradicating it and suturing, it ought to be anointed with oil ready with realgar, elā – Elettaria cardamomum, sumana – Mesua ferrea, granthi – Root of Piper longum, bhallātaka – Semecarpus anacardium ought to be organized for cleaning the morbid fats until the ulcer heels, anointing it with oil and fomentation ought to be executed.
Mutraja Vriddhi Chikitsa
मूत्रजं स्वेदितं स्निग्धैर्वस्त्रपट्टेन वेष्टितम् ।
विध्येदधस्तात् सेवन्याः स्रावयेच्च यथोदरम्॥३९॥
व्रणं च स्थगिकाबद्धं रोपयेदन्त्रहेतुके ।
Mutraja vrddhi (scrotal enlargement attributable to accumulation of urine/ fluid/ hydrocele) ought to be given fomentation, wrapped with fabric, soaked in oil, punctured beneath, close to the suture (raphea) with the assistance of a vrihimukha sastra (trocar and canula) and the fluid drained out simply just like udara (enlargement of the stomach attributable to accumulation of fluid described in chapter 15). The wound ought to be tied with sthagika bandha (a sort of bandage vide chapter 29 of sutrasthana) and made to heal.
Antraja Vriddhi Chikitsa
अन्त्रहेतुके।
फलकोशमसम्प्राप्ते चिकित्सा वातवृद्धिवत् ॥४०॥
For antra vrddhi (scrotal enlargement attributable to descent of the small gut/ scrotal hernia) when the gut has not descended into the scrotum, remedy is just like that of vatavrddhi (scrotal enlargement arising from vata).
Sukumara Ghrita
पचेत्पुनर्नवतुलां तथा दशपलाः पृथक् ।
दशमूलपयस्याश्वगन्धैरण्डशतावरीः ॥ ४१ ॥
द्विदर्भशरकाशेक्षुमूलपोटगलान्विताः ।
वहेऽपामष्टभागस्थे तत्र त्रिंशत्पलं गुडात् ॥ ४२ ॥
प्रस्थमेरण्डतैलस्य द्वौ घृतात्पयसस्तथा ।
आवपेद्द्विपलांशं च कृष्णातन्मूलसैन्धवम् ॥ ४३ ॥
यष्टीमधुकमृद्वीकायवानीनागराणि च ।
तत्सिद्धं सुकुमाराख्यं सुकुमारं रसायनम् ॥ ४४ ॥
वातातपाध्वयानादिपरिहार्येष्वयन्त्रणम् ।
प्रयोज्यं सुकुमाराणामीश्वराणां सुखात्मनाम् ॥ ४५ ॥
नृणां स्त्रीवृन्दभर्तॄणामलक्ष्मीकलिनाशनम् ।
सर्वकालोपयोगेन कान्तिलावण्यपुष्टिदम् ॥ ४६ ॥
वर्ध्मविद्रधिगुल्मार्शोयोनिमेढ्रानिलार्तिषु ।
शोफोदरखुडप्लीहविड्विबन्धेषु चोत्तमम् ॥ ४७ ॥
One tula (4.8 Kg) of punarnava – Boerhavia diffusa, ten pala (480 grams) every of group of ten roots, payasya – Ipomoea digitata, aśvagandha – Withania somnifera, eraṇḍa – Ricinus communis, śatāvarīḥ – Asparagus racemosus, dvidarbha – roots of the 2 darbha (Desmostachya bipinnata), śara – Saccharum munja, kāśa – Saccharum spontaneum, ikṣu mūla – Saccharum officinarum, poṭagala – and Typha elephantina, are boiled in a single vaha (one drona – 12 litres 228 ml) of water and decoction diminished to one- eight half and filtered. To this are added thirty pala (1 Kg 440 grams) of molasses one prastha (768 ml) of castor oil, two prastha (1536 grams) every of ghrta (1536 ml of) milk and combined with paste of two pala (96 grams) every of kṛṣṇā – Piper longum, root of Piper longum, rock salt, yaṣṭīmadhuka – Glycyrrhiza glabra, mṛdvīkā – Vitis vinifera, yavānī – Trachyspermum ammi, and nāgara – Zingiber officinale. Ghee is ready. This method often called sukumara rasayanam, is a rejuvenator for individuals of tender structure, possesses limitless energy in relieving the results of wind, daylight, lengthy stroll, driving on autos and so forth. appropriate for administration to those that are of tender physique, rich, and desirous of consolation; husbands who’re surrounded by teams of girls, it wards off inauspiciousness and dispels sorcery, furnishes good complexion, magnificence and nourishment; By steady use all the time it’s the finest medication for scrotal enlargement, abscess, stomach tumor, hemorrhoids, dysfunction of vagina and penis, ailments of anila (vata), dropsy, enlargement of the stomach, vatarakta/ gout, ailments of the spleen and intestinal obstruction from feces.
Agnikarma: Thermal cautery
यायाद्वर्ध्म न चेच्छान्तिं स्नेहरेकानुवासनैः ।
वस्तिकर्म पुरः कृत्वा वङ्क्षणस्थं ततो दहेत्॥४८॥
अग्निना मार्गरोधार्थं मरुतोऽर्धेन्दुवक्रया ।
If the inguinal hernia doesn’t subside by oleation, purgation and lubrication enema therapies; basti (decoction enema) ought to be administered first after which the mass within the groin ought to be branded with fireplace (cauterized) so as to clear the passage of maruta (vata).
Agnikarma: Thermal cautery
अर्धेन्दुवक्रया।
अङ्गुष्ठस्योपरि स्नाव पीतं तन्तुसमं च यत् ॥ ४९ ॥
उत्क्षिप्य सूच्या तत्तिर्यग्दहेच्छित्त्वा यतो गदः ।
ततोऽन्यपार्श्वेऽन्ये त्वाहुर्दहेद्वाऽनामिकाङ्गुलेः ॥ ५० ॥
गुल्मेऽन्यैर्वातकफजे प्लीह्नि चायं विधिः स्मृतः ।
कनिष्ठिकानामिकयोर्विश्वाच्यां च यतो गदः ॥ ५१ ॥
The yellow tendon resembling a thread, located over the thumb ought to be raised up and lower as per illness, (its surrounding constructions), after which branded (with the fireplace) utilizing a needle curved just like the half-moon (which is made pink scorching) choosing the thumb of the other facet. Others (authorities) say that branding ought to be executed over the tendon above the ring finger some others say, that the identical process ought to be executed in Gulma (stomach tumor) of vata kapha origin and enlargement of spleen. In visvaci (ache and rigidity of the arm/ shoulder-arm syndrome) branding ought to be executed between the little finger and ring fingers of the identical facet (of the affected arm).
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने विद्रधिवृद्धिचिकित्सितं नाम त्रयोदशोऽध्याय: ॥१३॥
Thus, ends the chapter, vidradhi-vrddhi cikitsita – the thirteenth in cikitsita sthana of Astangahrdaya Samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.