The nineteenth chapter of Chikitsasthana of Sushruta Samhita is called as Vrddhi-Upadamśa Slipada Cikitsitam Adhyaya. This chapter offers with Remedy of Scrotal Enlargement – Venereal Illnesses and Filariasis. 

अथातोवृद्ध्युपदंशश्लीपदचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।

We are going to now expound the chapter by title Vrddhyupadamsa –slīpada chikitsa – remedy of scrotal enlargement,venereal illnesses and filariasis; as revealed by the venerable Dhañvañtari.

 

1. Vrddhi – Scrotal enlargement

अन्त्रवृद्ध्याविनाषड्यावृद्धयस्तासुवर्जयेत्।।
अश्वादियानंव्यायाममैथुनंवेगनिग्रहम्।।३।।
अत्यासनंचङ्क्रमणमुपवासंगुरूणिच।।

Antra Vrddhi means herniation of the gut into the scrotum. Apart from Antra Vrddhi, the remaining six sorts of Vrddhi (defined in chapter 12 of Nidana Sthana part of the identical treatise) are curable.

Sufferers of Vrddhi ought to keep away from the beneath talked about issues –

–        driving on animals like horses and so on.

–        bodily workout routines,

–        copulation,

–        suppression of urges,

–        sitting for lengthy durations,

–        strolling for lengthy durations of time,

–        fasting,

–        consumption of heavy (indigestible or troublesome to digest) meals

Vātaja vrddhi cikitsā

तत्रादितोवातवृद्धौत्रैवृतस्निग्धमातुरम्।।४।।
स्विन्नंचैनंयथान्यायंपाययेतविरेचनम्।।
कोशाम्रतिल्वकैरण्डफलतैलानिवानरम्।।५।।
सक्षीरंवापिबेन्मासंतैलमेरण्डसंभवम्।।
ततःकालेऽनिलघ्नानांक्वाथैःकल्कैश्चबुद्धिमान्।।६।।
निरूहयेन्निरूढंचभुक्तवन्तंरसौदनम्।।
यष्टीमधुकसिद्धेनततस्तैलेनयोजयेत्।।७।।
स्नेहोपनाहौकुर्याच्चप्रदेहांश्चानिलापहान्।।
विदग्धांपाचयित्वावासेवनीपरिवर्जयेत्।।८।।
भिन्द्यात्ततःप्रभिन्नायांयथोक्तंक्रममाचरेत्।।

Snehana – Combination of three fat i.e. oil, ghee and muscle fats must be given for ingesting to the affected person having scrotal swelling produced by aggravated vata.

Swedana – He must also be given sudation remedy within the regular manner.

Virechana – After Snehana – oleation and Swedana – sudation, the affected person must be administered purgatives. One of many beneath talked about purgative recipes must be given –

–        oil of kosamra,

–        oil of tilvaka,

–        oil of errands phala or

–        eranda taila combined with milk

These recipes shall be given each day, for a time interval of 1 month.

Vasti – Subsequent, decoction enema must be administered. The enema liquid must be ready with decoction and paste of vata mitigating herbs.

The affected person is suggested to take meals together with meat soup.

After that he must be administered with oil enema. For this, Yastimadhu Taila must be used.

Different measures – Under talked about measures must also be administered –

–        anointing with oils,

–        heat poultices

–        software of pastes ready with vata mitigating herbs

The swelling which is ripening must be made ripe. After ripening it must be reduce open taking care to keep away from the suture (scrotal raphae). Following this, therapies really useful for wounds described beforehand must be adopted.

Pittaja vrddhi cikitsā

पित्तजायामपक्वायांपित्तग्रन्थिक्रमोहितः।।९।।
पक्वांवामेदयेद्भिन्नांशोधयेत्क्षौद्रसर्पिषा।।
शुद्धायांचभिषग्दद्यात्तैलंकल्कंचरोपणम्।।१०।।

For treating the ama (unripe) stage of scrotal swelling produced by pitta, the identical therapies prescribed for pittaja granthi must be adopted.

Alternatively, if the swelling has ripened, it must be punctured (or incised).

The wound must be purified utilizing a mix of honey and ghee.

After this, the doctor ought to result in therapeutic of the injuries by utilizing oils and pastes ready from therapeutic herbs.

Raktaja vrddhi cikitsa (haematocele)

रक्तजायांजलौकोभिःशोणितंनिहरेद्भिषक्।।
पिबेद्विरेचनंवाऽपिशर्कराक्षौद्रसंयुतम्।।११।।
पित्तग्रन्थिक्रमंकुर्यादामेपक्वेचसर्वदा।।

The doctor ought to administer the beneath talked about therapies in scrotal swelling brought on by vitiated blood –

–        ought to take away blood (conduct bloodletting) utilizing leeches or

–        administer purgation recipe added with honey and sugar

Therapies indicated for pittaja granthi must be administered in each ripening and ripe phases of the illness.

Kaphaja Vrddhi Cikitsa

वृद्धिकफात्मिकामुष्णैर्मूत्रपिष्टैःप्रलेपयेत्।।१२।।
पीतदारुकषायंचपिबेन्मूत्रेणसंयुतम्।।
विम्लापनाइतेवाऽपिश्लेष्मग्रन्थिक्रमोहितः।।१३।।
पक्वायांचविभिन्नायांतैलंशोधनमिष्यते।।
सुमनारुष्कराकोठसप्तपर्णेषुसाधितम्।।१४।।

For treating Vriddhi brought on by vitiated kapha, paste of herbs having sizzling efficiency macerated in gomutra – urine of cow must be utilized.

For oral consumption, decoction of Pitadaru i.e. Daruharidra (Berberis aristata) must be used together with gomutra – urine of cows.

Besides Vimlapana (kneading), the opposite therapies prescribed for Kaphaja Granthi must be used for treating Kaphaja Vrddhi.

The doctor ought to incise the ripe swelling.

The wound must be made to heal utilizing oil boiled and processed with the beneath talked about herbs –

–        Sumana,

–        Aruskara,

–        Ankotha and

–        Saptaparna

Medaja Vrddhi Chikitsa

मेदःसमुत्थांसंस्वेद्यलेपयेत्सुरसादिना।।
शिरोविरेकद्रव्यैर्वासुखोष्णैर्मूत्रसंयुतैः।।१५।।
स्विन्नांचावेष्टयपट्टेनसमाश्वास्यतुमानवम्।।
रक्षन्फलेसेवनीचवृद्धिपत्रेणदारयेत्।।१६।।
मेदस्ततःसमुद्धृत्यदद्यात्कासीससैन्धवे।।
बनीयाच्चयथोद्दिष्टंशुद्धेतैलंचदापयेत्।।१७।।
मनःशिलाललवणैःसिद्धमारुष्करेषुच।।

Medoja Vrddhi i.e. vrddhi brought on by morbid fats must be given fomentation.

It must be utilized with paste of herbs belonging to Surasadi Gana or herbs belonging to Sirovirecana Gana macerated in Gomutra – cow urine. The appliance must be heat.

The swelling must be wrapped with material bands after administering fomentation. Later, it must be incised utilizing Vrddhipatra – a pointy instrument, whereas defending the testes and raphae. The fats therein is eliminated by scraping.

After this, the powder of Kasisa and Saindhava is utilized. Bandaging is finished as appropriate.

The medicated oil ready with manashila, ala, lavana and aruskara must be used for selling therapeutic.

Mutraja Vrddhi Chikitsa – (Hydrocele)

मूत्रजांस्वेदयित्वातुवस्त्रपट्टेनवेष्टयेत्।।१८।।
सेवन्याःपार्श्वतोऽधस्ताद्विध्येद्व्रीहिमुखेनतु।।
अथात्रद्विमुखांनाडीदत्त्वाविस्रावयेद्भिषक्।।१९।।
मूत्रं,नाडीमथोद्धृत्यस्थगिकाबन्धमाचरेत्।।
शुद्धायांरोपणंदघात्

For remedy of Vrddhi brought on by urine i.e. hydrocele, fomentation must be first given. It ought to now be wrapped with material band following which puncture is made beside the raphae, beneath the swelling.

A tube with opening at each ends must be taken. It’s inserted and the urine is drained out. Afterwards, the tube is eliminated. Sthagika kind of bandage is utilized.

It’s made to heal as regular after cleansing the vrddhi as described.

Antraja Vrddhi Cikitsa – (scrotal hernia)

 …………………वर्जयेदत्रहैतुकीम्।।२०।।
अप्राप्तफलकोषायांवातवृद्धिक्रमोहितः।।
तत्रयावङ्क्षणस्थातांदहेदर्धेन्दुवक्रया।।२१।।
सम्यङमार्गावरोधार्थकोशप्राप्तांतुवर्जयेत्।।
त्वचंभित्त्वाऽङ्गुष्ठमध्येदहेच्चाङ्गविपर्ययात्।।२२।।
अनेनैवविधानेनवृद्धीवातकफात्मिके।।
प्रदहेत्प्रयत: किंतुस्नायुच्छेदोऽधिकस्तयोः।।२३।।
शङ्खोपरिचकर्णान्तेत्यक्त्वायत्नेनसेवनीम्।।
व्यत्यासाद्वासिरांविध्येदत्रवृद्धिनिवृत्तये।।२४।। 

Vrddhi brought on by añtra i.e. intestinal hernia ought to typically be rejected (shouldn’t be handled).

Therapies to mitigate the aggravated vata are useful and must be carried out when the gut has not descended into the scrotum.

When the vrddhi is localized within the groin i.e. inguinal hernia, it must be cauterized (branded by hearth) with curved iron rod which is semilunar in form. This could block its passage into the scrotum. The vrddhi must be rejected if it has descended into the scrotum.

A reduce or incision must be made within the pores and skin of the center of the thumb (massive toe). Cauterization must be carried out within the reverse half i.e. massive toe reverse to the aspect of swelling.

The identical strategies of remedy must be adopted in vriddhi brought on by vata-kapha and the realm is cauterized with nice effort. This must be carried out as a result of there are nice probabilities of reducing off the ligaments herein.

The vein current between the temples and ear must be punctured within the reverse aspect. Whereas doing the puncture, the sevani i.e. suture on the cranium must be averted (care must be taken that it’s not injured).

2. Upadamsa Chikitsa – remedy of venereal illnesses

उपदंशेषुसाध्येषुस्निग्धस्विन्नस्यदेहिनः।।
सिरांविध्येन्मेढ़मध्येपातयेद्वाजलौकसः।।२५।।
हरेदुभयतश्चापिदोषानत्यर्थमुच्छ्रितान्।।
सद्योऽपहृतदोषस्य रुक्शोफावुपशाम्यतः ||२६||
यदिवादुर्बलोजन्तुर्नवाप्राप्तंविरेचनम्।।
निरूहेणहरेत्तस्यदोषानत्यर्थमुच्छ्रितान्।।२७।।

Within the remedy of curable types of Upadamsa (venereal illnesses), the doctor ought to at first administer oleation and sudation therapies.

After this, the vein on the centre of the penis must be punctured or bloodletting must be carried out utilizing leeches.

Elimination therapies to expel the enormously aggravated doshas must be administered in each instructions i.e. each vamana – emesis and virecana – purgation must be given.

Ache and swelling would subside by doing so.

The enormously elevated doshas must be expelled by administration of decoction enema if the particular person is debilitated or didn’t have correct purgations.

Vātaja Upadamśa Cikitsā

प्रपौण्डरीकयष्टयाह्ववर्षाभूकुष्टदारुभिः।।
सरलागुरुरास्नाभिर्वातजंसंप्रलेपयेत्।।२८।।
निचुलेरण्डबीजानियवगोधूमसक्तवः।।
एतैश्चवातजंस्निग्धैःसुखोष्णैःसंप्रलेपयेत्।।२९।।
प्रपौण्डरीकपूर्वैश्चद्रव्यैःसेकःप्रशस्यते।।

Paste of the beneath talked about herbs must be utilized on the penis of the particular person affected by Vataja Upadamsa –

–        Prapaundarīka,

–        Yastyāhvā,

–        Varsābhūkuştha,

–        Devadāru,

–        Sarala,

–        Aguru and

–        Rāsñā

Alternatively, paste of the beneath talked about must be utilized comfortably heat –

–        Nicula,

–        Eranda Bija,

–        Flour of Yava and

–        Godhuma

It is usually superb to pour decoction of Prapaundarika and different herbs talked about above on the lesion.

Pittaja Upadamśa Cikitsā

 गैरिकाञ्जनयष्टयावसारिवोशीरपद्मकैः।।३०।।
सचन्दनोत्पलैःस्निग्धैःपैत्तिकंसंप्रलेपयेत्।।
पद्मोत्पलमृणालैश्चससर्जार्जुनवेतसैः।।३१।।
सर्पि:स्निग्धैःसमधुकैःपैत्तिकंसंप्रलेपयेत्।।
सेचयेच्चघृतक्षीरशर्करेक्षुमधूदकैः।।३२।।
अथवाऽपिसुशीतेनकषायेणवटादिना।।

Paste of the beneath talked about elements must be used for software in remedy of Pittaja Upadamsa –

–        Gairika,

–        Anjana,

–        Yastyahva,

–        Sariva,

–        Usira,

–        Padmaka,

–        Candana and

–        Utpala

The paste must be made unctuous earlier than making use of.

Alternatively, ghee boiled with the beneath talked about elements must be utilized –

–        Padma,

–        Utpala,

–        Mrnala,

–        Sarja,

–        Arjuna,

–        Vetasa and

–        Madhuka

The lesion must be bathed with the beneath talked about –

–        ghee,

–        milk,

–        sugar,

–        water,

–        sugarcane juice,

–        honey water or

–        chilly infusion of vata and so on.

Kaphaja Upadamśa Cikitsa

सालाश्वकर्णाजकर्णधवत्वग्भिःकफोत्थितम्।।३३।।
सुरापिष्टाभिरुष्णाभिःसतैलाभिःप्रलेपयेत्।।
रजन्यतिविषापुस्तासुरसासुरदारुभिः।।३४।।
सपत्रपाठापत्तूरैरथवासंप्रलेपयेत्।।
सुरसारग्वधाद्योश्चक्वाथाभ्यांपरिषेचयेत्।।३५।। 

Paste of the beneath talked about elements must be macerated in sura (beer) and made into paste –

–        barks of Sala,

–        Asvakarna,

–        Ajakarna and

–        Dhava

This paste must be utilized heat in Upadamsa brought on by vitiated kapha after including oil to the submit.

Alternatively, paste of the beneath talked about elements too shall be utilized –

–        Rajani,

–        Ativisa,

–        Musta,

–        Surasa,

–        Suradaru,

–        Patra,

–        Patha and

–        Pattara

For pouring over / bathing the lesion of Kaphaja Upadamsa, decoction of Surasa and Aragvadha Gana must be used.

 

एवंसंशोधनालेपसेकशोणितमोक्षणैः।।
प्रतिकुर्यात्क्रियायोगैःप्राक्स्थानोक्तैर्हितैरपि।।३६।।
नयातिचयथापाकंप्रयतेततथाभिषक्।।
विदग्धैस्तुसिरास्नायुत्वङ्मासैःक्षीयतेध्वजः।।३७।।
शस्त्रेणोपचरेच्चापिपाकमागतमाशुवै।।
तदाऽपोह्यतिलैःसर्पिःक्षौद्रयुक्तैःप्रलेपयेत्।।३८।।
करवीरस्यपत्राणिजात्यारग्वधयोस्तथा।।
प्रक्षालनेप्रयोज्यानिवैजयन्पर्कयोरपि।।३९।।

Upadamsa must be handled with –

–        shodhana – purificatory therapies,

–        alepa – making use of pastes,

–        seka – showering, bathing,

–        shonita mokshana – eradicating blood / bloodletting and

–        such different useful therapies described in earlier sections of this treatise

Crucial is that the doctor ought to attempt to forestall suppuration.

The penis would lose its veins, ligaments, pores and skin and muscle tissue if suppuration happens.

Upadamsa must be shortly handled utilizing sharp / surgical devices when suppuration has commenced.

Decoction of the leaves of the beneath talked about herbs could also be used for laundry the upadamsa wound –

–        karavīra,

–         jātī,

–        āragvadha,

–        vaijayañti and

–        arka

सौराष्ट्रींगैरिकंतुत्थंपुष्पकासीससैन्धवम्।।
रोधंरसाञ्जनंदार्वीहरितालंमनःशिलाम्।।४०।।
हरेणुकैलेचतथासूक्ष्मचूर्णानिकारयेत्।।
तच्चूर्णंक्षौद्रसंयुक्तमुपदंशेषुपूजितम्।।४१।।

Good powder of the beneath talked about elements is ready –

–        Saurastri,

–        Gairika,

–        Tuttha,

–        Puspa Kasisa,

–        Saindhava,

–        Rodhra,

–        Rasanjana,

–        Darvi,

–        Haritāla,

–        Manaśśilā,

–        Hareņuka and

–        Elā

This powder must be combined with honey and utilized. It’s extremely useful in curing venereal illnesses.

जम्ब्वाम्रसुमनानिम्बश्वेतकाम्बोजिपल्लवाः।।
शल्लकीबदरीबिल्वपलाशतिनिशत्वचः।।४२।।
क्षीरिणांचत्वचोयोज्याःक्वाथेत्रिफलयासह।।
तेनक्वाथेननियतंव्रणंप्रक्षालयेद्भिषक्।।४३।।
अस्मिन्नेवकषायेतुतैलंधीरोविपाचयेत्।।
गोजीविडङ्गयष्टीभिःसर्वगन्धैश्चसंयुतम्।।४४।।
एतत्सर्वोपदंशेषुश्रेष्ठंरोपणमिष्यते।।

The doctor ought to take care to see that the ulcer is washed usually, every single day, with the decoction of the beneath talked about herbs –

–        tender leaves of Jambu,

–        Amra,

–        Sumanā,

–        Nimba,

–        Sveta Kāmbojā;

Alternatively, the barks of the beneath talked about herbs shall be used to organize the decoction with which the ulcers will be washed –

–        barks of Sallaki,

–        Badari,

–        Bilva,

–        Palasa and

–        Tinisa

Barks of Ksiri Vrksas / Pancavalkala (latex yielding bushes) must be added with Triphala and used for a similar function.

With the identical decoction, medicated oil could also be ready and added with paste of Goji, Vidanga, Yasti and Sarvagandha herbs. This oil is alleged to be the perfect one for therapeutic the ulcers of every kind of upadamsa.

स्वर्जिकातुत्थकासीसंशैलेयंचरसाञ्जनम्।।४५।।
मनःशिलासमैश्चूर्णंव्रणवीसर्पनाशनम्।।
गुन्द्रांदग्ध्वाकृतंभस्महरितालंमनःशिला।।४६।।
उपदंशविसर्पाणामेतच्छान्तिकरंपरम्।।
मार्कवस्त्रिफलादन्तीताम्रचूर्णमयोरजः।।४७।।
उपदंशंनिहन्त्येषवृक्षमिन्द्राशनिर्यथा।।

The beneath talked about elements, all taken in equal components are properly powdered –

–        Svarjikā,

–        Tuttha,

–        Kāsīsa,

–        Saileya,

–        Rasāñjana AND

–        Manaśśilā

When used, this powder cures ulcers and erysipelas.

Powder of the beneath talked about elements is good for curing upadamsa and visarpa –

–        ash of Gundra,

–        Haritala and

–        Manassila

Powder must be ready from the beneath talked about elements –

–        Mārkava,

–        Triphalā,

–        Dañti,

–        powder of Tāmra (copper) and

–        Ayas (iron)

This powder when used destroys upadamśa identical to the thunderbolt destroys the tree.

उपदंशद्वयेऽप्येतांप्रत्याख्यायाचरेत्क्रियाम्।।४८।।
तयोरेवचयायोग्यावीक्ष्यदोषबलाबलम्।।

 In case of Sannipataja Upadamsa and Raktaja Upadamsa, the affected person and his attendants must be intimated concerning the incurability of the illness after which the therapies must be commenced.

Any sort of remedy which is good in accordance with energy or weak spot of the doshas must be adopted within the remedy of Upadamsa. 

उपदंशेविशेषेणशृणुभूयस्त्रिदोषजे।।४९।।
दुष्टव्रणविधिंकुर्यात्कुथितंमेहनंत्यजेत्।।
जम्ब्बोष्ठेनाग्निवर्णेनपश्चाच्छेपंदहेद्भिषक्।।५।।
सम्यग्दग्धंचविज्ञायमधुसर्पिःप्रयोजयेत्।।
शुद्धेचरोपणंदद्यात्कल्कंतैलंहितंचयत्।।५१।।

Subsequent, the remedy of Upadamsa brought on by all three doshas shall be defined. Take heed to the identical.

The wound must be handled on the strains of treating Dusta Vrana (septic ulcer).

The portion of the decomposed / gangrenous penis must be eliminated and discarded. The remaining a part of the penis must be burnt utilizing Jambavostha (black cylindrical piece of stone) which is heated on hearth and made purple sizzling.

A combination of honey and ghee must be utilized whether it is improperly burnt.

Following this, appropriate paste of herbs or medicated oils shall be used for selling the therapeutic.

3. Slipada chikitsa -Remedy of Filariasis

Vātaja slīpada cikitsā

स्नेहस्वेदोपपन्नेतुश्लीपदेऽनिलजेभिषक्।।
कृत्वागुल्फोपरिसिरांविध्येत्तुचतुरङ्गुले।।५२।।
समाप्यायितदेहंचबस्तिभिःसमुपाचरेत्।।
मासमेरण्डजंतैलंपिबेन्मूत्रेणसंयुतम्।।५३।।
पयसौदनमश्नीयानागरक्वथितेनच।।
त्रैवृतंचोपयुञ्जीतशस्तोदाहस्तथाऽग्निना।।५४।।

Firstly, the doctor ought to administer Snehana – oleation and Swedana – sudation therapies in Vataja Slipada – Slipada (filariasis) produced by vitiated vata.

Then he ought to puncture the vein located 4 angula (8cm) above the ankle joint.

Enemas must be administered as soon as the physique regains energy.

The affected person ought to drink Eranda Taila combined with urine of cow for a interval of 1 month. Milk boiled with Nagara (ginger) must be taken together with meals.

Trivrt Ghrta must also be administered.

Cauterization (burning) can be useful on this situation.

Pittaja slīpada cikitsa

गुल्फस्याधःसिरांविध्येच्छ्लीपदेपित्तसंभवे।।
पित्तघ्नींचक्रियांकुर्यात्पित्ताबुंदविसर्पवत्।।५५।।

Siravedha – venepuncture must be carried out beneath the ankle joint in Slipada produced by vitiated pitta.

Additionally, therapies must be carried out to mitigate pitta on related strains of therapies defined within the context of remedy of Pittaja Arbuda or Pittaja Visarpa.

Kaphaja slīpada cikitsa

सिरांसुविदितांविध्येदङ्गुष्ठेश्लैष्मिकेभिषक्।।
मधुयुक्तानिचाभीक्ष्णंकषायाणिपिबेन्नरः।।५६।।
पिबेद्वाऽप्यभयाकल्कंमूत्रेणान्यतमेनच।।
कटुकाममृतांशुण्ठीविडङ्गंदारुचित्रकम्।।५७।।
हितंवालेपनेनित्यंभद्रदारुसचित्रकम्।।
विडङ्गमरिचार्केषुनागरेचित्रकेऽथवा।।५८।।
भद्रदार्वेलुकाख्येचसर्वेषुलवणेषुच।।
तैलंपक्वंपिबेद्वाऽपियवान्नंचहितंसदा।।५९।।
पिबेत्सर्षपतैलंवाश्लीपदानांनिवृत्तये।।
पूतीकरञ्जपत्राणांरसंवाऽपियथाबलम्।।६०।।
अनेनैवविधानेनपुत्रञ्जीवकजंरसम्।।
प्रयुञ्जीतभिषक्प्राज्ञःकालसात्म्यविभागवित्।।६१।।
केबुकाकन्दनिर्यासंलवणंत्वथपाकिमम्।।
रसंदत्त्वाऽथपूर्वोक्तंपेथमेतद्भिषग्जितम्।।६२।।

The doctor ought to first puncture the vein outstanding within the massive toe whereas treating the sufferers of Slipada brought on by vitiated pitta.

Decoction of kapha mitigating herbs added with honey must be prescribed for ingesting usually.

The affected person ought to alternatively eat paste of Abhaya / Haritaki combined with urine of cow or every other animal.

Paste of the beneath talked about elements must be used for software –

–        Katuka,

–        Amrta,

–        Sunthi,

–        Vidanga,

–        Dru and

–        Citraka

Oil cooked with one of many beneath talked about must be consumed every single day after including all salts to it –

–        Vidanga, Marica and Arka or

–        Nagara and Citraka or

–        Bhadradaru and Eluka (Elavaluka)

The affected person ought to all the time take boiled Yava as meals.

He ought to drink Sarsapa Taila or contemporary juice of Putikaranja as appropriate to his energy.

Equally, after having thought-about the season and habituation, a clever doctor ought to administer the juice of Putranjivaka.

Additionally, juice of tubers of Kebuka, Pakima Lavana / Bida Lavana salt added to the juices described earlier must be consumed. It’s the finest medication for Slipada.

काकादनीकाकजवांबृहतीकण्टकारिकाम्।।
कदम्बपुष्पीमन्दारीलम्बांशुकनसांतथा।।६३।।
दग्ध्वामूत्रेणतद्भस्मस्रावयेत्क्षारकल्पवत्।।
तत्रदद्यात्प्रतीवापंकाकोदुम्बरिकारसम्।।६४।।
मदनाच्चफलात्क्वाथंशुकाख्यस्वरसंतथा।।
एषक्षारस्तुपानीयःश्लीपदंहन्तिसेवितः।।५।।
अपचींगलगण्डंचग्रहणीदोषमेवच।।
भक्तस्यानशनंचैवहन्यात्सर्वविषाणिच।।६६।।

The beneath talked about elements are burnt to acquire their ash –

–        Kakadani,

–        Kākajangha,

–        Brhati,

–        Kantakari,

–        Kadambapuspi (alambusā),

–        Mandarin (āli),

–        Lambā (kațukālābu) and

–        Sukanāsa

This ash is now dissolved within the urine of cows and filtered many occasions.

After this, it’s added with the beneath talked about and cooked within the technique of getting ready Ksara – alkali, in order to organize their alkali –

–        Juice of Kakodumbarika,

–        Decoction of Madanaphala and

–        contemporary juice of Sukakhya (Sukanasa)

Advantages – When used, this ksara would remedy the beneath talked about situations –

–        slipada – filariasis,

–        goiter,

–        cervical lymphadenitis,

–        illnesses of the duodenum,

–        incapacity to eat meals and

–        every kind of poisons

एष्वेवतैलंसंसिद्धंनस्याभ्यङ्गेषुपूजितम्।।
एतानेवामयान्हन्तियेचदुष्टव्रणानृणाम्।।६७।।

The medicated oil cooked with the identical herbs is alleged to be the perfect one for utilization as nasal drops and in addition for anointing / massaging. This oil cures all of the illnesses talked about above. It additionally cures dusta vrana – unhealthy / septic ulcers.

द्रवन्तींत्रिवृतांदन्तींनीलींश्यामांतथैवच।।
सप्तलांशङ्खिनीचैवदग्ध्वामूत्रेणगालयेत्।।६८।।
दद्याच्चत्रिफलाक्वाथमेषक्षारस्तुसाधितः।।
अधोगच्छतिपीतस्तुपूर्वैश्चाप्याशिषःसमाः।।६९।।

Ash of the beneath talked about elements must be obtained by burning them –

–        Dravañtī,

–        Trivrt,

–        Dañtī,

–        Nīlī,

–        Syāmā,

–        Saptalā and

–        Sañkhinī

This ash is added with the urine of cows and Triphala decoction. All these are cooked collectively in order to organize their ksara (alkali).

This ksara produces purgation when consumed. It’s related in properties as these talked about earlier.

इतिसुश्रुतसंहितायांचिकित्सास्थानेवृद्ध्युपदंशश्लीपदचिकित्सितंनामैकोन– विंशोऽध्यायः।।१९।।

Thus ends the nineteenth chapter by title Vrddhyupadamśa-Slīpada

Cikistita in Cikitsā Sthāna of Suśruta Samhita.