The 14th chapter of Uttaratantra of Sushruta Samhita is known as as Bhedya Roga Pratisedha Adhyaya. This chapter offers with the therapy of Illnesses Requiring Puncturing.

अथातो भेद्यरोगप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We’ll now expound the therapy of Bhedya roga – ailments requiring incising / slicing open; as revealed by the venerable Dhanvantari.

Bisa Granthi Cikitsa

स्वेदयित्वा बिसग्रन्थिं छिद्राण्यस्य निराशयम् |
पक्वं भित्त्वा तु शस्त्रेण सैन्धवेनावचूर्णयेत् ||३||
कासीसमागधीपुष्पनेपाल्येलायुतेन तु |
ततः क्षौद्रघृतं दत्त्वा सम्यग्बन्धमथाचरेत् ||४||

Under talked about are the steps concerned in treating Bisa Granthi –

–        Firstly, the cystic swelling in Bisa Granthi must be given with swedana – fomentation.

–        Utilizing a shastra – sharp instrument the cavity of ripened swelling must be reduce open. After opening it, its contents like pus and so forth must be cleared out fully with out leaving any traces. (Solely ripened swelling must be reduce open)

–        The cavity ought to now be crammed with clean powder ready with Saindhava, Kasisa, Magadhi, Puspa (Puspanjana), Nepali (Manasila) and Ela.

–        The lesion is now bathed with a mix of honey and ghee after which bandaged correctly.

Lagana Cikitsa

रोचनाक्षारतुत्थानि पिप्पल्यः क्षौद्रमेव च |
प्रतिसारणमेकैकं भिन्ने लगण इष्यते ||५||
महत्यपि च युञ्जीत क्षाराग्नी विधिकोविदः |

Therapy of small sized Lagana – If the dimensions of Lagana is small it must be subjected to bhedana i.e. reduce open. Later, it must be utilized with powder of the under talked about individually, added with honey –

–        Gorocana

–        Ksara (Yavaksara)

–        Thutha

–        Pippali

Therapy of huge sized Lagana – If the dimensions of Lagana is large, Ksara – caustic alkali or Agni – hearth cautery must be utilized on it by a talented doctor / surgeon nicely versed with the process.

Anjananamika Cikitsa

Therapy of Anjananamika which has received open by itself

स्विन्नां भिन्नां विनिष्पीड्य भिषगञ्जननामिकाम् ||६||
शिलैलानतसिन्धूत्थैः सक्षौद्रैः प्रतिसारयेत् |

Swedana – Fomentation ought to firstly be given to Anjananamika which has opened / burst open by itself.

Nispidana – The swelling must be squeezed nicely.

Pratisarana – Powder of Manassila, Ela, Nata and Saindhava combined with honey must be utilized over the anjananamika which has been given swedana and squeezed completely.

Therapy of Anjananamika which has not received open by itself

रसाञ्जनमधुभ्यां तु भित्त्वा वा शस्त्रकर्मवित् ||७||
प्रतिसार्याञ्जनैर्युञ्ज्यादुष्णैर्दीपशिखोद्भवैः |

Bhedana – If Anjananamika has not opened or burst open by itself, it must be subjected to bhedana – i.e. it must be reduce open by a doctor / surgeon who completely is aware of the surgical procedures.

Software of Rasanjana – After Bhedana, the surgeon ought to apply Rasanjana combined with honey over it.

Software of Anjana – Later, collyrium ready from dipashika i.e. lamp black must be utilized on it.

Krimigranthi cikitsa

सम्यक्स्विन्ने कृमिग्रन्थौ भिन्ने स्यात् प्रतिसारणम् ||८||
त्रिफलातुत्थकासीससैन्धवैश्च रसक्रिया |

Swedana – Krimigranthi must be correctly fomented first.

Bhedana – Now, the cyst which has been fomented must be reduce open by a talented surgeon.

Rasakriya – Subsequent, thick decoction ready with Triphala, Tuttha, Kasisa and Saindhava must be utilized over it.

Upanaha Cikitsa

भित्त्वोपनाहं कफजं पिप्पलीमधुसैन्धवैः ||९||
लेखयेन्मण्डलाग्रेण समन्तात् प्रच्छयेदपि |

Bhedana – Upanaha which is produced by morbid Kapha must be reduce open by a clever surgeon.

Lepana – Paste of honey and Saindhava must be utilized over it.

Lekhana – Subsequent, Upanaha must be correctly scraped throughout with the assistance of Mandalagra Sastra.

Therapy rules of all of the above stated ailments

संस्नेह्य पत्रभङ्गैश्च स्वेदयित्वा यथासुखम् ||१०||
आपाकाद्विधिनोक्तेन पञ्चमेद्यानुपाचरेत् |
सर्वेष्वेतेषु विहितं विधानं स्नेहपूर्वकम् |
सम्पक्वे प्रयतो भूत्वा कुर्वीत व्रणरोपणम् ||११||

Snehana and Swedana – In all of the above stated Bhedya Rogas i.e. ailments match to be handled by incising or slicing open ought to first be anointed. Following oleation, sudation must be comfortably given with patra bhanga – chips of dried leaves.

Pacana – all strategies to trigger ripening of the swellings must be adopted till they get fully ripened.

Snehapurvaka vidhanam – Therapies preceded by oleation must be accomplished procedurally in all these ailments.

Vranaropanam – After they get ripened, they need to be reduce open and cleansed. Following this, the procedures of vrana ropana i.e. therapeutic the wound are adopted.

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे भेद्यरोगप्रतिषेधो नाम चतुर्दशोऽध्यायः ||१४||

Thus ends the fourteenth chapter by title ‘Bhedya roga Pratisedha’ in Uttara sthana of Susruta Samhita.