Sushruta Samhita Chikitsasthana Chapter 18 Granthi – Apaci – Arbuda

ग्रन्थिष्वथामेषुभिषग्विदध्याच्छोफक्रियांविस्तरशोविधिज्ञः।।
रक्षेद्वलंचापिनरस्यनित्यंतद्रक्षितंव्याधिबलंनिहन्ति।।३।।

Ama avastha is a stage of Granthi – benign tumours during which the tumours are unripe. In these circumstances, the therapies indicated for sopha (inflammatory swelling) needs to be adopted intimately by the doctor, in response to process. Care needs to be taken to guard the energy of the affected person continuously. The protected energy in flip controls the energy of the illness.

Vātaja grañthi cikitsā 

तैलंपिबेत्सर्पिरथोद्वयंवादत्त्वावसांवात्रिवृतंविदध्यात्।।
अपेहिवातादशमूलसिद्धंवैद्यश्चतुःस्नेहमथोद्वयंवा।।४।।

Vataja Granthi is a granthi which is produced by Vata. These having Vataja Granthi ought to drink one of many under talked about –

–        oil individually or

–        ghee individually or

–        oil and ghee collectively or

–        a combination of three fat i.e. oil, ghee and muscle fats

The doctor could administer a combination of all 4 snehas (fat) or any two snehas together with Dasamula decoction, for mitigating Vata.

हिंस्राऽथरोहिण्यमृताऽथभार्गीश्योनाकबिल्वागुरुकृष्णगन्धाः।।
गोजीचपिष्टासहतालपत्र्याग्रन्थौविधेयोऽनिलजेप्रलेपः।।५।।
स्वेदोपनाहान्विविधांश्चकुर्यात्तथाप्रसिद्धानपरांश्चलेपान्।।
विदार्यवापक्वमपोह्यपूयंप्रक्षाल्यबिल्वार्कनरेन्द्रतोयैः।।६।।
तिलैःसपञ्चाङ्गलपत्रमित्रैःसंशोधयेत्सैन्धवसंप्रयुक्तः।।
शुद्धंव्रणंवाऽप्युपरोपयेत्तुतैलेनरास्नासरलान्वितेन।।७।।
विडङ्गयष्टीमधुकामृताभिःसिद्धेनवाक्षीरसमन्वितेन।।

Paste of the under talked about components needs to be ready and utilized on the granthi brought on by vata –

–        Himsra,

–        Rohini (katukarohini),

–        Amrta,

–        Bharngi,

–        Syonāka,

–        Bilva,

–        Aguru,

–        Krsna gandha,

–        Goji (gojihvā) and

–        Tālapatra (musali)

The doctor ought to apply completely different sorts of sweda – sudation, upanaha – poultice and lepa – pastes that are well-liked or in any other case.

As soon as the granthi turns into ripe, it needs to be lower open and the pus inside it shall be eliminated. Now, the ulcer is washed with decoction of Bilva, Arka and Narendra (Aragwadha). Subsequent, the ulcer is purified by filling it with paste of tila, leaves of Pancangula and Saindhava.

Following this the wound needs to be made to heal by making use of the oil ready with the under talked about components –

–        Rasna,

–        Sarala,

–        Vidanga,

–        Yastimadhuka,

–        Amrta and

–        Ksira – milk

Pittaja grañthi cikitsa

जलौकसःपित्तकृतेहितास्तुक्षीरोदकाभ्यांपरिषेचनंच।।८।।
काकोलिवर्गस्यचशीतलानिपिबेत्कषायाणिसशर्कराणि।।
द्राक्षारसेनेक्षुरसेनवाऽपिचूर्णंपिबेच्चापिहरीतकीनाम्।।९।।
मधूकजम्ब्वर्जुनवेतसानांत्वग्भिःप्रदेहानवचारयेत।। 
सशर्करैर्वातृणशून्यकन्दैदिह्यादभीक्ष्णंमुचुलुन्दजैर्वा।।१०।।
विदार्यवापक्वमपोह्यपूर्यधावेत्कषायेणवनस्पतीनाम्।।
तिलैःसयष्टीमधुकैर्विशोध्यसर्पिःप्रयोज्यंमधुरैर्विपक्वम्।।११।।

In Pittaja Granthi i.e. granthi produced by pitta, bloodletting needs to be executed utilizing leeches.

For laundry the granthi, a combination of milk and water is helpful.

For ingesting functions – decoction ready utilizing the herbs belonging to Kakolyadi Varga / Gana added with sugar and cooled is helpful.

Haritaki – Terminalia chebula powder needs to be consumed together with juice of draksa – raisins or iksu – sugarcane.

Heat poultice ready utilizing the under talked about components needs to be utilized over the granthi after mixing sugar with it –

–        barks of madhuka, jambu, arjuna and vetasa or

–        tubers of trnasanya (ketaki) or muculunda (kantakimadana)

Under talked about therapies needs to be executed for the ripened granthi –

–        it needs to be lower open and the pus drained,

–        the wound is then washed with decoction of bark of vanaspatis (Pancavalkala bushes)

–        the wound / ulcer is then purified by filling paste of Tila and Yastimadhuka in it and

–        its therapeutic is completed by utilizing ghee boiled and ready with the herbs belonging to Madhura varga – candy group of herbs

Kaphaja granthi chikitsa 

हृतेषुदोषेषुयथानुपूर्व्याग्रन्थौभिषक्श्लेष्मसमुत्थितेतु।।
स्विन्नस्यविम्लापनमेवकुर्यादङ्गुष्ठलोहोपलवेणुदण्डैः।।१२।।
विकङ्कतारवधकाकणन्तीकाकादनीतापसवक्षमूलैः।।
आलेपयेत्पिण्डफलाकभार्गीकरकालामदनैधविद्वान्।।१३।।
अमर्मजातशमयप्रयान्तमपक्वमेवापहरेविदार्थ।।
दहेत्स्थितेचासजिसिखकर्मासयक्षतोक्तंचविधिविदध्यात्।।१४।।

In kaphaja granthi i.e. tumour produced by kapha, elimination of morbid doshas needs to be executed within the standard method as has been described earlier.

Following this, svedana – fomentation and vimplapana – kneading with thumb, iron rod, stone or bamboo needs to be executed to the granthi.

After this, paste of the under talked about components needs to be utilized on it –

–        Vikankata,

–        Aragvadha,

–        Kakananti,

–        Kakadani,

–        Bark of Täpasavrksa,

–        Pindaphala (tiktaalübü),

–        Arka, Bhärñgi, Karanja,

–        Kälä and

–        Madana

The granthi which isn’t current on marma sthana i.e. deadly spot or organ and that which isn’t going to turn out to be ripe i.e. that which doesn’t suppurate needs to be excised in its unripe stage itself and eliminated.

Now, this website needs to be burnt by fireplace (cauterization). After the stoppage of bleeding, remedy advocated for recent wounds needs to be adopted by the sensible and profitable doctor.

यामांसकन्धःकठिनाबहत्यस्तास्वेषयोज्यक्षविधिविधिज्ञैः।।
शस्त्रेणवाऽऽपाट्यसुपक्वमाशुप्रक्षालयेत्पथ्यतमैःकषायैः।।१५।।
संशोधनैस्तंचविशोधयेत्तुक्षारोत्तरैःक्षौद्रगुडप्रगावैः।।
शुद्धेचतैलंत्ववचारणीयविडङ्गपाठारजनीविपक्वम्।।१६।।

The physicians conversant with remedy procedures ought to comply with and conduct the identical therapies for the muscular swellings that are onerous and massive.

Alternatively, ripe granthi could also be excised utilizing sharp devices and later washed with decoction of acceptable herbs.

The granthi needs to be later cleansed with a combination of alkalies, honey and jaggery.

After cleansing, oil processed and ready with Vidanga, Patha and Rajani shall be used over them for therapeutic.

Medograñthi chikitsa – remedy of fatty tumor

मेदःसमुत्थेतिलकल्कदिग्धंदत्त्वोपरिष्टादिद्वगुणंपटान्तम्।।
हुताशतप्तेनमुहुःप्रमृज्याल्लोहेनधीमानदहन्हिताय।।१७।।
प्रलिप्यदावीमथलाक्षयावाप्रतप्तयास्वेदनमस्यकार्यम्।।
निपात्यवाशस्त्रमपोह्यमेदोदहेत्सुपक्वंत्वथवाविदार्य।।१८।।
प्रक्षाल्यमूत्रेणतिलैःसुपिष्टैःसुवर्चिकाद्यैर्हरितालमित्रैः।।
ससैन्धवैःक्षौद्रघृतप्रगाढेःक्षारोत्तरैरेनमभिप्रशोध्य।।१९।।
तैलंविदधादिद्वकरञ्जगुञ्जावंशावलेखेङ्गुदमूत्रसिद्धम्।।

Paste of Tila – sesame needs to be saved in between two layers of fabric. This needs to be used to provide a coating to the Medoja Granthi i.e. tumour produced by morbid fats which is in its unripe stage (ama avastha), as a primary step in its remedy.

Subsequent, the granthi needs to be burnt (cauterized) with a heated iron rod. Alternatively a picket stick, the entrance tip of which is capped with laksa (lac) can be utilized.

Or, the fats of the medoja granthi needs to be eliminated by scraping it with a pointy instrument after which burnt.

After this, the burnt space needs to be washed. For this function, gomutra – urine of cows needs to be used.

Following this, the great paste of the under talked about components needs to be put into the granthi in order to cleanse it –

–        Tila – sesame,

–        Suvarcika,

–        Haritala and so forth.

This mix needs to be added with extra honey and ghee earlier than placing it into the granthi.

In line with Acharya Dalhana, Yavaksara, Saindhava and Haritala added with extra honey and ghee needs to be used for filling into the granthi.

For therapeutic the wound of granthi, oil ready with the under talked about components needs to be used –

–        two sorts of Karanja,

–        Gunja,

–        Bark of Vamsa,

–        Inguda and

–        Gomutra

2. Apacī cikitsā – remedy of cervical lymphadenitis

जीमूतकैःकोशवतीफलैश्चदन्तीद्रवन्तीत्रिवृतासुचैव।।२०।।
सर्पिःकृतंहन्त्यपचीप्रवृद्धांद्विधाप्रवृत्तंतदुदारवीर्यम्।।
निर्गुण्डिजातीबरिहिष्ठयुक्तंजीमूतकंमाक्षिकसैन्धवाढ्यम्।।२१।।
अभिप्रतप्तंवमनंप्रगाढंदुष्टापचीषूत्तममादिशन्ति।।
कैडर्यबिम्बीकरवीरसिद्धंतैलंहितंमूर्धविरेचनंच।।२२।।
शाखोटकस्यस्वरसेनसिद्धंतैलंहितंनस्यविरेचनेषु।।
मधूकसारश्चहितोऽवपीडेफलानिशिग्रोःखरमञ्जरेर्वा।।२३।।

Medicated ghee needs to be ready with the under talked about components –

–        Jimutaka,

–        Kosavati phala,

–        Danti,

–        Dravanti and

–        Trivrit

Advantages – Being a extremely potent medication, this ghee removes the morbid doshas in each methods i.e. by emesis and purgation. It additionally cures Apaci together with the situation which has tremendously elevated (extreme types of apache).

Different recipes – Juice needs to be ready from Nirgundi, Jati and Barihista (Valaka). It needs to be added with extra honey and saindhava – rock salt. This needs to be made comfortably heat. When consumed, it produces vomiting. Due to this fact it’s thought of as the perfect recipe for Dusta Apaci (suppurative lymphadenitis).

Medicated oil is ready with kaidarya, bimbī and karavīra. This oil is helpful for producing purgation of the top.

Likewise, oil ready with Sakhotaka juice is right as purgative and may also be used as nasal drops.

Additionally, the oil ready with Madhūkasāra, fruits of Sigru, and Kharamañjari (apāmārga) is finest for avapīda nasya (nasal drops).

ग्रन्थीनमर्मप्रभवानपक्वानुद्धृत्यचाग्निंविदधीतपश्चात्।।
क्षारेणवाऽपिप्रतिसारयेत्तुसंलिख्यशस्त्रेणयथोपदेशम्।।२४।।

Therapy for granthis which aren’t developed on marmas – very important spots and people that are in unripe stage embody –

–        excision (reducing and eradicating them) and

–        burning the world with fireplace (cauterization with heated iron rod) or

–        smearing of caustic alkalies after scraping the world with sharp devices as described earlier

पार्ष्णिप्रतिद्वेदशचाङ्गुलानिमित्वेन्द्रबस्तिपरिवय॑धीमान्।।
विदार्यमत्स्याण्डनिभानिवैद्योनिष्कृष्यजालान्यनलंविदध्यात्।।२५।।

The clever doctor, ought to conduct the under talked about procedures to remedy apaci (cervical lymphadenitis) –

–        firstly he ought to lower open the foreleg of the affected person of apaci, about twelve angula (24 cms) above the paarsni i.e. ankle / calcaneus, taking care to keep away from damage to indrabasti marma (deadly spot in the midst of calf muscle)

–        then he ought to pull out (take away) the community of nodules situated therein, resembling the shoal of fish eggs and

–        burn the world with fireplace (heated iron rod)

आगुल्फकर्णात्सुमितस्यजन्तोस्तस्याष्टभार्गखुडकाद्विभज्य।।
घोणर्जुवेधःसुरराजबस्तेहित्वाऽक्षिमात्रंत्वपरेवदन्ति।।२६।।

In line with the opinion of another students –

In sufferers of apaci, an space equal to at least one eighth of the size of foreleg, upwards from the ear like projections of ankle joints (parts of ankle joints projecting outwards and laterally – malleolus?) needs to be lower open.

Whereas reducing, Suraraja Basti (Indrabasti) Marma situated within the leg (calf muscle) needs to be prevented (not injured).

The incision needs to be straight just like the ridge of the nostril. It needs to be of the dimensions (width) of the attention. Following this, the community of fatty nodes needs to be eliminated and the world is burnt with fireplace.

मणिबन्धोपरिष्टाद्वाकुर्याद्रखात्रयंभिषक्।।
अङ्गुल्यन्तरितंसम्यगपचीनांनिवृत्तये।।२७।।

Three traces of incisions needs to be made above the wrist joint. There needs to be an area of 1 angula (2 cm) between these traces. This might remedy apaci.

चूर्णस्यकालेप्रचलाककाकगोधाहिकूर्मप्रभवांमसींतु।।
दद्याच्चतैलेनसहेङ्गुदीनांयद्वक्ष्यतेश्लीपदिनांचतैलम्।।२८।।
विरेचनंधूममुपाददीतभवेच्चनित्यंयवमुद्गभोजी।।

Under talked about therapies needs to be executed through the interval of therapeutic,

Under talked about components combined in Ingudi Taila needs to be utilized –

–        ash of feathers of peacock and cock

–        pores and skin of iguana, snake and tortoise

Alternatively, medicated oils indicated for slipada (filariasis) could also be utilized.

Every single day, Virecana Dhuma (inhalation of head purging medicated smoke) needs to be given.

Meals ready with yava – barley and mudga – inexperienced gram needs to be consumed by the affected person.

2. 
   

     Arbuda Cikitsā – remedy of malignant tumour / carcinoma / most cancers