The thirteenth chapter of Uttaratantra of Sushruta Samhita is called as Lekhya Roga Pratisedha Adhyaya. This chapter offers with the remedy of Ailments Requiring Scarping.
अथातो रक्ताभिष्यन्दप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We are going to now expound the remedy of Lekhya roga – ailments requiring scraping – scarification; as revealed by the venerable Dhanvantari.
Lekhana Vidhi – Process of scraping
नव येऽभिहिता लेख्याः सामान्यस्तेष्वयं विधिः |
स्निग्धवान्तविरिक्तस्य निवातातपसद्मनि ||३||
(आप्तैर्दृढं गृहीतस्य वेश्मन्युत्तानशायिनः) |
सुखोदकप्रतप्तेन वाससा सुसमाहितः |
स्वेदयेद्वर्त्म निर्भुज्य वामाङ्गुष्ठाङ्गुलिस्थितम् ||४||
अङ्गुल्यङ्गुष्ठकाभ्यां तु नि र्भुग्नं वर्त्म यत्नतः |
प्लोतान्तराभ्यां न यथा चलति स्रंसतेऽपि वा ||५||
ततः प्रमृज्य प्लोतेन वर्त्म शस्त्रपदाङ्कितम् |
लिखेच्छस्त्रेण पत्रैर्वा, ततो रक्ते स्थिते पुनः ||६||
स्विन्नं मनोह्वाकासीसव्योषार्द्राञ्जनसैन्धवैः |
श्लक्ष्णपिष्टैः समाक्षीकैः प्रतिसार्योष्णवारिणा ||७||
प्रक्षाल्य हविषा सिक्तं व्रणवत् समुपाचरेत् |
स्वेदावपीडप्रभृतींस्त्र्यहादूर्ध्वं प्रयोजयेत् ||८||
व्यासतस्ते समुद्दिष्टं विधानं लेख्यकर्मणि |
There are in whole 9 ailments through which Lekhana – scraping has been indicated as a predominant remedy method. Beneath defined is the frequent process of Lekhana which needs to be adopted in treating all these 9 situations.
Preparatory purification – Firstly the affected person ought to have undergone purification therapies, together with snehana, swedana, vamana and virecana.
Preparatory measures
The one that has been thus purified is introduced right into a room which is properly shielded from heavy breeze and daylight.
He ought to then be requested to lie on a cot after having handed on the directions to be adopted through the process of Lekhana. The affected person needs to be properly knowledgeable about what she or he is present process. The affected person ought to lie in supine place, conserving his face upwards.
Sturdy and devoted attendants ought to now maintain the affected person tightly.
The attention through which Lekhana Karma is to be performed needs to be completely washed. Later, the attention is given fomentation with a sterile fabric dipped in comfortably heat water.
Positioning the affected person and conducting the process
Now the doctor ought to maintain the eyelid with the assistance of folds of sterile fabric, held firmly by the thumb and fingers of his left-hand, taking care that the lid is in place and it neither strikes nor slips away from the maintain.
The doctor ought to now elevate and evert the eyelid and gently therapeutic massage it with a sterile cotton swab.
Subsequent, he ought to mark the realm of the eyelid to be scraped by a pointy instrument.
Later, the doctor ought to conduct the Lekhana Karma and scrap the eyelid and the area chosen for scraping with both a pointy instrument or a tough leaf in such a manner that there might be no bleeding.
The lid shall be as soon as once more subjected to swedana – fomentation, after the bleeding has stopped. Later, the lid needs to be smeared with medicinal paste.
Paste for smearing – Beneath talked about components shall be macerated properly, combined with honey and gently utilized on the eyelid –
– Manohva
– Kasisa
– Vyosa
– Ardra
– Anjana (Rasanjana) and
– Saindhava Lavana
Observe up measures
The lids needs to be washed with heat water. Ghee needs to be utilized and the eyelid needs to be handled on the strains of treating a wound.
Swedana – fomentation, Avapida – nasal drops and so on ought to solely be performed after three days of Lekhana.
Thus, the detailed process of lekhana karma which is frequent for all lekhana sadhya vyadhis has been defined.
Samyak lekhana – options of correct scraping
असृगास्रावरहितं कण्डूशोफविवर्जितम् ||९||
समं नखनिभं वर्त्म लिखितं सम्यगिष्यते |
Beneath talked about are the indicators of lekhana karma correctly performed –
– stoppage of bleeding after lekhana has been accomplished
– absence of itching
– absence of swelling
– even – absence of depressions or elevations after the process
– eyelid resembling the color of nail
Durlekhana – improper / insufficient scraping
रक्तमक्षि स्रवेत् स्कन्नं क्षताच्छस्त्रकृताद्ध्रुवम् ||१०||
रागशोफपरिस्रावास्तिमिरं व्याध्यनिर्जयः |
वर्त्म श्यावं गुरु स्तब्धं कण्डूहर्षोपदेहवत् ||११||
नेत्रपाकमुदीर्णं वा कुर्वीताप्रतिकारिणः |
एतद्दुर्लिखितं ज्ञेयं स्नेहयित्वा पुनार्लिखेत् ||१२||
Beneath talked about are the options / indicators of improperly or inadequately performed lekhana karma – scraping, –
– discharge of clotted blood from the location of scraping, for extended time
– redness of the lid
– swelling of the lid
– exudation from the attention
– blindness
– illness persisting (not subsided even after scraping)
– bluish discolouration of eyelid
– lids are heavy and static
– itching
– tingling sensation
– thickness of the lid
– irritation of the attention will increase, if it isn’t handled rapidly
Treatment – In such situations, the eyelid needs to be anointed and the lekhana karma performed as soon as once more.
व्यावर्तते यदा वर्त्म पक्ष्म चापि विमुह्यति |
स्यात् सरुक् स्रावबहुलं तदतिस्रावितं विदुः ||१३||
स्नेहस्वेदादिरिष्टः स्यात् क्रमस्तत्रानिलापहः |
Beneath talked about are the options / indicators of excessively performed lekhana karma / scraping –
– eversion of eyelid for extended time
– bending of eyelashes
– extra of ache in eyelids
– extra of exudation / bleeding
Treatment – In such a situation, snehana, swedana and all different remedies and measures helpful for mitigating vata needs to be carried out.
Lekhya roga – ailments requiring scraping
वर्त्मावबन्धं क्लिष्टं च बहलं यच्च कीर्तितम् ||१४||
पोथकीश्चाप्यवलिखेत् प्रच्छयित्वाऽग्रतः शनैः |
समं लिखेत्तु मेधावी श्यावकर्दमवर्त्मनी ||१५||
कुम्भीकिनीं शर्करां च तथैवोत्सङ्गिनीमपि |
कल्पयित्वा तु शस्त्रेण लिखेत् पश्चादतन्द्रितः ||१६||
भवेयुर्वर्त्मसु च याः पिडकाः कठिना भृशम् |
ह्रस्वास्ताम्राश्च ताः पक्वा भिन्द्याद्भिन्ना लिखेदपि ||१७||
Within the under talked about situations, gentle and delicate lekhana karma needs to be performed utilizing a pointy instrument or a tough leaf –
– Vartmavabandha
– Klista Vartma
– Bahala Vartma and
– Pothaki
Correct and enough lekhana – scraping needs to be performed by a clever doctor within the under talked about situations –
– Syava Vartma
– Kardama Vartma
The eyelid needs to be first incised with a pointy instrument after which scraped correctly with none lethargy within the under talked about situations –
– Kumbhika Vartma
– Vartma Sarkara
– Utsanga Vartma
The pidakas i.e. eruptions or cystic swelling ought to first be reduce open by puncturing them after which subjected to lekhana, when they’re very exhausting, small, coppery in color and ripened.
तरुणीश्चाल्पसंरम्भा पिडका बाह्यवर्त्मजाः |
विदित्वैताः प्रशमयेत् स्वेदालेपनशोधनैः ||१८||
Swedana – fomentation, Lepana – utility of medicinal pastes and Shodana – purificatory therapies shall be performed for treating the pidakas – eruptions, within the under talked about situations –
– when they’re nascent / newly showing
– current with much less swelling
– situated externally on the eyelid
इति सुशुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे लेख्यरोगप्रतिषेधो नाम त्रयोदशोऽध्यायः ||१३||
Thus ends the thirteenth chapter by the title Lekhyaroga Pratisedha in Uttara Sthana of Susruta samhita.
