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Vartmarogapratishedam (Therapy of illnesses of the eyelids)


The ninth chapter of Uttara Sthanam of Ashtanga Hridayam is called as Vartma Roga Pratisedha adhyāyaṃ. This chapter offers with the reason of ‘remedy of illnesses of the eyelids.’

The subjects coated on this chapter embody –

Vartmarogapratishedam (Therapy of illnesses of the eyelids)
  • Therapy of Kricchronmila
  • Therapy of Kumbhika Vartma
  • Vartma Lekhana Vidhi – process of scraping the lids
  • Indicators of correct and extreme scraping of eyelids
  • Lodhra Putapakva Rasa
  • Bhedana
  • Lekhana and Bhedana
  • Therapy of Pittotklishta and Raktotklishta Vartma Roga
  • Therapy of Paksmasadana
  • Therapy of Paksmasata
  • Therapy of Pothaki
  • Saindhavadi Pratisarana in Kaphotklishta Vartma
  • Therapy of Lagana
  • Therapy of Anjananamika
  • Therapy of Kukuna
  • Recipes for emesis
  • Vartis for Kukunaka and Pothaki
  • Surgical course of in Paksmarodha
  • Dahakarma

Pledge by the writer(s)

अथातो वर्त्मरोगप्रतिषेधं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
athāto vartmaroga pratiṣedhaṃ vyākhyāsyāma: – After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘remedy of the illnesses of the eyelids.
iti ha smāhu: ātreyādayo maharṣaya: – Thus say (pledge) Atreya and different sages.

Therapy of Kricchronmila

कृच्छ्रोन्मीले पुराणाज्यं द्राक्षाकल्काम्बुसाधितम् ।
ससितं योजयेत्स्निग्धं नस्यधूमाञ्जनादि च ॥१॥
For Krchronmila, outdated ghee, paste of Vitis vinifera, boiled with decoction of the identical added with sugar ought to be made use of for lubricating nasal drops, fumigation, eye-salve and many others.

Therapy of Kumbhika Vartma

कुम्भीकावर्त्मलिखितं सैन्धवप्रतिसारितम् ।
यष्टीधात्रीपटोलीनां क्वाथेन परिषेचयेत् ॥ २ ॥
Kumbhika Vartma ought to be scraped, and rock salt ought to be sprinkled and decoction of yaṣṭī – Gylcyrrhiza glabra, dhātrī – Emblica officinalis, paṭolīnāṃ – Trichosanthes dioica poured over it.

Vartma Lekhana Vidhi: Process of scraping the lids

निवातेऽधिष्ठितस्याप्तैः शुद्धस्योत्तानशायिनः ।
बहिः कोष्णाम्बुतप्तेन स्वेदितं वर्त्म वाससा॥३॥
निर्भुज्य वस्त्रान्तरितं वामाङ्गुष्ठाङ्गुलीघृतम् ।
न स्रंसते चलति वा वर्त्मैवं सर्वतस्ततः ॥४॥
मण्डलाग्रेण तत्तिर्यक् कृत्वा शस्त्रपदाङ्कितम् ।
लिखेत्तेनैव पत्रैर्वा शाकशेफालिकादिजैः ॥५॥
फेनेन तोयराशेर्वा पिचुना प्रमृजन्नसृक् ।
स्थिते रक्ते सुलिखितं सक्षौद्रैः प्रतिसारयेत् ॥६॥
यथास्वमुक्तैरनु च प्रक्षाल्योष्णेन वारिणा ।
घृतेन सिक्तमभ्यक्तं बध्नीयान्मधुसर्पिषा ॥७॥
ऊर्ध्वाधः कर्णयोर्दत्त्वा पिण्डीं च यवसक्तुभिः ।
द्वितीयेऽहनि मुक्तस्य परिषेकं यथायथम् ॥८॥
कुर्याच्चतुर्थे नस्यादीन् मुञ्चेदेवाह्नि पञ्चमे ।
The affected person who has been purified (by emesis, purgation and many others.), is made to lie in a room devoid of breeze, along with his face up and surrounded by his well-wishers. The skin of the lids is then given fomentation with a material dipped in heat water, lids held twisted by the left thumb and left fingers wrapped with material in such a manner that the lid neither slips away nor makes any motion on all sides Then with the Mandalagra Sastra (Lancet), an incision ought to be made horizontally, after which scraping performed by its personal edge, or with leaves of Nyctanthes arbour-tristis and many others. (that are very tough); the exuding blood being washed by both Phena (Samudra Phena / cuttlefish) water or moist material. After the bleeding stops, the scraped place ought to be smeared with the powder of rock salt blended with honey as described earlier; after a while it (lid) ought to be washed with heat water, bathed with ghee and massaged; a bolus of flour of Hordeum vulgare blended with honey and ghee, is inserted inside and the lids bandaged above and under the ears. On the second day, it ought to be eliminated and bathing the attention performed as described earlier. On the fourth day, nasal medicine and many others. ought to be performed and from the fifth day, the bandage eliminated.

Indicators of correct and extreme scraping of eyelids

समं नखनिभं शोफकण्डूघर्षाद्यपीडितम् ॥९॥
विद्यात्सुलिखितं वर्त्म लिखेद्भूयो विपर्यये ।
रुक्पक्ष्मवर्त्मसदनस्रंसनान्यतिलेखनात् ॥१०॥
स्नेहस्वेदादिकस्तस्मिन्निष्टो वातहरः क्रमः ।
The lid turning into even, resembling the nail in form, relieved of swelling, itching, friction and such different troubles ought to be thought of as correctly scared, and in case of reverse signs it ought to be scraped once more. Ache, weak spot of the hairs and lids and dropping, end result from extra scraping for that, oleation, sudation and many others. and strategies of mitigating Vata are desired.

Lodhra Putapaka Rasa

अभ्यज्य नवनीतेन श्वेतलोध्रं प्रलेपयेत् ॥११॥
एरण्डमूलकल्केन पुटपाके पचेत्ततः ।
स्विन्नं प्रक्षालितं शुष्कं चूर्णितं पोटलीकृतम्॥१२॥
स्त्रियाः क्षीरे छगल्या वा मृदितं नेत्रसेचनम् ।
A chunk of Symplocos racemosus smeared with butter is given a overlaying with the paste of roots of Ricinus communis, and cooked within the Putapaka technique. After it will get cooked, it’s washed, dried, powdered and macerated both with breast milk or goat’s milk, made right into a ball (held inside material) and squeezed (in order that droops of juice fall into the attention).

Lodhra Putapaka Rasa

शालितण्डुलकल्केन लिप्तं तद्वत्परिष्कृतम्॥१३॥
कुर्यान्नेत्रेऽतिलिखिते मृदितं दधिमस्तुना ।
केवलेनापि वा सेकं मस्तुना जाङ्गलाशिनः ॥१४॥
The identical (svetarodhra) positioned inside paste of flour of Sali and cooked in the identical manner, macerated with water of curds/ whey ought to be squeezed to the lid which has been over scraped; or eye could also be bathed with whey or alone for the one who consumes meat of animals of desert-like lands.

Bhedana

पिटिका व्रीहिवक्त्रेण भित्त्वा तु कठिनोन्नताः ।
निष्पीडयेदनु विधिः परिशेषस्तु पूर्ववत् ॥१५॥
Arduous and elevated eruptions ought to be pricked with Vrihimukha Shastra (Trocar) and their contents squeezed out, afterwards Parisheka (bathing the attention) is finished as described earlier.

Lekhana and Bhedana

लेखने भेदने चायं क्रमः सर्वत्र वर्त्मनि ।
That is the process of scraping and pricking, Puncturing in all of the illnesses of the eyelids.

Therapy of Pittotklishta and Raktotklishta Vartma Roga

पित्तास्रोत्क्लिष्टयोः स्वादुस्कन्धसिद्धेन सर्पिषा ॥१६॥
सिराविमोक्षः स्निग्धस्य त्रिवृच्छ्रेष्ठं विरेचनम् ।
लिखिते स्रुतरक्ते च वर्त्मनि क्षालनं हितम् ॥१७॥यष्टीकषायः सेकस्तु क्षीरं चन्दनसाधितम् ।
In pittotklista and Raktotklista, venesection ought to be performed after making the affected person oleated with ghee ready with herbs of candy group (chapter 10 of Sutrasthana) adopted by purgation with Operculina turpethum. The lid is then scraped and bleeding stopped; it’s useful to scrub the lid with the decoction of Glycyrrhiza glabra and bathe it by pouring milk boiled with
Santalum album.

Therapy of Pakshmasadana

पक्ष्मणां सदने सूच्या रोमकूपान् विकुट्टयेत्॥१८॥ग्राहयेद्वा जलौकोभिः पयसेक्षुरसेन वा ।
वमनं नावनं सर्पिः शृतं मधुरशीतलैः ॥ १९ ॥
In Paksmasadana, the hair follicles ought to be pricked effectively with the needle or seized by leeches, emesis remedy utilizing milk and sugarcane juice and nasal medicine with ghee processed with herbs that are candy and chilly in efficiency ought to be performed.

Therapy of Pakshmasata

सञ्चूर्ण्य पुष्पकासीसं भावयेत्सुरसारसैः ।
ताम्रे दशाहं परमं पक्ष्मशाते तदञ्जनम् ॥२०॥
Puspakasisa effectively powdered is soaked within the juice of Ocimum sanctum stored in a copper vessel, after ten days this if used as a colyrium is finest in Paksmasata.

Therapy of Pothaki

पोथकीर्लिखिताः शुण्ठीसैन्धवप्रतिसारिताः ।
उष्णाम्बुक्षालिताः सिञ्चेत्खदिराढकिशिग्रुभिः ॥२१॥अप्सिद्धैर्द्विनिशाश्रेष्ठामधुकैर्वा समाक्षिकैः ।
Pothaki ought to be scared, smeared with Zingiber officinale and rock salt, washed with heat water, and sprinkled with water boiled with both khadira – Acacia catechu, āḍhaki – Cajanas cajana, śigrubhiḥ – Moringa oliefera or with the 2 Nisa (Haridra – Curcuma longa & Daruharidra – Berberis aristata), śreṣṭhā – Cynodon dactylon, madhukai – Glycyrrhiza glabra each blended with honey.

Saindhavadi Pratisarana in Kaphotklishta Vartma

कफोत्क्लिष्टे विलिखिते सक्षौद्रैः प्रतिसारणम्॥२२॥
सूक्ष्मैः सैन्धवकासीसमनोह्वाकणतार्क्ष्यजैः ।
वमनाञ्जननस्यादि सर्वं च कफजिद्धितम् ॥२३॥
In Kaphotklista after doing the scraping, good powder of rock salt, kāsīsa – ferrous sulphate, manohvā – realgar, kaṇa – Piper longum, tārkṣyajaiḥ – Emerald blended with honey ought to be utilized; emesis, making use of colyrium, nasal medicine and many others. and all therapies mitigating Kapha are useful

Therapy of Lagana

कर्तव्यं लगणेऽप्येतदशान्तावग्निना दहेत् ।
Even for Lagana the identical remedy ought to be performed; if it doesn’t subside then it ought to be burnt with hearth (cauterised).

Therapy of Anjananamika

स्विन्नां भित्त्वा विनिष्पीड्य भिषगञ्जननामिकाम् ।
शिलैलासैन्धवनतैः सक्षौद्रैः प्रतिसारयेत् ॥ २४१+(१) ॥
The doctor ought to apply fomentation to Utsanga and Anjanamika, prick it, take away its contents after which apply the powder of Asphaltum, Elettaria cardamomum, rock salt Valeriana wallicii added with honey

Therapy of Kukuna

कुकूणे खदिरश्रेष्ठानिम्बपत्रशृतं घृतम् ॥२४॥
पीत्वा धात्री वमेत्कृष्णायष्टीसर्षपसैन्धवैः ।
अभयापिप्पलीद्राक्षाक्वाथेनैनां विरेचयेत् ॥२५॥
मुस्ताद्विरजनीकृष्णाकल्केनालेपयेत्स्तनौ ।
धूपयेत्सर्षपैः साज्यैः शुद्धां क्वाथं च पाययेत् ॥२६॥
पटोलमुस्तमृद्वीकागुडूचीत्रिफलोद्भवम् ।
शिशोस्तु लिखितं वर्त्म स्रुतासृग्वाऽम्बुजन्मभिः ॥२७॥
धात्र्यश्मन्तकजम्बूत्थपत्रक्वाथेन सेचयेत् ।
In Kukunaka, the nursing mom ought to be made to eat medicated ghee ready with:
khadira – Acacia catechu,
śreṣṭhā – Cynodon dactylon
nimbapatra – Leaves of Azadirachta indica,
then emesis remedy administered utilizing Piper nigrum, yaṣṭī – Glycyrrhiza glabra, sarṣapa – Brassica juncea and rock salt and purgation remedy with the decoction of:
abhayā – Terminalia chebula,
pippalī – Piper longum
drākṣā – Vitis vinifera.
Her breasts ought to be smeared with the paste of mustā – Cyperus rotundus, the 2 rajani (Haridra – Curcuma longa & Daruharidra – Berberis aristata) kṛṣṇā – and Piper nigrum and uncovered to the fumes of sarṣapaiḥ – Brassica juncea blended with ghee, after purification she ought to be made to drink the decoction of ready from paṭola – Trichosanthes dioica, musta – Cyperus rotundus, mṛdvīkā – Vitis vinifera, guḍūcī – Tinospora cordifolia, triphala – and
Triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellerica & Amalaki – Emblica officinalis) The attention lid of the kid ought to be scrapped or blood taken out by making use of the leech; after it ought to be bathed with the decoction of dhātri – Emblica officinalis, aśmantaka – Ficus rumphii, jambūttha patra – leaves of Syzygium cumini.

Recipes for emesis

प्रायः क्षीरघृताशित्वाद्बालानां श्लेष्मजा गदाः॥२८ ॥
तस्माद्वमनमेवाग्रे सर्वव्याधिषु पूजितम् ।
सिन्धूत्थकृष्णापामार्गबीजाज्यस्तन्यमाक्षिकम्॥२९ ॥
चूर्णो वचायाः सक्षौद्रो मदनं मधुकान्वितम् ।
क्षीरं क्षीरान्नमन्नं च भजतः क्रमतः शिशोः॥३०॥
वमनं सर्वरोगेषु विशेषेण कुकूणके ।
सप्तलारससिद्धाज्यं योज्यं चोभयशोधनम् ॥३१॥
As a result of kids are consuming milk and Ghee (as meals) they genetically get affected by illnesses brought on by Kapha, therefore in all illnesses emesis remedy itself ought to be administered first. (powder of) rock salt, kṛṣṇā – Piper nigrum, apāmārga bīja – seeds of Achyranthes aspera blended with ghee, breast milk and honey, powder of vacāyāḥ – Acorus calamus blended with honey and Randia dumetorum with honey are finest emetic recipe for youngsters who eat breast-milk, these eat each milk and strong meals and people consuming solely strong meals respectively for emesis in all of the illnesses, particularly in Kukunaka. Medicated ghee ready from the decoction of Euphorbia neriifolia ought to be made use of to provide each the purifications (emesis and purgation).

Vartis for Kukunaka and Pothaki

द्विनिशालोध्रयष्ट्याह्वरोहिणीनिम्बपल्लवैः ।
कुकूणके हिता वर्तिः पिष्टैस्ताम्ररजोऽन्वितैः॥३२॥
क्षीरक्षौद्रघृतोपेतं दग्धं वा लोहजं रजः ।
एलालशुनकतकशङ्खोषणफणिज्जकैः ॥३३॥
वर्तिः कुकूणपोथक्योः सुरापिष्टैः सकट्फलैः ।
Wick ready with macerating in water the 2 Nisa (Haridra – Curcuma longa & Daruharidra – Berberis aristata), lodhra – Symplocos racemosa, yaṣṭyāhva – Glycyrrhiza glabra, rohiṇī – Picrorhiza kurroa, nimba pallavaiḥ – tender leaves of Azadirachta indica and wonderful powder of copper or the powder of burnt iron (iron slag) blended with milk, honey and ghee is useful in Kukunaka (when utilized as a collyrium to the eyes). Wick ready with elā – Elettaria cardamomum, laśuna – Allium sativum, kataka – Strychnos potatorum, śaṅkha – Convolvulus pluricaulis, ūṣaṇa – Piper nigrum, phaṇijjakaiḥ – Origanum majorana, sakaṭphalaiḥ – Myrica nagi, macerated with Sura (beer) is useful in each Kukunaka and Pothaki.

Surgical course of in Pakshmarodha

पक्ष्मरोधे प्रवृद्धेषु शुद्धदेहस्य रोमसु ॥ ३४ ॥
उत्सृज्य द्वौ भ्रुवोऽधस्ताद्भागौ भागं च पक्ष्मतः ।
यवमात्रं यवाकारं तिर्यक् छित्त्वाऽऽर्द्रवाससा ॥३५॥
अपनेयमसृक् तस्मिन्नल्पीभवति शोणिते ।
सीव्येत्कुटिलया सूच्या मुद्गमात्रान्तरैः पदैः ॥३६॥बद्ध्वा ललाटे पट्टं च तत्र सीवनसूत्रकम् ।
नातिगाढश्लथं सूच्या निक्षिपेदथ योजयेत् ॥३७॥
मधुसर्पिःकवलिकां न चास्मिन् बन्धमाचरेत् ।
न्यग्रोधादिकषायैश्च सक्षीरैः सेचयेद्रुजि ॥३८॥
पञ्चमे दिवसे सूत्रमपनीयावचूर्णयेत् ।
गैरिकेण व्रणं युञ्ज्यात्तीक्ष्णं नस्याञ्जनादि च॥३९ ॥
In Paksmarodha the place the hair (eyelashes) have grown an excessive amount of, the affected person who has been purified (by emesis and purgation) (is subjected to a surgery as follows) a horizontal incision is made beneath the eyebrows of the dimensions of a Hordeum vulgare( barley) and resembling a Hordeum vulgare(barley) in form, on the place on the eyelid, leaving off two thirds half from above and one third half from the border line of the eyelashes; the exuding blood eliminated with the assistance of moist material; after the bleeding stops, the wound sutured with a curved needle making stitches, on the distance of the dimensions of a inexperienced gram between them a band of material ought to be tied on the suture both thread of cotton, silk or flax, fastened to the band on the brow; the band ought to be fixed with the assistance of a needle neither tightly or loosely a cotton wick soaked in honey and ghee is then positioned over (the location of Operations), banding not be performed on this situation. In case there’s ache, decoction of herbs of Nyagrodhadi Gana (Chapter 15 of Sutrsthana) blended with milk ought to be poured on the place. On the fifth day the suture ought to be eliminated and powdered together with Gairika ought to be utilized on the wound Robust nasal medicine and collyrium ought to be made use of

Dahakarma

दहेदशान्तौ निर्भुज्य वर्त्मदोषाश्रयां वलीम् ।
सन्दंशेनाधिकं पक्ष्म हृत्वा तस्याश्रयं दहेत् ॥४०॥
सूच्यग्रेणाग्निवर्णेन दाहो बाह्यालजेः पुनः ।
भिन्नस्य क्षारवह्निभ्यां सुच्छिन्नस्यार्बुदस्य च ॥४१॥
If the illnesses don’t subside (by the above remedy) the folds of the lid the place within the Dosas are localised ought to be bent outwards and burnt, with the assistance of a forceps, the additional hairs are lower off and their residence (progress) burnt (cauterised) with the tip of the needle heated pink sizzling, In Bahyalaji, cauterising ought to be performed after Puncturing in Arbuda cauterising ought to be performed with each alkalies and hearth after exercising it utterly.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने वर्त्मरोगप्रतिषेधो नाम नवमोऽध्याय: ॥९॥
Thus ends the chapter Vartmaroga Pratisedha- the ninth in Uttaraasthana of Asthanga Hrdaya samhita composed by Srimad Vagbhata , son of sri vaidyapati Simhagupta .



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