Sushruta Samhita Uttaratantra Chapter 16 Paksma Roga Pratisedha (Remedy of Irritation of the Space of Eyelashes)

The sixteenth chapter of Uttaratantra of Sushruta Samhita is called as Paksma Roga Pratisedha Adhyaya. This chapter offers with the therapy of Irritation of the Space of Eyelashes.

अथातः पक्ष्मकोपप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We’ll now expound Paksmakopa pratisedha – therapy of illnesses of the realm of the eyelashes; as revealed by the venerable Dhanvantari.

Paksmakopa Cikitsa- therapy of irritation of space of eyelashes

याप्यस्तु यो वर्त्मभवो विकारः पक्ष्मप्रकोपोऽभिहितः पुरस्तात् |
तत्रोपविष्टस्य नरस्य चर्म वर्त्मोपरिष्टादनुतिर्यगेव ||३||
भ्रुवोरधस्तात् परिमुच्य भागौ पक्ष्माश्रितं चैकमतोऽवकृन्तेत् |
कनीनकापाङ्गसमं समन्ताद्यवाकृति स्निग्धतनोर्नरस्य ||४||
उत्कृत्य शस्त्रेण यवप्रमाणं बालेन सीव्येद्भिषगप्रमत्तः |
दत्त्वा च सर्पिर्मधुनाऽवशेषं कुर्याद्विधानं विहितं व्रणे यत् ||५||
ललाटदेशे च निबद्धपट्टं प्राक्स्यूतमत्राप्यपरं च बद्ध्वा |
स्थैर्यं गते चाप्यथ शस्त्रमार्गे बालान् विमुञ्चेत् कुशलोऽभिवीक्ष्य ||६||

The truth that Paksmakopa which develops on the eyelid is Yapya i.e. persistent, can’t be completely cured but manageable was acknowledged earlier on this treatise (Chapter 3, verses 29-30).

Coming to the administration of Paksmakopa –

The affected person of Pakshmakopa ought to be given with snehana – oleation remedy, beforehand.

The affected person who has been subjected to snehana ought to now be made to take a seat on a cushty chair or stool. The doctor ought to ask the affected person to shut his eyes.

Now, the doctor ought to lower the pores and skin of the eyelid with none delusion.

The place to make the lower? – The doctor ought to mark the place / level on the eyelid firstly, to make the lower exactly. He ought to go away two third portion of the eyelid under the eyebrow and lower the pores and skin close to the realm of eyelashes. The form of the lower ought to be yava akara – form of barley grain and ought to be made with a sterile, sharp instrument. It ought to be made at a spot equidistant from Kaninika – interior canthus and Apanga – outer canthus.

After chopping the pores and skin on the talked about place on the eyelid, the doctor ought to take away the pores and skin and discard it.

Then the doctor ought to rigorously suture the pores and skin utilizing the hairs (of horse). Then a combination of ghee and honey shall be utilized to that space and the therapies (bandaging and many others) indicated for wounds ought to be adopted typically.

Bands of stitched fabric ought to be tied spherical on the brow (together with the attention) and sutured. This suture ought to be sutured along with the suture and bandage tied across the eye.

Elimination of suture – The expert doctor ought to look forward to the wound to turn out to be secure and for indicators of full therapeutic. When that is achieved, he ought to take away the suture by pulling out the hair or thread used for the aim, from the positioning of operation.

Indication for Ksara Karma or Agni Karma

एवं न चेच्छाम्यति तस्य वर्त्म निर्भुज्य दोषोपहतां वलिं च |
ततोऽग्निना वा प्रतिसारयेत्तां क्षारेण वा सम्यगवेक्ष्य धीरः ||७||
छित्वा समं वाऽप्युपपक्ष्ममालां सम्यग्गृहीत्वा बडिशैस्त्रिभिस्तु |
पथ्याफलेन प्रतिसारयेत्तु घृष्टेन वा तौवरकेण सम्यक् ||८||

Ksara Karma – software of caustic alkali or Agni Karma – branding with hearth ought to be finished provided that the illness doesn’t subside after doing the above mentioned therapy.

The area of the eyelid ought to be cauterised by hearth, by touching the chosen space of the eyelid with a scorching iron rod. Alternatively caustic alkali ought to be utilized over the identical space. Each these procedures ought to be finished cautiously and in accordance with correct process.

Chedana – The doctor ought to maintain the upapaksma mala – row of eyelashes with badisa – sharp hook and lower / cut up it evenly, without delay. Following this, he ought to apply the paste of Pathya or Tuvaraka Phala on this space.

Summing up

चत्वार एते विधयो विहन्तुं पक्ष्मोपरोधं पृथगेव शस्ताः |
विरेचनाश्च्योतनधूमनस्यलेपाञ्जनस्नेहरसक्रियाश्च ||९||

All of the 4 strategies of intervention talked about above are individually finest suited to curing paksmoparodha – irritation of the area round eyelashes. Virecana, Ascyotana, Dhuma, Nasya, Lepa, Snehana, Rasakriya and Anjana are additionally likewise useful.

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे पक्ष्मगतरोगप्रतिषेधो नाम षोडशोऽध्यायः ||१६||

Thus ends the sixteenth chapter by identify  Paksmaroga  Pratisedha in Uttara Sthana of Susruta Samhita.