Sushruta Samhita Uttaratantra Chapter 38 Yonivyāpat Pratiṣedha (Therapy of Illnesses of Vagina)

AIAPGET Factors

–        Acharya Sushruta has defined the therapy of ailments of vagina i.e. YONIVYAPAT Pratisedha in chapter 38 of Uttara Tantra

–        Causes of yoni vyapad – copulation with a person having PRAVRUDDHA LINGA, copulation with different males, girl is RUKSHA, DURBALA and BALA (and has extreme copulation).

–        4 causes for manifestation of Yoni Vyapad – MITHYACHARA, ARTAVA PRADUSHTI, BIJA DOSHA & DAIVA.

–        5 sorts of Vatala Yoni Vyapad – Udavarta, Vandhya, Vipluta, Paripluta and Vatala

–        5 sorts of Pittala Yoni Vyapad – Rudhira (Rakta) Kshara Yoni, Vamini, Sramsini, Putragni and Pittala

–        5 sorts of Kaphaja Yoni Vyapad – Atyananda, Karnini, Acharana, Aticharana and Sleshmala

–        5 sorts of Tridoshaja Yoni Vyapad – Sandha, Phalini, Mahati, Sucivaktra and Sarvaja (Sannipataja)

Vataja Vaginal Problems –

–        Udavarta Yoni – discharge of frothy menstrual blood with issue

–        Vandhya Yoni – no menstruation in any respect

–        Vipluta Yoni – vaginal ache day by day

–        Paripluta Yoni – extreme ache throughout copulation

–        Vatala Yoni – vagina is tough, inactive, has ache and pricking

Pittaja Vaginal Problems –

–        Lohitaksara Yoni – menstrual blood is discharged in additional amount, has burning sensation

–        Vamini Yoni – expulsion of BIJA (ovum) together with RAJAS – menstrual blood, accompanied with VATA (discharge of air / gasoline)

–        Sramsini Yoni – extreme bleeding, weak point, issue in supply of kid (DUPRASUSCHA)

–        Putraghni Yoni – STHITAM STHITAM HANTI GARBHAM – Retention of seed (embryo) for brief time period and is later killed because of extra bleeding

–        Pittala Yoni – extreme DAHA, PAKA and presence of JWARA

Kaphaja Vaginal Problems –

–        Atyananda Yoni – NA SANTOSHAM GRAMYADHARMENA GACHCHATI – girl finds no pleasure from copulation

–        Karnini Yoni – sprouts or growths produced by kapha and blood within the vagina

–        Acarana Yoni – girl experiences orgasm sooner than man in copulation

–        Aticarana Yoni – BIJAM NA VINDATI – girl copulates a lot however doesn’t retain the bija (doesn’t conceive)

–        Slesmala Yoni – presence of very slimy vagina, itching and really chilly feeling

Tridoshaja Vaginal Problems

–        Sandha Yoni – ANARTAVA – menstruation, ASTANA – absence of breasts, KHARA SPARSHA CHA MAITHUNE – girl experiences roughness or friction throughout copulation

–        Aphalini Yoni – girl wants a person of huge dimension for copulation and nonetheless doesn’t conceive

–        Maha Yoni – presence of a really huge vagina

–        Sucivaktra Yoni – presence of very constricted vagina

–        Tridoshaja Yoni – presence of options / signs of aggravation of all of the three doshas

Therapy ideas of Yoni Vyapad –

–        PRATIDOSHAM TU SADHYASU Snehadi Krama, Uttara Basti.

–        Therapy if vagina is tough, chilly, inflexible and insensitive throughout copulation – KUMBHI SWEDA, introduction of VESAVARA (douche) into the vagina, all the time sporting PICHU TAILA – diaper soaked in oil and YONI DHAVANA & PURANA with appropriate liquids / decoctions and so on.

Different Therapies

–        SHITA VIDHI – in presence of osha chosha (Raktapitta Vidhi)

–        YONI PURANA with PANCHAVALKALA or RAJAVRKSHA Churna – for Durgandha and Pichchilata

–        YONI DHAVANA with Kashayas

–        SHODHANA Dravya Kashayas added with GOMUTRA and SAINDHAVA – for YONI SHODHANA – in presence of PUYASRAVA from YONI

–        Paste of the fruits of Brhati together with two sorts of Haridra needs to be used for filling within the vagina, if the vagina has itching and is insensitive. The vagina must also be fumigated with medicated smoke.

–        Paste of BRHATI, HARIDRA & DARUHARIDRA – for Purana if vagina has itching and is insensitive. YONI DHUPANA can also be desired.

–        PICHU ready with SHODHANA DRAVYAS – useful in Karnini Yoni.

–        Snehana with GHRTA – in Prasramsini Yoni. This needs to be adopted by Swedana with KSHIRA & MAMSARASA. After this, the Vagina needs to be pushed inside and bandage utilized.

–        SURA, ARISHTA or ASAVA needs to be administered applicable to every dosha, each morning.

–        MAMSARASA added with RASONA needs to be given for consuming. She must also be given meals with extra milk and meat-soup.

Therapy ideas of – SHUKRA-ARTAVA DOSHA, STANA Roga, KLAIBYA, MUDHA-GARBHA & GARBHINI Prati-roga Chikitsa needs to be adopted in treating YONI VYAPAD.

The thirty seventh chapter of Uttaratantra of Sushruta Samhita is known as as Yonivyāpat Pratiṣedha Adhyaya. This chapter offers with the Therapy of Illnesses of Vagina.  

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

We’ll now expound Yoni vyāpatpratiṣedha – therapy of ailments of vagina and uterus; as revealed by the venerable Dhanvantari.

Vyāpat kārana – causes of diseases-

प्रवृद्धलिङ्गं पुरुषं याऽत्यर्थमुपसेवते |
रूक्षदुर्बलबाला या तस्या वायुः प्रकुप्यति ||३||
स दुष्टो योनिमासाद्य योनिरोगाय कल्पते |४|
Causative elements –

–        girl copulating excessively with a person having huge penis,

–        girl copulating excessively with different males,

–        girl who’s dry (and has copulation in extra)

–        girl who’s debilitated (and has copulation in extra) or

–        girl who could be very younger (and has copulation in extra)

Pathogenesis – Vata will get aggravated within the physique of the girl because of the above mentioned etiological elements. Later it will get localized in her vagina and provides rise to many ailments of the vagina.

त्रयाणामपि दोषाणां यथास्वं लक्षणेन तु ||४||
विंशतिर्व्यापदो योनेर्निर्दिष्टा रोगसङ्ग्रहे |
मिथ्याचारेण याः स्त्रीणां प्रदुष्टेनार्तवेन च ||५||
जायन्ते बीजदोषाच्च दैवाच्च शृणु ताः पृथक् |६|
The signs of every of the three doshas would manifest in another way with their particular options. Earlier it was talked about that such vaginal problems are twenty in quantity. Now, hearken to these ailments produced by indulgence in improper actions, problems of menstrual fluid, abnormalities of seed (ovum on this context) and windfall (act of God).

Roganama – names of diseases-

उदावर्ता तथा वन्ध्या विप्लुता च परिप्लुता ||६||
वातला चेति वातोत्थाः, पित्तोत्था रुधिरक्षरा |
वामिनी स्रंसिनी चापि पुत्रघ्नी पित्तला च या ||७||
अत्यानन्दा च या योनिः कर्णिनी चरणाद्वयम् |
श्लेष्मला च कफाज्ज्ञेया, षण्डाख्या फलिनी तथा ||८||
महती सूचिवक्त्रा च सर्वजेति त्रिदोषजा |९|

Laksanas – options of each-

Kinds of Vataja Yoni Vyapat and their signs

सफेनिलमुदावर्ता रजः कृच्छ्रेण मुञ्चति ||९||
वन्ध्यां नष्टार्तवां विद्याद्विप्लुतां नित्यवेदनाम् |
परिप्लुतायां भवति ग्राम्यधर्मे रुजा भृशम् ||१०||
वातला कर्कशा स्तब्धा शूलनिस्तोदपीडिता |
चतसृष्वपि चाद्यासु भवन्त्यनिलवेदनाः ||११||
Vataja Vaginal Problems –

Within the first 4 ailments talked about right here, ache and different options of vata aggravation are current.

Kinds of Pittaja Yoni Vyapat and their signs

सदाहं प्रक्षरत्यस्रं यस्यां सा लोहितक्षरा |
सवातमुद्गिरेद्बीजं वामिनी रजसा युतम् ||१२||
प्रस्रंसिनी स्यन्दते तु क्षोभिता दुःप्रसूश्च या |
स्थितं स्थितं हन्ति गर्भं पुत्रघ्नी रक्तसंस्रवात् ||१३||
अत्यर्थं पित्तला योनिर्दाहपाकज्वरान्विता |
चतसृष्वपि चाद्यासु पित्तलिङ्गोच्छ्रयो भवेत् ||१४||

Pittaja Vaginal Problems –

Within the first 4 of the above talked about ailments, there might be options of aggravation of pitta.

Kinds of Kaphaja Yoni Vyapat and their signs

अत्यानन्दा न सन्तोषं ग्राम्यधर्मेण गच्छति |
कर्णिन्यां कर्णिका योनौ श्लेष्मासृग्भ्यं प्रजायते ||१५||
मैथुनेऽचरणा पूर्वं पुरुषादतिरिच्यते |
बहुशश्चातिचरणादन्या बीजं न विन्दति ||१६||
श्लेष्मला पिच्छिला योनिः कण्डूयुक्ताऽतिशीतला |
चतसृष्वपि चाद्यासु श्लेष्मलिङ्गोच्छ्रितिर्भवेत् ||१७||

Kaphaja Vaginal Problems –

Within the first 4 ailments talked about above, there might be kapha aggravation signs.

Kinds of Tridoshaja Yoni Vyapat and their signs

अनार्तवस्तना षण्डी खरस्पर्शा च मैथुने |
अतिकायगृहीतायास्तरुण्याः फलिनी भवेत् ||१८||
विवृताऽतिमहायोनिः सूचीवक्त्राऽतिसंवृता |
सर्वलिङ्गसमुत्थाना सर्वदोषप्रकोपजा ||१९||
चतसृष्वपि चाद्यासु सर्वलिङ्गोच्छ्रितिर्भवेत् |
पञ्चासाध्या भवन्तीमा योनयः सर्वदोषजाः ||२०||

Tridoshaja Vaginal Problems 

Within the first 4 ailments talked about above, signs of aggravation of all of the doshas might be current. These 5 ailments produced by the three doshas are incurable.

Cikitsã – therapy

प्रतिदोषं तु साध्यासु स्नेहादिक्रम इष्यते |
दद्यादुत्तरबस्तींश्च विशेषेण यथोदितान् ||२१||
कर्कशां शीतलां स्तब्धामल्पस्पर्शां च मैथुने |
कुम्भीस्वेदैरुपचरेत् सानूपौदकसंयुतैः ||२२||
मधुरौषधसंयुक्तान् वेशवारांश्च योनिषु |
निक्षिपेद्धारयेच्चापि पिचुतैलमतन्द्रितः ||२३||
धावनानि च पथ्यानि कुर्वीतापूरणानि च |२४|

Administration of therapies like oleation and so on. (and Pancakarma therapies as and when wanted) are fascinating for the ailments brought on by every dosha individually and in addition these that are curable. Primarily, vaginal enema could be very efficient and needs to be administered.

Beneath talked about therapies needs to be executed if the vagina is tough, chilly, inactive (inflexible) and insensitive throughout copulation –

Kumbhi Sveda – Meat of animals residing in marshy lands and people residing in water needs to be boiled with water. The steam coming from it needs to be allowed to the vagina.

Vesavara i.e. meat soup cooked with herbs predominantly of candy style needs to be launched into the vagina (douche).

The lady ought to all the time use / put on a diaper soaked in oil with out laxity.

The vagina needs to be washed with appropriate medicines (medicated decoction and so on).

ओषचोषान्वितासूक्तं कुर्याच्छीतं विधिं भिषक् ||२४||
दुर्गन्धां पिच्छिलां चापि चूर्णैः पञ्चकषायजैः |
पूरयेद्राजवृक्षादिकषायैश्चापि धावनम् ||२५||
योन्यां तु पूयस्राविण्यां शोधनद्रव्यसम्भृतैः |
सगोमूत्रैः सलवणैः शोधनं हितमिष्यते ||२६||

Chilly therapies described beforehand (within the context of bleeding ailments) needs to be administered if there’s burning and sucking sensation.

Powder of 5 astringent herbs (Pancavalkala) or that of Rajavrksa needs to be used to fill within the vagina, when there’s foul scent and sliminess within the vagina. The vagina must also be washed with natural decoctions.

Decoction of purificatory herbs added with gomutra and saindhava lavana needs to be used for laundry the vagina if the vagina is exuding pus.

बृहतीफलकल्कस्य द्विहरिद्रायुतस्य च |
कण्डूमतीमल्पस्पर्शां पूरयेद्धूपयेत्तथा ||२७||
वर्तिं प्रदद्यात् कर्णिन्यां शोधनद्रव्यसम्भृताम् |
प्रस्रंसिनीं घृताभ्यक्तां क्षीरस्विन्नां प्रवेशयेत् ||२८||
पिधाय वेशवारेण ततो बन्धं समाचरेत् |
प्रतिदोषं विदध्याच्च सुरारिष्टासवान् भिषक् ||२९||
प्रातः प्रातर्निषेवेत रसोनादुद्धृतं रसम् |
क्षीरमांसरसप्रायमाहारं विदधीत च ||३०||

Wicks ready with purificatory herbs needs to be put into the vagina in Karnini Yoni.

Within the case of Prasramsini Yoni, ghee needs to be used to anoint the vagina. Later, fomentation needs to be executed with milk and meat soup. Following this, the vagina needs to be pushed inside and bandage utilized.

Each morning, dura, arista or asava, applicable to every dosha, needs to be administered by the doctor. She needs to be given meat soup added with rasona – garlic for consuming. She ought to eat meals with extra milk and meat soup.

शुक्रार्तवादयो दोषाः स्तनरोगाश्च कीर्तिताः |
क्लैब्यस्थानानि मूढस्य गर्भस्य विधिरेव च ||३१||
गर्भिणीप्रतिरोगेषु चिकित्सा चाप्युदाहृता |
सर्वथा तां प्रयुञ्जीत योनिव्यापत्सु बुद्धिमान् |
अपप्रजातारोगांश्च चिकित्सेदुत्तराद्भिषक् ||३२||

Therapy of problems of Sukra and Artava and of breasts, causes of klaibya – impotence, mudha garbha – foetal obstruction and therapy of pregnant ladies throughout every month have already been described.

In Yoni Vyapat i.e. vaginal ailments, the clever doctor ought to undertake all these with none laxity. Illnesses of untimely supply corresponding to fevers and so on. needs to be handled by the doctor by referring to additional chapters of Uttara Sthana.

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कुमारतन्त्रे योनिव्यापत्प्रतिषेधो नाम (द्वादशोऽध्यायः, आदितोऽ) अष्टत्रिंशत्तमोऽध्यायः।।३८।।

Thus ends the thirty-eighth chapter by title Yoni vyāpat pratiședha in Uttara sthana of Suśrutasamhita.

Thus ends Kaumārabhrtya/Balacikitsa in Uttara sthana of Suśruta samhita.