By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Vaikrutapaha is the seventh and last type of therapy included within the ‘Sapta Upakrama’ i.e. 7 forms of remedies defined by Grasp Sushruta. Together with the opposite six types of therapy it goals at therapeutic and treating the ulcers, wounds and swelling and to stop its problems. These procedures are executed after Shodhana and Ropana. If the situation of the wound / ulcer or swelling accessible to the doctor on the time of treating the affected person is match to bear one in all these therapies immediately, they shall be skillfully chosen.
Learn – Sushruta’s 7 Types of Treatments Sapta Upakrama
“Lastly (following the chronology) Vaikrutapaha (seventh therapy amongst the seven remedies) needs to be executed…!”
Vaikritapaha means eradicating the deformities or undesired modifications which have occurred as problems or sequels of wounds. So after having executed cleaning and therapeutic strategies or in actual fact the sooner 6 sorts of remedies of sapta upakrama, vaikretapaha is finished to deal with or take away the residual deformities or sequels of ulcers or wounds that are left over.
Primarily 26 remedies are included beneath Vaikrutapaha from amongst the 60 remedies talked about in Shashti Upakrama. They’re –
|Sl No||Title of the Upakrama (therapy)||That means|
|1||Utsaadana||Elevation of wounds|
|2||Avasaadana||Despair of wounds|
|3||Mrudu Karma||Softening the sides of the injuries|
|4||Daaruna Karma||Hardening the margins of the injuries|
|5||Kshara Karma||Software of alkalis / alkali cauterization|
|6||Agni Karma||Software of fireside / fireplace cauterization|
|7||Krshna Karma||Inducing black coloration|
|8||Pandu Karma||Inducing white coloration|
|9||Pratisaarana||Rubbing tablets made up of tough medicinal powder on the ulcer|
|10||Roma Sanjanana||Remedies and medicines (measures) enabling progress of hairs|
|11||Loma Apaharana||Remedies and medicines (measures) enabling elimination of pointless hairs|
|12||Vasti Karma||Medicinal Enemas|
|13||Uttara Vasti Karma||Enemas given via urinary and genital passages|
|15||Patra Daana||Protecting the injuries with leaves|
|17||Brmhana||Bulk selling and strengthening remedies|
|19||Shiro virechana||Nasal instillation of medicines / head cleaning|
|20||Nasya||Nasal instillation of medicine / Errhines|
|21||Kavala dharana||Rinsing of mouth with medicinal liquids|
|23||Madhu sarpi||Administration of honey and ghee|
1. Utsaadana – elevation of ulcer
This contains the therapy of wounds / ulcers in order to enhance the granulation tissue and in addition to boost the ground of the wound. That is executed when wound space is depressed. Utsadana is reverse of Avasadana (despair of wounds – defined beneath).
Situations wherein wounds have to be elevated –
- Parishushka – dried ulcers and wounds
- Alpa mamsanam – ulcers lined with much less muscle tissue (most muscle tissue have been destroyed)
- Gambhiranam – deep seated ulcers
In these circumstances the ghee and anointments ready with the herbs used for elevating the injuries are administered. The sufferers are fed with the meat of carnivorous animals. By the consumption of such meat the thoughts of the individual will get devoid of undesirable feelings like anger, grief and so forth. This can additional facilitate and hasten the expansion of the muscle tissue and elevation of the depressed ulcers.
Learn – Foods That Increase Sattva, Rajas, Tamas: Srimad Bhagavat Geeta
2. Avasadana – despair of ulcers
This contains the measure used for the elimination of unhealthy, pointless, hyper-granulation tissue from ground of the wound in order to trigger their despair and make the floor of the ulcer even. That is administered in circumstances the place the ulcers / wounds are elevated above the floor of the pores and skin. Avasadana is reverse of Utsadana (defined above).
Situations wherein wounds have to be depressed –
Utsanna mrdu mamsa – ulcers surrounded by elevated and clean muscle tissue needs to be depressed with medicines used for miserable the ulcers blended with honey.
3. Mrdu Karma – softening the sides of the ulcers
Situations wherein the sides of the ulcers have to be softened –
- Kathinanam – laborious ulcers
- Amamsanam – ulcers having much less or no muscle tissue round (losing or destruction of muscle tissue)
- Dushtanam matarishvanaa – ulcers that are contaminated by vitiated vata
In ulcers related to the above talked about circumstances, remedies and medicines for softening the sides of the ulcers needs to be administered.
Together with this the beneath talked about interventions too shall be included –
4. Daruna Karma – hardening the sides of the ulcers
Some ulcers / wounds have much less tensile energy in order that the wound margin simply separate. This causes early dehiscence and wound therapeutic delayed. To keep away from very long time wound therapeutic, daaruna karma i.e. hardening the wound margins is finished.
Situations wherein the sides of the ulcers have to be hardened –
- Mrudutvam ashu roham cha gaadho bandhah karoti hello – when the ulcers turn into clean and heal rapidly owing to them being bandaged commonly
- Mrdu mamseshu vraneshu – ulcers having gentle muscle tissue
Equal parts of the graceful powder of the beneath talked about substances needs to be sprinkled on these ulcers to make them laborious –
- Dhava – Anogeissus latifolia
- Priyangu – Callicarpa macrophylla
- Ashoka – Saraca asoca
- Rohini twak – bark of Picrorhiza kurroa
- Triphala – fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis
- Dhataki Pushpa – flowers of Woodfordia fruticosa
- Lodhra – Symplocos racemosa
- Sarjarasa – Vateria indica
5. Kshara Karma – software of alkalis / alkali cauterization
Situations wherein alkali must be utilized in treating the ulcers –
- Utsanna mamsan – ulcers with elevated muscle tissue of their neighborhood
- Kathinan – laborious ulcers
- Kandu yuktan – ulcers related to itching
- Chirotthitan – ulcers that are persisting for a very long time (persistent ulcers / wounds)
- Dusadhyan – ulcers that are tough to cleanse and deal with
6. Agni Karma – fireplace cauterization
Situations wherein fireplace cauterization utilized to deal with ulcers –
- Sravato mutran – ulcers discharging urine
- Ashma bhavan – ulcers brought on by stones within the urinary tract (alternatively we are able to perceive combining each these factors as – ulcers fashioned by stones within the urinary tract which ends up in discharge / dribbling of urine)
- Raktavahinah – bleeding ulcers
- Nishesha chinna sandheen cha – ulcers that are related to utterly destroyed (crushed) joints
Learn – Sushruta’s 8 Types Of Surgical Procedures – Astavidha Shastra Karma
7. Krishna Karma – inducing black coloration
This therapy is carried out to make the hypo-pigmentation areas brought on by ulcers regular like surrounding tissue.
Durudhatvat tu shuklaanaam – Black coloration shall be induced within the ulcers which have turn into white attributable to improper therapeutic.
Technique of inducing black coloration within the ulcers
Bhallataka (Semecarpus anacardium) which has been saved within the cow urine for seven days is then saved dipped within the milk for seven days.
Bhallataka is then reduce into two items and positioned in an iron vessel. The orifice of this vessel is saved over the opening of one other vessel of comparable dimension. The junction of each these vessels is sealed and the whole equipment is saved within the pit. On the highest of this dry items / truffles of cow-dung are positioned and lit with fireplace. As a result of warmth, Bhallataka melts and its oil is collected within the decrease pot.
To this oil, positive powder of the hoofs of animals dwelling within the villages and marshy areas are added and blended completely. The resultant combination is utilized on the ulcers which have turn into white.
8. Pandu Karma – inducing white coloration
This therapy is carried out to make the hyper-pigmented areas brought on by ulcers regular like surrounding tissue.
Durudhatvat tu krshnanam – White coloration (regular pores and skin coloration) shall be induced within the ulcers which have turn into black attributable to improper therapeutic.
Technique of inducing regular coloration within the ulcers
1. The fruit of Rohini – sort of Terminalia chebula is saved in goat’s milk for 7 days and floor with the identical milk to arrange its paste. This paste is utilized on the hyper-pigmented ulcers which have to be dropped at regular coloration.
2. The beneath talked about substances needs to be blended with honey and utilized on the ulcer –
- Kapalika Churna – powder of plate of earthen pot
- Baidula – a part of a reed known as vidula / bamboo?
- Sarjarasa – Vateria indica
- Kasisa – inexperienced vitriol
- Madhuka – Glycyrrhiza glabra
3. The pulp from within Kapittaha fruit (Feronia linonia) is eliminated. The hole of the fruit is crammed with goat urine. Later the powder of the beneath talked about are added –
- Kasisa – inexperienced vitriol
- Gorochana – bezoar
- Tuttha – purified copper sulfate
- Haratala – orpiment
- Manashila – realgar
- Venu nirlekhanam – bamboo bark
- Chakramarda bija – seeds of Cassia tora
- Rasanjana – extract of Berberis aristata
This fruit is buried within the floor, beneath the basis of Arjuna (Terminalia arjuna) tree for one month and left in place. The resultant medication needs to be utilized on the ulcer for a couple of month time interval.
On this, the tablets ready from tough powder of medicinal herbs are rubbed on the shiny pores and skin after wound therapeutic has occurred. That is executed to make the pores and skin floor tough and identical to the conventional texture of the pores and skin.
The powders of the beneath talked about substances taken in equal amount are blended and floor with cow urine and tablets are ready –
- Kukkutanda kapalani – items of outer shell of egg
- Kataka – Strychnos potatorum
- Madhuka – Glycyrrhiza glabra
- Samudra Manduki / Mukta Shukti – Oyster shell
- Mani – alum, pearl and so forth
This pill is rubbed on the ulcers.
10. Roma Sanjanana – enabling progress of hairs
a. The tusks of elephant are burnt and their ash ready. To this good high quality Rasanjana – extract of Berberis aristata is added and blended with goat milk. When utilized this medication even produces hairs on the fingers (palm).
b. Pores and skin, hairs, hoof, horns and bones of animals are burnt to ash and blended with oil. When that is utilized it produces hairs.
c. Kasisa – inexperienced vitriol and leaves of Karanja – Pongamia pinnata are floor within the juice of Kapittha would produce hairs when utilized.
11. Loma Apaharana – elimination of pointless hairs
When a number of pointless hairs develop within the web site of ulcer they arrive into the best way of ulcer therapeutic. These hairs needs to be reduce and trimmed utilizing scalpel and forceps and completely eliminated.
- Powder of conch shell and Haratala – orpiment taken in equal proportions are floor with bitter fruit juices and utilized. This can assist in elimination of undesirable hairs.
- Oil of Bhallataka and latex of Snuhi (Euphorbia neriifolia) are blended collectively and utilized to take away undesirable hairs.
- Ash of kadali – plantain and stem bark of Aralu – Ailanthus excelsa are blended with Haratala – orpiment, Rock salt and seeds of shami and floor with chilly water. That is utilized to take away undesirable hairs.
12. Vasti Karma – natural enemas
Situations whereby natural enemas shall be administered in treating ulcers –
13. Uttara Vasti Karma – urinary and genital enema
Situations wherein enemas needs to be administered via urinary and genital tracts –
- Mutraghata – obstruction of urine
- Mutra dosha – contamination of urine
- Shukra dosha – contamination of semen
- Ashmari janya vrana – ulcers brought on by urinary calculi
- Artava dosha – contamination of menstrual blood
Learn – Uttara Basti: Method, Indications, Mode of Action
14. Bandha – bandages
Advantages of bandaging the ulcers / wounds –
- Shudhyati vrano – wounds get cleansed
- Yati cha mardavam – ulcers / wounds turn into clean
- Rohatyapi – the therapeutic would happen comprehensively
15. Patradaana – masking the injuries with leaves
Situations wherein the ulcers have to be lined with leaves –
- Sthiranam – motionless ulcers / wounds
- Alpa mamsanam – ulcers / wounds lined with much less / scanty muscle tissue
- Raukshyaad anuparohataam – wounds / ulcers which haven’t healed attributable to excessive dryness in them
Within the above stated circumstances the leaves are used to cowl the ulcers / wounds in accordance to the doshas concerned and the seasons. Leaves having medicinal properties is roofed on the injuries after having utilized medicinal pastes on them.
16. Krimighna – disinfectants
When the flies and different bugs sitting on open ulcers / wounds produce worms / germs they’d chunk the ulcers resulting in swelling (irritation) which is severely troublesome. Consequently extreme and totally different sorts of pains and bleeding happen from the injuries. On this situation Surasadi Gana group of herbs are used washing the ulcers and therapeutic them.
The beneath talked about herbs shall be floor in cow’s urine and utilized over the ulcers –
Alternatively the injuries shall be washed with alkali water or the ulcers are showered with the identical. The ulcers / wounds are lined with muscle tissue / flesh which might entice the worms from contained in the ulcers. This can be a technique of de-worming the ulcers and wounds.
17. Brmhana – bulk selling remedies
Situations for administering bulk selling / strengthening remedies for ulcer / wound therapeutic –
- Dirgha kala aturanam – ulcers persisting for very long time (persistent ulcers) or for an individual affected by ailments for very long time
- Krshanam – emaciated individuals
- Vrana shoshinaam – those that are debilitated because of the ulcers
Within the above stated circumstances all types of bulk selling / strengthening remedies shall be administered defending one’s digestive fireplace (capability).
Learn – Brumhana Therapy – Nourishing Ayurvedic Treatment Principle
18. Vishaghna – anti-toxins
This contains remedies which nullify or neutralize the impact of poisons and toxins on ulcers / wounds.
The signs induced after consuming toxic meals and drinks, examination of varied forms of toxins / poisons and their therapy are defined intimately within the Kalpa Sthana Part of Sushruta Samhita and therefore not detailed on this context.
19. Shirovirechana – nasal instillation of medicines
20. Nasya – nasal instillation of medicines / errhines
Situations for administering errhines in ulcers / wounds –
- Rujavanto – ulcers related to ache
- Anilaveshta – ulcers bothered by vitiated vata
- Ruksha – dry ulcers
- Urdhwa jatruga vrana – ulcers situated above the extent of clavicle
In these circumstances unctuous errhines needs to be administered.
21. Kavala Dharana – rinsing of mouth with medicinal liquids
Situations for administering mouth rinse in ulcers / wounds –
Cold and warm (as per situation) medicinal liquids needs to be used for mouth rinsing for the beneath talked about functions –
- Dosha prachyavanartham – to expel the morbid doshas
- Ruja daha kshayaya cha – cut back the ache and burning sensation related to ulcers
- Jihva danta samutthasya haranaartham malasya cha – take away the wastes from the tongue and tooth and to cleanse them
- Shodhana ropanascha eva vranasya mukhajasya vai – for cleaning and therapeutic the ulcers occurring within the oral cavity
Learn – How To Do Oil Pulling In Genuine Ayurvedic Way?
22. Dhuma – fumigation
Situations wherein fumigation needs to be executed to deal with the injuries / ulcers –
- Urdhwa jatru gatan – ailments occurring above the extent of clavicles
- Kaphavata janya vranan – ulcers / wounds brought on by vitiated kapha and vata
- Shopha srava ruja yuktan – ulcers / wounds related to swelling (irritation), discharges and ache
Learn – Dhoopana (Fumigation) Blends, Benefits, Procedure, Mode of Action
23. Madhu Sarpi – use of honey and ghee
- Kshatoshmano nigrahartham – to manage the warmth generated by the harm / trauma
- Sandhanartham – for unification
- Sadhyo vraneshu ayatesu – in freshly fashioned wounds / ulcers and in massive ulcers
24. Yantra – instrumentation
Situations whereby devices are utilized in treating ulcers –
25. Ahara – dietetic routine
A clever doctor ought to recommendation lesser amount of meals that are mild for digestion to all of the sufferers affected by ulcers / wounds.
26. Raksha Vidhana – Sterilization
This contains sterilization of the surgical wards and devices via the strategies of fumigation with herbs like Guggulu (Commiphora mukul) and so forth and by Mantra Uccharana i.e. reciting holy hymns in order to kill the small pathogenic organisms. For a similar functions yama and niyama are additionally adopted.
Above talked about are the 26 therapy procedures that are meant for eradicating the deformities and undesired modifications which have occurred as problems of wounds. They shall be used skillfully both individually or in combos as and when required relying on the state and stage of ulcer / wound offered on the time of therapy.
Click to Consult Dr Raghuram Y.S. MD (Ayu)