By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Vaikrutapaha is the seventh and remaining 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 forestall its issues. These procedures are accomplished after Shodhana and Ropana. If the situation of the wound / ulcer or swelling out there to the doctor on the time of treating the affected person is match to endure certainly one of these therapies immediately, they shall be skillfully chosen.
Learn – Sushruta’s 7 Kinds of Remedies Sapta Upakrama
“Lastly (following the chronology) Vaikrutapaha (seventh therapy amongst the seven remedies) needs to be accomplished…!”
Vaikritapaha means eradicating the deformities or undesired modifications which have occurred as issues or sequels of wounds. So after having accomplished cleaning and therapeutic strategies or in truth the sooner 6 sorts of remedies of sapta upakrama, vaikretapaha is completed to deal with or take away the residual deformities or sequels of ulcers or wounds that are left over.
Primarily 26 remedies are included underneath Vaikrutapaha from amongst the 60 remedies talked about in Shashti Upakrama. They’re –
|Sl No||Identify of the Upakrama (therapy)||Which means|
|1||Utsaadana||Elevation of wounds|
|2||Avasaadana||Melancholy of wounds|
|3||Mrudu Karma||Softening the sides of the injuries|
|4||Daaruna Karma||Hardening the margins of the injuries|
|5||Kshara Karma||Utility of alkalis / alkali cauterization|
|6||Agni Karma||Utility of fireside / hearth 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 development 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 by way of urinary and genital passages|
|15||Patra Daana||Masking 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 treatment / 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 lift the ground of the wound. That is accomplished when wound space is depressed. Utsadana is reverse of Avasadana (melancholy of wounds – defined beneath).
Circumstances through which wounds must be elevated –
- Parishushka – dried ulcers and wounds
- Alpa mamsanam – ulcers coated with much less muscle mass (most muscle mass have been destroyed)
- Gambhiranam – deep seated ulcers
In these situations 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 particular person will get devoid of undesirable feelings like anger, grief and many others. This may additional facilitate and hasten the expansion of the muscle mass and elevation of the depressed ulcers.
Learn – Meals That Improve Sattva, Rajas, Tamas: Srimad Bhagavat Geeta
2. Avasadana – melancholy 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 melancholy and make the floor of the ulcer even. That is administered in instances the place the ulcers / wounds are elevated above the floor of the pores and skin. Avasadana is reverse of Utsadana (defined above).
Circumstances through which wounds must be depressed –
Utsanna mrdu mamsa – ulcers surrounded by elevated and easy muscle mass needs to be depressed with medicines used for miserable the ulcers blended with honey.
3. Mrdu Karma – softening the sides of the ulcers
Circumstances through which the sides of the ulcers must be softened –
- Kathinanam – exhausting ulcers
- Amamsanam – ulcers having much less or no muscle mass round (losing or destruction of muscle mass)
- Dushtanam matarishvanaa – ulcers that are contaminated by vitiated vata
In ulcers related to the above talked about situations, 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 power 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 completed.
Circumstances through which the sides of the ulcers must be hardened –
- Mrudutvam ashu roham cha gaadho bandhah karoti hello – when the ulcers turn into easy and heal shortly owing to them being bandaged frequently
- Mrdu mamseshu vraneshu – ulcers having delicate muscle mass
Equal parts of the sleek powder of the beneath talked about substances needs to be sprinkled on these ulcers to make them exhausting –
- 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
Circumstances through which alkali must be utilized in treating the ulcers –
- Utsanna mamsan – ulcers with elevated muscle mass of their neighborhood
- Kathinan – exhausting ulcers
- Kandu yuktan – ulcers related to itching
- Chirotthitan – ulcers that are persisting for a very long time (power ulcers / wounds)
- Dusadhyan – ulcers that are tough to cleanse and deal with
6. Agni Karma – hearth cauterization
Circumstances through which hearth 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 results in discharge / dribbling of urine)
- Raktavahinah – bleeding ulcers
- Nishesha chinna sandheen cha – ulcers that are related to fully destroyed (crushed) joints
Learn – Sushruta’s 8 Varieties 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 as a result of improper therapeutic.
Methodology of inducing black coloration within the ulcers
Bhallataka (Semecarpus anacardium) which has been stored within the cow urine for seven days is then stored 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 stored over the opening of one other vessel of comparable dimension. The junction of each these vessels is sealed and your complete equipment is stored within the pit. On the highest of this dry items / muffins of cow-dung are positioned and lit with hearth. Because of the warmth, Bhallataka melts and its oil is amassed within the decrease pot.
To this oil, superb powder of the hoofs of animals residing 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 as a result of improper therapeutic.
Methodology of inducing regular coloration within the ulcers
1. The fruit of Rohini – kind of Terminalia chebula is stored in goat’s milk for 7 days and floor with the identical milk to organize its paste. This paste is utilized on the hyper-pigmented ulcers which must be delivered to 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 referred to 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 stuffed 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 foundation of Arjuna (Terminalia arjuna) tree for one month and left in place. The resultant medication needs to be utilized on the ulcer for multiple 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 accomplished to make the pores and skin floor tough and similar 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 many others
This pill is rubbed on the ulcers.
10. Roma Sanjanana – enabling development 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 arms (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 lot 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 may 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
Circumstances whereby natural enemas shall be administered in treating ulcers –
13. Uttara Vasti Karma – urinary and genital enema
Circumstances through which enemas needs to be administered by way of 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: Methodology, Indications, Mode of Motion
14. Bandha – bandages
Advantages of bandaging the ulcers / wounds –
- Shudhyati vrano – wounds get cleansed
- Yati cha mardavam – ulcers / wounds turn into easy
- Rohatyapi – the therapeutic would happen comprehensively
15. Patradaana – protecting the injuries with leaves
Circumstances through which the ulcers must be coated with leaves –
- Sthiranam – motionless ulcers / wounds
- Alpa mamsanam – ulcers / wounds coated with much less / scanty muscle mass
- Raukshyaad anuparohataam – wounds / ulcers which haven’t healed as a result of excessive dryness in them
Within the above stated situations 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 might 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 coated with muscle mass / flesh which might entice the worms from contained in the ulcers. This can be a methodology of de-worming the ulcers and wounds.
17. Brmhana – bulk selling remedies
Circumstances for administering bulk selling / strengthening remedies for ulcer / wound therapeutic –
- Dirgha kala aturanam – ulcers persisting for very long time (power ulcers) or for an individual affected by illnesses for very long time
- Krshanam – emaciated individuals
- Vrana shoshinaam – those that are debilitated as a result of ulcers
Within the above stated situations every kind of bulk selling / strengthening remedies shall be administered defending one’s digestive hearth (capability).
Learn – Brumhana Remedy – Nourishing Ayurvedic Remedy Precept
18. Vishaghna – anti-toxins
This contains remedies which nullify or neutralize the impact of poisons and toxins on ulcers / wounds.
The signs triggered after consuming toxic meals and drinks, examination of assorted 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
Circumstances for administering errhines in ulcers / wounds –
- Rujavanto – ulcers related to ache
- Anilaveshta – ulcers by vitiated vata
- Ruksha – dry ulcers
- Urdhwa jatruga vrana – ulcers positioned above the extent of clavicle
In these situations unctuous errhines needs to be administered.
21. Kavala Dharana – rinsing of mouth with medicinal liquids
Circumstances for administering mouth rinse in ulcers / wounds –
Cold and hot (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 – scale 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 Real Ayurvedic Method?
22. Dhuma – fumigation
Circumstances through which fumigation needs to be accomplished to deal with the injuries / ulcers –
- Urdhwa jatru gatan – illnesses 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, Advantages, Process, Mode of Motion
23. Madhu Sarpi – use of honey and ghee
- Kshatoshmano nigrahartham – to regulate the warmth generated by the harm / trauma
- Sandhanartham – for unification
- Sadhyo vraneshu ayatesu – in freshly fashioned wounds / ulcers and in giant ulcers
24. Yantra – instrumentation
Circumstances whereby devices are utilized in treating ulcers –
25. Ahara – dietetic routine
A clever doctor ought to recommendation lesser amount of meals that are gentle for digestion to all of the sufferers affected by ulcers / wounds.
26. Raksha Vidhana – Sterilization
This contains sterilization of the surgical wards and devices by way of the strategies of fumigation with herbs like Guggulu (Commiphora mukul) and many others 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 issues 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 introduced on the time of therapy.
Click on to Seek the advice of Dr Raghuram Y.S. MD (Ayu)