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Vrana Chikitsa-Shashtiupakarma , Vrana upadrava, Pathya-Apathya.pptx
- 1. Vrana Chikitsa- Shashtiupakrama Pathya andApathya in Vrana Presented by : Dr Megha R PG Scholar Dept. of Shalya Tantra Ayurveda Mahavidyalaya and Hospital Hubballi Guided By : Dr C Thyagaraja Professor and HOD Dept. of Shalya Tantra Ayurveda Mahavidyalaya and Hospital Hubballi
- 2. 2 Contents Key points ofvrana Sadyaasadyata of vrana Vrana Chikitsa Shashtiupakrama Upadrava of vrana Pathya-Apathya in vrana Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 3. 3 Key points ofVrana • Definition वृणोति यस्माद्रूढेऽपि व्रणवस्तु न नश्यति / आदेहधारणात्तस्माद्ब्रण इत्युच्यते बुधैः// Su su 21/40 • षण्मूलोऽष्टपरिग्राही पञ्चलक्षणलक्षितः षष्ट्या विधानैर्निर्दिष्टैश्चतुर्भिः साध्यते व्रणः// Su chi 1/134 Vrana Chikitsa - Shashtiupakrama Dr Megha R षण्मूलो(6 moola) – Causative factors Vata Pitta Kapha Rakta Sannipataja Agantuja अष्टपरिग्राहि (Sites of localization of dosha) Twacha Mamsa Sira Snayu Asthi Sandhi koshta Marma पञ्चलक्षण (Features of identification) Gandha Varna Srava Vedana Akriti चिकित्सा विधान (measure of treatment) षष्टि उपक्रम
- 4. – साध्या असाध्यत ofव्रण Vrana Chikitsa - Shashtiupakrama Dr Megha R 4 सुखसाध्या त्वचास्थित वयःस्थान (Young), दृढा(Strong) , प्राणवता(Energetic), सत्त्ववता(Self controlled) स्फिक(Gluteal) प्रजनन (Genitalia) ललाट(Forehead) गण्ड (Cheek)पायु (Rectum) ओष्ठ(lip) पृष्ठ( back) कर्ण(ear) फलकोष (Scrotum) उदर(Abdomen) जत्रु(Head) मुखआभ्यन्तर(Oral cavity) कृछ्रसाध्या व्रण that are situated other than त्वक् वृद्ध(Old age) कृश(Emaciated) अल्पप्राण(Less will power) भीरु नेत्र, दंत, नासा, अपांग, कर्ण, नाभि, उदर, नितम्ब, पार्श्व, कुक्षि, उर, कक्षा, स्तन, संधि, पूयरक्त वायु स्त्रवित व्रण, शल्ययुक्त व्रण, अधोभागस्थित व्रण discharge from उर्ध्व भाग, रोमान्त, उपनख, मर्म, जंघास्थित व्रण, अन्तर्मुखी भगंदर, सेवनी, कुटकास्थि (श्रोणीकाण्डास्थि).
- 5. 5 व्रण चिकित्सा निज व्रण •According to Sushruta – षष्टि उपक्रम • According to Charaka – षट्त्रिंशति व्रण उपाक्रमत • According to Vagbhatta – शोधन, रक्त मोक्षण (Mainly जलौकवचलण), लेपन, प्रदेह, Application of वेशावर / निर्वापन, उपनाह, दारण, पिडन सध्यो/आगंतुज व्रण • According to Sushruta – First 7 days it should be treated with कषाय मधुर शित स्निग्ध धार followed by Previously mentioned व्रण चिकित्सा • According to Vagbhatta – सेचन/परिषेक, लेपन, संधान, वमन, विरेचन, लङ्घन, रक्तमोक्षण for 7 days followed by व्रण चिकित्सा Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 6. व्रण चिकित्सा accordingto Charaka Acharya Charaka has told urdwa and adhobhaga shodhana i.e., vamana and virechana, shastra karma and basti karma Vrana Chikitsa - Shashtiupakrama Dr Megha R 6 शोधन Cleansing शोफघ्ना 6 शस्त्र कर्म 6 surgical procedures like incision, excision, puncturing, scraping, scarification, suturing अवपिडन Pressing निर्वापण Sheeta dravya application सन्धान Uniting स्वेदन Fomentation शमन Pacification एषण Probing शोधन कषाय Cleansing decoction रोपण कषाय Healing decoction शोधन लेप Cleaning paste रोपण लेप Healing paste शोधन तैल Cleansing oil रोपण तैल Healing oil शोधन घृत Cleansing ghee रोपण घृत Healing ghee बाह्य पत्र छादन Covering of leaves आभ्यंतर पत्र छादन बन्धन Bandaging पथ्य आहार Diet उत्सादन elevation अवसादन Depression क्षार Alkaline अग्नि cauterization काठिन्यकर धूपन Hardening fumigation मार्दवकर धूपन Softening काठिन्यकर लेप Hardening paste अवचूर्णन Dusting / powdering व्रण्यकर्म colourisation रोपण Healing लोमरोहण Repilatory 36 Vrana upakarma’s has been explained
- 7. षष्टि उपक्रम अपतर्पण Fastingलेखन Scrapping तैल Use of medicated oil वस्तिकर्म Enema आलेप Application of medicinal paste एषण Probing रसक्रिया Thick decoction उत्तरवस्ति Douching परिषेक Irrigation आहरण Extraction अवचूर्णन Dusting बन्ध Bandaging अभ्यङ्ग Anointing व्यधन Puncturing व्रणधूपन Fumigation पत्रदान Application of leaves स्वेद Fomentation विस्रावण Drainage उत्सादन Promotion of granulation tissue कृमिघ्न Disinfection विम्लापन Gentle massage सीवन Suturing अवसादन Removing of granulation tissue बृंहण Restorative measure उपनाह Application of poultice सन्धान Approximation of margin मृदुकर्म Softening विषघ्न Antioxidant पाचन Induction of Suppuration पीडन Squeezing दारुणकर्म Hardening शिरोविरेचन Medication through nasal route विस्रावण Blood letting शोणितास्थापन Hemostasis क्षारकर्म Chemical cauterization नस्य Nasal drops स्नेह Internal oleation निर्वापण Soothing अग्रिकर्म Thermal cauterization कवलधारण Gargling वमन Emesis उत्कारीका Warm Application कृष्णकर्म Pigmentation धूम Medicinal smoking विरेचन Purgation कषाय Decoction पाण्डुकर्म Normal skin color मधुसर्पि Internal ghee and honey छेदन Excision वर्ति Use of medicated wicks प्रतिसारण Rubbing यन्त्र Instrument भेदन Incision कल्क Medicated paste रोमसञ्जनन Promoting of hair growth आहार Diet दारण Bursting by medicine application सर्पि Use of medicated ghrita लोमापहरणं Depilation रक्षाविधान Asepsis Vrana Chikitsa - Shashtiupakrama 7
- 8. 8 Incorporation of Shashtiupakramain Saptopakrama • Apatarpana, Alepa, Parisheka, Abhyanga, Swedana, Vimlapana Vimlapana • Visravana, Snehana, Vamana, Virechana Avasechana • Upanaha, Pachana Upanaha • Chedana, Bhedana, Dharana, Lekhana, Eshana, Aharana, Vyadhana, Visravana, Seevana Patana • Sandhana, Peedana, Shonitasthapana, Nirvapana, Utkarika, Kashaya, Varti, Kalka, Sarpi, Taila, Rasakriya, choorna, Dhoopana Shodhana, Roopana • Utsadhana to Rakshavidhana (26 procedures) Vaikrutapahan Vrana Chikitsa - Shashtiupakrama Dr Megha R Vranashopa chikitsa Shastra karma Vrana chikitsa
- 9. 9 Incorporation of Shashtiupakramain TRIVIDHAKARMA Nirvapana, Utkarika, Kashaya, varti, Kalka, Sarpi, Taila, Rasakriya,Avachurnana, Vranadhoopana, Utsadana, Avasadana, Mrudukarma, Dharunakarma, Ksharakarma, Agnikarma, Krishnikarma, Pandukarma, Pratisarana, Romasanjanan, Romapaharana, bastikarma, Uttarabasti, Bandhana, Patradana, Krimighna, Brihmana, Vishagna, Shirovirechana, Nasya, Kavala, Dhooma, Madhusarpi, Ahara, Rakshavidhana Pashchat karma Chedana Bhedana Dharana Lekhana Eshana Aharana Vydhana Visravana Seevana Sandhana Peedana Shonithasthapana Yantra Pradhana karma Apatarpana Alepa Parisheka Abhyanga Sweda Vimlapna Upanaha Pachana Visravana Snehana Vamana Virechana Poorva karma Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 10. 10 Vrana Chikitsa -Shashtiupakrama Dr Megha R 1. अपतर्पण (Fasting) One of the Shodhana chikitsa अपतर्पणमाद्य उपक्रमः First chikitsa for all vranashopha. Considered as Pradhana upakarma among all due to it Ashukari guna Apatarpana also called as Langhana/Upavasa should be advised in aama condition along with dosha, dhatu and mala dushti to bring them back to normal condition. To break the pathology and to limit the progression of disease. 2. आलेप (Application of medicinal paste ) Used in Vranashopa and extremely painful vrana. Aalepana dravyas are used based on the dosha predominance. Mainly used for shamana of local kupita dosha and reduce vedana and daha locally. It dose Manah prasanata, vrana shodhana, shopa nivarana, vrana utsadana and ropana. 3. परिषेक (Irrigation) Wound irrigation or sprinkling with dugdha, ghrita, kwatha etc. based on dosha predominance to pacify dushita dosha. Mainly does shamana of sthanika doshagni. Does daha and vedana shamana.
- 11. 11 Vrana Chikitsa -Shashtiupakrama Dr Megha R 4. अभ्यङ्ग ( Anointing ) Anointing or massage with oil to soften the vranashopha. Local abhyanga help in relieving srotoavarodha and prevents progression of disease. 5. स्वेद (Fomentation) Vedanayukta(Pain), Daruna(Indurated), Katina(Hard) Swedana is done Does Doshavilayana 6. विम्लापन (Gentle massage) विम्लापनम् अङ्गुल्यादिमर्दनेन Gentle massage using bamboo, pani-padatala, angushta Done in case of alpa, shulayukta vranashotha. 7. उपनाह (Warm Poultice) Used in Ama avasta of vranashopha Leads to early resolution or suppuration
- 12. 12 Vrana Chikitsa -Shashtiupakrama Dr Megha R 8. पाचन (Induction of suppuration) Alepa of Teekshna-ushna dravyas on Pachymana vranshotha Leads to Pakwavastha. 9. विस्रावण (Blood letting) Recommended in Kathina shotha, Vedanayukta, vishama and Savisha vrana. Helpful to reduce pain in newly formed Vranashotha. 10. स्नेह (Oleation) As a brihmana karma in vataja vrana or as a poorvakrama of visravana Useful in newly formed vranashotha, Can also be used in Vrana upadrava avastha. 11. वमन (Emesis) Newly formed vranashotha, Prescribed in utsanna mamsashopha, kapha dushti. 12. विरेचन (Purgation) In jeerna vrana/ chirakari vrana, Pitta-Vataja vrana.
- 13. 13 Vrana Chikitsa -Shashtiupakrama Dr Megha R छेदन(Excision) Kathina, Sthira, Apaki, snayukothayukta vrana भेदन(Incision) Puyayukta vranashopha, utsangi, vidradi without opening, gatiyukta vranashopha. दारण(Bursting by local application) Adopted in bala, ksheena, and marmastitha vrana लेखन(Scraping) Done on sthulaoshtha, utsanmamsa, kathina vrana. Should be done using kshouma, plota, pichu, and kharapatra. एषण(Probing) Decides the direction or gati of vrana. आहरण(Extraction) Extraction of foreign body from sukshmamukhi vrana. व्यधन(Puncturing) विस्रावण(Drainage) To drain out puya. Should be done only in pakwaavasta. सीवन(Suturing) सन्धान (Grafting) Done in apaki, without any upadrava, mamsastitha, vivruta(widely gapping) पीडन(Squeezing) In puyayukta vrana, sukshmamikhi vrana शोणितास्थापन(Haemostasis) Indicated in agantuja, Sadyovrana and shastrakarmaja vrana.
- 14. 14 Vrana Chikitsa -Shashtiupakrama Dr Megha R 25. निर्वापण (Cooling measures) • Lepa and seka of sheetala dravyas. • Applicable in Kapha-Pitta-Rakta dushti vrana and dahayukta vrana. • Does Sandhana karma and ushna guna shamana. 26. उत्कारीका (warm application) • It is indicated for Ksheenmamsi, Alpasravi, Todayukta, Shulayukta, Kathinyayukta and Kampayukta Vrana. • Vataghna dravyas are used. • कषाय(Wound Cleaning) - For Dushtavrana Shodhana Kashaya dravyas are used, for suddhavrana Ropana Kashaya dravyas are used. • वर्ति (medicated wicks) - Indicated in Puyayukta, Dushta and Suddhavrana. Varti is useful in Sukshmamukhi, NadiVrana and deep Vrana. • कल्क (Medicated paste) - Shodhana Kalka is applied in Shalyayukta, Anumukhi, Gambhira, Putimamsi Vrana while Ropana Kalka is applied in MarmasthitaVrana. • सर्पि (Medicated ghee) - This Upakrama is indicated for Pittaja, Raktaja, Vishaja, Agantu and Gambhir Vrana. • तैल (Medicated oil) - Vata-KaphajaVrana, Utsannamamsi and AlpasraviVrana. • रसक्रिया - Shodhana and Ropana Rasakriya are used for Dushta and Sudhavrana respectively. • अवचूर्णन (Dusting) - Twaksthita, Sthiramamsi, Avikrutakruti and GhrishtaVrana. • व्रणधूपन (Fumigation) - Vataja, Tivrashulayukta and Sravi Vrana. Fumigation is done with many preparations, which are mainly containing Ghrita, Vacha, Sarjarasa etc. 27. कषाय to 34. – व्रणधूपन Upakramas are used for Shodhana and Ropana of vrana. The dravyas used depends on the dosha predominance. Shodhana dravyas for cleaning the Dushta vrana and Ropana dravya for enhancing the healing of suddhavrana.
- 15. 15 Vrana Chikitsa -Shashtiupakrama Dr Megha R 35. उत्सादन (Promoting granulation tissue) to 60. रक्षाविधान(Asepsis) may be considered into the last saptaupakrama of sopha i.e.Vaikritapaham उत्सादन (Promoting granulation tissue) अवसादन(Removing granulation tissue) मृदुकर्म (Softening procedure) दारुणकर्म (Induction of fibrosis) क्षारकर्म (Application of Caustics) अग्रिकर्म (Cauterization) कृष्णकर्म (Pigmentation) पाण्डुकर्म (Normal color) प्रतिसारण (Rubbing) रोमसञ्जनन (Promoting hair growth) लोमापहरण (Depilation) पत्रदान (Application of leaves) यन्त्र (Usage of instruments) Sthanika (Local treatment) वस्तिकर्म (Enema) उत्तरवस्ति (Douching) बन्ध (Bandaging) कृमिघ्न (Disinfection) बृंहण(Nourishment) विषघ्न (Neutralization of poison) शिरोविरेचन नस्य कवलधारण (Gargling) धूम (Medicinal smoking) मधुसर्पि (Combination of Ghee and honey) आहार (Diet) रक्षाविधान (Asepsis) Nasal therapy Sarvadaihika (Systemic treatment)
- 16. Vrana Chikitsa -Shashtiupakrama Dr Megha R 16 उत्सादन – AlpamamsiVrana, vata, vata-pittaja, Dushta vrana. Aalepa of VataghnaDravyas with Ghrita is applied for Utsadana. Utsadana is for rising of the beds and cavities of deep Vranas. अवसादन - UnnatmamsiVrana and is achieved by applying Avasadan drugs and Madhu मृदुकर्म - in Vataj, Kathina, AlpamansiVranas with the help of lotions, Ghrita etc. – दारुणकर्म in MruduVrana, Kashayarasatmaka Dravyas are used for this purpose. क्षारकर्म- Shodhana of Chirakari, Kandu, Kleda and SravayuktaVrana. For this application of Teekshna, Ushna Gunatmak Kshara is used. अग्रिकर्म - Atiraktasravi, Sandhichchinna, Ashmarinirharan Shastrakarmaja Vrana कृष्णकर्म - The blackening of white cicatrix by using medicinal drugs such as Bhallatak Taila. पाण्डुकर्म - treated with drug like Haritaki with Ajaksheera that make skin similar to surrounding skin. प्रतिसारण - impart natural skin colour to a discolored scar by Applying medicinal Churna. रोमसञ्जनन - produce hair on a scar which is lacking hair. Like rubbing Hastidanta masi लोमापहरणं - remove Roma from Romavyapta and Nonhealing Vrana. It is done by using Yantra as well as by applying Medicinal Dravyas. For this purpose, shankha Churna & haratala in 2:1 ratio mix with amla dravya and apply as lepa.
- 17. 17 Vrana Chikitsa -Shashtiupakrama Dr Megha R बन्ध - It is necessary to keep the Vrana away from foreign bodies, to keep gatra in position and to promote healing. पत्रदान- selected according to Doshadushti in Vrana, they are lubricated, either heated or cooled and tied over Vrana. It serves to generate heat or cold and retain medicated oil at Vrana कृमिघ्न - destruction of Krimi and Relieving Kandu. It includes washing by Kashaya and application of Kalka of Krimighna Dravyas. बृंहण indicated for Vataj, Ruksha, and Chirakari Vrana and in Krusha Rugna. रक्षाविधान It is the measure adopted to protect the Vrana from Krimi, Jantu etc. It is done by keeping Vranitagara very clean and by Dhoopana by Krimighna and Rakshoghna Dravyas. Mantra vidhi, yama, niyama should be followed.
- 18. 18 Vrana Upadrava 5 Akriti, Gandha,Srava, Varna, Vedana Vranita Upadrava 10 Jwara, Atisara, Murcha, Hikka, Chardi, Arochaka, Swasa, Kasa, Vipaka, Trishna Vrana Chikitsa - Shashtiupakrama Dr Megha R UPADRAVA
- 19. 19 AKRITI Vrana Prakruta Akriti •Aayata(Dheerga) – Rectangular • Chaturasra – Square • Vrutta – Circular • Triputaka – Triangular Agantuja Vrana Akriti • Aayata (rectangular) • Chaturasra(Quadrangular/Square) • Trayasra(Triangular) • Mandala (Circular) • Ardachandrakara(C – Shaped) • Vishala (extensive) • Kutila (Crooked) • Sharava(Depressed in center) • Yava (Raised in center) Vikruta Vrana Akriti • Shapes apart from these are considered as Vikruta Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 20. 20 VRANA VARNA Vataja Bhasma (Ash),Kapota(Grey), Asthi varna(Burnt bone), Parusha(rough), krishna(dusky). Pittaja and Raktaja Neela(bluish), Peeta(yellow), Harita(green), Krishna(Dark/dusky), Rakta, kapila(orange) Kaphaja Shweta(Whitish), snigdha(unctuous), Pandu(Pale). Tridoshaja Sarvavarna (combination of all the doshik colors) Asadya vrana varna Dyama (Krishna varna – Black), Kunkuma, kankushta, pitta vitiated varna. Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 21. 21 VRANA SRAVA (BASEDON DOSHAS) Vataja – Parushya (Rough), Shyava (Blackish), Avashyaya(Foggy), Dadhi mastu(supernatant water of curd), ksharodaka, mamsadhavana, pulakodaka. Pittaja – Gomeda (Zircon), Gomutra, Bhasma, Shanka, Kashayodaka, madhvika taila. Kahaja – Kasisa, Navaneeta, majja, pishta, tilataila, narikelodaka, Varaha vasa. Tridoshaja – Narikelodaka, ervaruka, rasa kanjika, arukodaka, priyanguphala, yakrit, mudgha yusha. Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 22. 22 Vrana srava (Basedon adhishtana) Twak srava is seen on grishta(scratch), chinna(Laceration), sphota(bursting), binna(abrasion) which resembles saleela prakasha(serous), visra Gandha and peetavabhasata. Mamsa – Sarpi prakasha, Sandra, Shweta, picchila. Sira – Raktatipravrita on damage to sira, on suppuration puya gamana(Pus discharge), srava will be tanu(thin), vicchina(less quantity), pichila, avalambhi, shyava varna. Snayu – snigdha, ghana, singanaka Pratima, sa- raktata Asthi – site of injury will cracked or fractured, asthi becomes Nhi- sara, discharge will resemble shukti dhouta(oyster water) Sandhi – On movement of sandhi srava will be pichila, avalambi, sa- rudira. Koshta – Srava of rakta, mutra, purisha and puya from injured site. Marma – all the above lakshanas depending on the site. Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 23. 23 Asadya Vrana Srava SthanaSrava Vrana Chikitsa - Shashtiupakrama Dr Megha R Pakwaashaya Raktashaya Amashaya Trikasandhi Pulakodaka Ksharodaka Kalaya Kalaya
- 24. Vrana Chikitsa -Shashtiupakrama Dr Megha R 24 Vrana Gandha PRAKRUTA • Vata – Katu • Pitta – Tikshna • Kapha – Visra (Aama) • Rakta – Loha • Tridosha – Samishra • Vata-Pitta – Laaja • Vata-Kapha – Atasi • Pitta-kapha – Taila Gandha • Dwandwaja – Aama gandha APRAKRUTA • Madhu, Agaru, Sumana, Padma, Chandana, Divya Gandha, Shwana, Ashwa, Mushika, Kaka, Putivalluraka, kathphala, pankha, bhumi etc
- 25. 25 Vrana Vedhana combination of allthe above pain. Tridoshaja Kandu(itching), Gurutva(Heaviness), Suptata(Numbness), Upadeha(Paste like coating), Alpa Vedana(Mild pain), Stabda( rigidity), Shitya(coldness) Kaphaja Osha(Local burning sensation), Chosha(Regional burning sensation), Paridaha(Generalised burning sensation), Dhumayana(Smoking), Angaraavakirniva(Red hot coal), Ushnativrudhi(Rise in temperature), Ksharavat dahana(Caustic). Pittaja Todana(Pricking pain), Bhedana(Stabbing), Tadana(Beating), Chedana(Cutting), Aayamana(Stretching), Manthana(Churning/Drilling), Vikshepana(Throwing), Chumchumayana(Irritating), Nirdahana(Burning), Avabhanjana(Breaking), Sphotana(Bursting), Vidarana(Tearing), Utpatana(Driving), Kampana(Cramping), Vivida shola(Vague pain), Vishleshana(Dividing), Vikirana(Radiating), Stambhana(Stiffness), Purana(Filling), Swapa(Numbness), Aakunchana(Cramps), Ankushika(penetrating), akarana Vedana(unknown origin), Punah-punah Vedana(Recurrance). Vataja Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 26. 26 Pathya – ApathyaAhara in VRANA PATHYA APATHYA Charaka (Chi.25/97-98) Na Ati Sheet, Na Ati Guru, Na Ati Snigdha, Avidahi Lavana, Amla, Katu, Ushna, Vidhahi, Guru, Viruddhanna, Adhyashana, Sushrutha (Sutra.19/33 - 36) Jeerna Shaalyodana, Jangala Mamsa, Tanduliyaka, Jivanti, Sunishannaka, Vastuka, Bala- Mulaka, Vartaka, Patol, Karvellaka, Dadima, Amlaki, Saindhava, Mudga Rasa, Saktu, Vilepi, Kulmasha, Shrit-Jala Navadanya, Masha, Tila, Kalaya, Kulatta, Nishpava, Haritaka, Amla, Lavana, Katu Rasa Pradhana Dravyas, Guda Pishta Vikruti, Vallura, Shushka Shaka, Aja, Avi, Aanupa, Oudaka Mamsa, Shitodaka, Krushaara, Dadhi, Dugdha, Takra Vagbhatta (Sutra.29/34- 40) Yava, Godhuma, Sashatika, Masura, Mudaga, Tuvari, Jivanti, Sunissnika, Bal- Mulaka, Vartaka, Tanduliyak, Vastuka, Karvellaka, Karkota, Patola, Katukaphala, Saindhava, Dadima, Dhatri, Ghrita, Jala, Jangala Mansa Rasa. Nava Dhanya, Tila, Masha, Mansa, Ksheera, Ikshu-Vikrati, Amla, Katu, Visthambi, Vidahi, Guru, Sheetal, Madhya. Yogratnakara (SarvaVrana RogaPathyaAp athya) Yava, Sashtika, Godhuma, Shali, Yusha (Masura, Tuvari, Mudga), Madhu-Sharkra, Vilepi, Laj- Manda, Jangala Mriga-Pakshi, Ghrita, Taila, Patola, Vaitagra, BalMulaka, Vartaka, Karvellaka, Karkota, Tanduliyaka. Ruksha, Amla, Sheeta, Lavana, Vyavaya, Aayasa, Ucche-Paribhasanam, Priyasama-Alokanam, Nidra, Prajagaram, Nitanta Chankraman, Shoka, Viruddhashana, Ambu Pana, Tambula, Patra- Shaka, Ajangal Mansa. Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 27. 27 Pathya – ApathyaVihara in VRANA PATHYA APATHYA Charaka (Chi.25/97-98) Aswapnam diva Maithuna Sushrutha (Sutra.19/33 - 36) Nicha nakha and roma, shuchi, shukla vaasina, dhoopa with sarshapa, nimba leaves, lavana and ghee Should avoid chankramana, asana, streenaam darshana, sambhasana, samsparsha, vaata, atapa, rajo, dhooma, irshya, bhaya, shoka, raatri jagarana, vishama aashana, shayana, upavasa, vyayama, Vagbhata (Sutra.29/34- 40) Aswapanam diva Maithuna Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 28. 28 Discussion • Acharya Sushruthadescribed Vrana and Vrana Upakramas in detail. It is easy to learn and apply the principle of saptopakrama in the management of surgical wounds whereas Shashtiupakrama provide us lot of option for the management of wound in different stages. • Acharya has no where mentioned that all the 60 upakramas should be used in all type of vrana, he has given few examples/lakshana while explaining each upakramas and its applicability. Hence it’s the management of vrana should be based on the yukti and avasta of the vrana. • Along with the local vrana chikitsa, the attention has been given on the Vranita and his general health, which includes various systemic treatment mentioned in the Shastiupakramas of Sushruta. Vrana Chikitsa - Shashtiupakrama Dr Megha R
- 29. 29 Vrana Chikitsa -Shashtiupakrama Dr Megha R THANK YOU