OFFICE PROCEDURES AND COST –EFFECTIVE TREATMENT IN SHALAKYATANTRA Souvenir on shalakyatantra 2002 It is day to day experience , that Basic principles, especially the Triskandha Sutra stated by Ayurveda are really eternal of any branch of Ayurveda; it may be Shalya tantra, Shalakya tantra, Kayachikitsa, or Stri Rog Prasuti Tantra. It is obvious that this requires sharpness of intelligence and perfect acumen clinically, alongwith a courage to follow it. It is said that India is poor country. This may be right or wrong; if true, it cannot be imagined how much rich are the other countries. Ayurveda is very advanced science. It is upcoming at both, in our country as well as western world. People want it. But I cannot guess if it is wanted by our graduates, as they want Allopathy more than our Ayurveda. Such a contradictory fact is seen at least in Pune. Whatever it may be; if we want rejuvenation of Ayurveda, it must be proved and practiced in the form of positive results on patients, every moment. Its results in the positive form must be a frequent experience by general public and even to our Graduates. It is a need of hour to have an economical regime of treatment of a Vaidya of Ayurveda in this era of ever - costly medicine. I always make an ernest effort in this direction. This is a small effort to present this side of our Science. We are going to consider here, some of the conditions in ShalakyaTantra, which require quick relief to the patient. I have practiced these remedies on hundreds of patients, which I am going to present here. I can demonstrate them even here; and if it is not sufficient, you can affirm it by interrogating any of my such patients.
KARNA SHULA : Ayurveda has advocated to instil Sesame oil drops in the Vataj Karnashula. Some time before, I translated some of the part of Hasti- Ayurveda, where I got a reference regarding a remedy for Dantashula, in which, instillation of Sesame oil in the ear of same side was advocated. I did the same experiment with some modifications in Human beings and got positive result. Thus I got the experience of -
एकं शास्त्रमधीयानो न विद्यात् शास्त्रनिश्चयम्। तस्माद् बहुश्रुतः शास्त्रं विजानीया चिकित्सकः ॥ सु.सू.४/६
It is equally imporlant here, that Dantashula is Vataj. For eliminating fatigue and having-peaceful sleep nothing equals karnapuran by sesame oil. This statement is subject to under presumption of a normal ear. It is a debatable point, that whether one should advise to instil oil in ear. Reason is Staunch oppose from the Westerners. It is both right and wrong .We forget here the indications of Karnapuran. Ayurveda has laid down some specific criteria regarding the following points-
1] Which oil is expected by Ayurveda ? Ans.: Sesame ol is exsected. () [because of its specific properties in treatment]. 2] How much it should be warm? Ans.:- Sesame oil is taken from a lamp for 24 hrs. (Hence, continuous heat and light make it sterile). Such Til taila should be used in a state of low temperature indicator (i, e. tolerable by our finger) 3] What is the quantity to be used?- The quantity should be such that , after dipping our index finger up to 2nd knuckle in oil, whatever amounts of oil is dropped down is the dose of instillation
(see fig no.1)
Who will dare to question such scientific acumen like selection of Oil, temperature barely sustainable by finger, as well as non freezing property of the Til taila? Certainly NOT And If the oil is instilled without following these guidelines, it is unnecessarily blamed on our science . Still, we make tall claims about Karnapuran without taking note of these precautions by our parents / grandparents. Such facts must be studied in details by our P.G. Scholars of Shalakyatantra.
Another beneficial treatrnent in Otalgia is the Agni karma done at Apanga pradesha or the Viddhakarma al the same site
(See Figure No.2).
In Dentalgia, Viddha therapy has been advised at the root of tongue-
जिव्हारोगेषु अधोजिव्हायां दन्तव्याधिषु च । सु.शा.८/१७
In diseases of tongue and teeth , puncture at the base of the tongue should be performed. Location-On the veins of both sides of frenulurn of tongue. Prick to cause bleeding. OR Location- Above the Adam’s apple, in the depression of upper border of hyoid bone Vasculature Ant. Jugular vein. Innervations -Branches of cut. Cervical ns. Hypoglossal N. and Branches of Glossopharyngeal N. Fig. No. 2 Root of Tongue. Fig. No. 3- Anterior aspect of Neck, point just above Adarm's apple
This place is Adam's apple or the site of attachment of the Frenulum of tongue. In the diseases of tongue & teeth, puncture at base of the tongue should be carried out. The same Viddha therapy is beneficial in the loss of- the conditions like मूक, मिन्मिन्,गदगद् very effectively. Patient will get a magic result. Do not forget that.
MANYASTAMBHA-
मन्यास्तम्भेऽ प्येतदेव विधानं, विशेषतो वातश्लेष्महरैः नस्यैः रूक्षस्वेदैश्चोपचारेत्
One precaution must be mentioned here that pi officinarum- Alpina galangal) should not be used
धूमो हि वक्रकुष्ठोभ्यां विलालयति मस्तिष्कं तध्दि विष्यण्णं नाशाय प्रतिपाद्यते ॥ सु.चि.
This comment indicates very clearly, that use of irritation at root of the nose which can lead to C.S In the same chapter sushruta says
मस्तुलुंगागमो वातवृध्दिरिन्द्रियविभ्रमः । शून्यता शिरसाश्चापि मूर्ध्नि -
This means-Extrusion of brain matter, increase of organs and vacantness of head- these are the signs of head evacuated. This is why, Sushruta has contraindicated the use of Nasya. Instead, he has advised to apply lepa or pradhaman of cardamomum) and vacha ( Acornscallamus), and dry
तस्मात् कुष्ठतगरवर्जितेचैलादिना लेपयेत । सु.चि.४
This definitely indicates that CSF Rhinorrhea is known to A But we, the people of ShalakyaTantra do not diagnose in this way. This is astonishing. Another effective therapy in Manyastambha ( Torticollis as it may be called ) is Agni karma (cauterization) [See Figure No. 4].
Fig No. 4 Back of the Neck (point of Agnikarma on the Post. Neck muscles)
In प्रतिश्याय and D, N. S., internal application of Bhallataka Talia ( Semicarpus anacardium) to the Nasal Septum and Lateral nasal wall is useful. Dose of 3-4 drops is enough for this and immediate effect is relief in blocking sensation of nose. Fig.No. 5- Bhallataka Pratisaran
If there is Anosmia developed in Pratishaya or due to some other reason, Viddha therapy at the tip of nose is to be experimented. Sushruta says- गन्धग्रहणे......नसाग्रेषु.....। सु.शा.८/१७
Location-On tip of the nose. Vasculature – Lateral Nasal branch of facial artery P and vein Fig. No. 6-Tip of the Nose point of SIravyadh
Tamakashwasa alongwith Pratishyay is treated by dry Anjera (Garden fig) + Goraksha Chincha magaja powder ( Adansonia digtata ) daily on empty stomach very effectively. Those who sutfering from recurrent Cold must be advised to apply Ghee at inside of nose daily and a betel leaf along with its stem should chewed. This reduces Pratishyaya as weil as prevents post-nasal discharge. In children, Panavela juice along with honey is fruitful. Instantly beneficial and quick –relieving medicine for Stomatitis is Deep red shoe flower ( i.e.जास्वंद Hibiscus rosasinensis). Two or three flowers must be chewed, which will give instant result. Real SMILE will linger on patients face. You will not get dispensing charges, or trader will not get his commission, but patient will benefit from medicinal expenses and you will get a Consultation fees. Visravana therapy and Viddha therapy have been adivocated al the same places in Ayurveda. In Viddha, evacuation of the collected Dosha is important, in which, the substance having fluidity will be drained, like fluid in Ascites as well as Hydrocele.Even Vayu is evacuated through it.
तत्र या सूक्ष्मशस्त्रविध्दाऽव्यक्तमसृकस्रवति । सु.शा.८/१७
While we are carrying out Viddha therapy, undisclosed bleeding is inevitable, through which Vayu is evacuated first from Sira - this leads to conclusion of the Obstructive pathogenesis (मार्गावरोध ) and normalcy is restored. Trauma on Dhamani Marma leads to noisy and frothy bleeding at first. Although there are secretions in the cases of perforations, Vayu is evacuated first. There is no real difference in the Viddha and Acupuncture, as both the therapies are based on the principles of उष्ण-शीत . Sushruta did not exposed himself by naming Acupuncture, wherein the points to be punctured Jinjun Lt.Yuyu Rt. Liangu won and Sulio point. Cultures. These are same points advocated for by Sushruta
जिव्हारोगेषु- दन्तव्याधिषु-अधोजिव्हायां ..... । गन्धग्रहणे....नासाग्रेषु.....।
In the Otalgia and other related diseases, the ear and round.(अपांगे) Tailors point or लल्याट्यामपांग वा, एता एव शिरोरोगाधिमन्थ प्रभृतिषु रोगेषु इति । सु.शा.
Following are some conditions related to ....treated by Siravedha or Agni karma as stated by 1] उपनासा Depression at intra orbital foramen. Vasculature - Brs. of Facial artery and v. Infra orbital artery and vein. Innervation- Brs of facial N This point is right on the course of intra orbital Nerve. (Sabai)
2] अनन्तवाते कर्तव्यः सूर्यावर्तहरोविधिः । सु.उ.२६/३६ शंखक-पश्चात उपचारेत सम्यक सिराणां अस्रमोक्षणे । सु.उ. २६/४४ सशोफ- अशोफ अक्षिपाक- स्नेहस्वेदोपपत्रस्य तत्र विध्द्वां सिराः भिषक् । सु.उ.१२/३८ Location- Mid point above eye brow.2/3 11/31 Lateral branches of Frontal a. and v. Lateral brs. of Frontal N. (Yang boil)
3]अधिमन्थ- स्वेदयित्वा यथान्यायं सिरामोक्षणं योजयेत्। सु.उ.९/३ अभिष्यंद- पित्तास्यन्दे पैत्तिके चाधिमन्थे रक्तस्रावः स्रंसनं चापि कार्यम्। सु.उ/१०/३ स्यन्दाधिमन्थौ कफजौ प्रवृध्दो जयेत सिरणां अथ मोक्षणेन । सु.उ. ११/३ अर्जुनादि- पुटपाकावसानेन रक्तविस्रावणादिना ॥ सु.उ.१२/२६ पूयालसे – पूयालसे शोणितमोक्षणं च हितं । उ.१२ Location - Depression post. to midpoint between lateral end of eyebrow and outer canthus.
4]शिरोरोगं शिरोबस्तिः हन्ति वाऽसृग्विमोक्षणम । सु.चि.४/१९ भवन्ति याप्याः खलुः ये षडामया हरेदसृक्तेषु सिराविक्षणैः । सु.उ.१७/२८
A group of four points on the vertex of skull ( Antero-posterior and lateral). Considering all these points it seems quite clear that Siravyadha Vidhi, Which is a part of Raktamokshana is very beneficial in shalakya tantra.
यथा कुसुम्भ्पुष्पेभ्यः पूर्व स्रवति पीतिका । तथा सिरासु विध्दासु दुष्टमग्रे प्रवर्तते ॥ सु.शा. ८/१२
As, at first, yellow sap oozes out from kusumbha flowers,vitiated blood comes out first on puncturing the vein. Sushruta has rightly commented in this regard as follows-
सिराव्यधचिकित्सार्धं शल्यतन्त्रे प्रकीर्तितः । यथा प्रणिहितः सम्यग्बस्तिः कायचिकित्सिते । सु.शा. ८/२३
Sira vyadha is known in surgery as half of therapeutic measures, occupying the same place as a properly induced enemata in general medicine. Also, the therapeutic measures like unction, paste etc. do not cause diseases to get pacified as by siravyadha. This is the statement by sushruta -
स्नेहादिभिः क्रियायोगेः न तथा लेपनैरपि । यान्त्याशु व्याधयः शान्तिं यथा सम्यक सिराव्यधात्॥ सु.शा.८/२२
Of course, some of the Ayurvedic simple preparations are really good substitutes for Modern medicines, e.g. the parched Brute borax (टंकणखारलाही) is an excellent mucolytic agent in all the E.N.T. conditions where there are mucoid secretions. Many such cost effective and beneficial remedies have been available in Ayurveda. One can use them to become a successful practioner. i.e.पथ्यापथ्य Ultimately, it must be said that - What is practicality seen and whatever is known from scripture - that both combined together develops the knowledge further. This is very much applicable to Shalya and ShalakyaTantra.
प्रत्यक्षतो हि यद् दृष्टं च यद्भवेत्। समास्तस्त दुभयं भूयो ज्ञानवर्धनम्॥ सु.शा. ५/४८
Please note: The article(s) were written by Dr. R. B. Gogate during 1961-2010. The fundamental relevance of these holds true even today, yet the readers/viewers should consider the timeline and the limited availability of the resources which might conflict with the recent advancements.
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