Changes

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' ===

• Vrana (ulcers) are broadly classified into two types viz. nija (endogenous) and agantu (exogenous).  

*''Vrana'' (ulcers) are broadly classified into two types viz. ''nija'' (endogenous) and ''agantu'' (exogenous).  

• The treatment of both types of ulcers is based upon the dosha dominance.  

*The treatment of both types of ulcers is based upon the ''dosha'' dominance.  

• Endogenous ulcers are caused due to vitiation of dosha located in external pathways.

*Endogenous ulcers are caused due to vitiation of ''dosha'' located in external pathways.

• The clinical features of vata dominance in ulcer are stiffness, hardness  on touch, scanty exudation, excruciating and pricking pain with throbbing and blackish discolouration. It should be treated with sampurana (filling of ulcer cavity), intake of unctuous substances (oleation therapy), unctuous fomentation and poultices, ointments and sprinklings.

*The clinical features of ''vata'' dominance in ulcer are stiffness, hardness  on touch, scanty exudation, excruciating and pricking pain with throbbing and blackish discoloration. It should be treated with ''sampurana'' (filling of ulcer cavity), intake of unctuous substances (oleation therapy), unctuous fomentation and poultices, ointments and sprinklings.

• The clinical features of pitta dominant ulcer are excessive thirst, unconsciousness, fever, sweating, burning sensation, impurities at the site of ulcer, tearing and foul smell with discharge pus from ulcer. The treatment includes anointing and sprinkling with cold drugs, intake of sweet and bitter drugs, intake of ghee and purgation.

*The clinical features of ''pitta'' dominant ulcer are excessive thirst, unconsciousness, fever, sweating, burning sensation, impurities at the site of ulcer, tearing and foul smell with discharge pus from ulcer. The treatment includes anointing and sprinkling with cold drugs, intake of sweet and bitter drugs, intake of ghee and purgation.

• The clinical features of kapha dominance in ulcer are sliminess, heaviness, unctuousness, numbness, with mild pain, paleness in colour, little slough and prolonged healing. It is treated with anointing and sprinkling with astringent, pungent, dry and hot drugs as well as fasting and digestive measures.

*The clinical features of ''kapha'' dominance in ulcer are sliminess, heaviness, unctuousness, numbness, with mild pain, paleness in color, little slough and prolonged healing. It is treated with anointing and sprinkling with astringent, pungent, dry and hot drugs as well as fasting and digestive measures.

• The two types of ulcers are further divided into twenty types on the basis of distinctive features. Their examination can be done by three ways, signs of excess vitiation at site of ulcer are of twelve types, eight locations, fourteen types of discharges, sixteen complications, twenty four defects and thirty six therapeutic measures.

*The two types of ulcers are further divided into twenty types on the basis of distinctive features. Their examination can be done by three ways, signs of excess vitiation at site of ulcer are of twelve types, eight locations, fourteen types of discharges, sixteen complications, twenty four defects and thirty six therapeutic measures.

• Skin, blood vessels, flesh, fat, bone, ligament, vital parts and viscera are involved in the pathogenesis of ulcer.

*Skin, blood vessels, flesh, fat, bone, ligament, vital parts and viscera are involved in the pathogenesis of ulcer.

• The treatment of ulcer is done in two ways viz.1. systemic treatment (internal administration)  and 2. Local treatment of ulcer. The treatment is done with drugs that promote healing, purify body and local site of ulcer.   

*The treatment of ulcer is done in two ways viz.1. systemic treatment (internal administration)  and 2. Local treatment of ulcer.  

• The first principle of management of ulcer is body purification through therapeutic emesis, purgation, shastra karma (surgical intervention) or basti (medicated enema) after assessment of condition because the ulcers get healed quickly in those with cleansed body.

 

• The thirty six measures for treatments of ulcers are those for pacification of swelling, six types of surgical operations, pressing, refrigerating, uniting, fomentation, pacification, probing, cleansing, healing, cleaning paste, healing paste, cleaning oil, healing oil, two types of covering with leaf, two types of bandaging, diet, elevation, two types of cauterization, depression, hardening fumigation, softening fumigation, hardening paste, softening paste, powdering, colourisation, healing, repilatory.  

The treatment is done with drugs that promote healing, purify body and local site of ulcer.   

• At first, bloodletting therapy is done first to reduce swelling in ulcer. Upanaha (hot poultice) and patana (incision) are done according to stage of ulcer.

*The first principle of management of ulcer is body purification through therapeutic emesis, purgation, ''shastra karma'' (surgical intervention) or ''basti'' (medicated enema) after assessment of condition because the ulcers get healed quickly in those with cleansed body.

• Six types of surgical treatments are incision, puncturing, excision, scrapping, scarification and suturing.

*The thirty six measures for treatments of ulcers are those for pacification of swelling, six types of surgical operations, pressing, refrigerating, uniting, fomentation, pacification, probing, cleansing, healing, cleaning paste, healing paste, cleaning oil, healing oil, two types of covering with leaf, two types of bandaging, diet, elevation, two types of cauterization, depression, hardening fumigation, softening fumigation, hardening paste, softening paste, powdering, colorization, healing, repillatory.  

• The contraindications in ulcer patients include salt, sour, pungent, hot, burning and heavy food and drinks, sexual intercourse. Food and drinks that are not too cold, heavy and fatty, non-burning, according to the nature of ulcer are beneficial. Day-sleep is not suitable in these patients.

*At first, bloodletting therapy is done first to reduce swelling in ulcer. ''Upanaha'' (hot poultice) and ''patana'' (incision) are done according to stage of ulcer.

• Fractured bone and dislocated joints should be set correctly comparing with its counterpart. Setting with firm pad-bandages and splints, it should be immobilised without any discomfort by binding with cloth pieces dipped in plenty of ghee.

*Six types of surgical treatments are incision, puncturing, excision, scrapping, scarification and suturing.

*The contraindications in ulcer patients include salt, sour, pungent, hot, burning and heavy food and drinks, sexual intercourse. Food and drinks that are not too cold, heavy and fatty, non-burning, according to the nature of ulcer are beneficial. Day-sleep is not suitable in these patients.

*Fractured bone and dislocated joints should be set correctly comparing with its counterpart. Setting with firm pad-bandages and splints, it should be immobilized without any discomfort by binding with cloth pieces dipped in plenty of ghee.

=== Vidhi Vimarsha ===

=== Vidhi Vimarsha ===