By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Patana is the fourth sort of therapy talked about amongst ‘Sapta Upakrama’ i.e. the 7 varieties of therapies. These 7 therapies talked about by Grasp Sushruta are usually not solely meant to deal with and heal the injuries, ulcers and associated swelling but additionally to forestall their problems.
Learn – Sushruta’s 7 Sorts of Remedies Sapta Upakrama
“Fourthly patana needs to be carried out…!”
- dividing or
- making incision
Kriya is the strategy during which that is performed. 9 therapies from amongst the checklist of 60 therapies talked about in shashti upakrama are included underneath patana kriya. They have to be selectively carried out as per situation of the wound / ulcer / swelling across the ulcer.
Vimlapana means to melt or trigger to wither. This process is completed to melt the injuries or ulcers. This must be carried out first within the therapy of wounds and ulcers. The primary 6 therapies amongst the Shashti Upakrama are included underneath vimlapana. These therapies needs to be skillfully used to make the injuries or ulcers gentle. The set of those 6 therapies comprise vimlapana.
Learn – Shashti Upakrama That means, Classification, Medical Significance
Primarily 9 therapies are included underneath Patana.
|Sl No||Identify of the Upakrama (therapy)||That means|
If we’re following the chronology of the therapies as per shashti upakrama procedures, patana group of therapies needs to be strictly carried out after upanaha. If the situation of the wound or swelling obtainable on the time of treating the affected person is match to bear one in all these patana therapies instantly, they shall be skillfully chosen.
Learn – Kaphaja Upanaha (Netra Roga) – Definition, Signs, Therapy
1. Chedana – excision
Situations during which excision must be carried out –
- Apakveshu tu rogeshu – within the wounds and ulcers which haven’t undergone suppuration
- Kathineshu rogeshu – wounds and ulcers that are laborious
- Stihreshu rogeshu – wounds and ulcers that are motionless
- Snayu kothadishu – wounds and ulcers whereby gangrene of the ligaments (tendons, blood vessels and many others) have occurred within the environment
2. Bhedana – incision
Situations during which incision must be carried out –
Incision needs to be carried out within the wounds and ulcers / swellings whereby –
3. Daarana – splitting
Situations during which splitting must be carried out –
- Bala Vrddha Asaha Kshina Bhiru Yoshitam – ulcers manifesting in youngsters, previous aged folks, those that are illiberal, emaciated, fearful and in girls
- Marmopari Jateshu – ulcers and wounds manifested on the important spots of the physique
How ulcers are break up ?
a. Pidana – A smart doctor who’s nicely versed and has immense expertise in coping with totally different levels of wounds and ulcers ought to first conduct pidana karma i.e. compression of wounds and ulcers. This needs to be carried out when the swelling across the ulcers are lumped up and the pores and skin across the ulcers has been suppurated.
The best way to do?
The herbs that are prescribed for pidana needs to be floor and made right into a paste. This paste is utilized on and across the opening of the ulcer and allowed to dry. When the paste of medicines dry up it shrinks the pores and skin across the ulcer and imparts strain on the ulcer. This can allow the buildup of pus at one place. The powder of barley, wheat and black gram shall be used for this objective.
b. Darana – After the ulcers and swelling round them have been correctly pressed and compressed following the administration of pidana therapy, darana needs to be carried out. So pidana is the preparation for darana and when carried out on the backdrop of pidana, darana yields good outcomes.
The darana needs to be carried out utilizing darana dravyas i.e. herbs able to splitting or tearing the swelling / ulcer or by means of kshara.
The beneath talked about herbs are used for this objective –
- Chirabilva – Holoptelea integrifolia
- Agni – Semecarpus anacardium
- Danti – Baliospermum montanum
- Chitraka – Plumbago zeylanica
- Hayamaraka – Nerium indicum
- Kapota purisha – feces of pigeon / dove
- Grdhra purisha – feces of vulture
- Kanka purisha – feces of heron
4. Lekhana – scraping
Situations during which scraping must be carried out –
- Kathina – ulcers that are laborious and difficult
- Sthula Vrutta oshtan – ulcers which have thick and rounded edges
- Diryamanan punah punah – ulcers which break open repeatedly
- Kathina utsanna mamsa – presence of laborious and elevated muscle tissue across the ulcers
How a lot scraping needs to be carried out?
- Within the laborious and difficult wounds and ulcers needs to be scraped evenly i.e. neither an excessive amount of nor too much less.
- In thick and spherical edged ulcers scraping needs to be carried out in extra.
- Within the ulcers that break open repeatedly full scraping needs to be carried out with out leaving any portion which must be scraped.
- In ulcers having laborious and elevated ulcers, the extreme parts needs to be scraped off utilizing appropriate devices.
Within the absence of surgical devices for scraping, gauze, cotton, cuttlefish, alkali of barley, rock salt or tough leaves are used for a similar objective.
5. Eshana – probing
Situations during which probing must be carried out –
- Nadivrana – sinus ulcers
- Shalya garbha – ulcers containing overseas substances
- Unmargi vrana – fistula in anal area
- Utsangi vrana – hole ulcers
Shoot of a bamboo, hairs, fingers and metallic probes needs to be utilized by the doctor step by step and thoroughly for the aim of probing.
Learn – Fistula In Ano Ayurvedic Understanding And Efficient Therapy
6. Aaharana – extraction
A smart doctor ought to extract the overseas physique from the wound / ulcer with none a part of it remaining inside it. It shall be extracted from the closed or open ulcers following the ideas of extraction defined within the sutra sthana part. ‘Signs of correct extraction’ are the indications of the overseas physique being eliminated utterly.
Nishalya Lakshana – indicators / signs of correct removing of overseas physique from the wound / ulcer
- Alpa badham – much less hassle / ache
- Ashunam – lack of numbness
- Nirujam – painless
- Nirupadravam – absence of problems
- Prasannam – appears clear
- Mrdu paryantam – edges are gentle / easy
- Niraghattam – motionless
- Anunnatam – not raised
The ulcer having above stated indicators needs to be examined with the assistance of a probe and in addition by flexing and lengthening the a part of the physique / limb whereby the ulcer consisting of the overseas physique is positioned. Following this the surgeon ought to declare that the ulcer / wound / swelling are devoid of overseas materials.
Learn – Sushruta’s 8 Varieties Of Surgical Procedures – Astavidha Shastra Karma
7 and eight Vyadhana – puncturing and Vidravana – liquefaction (drain)
Puncturing and draining of ulcers / wounds (accumulation of fluids within the ulcers and swelling surrounding them) are associated procedures. First the surgeon punctures the ulcers after which drains them of their content material.
Professional surgeon ought to puncture the ulcer / wound that are eligible to be punctured utilizing appropriate devices. Puncturing is beneficial in ailments like ascites, abscess and hydrocele. Following puncture the contents like pus and many others contained within the ulcer / swelling across the ulcer shall be drained.
9. Seevana – suturing
Situations during which suturing must be carried out –
The above talked about measures of Patana therapy are helpful in opening (excision, incision, tearing) the ulcers and swelling round it, to scrap off the undesirable tissues across the ulcers and wounds, to probe the interiors of ulcers and sinuses, to extract the overseas substances impacted contained in the ulcers and swellings, to puncture and drain the gathered fluids like pus and water and for suturing the open wounds and ulcers. All these measures embrace minor surgical measures which have to be carried out at correct time seeing the situation of the ulcers. A very good experience and expertise is required by the surgeon to diagnose the situation correctly and to manage the therapy as per the necessity and situation. These procedures are often carried out after upanaha (poultice and different associated therapies) if chronology is being adopted. The 13 procedures included underneath shodhana (cleaning therapies) and ropana (therapeutic therapies) shall be carried out after patana procedures.