Critical review of Shashti Upakrama by Sushruta in vrana management.
Journal name: World Journal of Pharmaceutical Research
Original article title: A critical review on shashti upakrama by acharya shusruta in the management of vrana
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Upendra Bhardwaj and Rajkumar Sharma
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: A critical review on shashti upakrama by acharya shusruta in the management of vrana
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20229-24744
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Summary of article contents:
Introduction
The "Sushruta Samhita," authored by the ancient surgeon Acharya Sushruta, serves as a cornerstone of Ayurvedic medicine and surgery. Comprising numerous chapters on various medical conditions, surgical techniques, and treatments, this text has significantly influenced the evolution of surgical practices in Ayurvedic traditions. Among the many topics explored in the Sushruta Samhita, the management of wounds (Vrana) through the Shashti Upakrama (sixty methods) is particularly noteworthy. This approach underscores the comprehensive strategies available for effective wound management, integrating ancient wisdom with modern principles of care.
The Concept of Shashti Upakrama (Sixty Methods)
The Shashti Upakrama refers to a systematic and holistic approach to wound management described in the Sushruta Samhita. Acharya Sushruta delineates sixty different therapeutic methods. These methods are not just conventional treatments; they encompass a variety of surgical techniques and drug therapies tailored to address different types of wounds at various healing stages. Importantly, these practices also adapt according to the nature of the wound—whether acute or chronic—and the underlying doshic imbalances (Vata, Pitta, Kapha) involved. This comprehensive methodology not only facilitates quick recovery but also emphasizes prevention of further complications.
Ropana Kriya (Healing Management)
One key aspect of the Shashti Upakrama is Ropana Kriya, which focuses on the healing of wounds. Ropana emphasizes the importance of specific herbal preparations and techniques designed to foster tissue regrowth and support recovery from injuries. The methods used in Ropana involve utilizing various medicated oils, powders, and pastes that promote tissue regeneration and restore skin integrity. Sushruta elaborates that in the context of chronic or complicated wounds, the choice of the healing agents and methods must correspond to the doshic state of the patient, thus personalizing treatment for optimal outcomes.
Vaikritapaham (Cosmetic Improvement)
Another crucial element of the wound management process is the concept of Vaikritapaham, which deals with the rectification of any aesthetic blemishes resulting from injuries or surgical interventions. The aim is to restore normal color and texture to the skin post-healing, addressing issues such as scarring and discoloration. This component involves both local and systemic treatments to balance doshas, including the application of special herbal pastes and oils designed to heal without leaving marks. The sophisticated approach to scar management in Ayurveda reflects an understanding of the psychological impacts of physical appearance post-surgery, paralleling modern surgical approaches to scar minimization.
Conclusion
In conclusion, the Shashti Upakrama outlined in the Sushruta Samhita presents a rich framework for managing wounds effectively within Ayurvedic medicine. By combining detailed treatment methodologies like Ropana Kriya with cosmetic considerations under Vaikritapaham, Acharya Sushruta's teachings remain relevant today, offering strategies that align well with contemporary surgical practices. There is a pressing need for further exploration and integration of these ancient techniques within modern medicine, particularly in enhancing wound healing and managing postoperative scars. The teachings of Sushruta provide not only practical solutions but also a philosophical understanding of the interplay between medicine and healing within the context of holistic patient care.
FAQ section (important questions/answers):
What is the significance of Sushruta Samhita in surgery?
Sushruta Samhita, written by Acharya Sushruta, is foundational in Ayurvedic medicine and surgery, detailing surgical concepts, wound management, and various surgical techniques. It remains a critical text for understanding ancient surgical practices.
What does 'Vrana' refer to in Ayurvedic medicine?
In Ayurvedic terminology, 'Vrana' refers to a wound. It encompasses various injuries affecting skin, muscles, and other tissues, emphasizing the healing process and management methodologies described in Sushruta's work.
What are 'Shashti Upkrama' in wound management?
'Shashti Upkrama' refers to sixty different methods for managing wounds described in Sushruta Samhita. These methods cater to different stages of wound healing, aiming at effective treatment based on the wound's condition.
How does Sushruta categorize the management of wounds?
Sushruta categorizes wound management into initial treatments and various surgical procedures, incorporating methods like excision, drainage, and medicated applications, depending on the wound's condition and type.
What modern implications do Shashti Upkrama have?
Shashti Upkrama has modern implications in surgical practice, providing options for wound management and scar treatment. Techniques such as Ksharakarma and Utsadana are relevant for managing chronic ulcers and optimizing healing.
What are the benefits of using Ayurvedic techniques in surgery?
Ayurvedic techniques, including Shashti Upkrama, offer natural and holistic approaches to wound management, combining herbal treatments and surgical interventions that benefit healing, minimize complications, and enhance cosmetic outcomes.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Critical review of Shashti Upakrama by Sushruta in vrana management.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Vrana:
In Ayurveda, 'Vrana' refers to a wound or injury that affects the skin and underlying tissues. This concept includes different types of wounds, their healing processes, and the surgical management described in texts like the 'Sushruta Samhita.' A comprehensive understanding of 'Vrana' is crucial for effective wound care and surgery.
2) Dravya:
The plural form of 'Dravya,' 'Dravyas' encompasses various substances utilized in Ayurveda for healing and treatment. These can consist of herbal formulations, preparations from animal or mineral sources, and are instrumental in therapies, especially in managing wounds, diseases, and promoting overall health.
3) Shodhana (Sodhana):
'Shodhana' means purification or detoxification. In Ayurvedic treatment, 'Shodhana' is applied to remove toxins and impurities from the body, which is particularly important in managing chronic conditions and wounds. Its techniques are vital for restoring balance and promoting the healing process.
4) Upakrama:
'Upakramas' encompass various treatments or methods utilized in Ayurveda to manage health issues. Their application is tailored according to individual conditions and can include drug therapies, surgeries, or lifestyle changes.
5) Ropana:
'Ropana' signifies the process of healing or closure of wounds. Ayurvedic texts, particularly 'Sushruta Samhita,' detail numerous 'Ropana' techniques that support tissue regeneration and recovery after injury, making it a critical focus in wound management.
6) Kashaya (Kasaya):
'Kashaya' refers to herbal decoctions or infusions, commonly used in Ayurveda for their medicinal properties. Often employed in 'Shodhana' and 'Ropana' therapies, 'Kashaya' is crucial for treating wounds and imbalances caused by underlying doshas.
7) Taila (Thaila):
In Ayurveda, 'Taila' means oil, particularly medicinal oils prepared with various herbal constituents. 'Taila' is widely used for therapeutic massage, enhancing absorption of medications, and in wound management to promote healing and soothe skin injuries.
8) Samhita:
'Samhita' signifies an ancient compilation of Ayurvedic texts that detail medical knowledge, including surgical techniques. The 'Sushruta Samhita' is one of the most significant texts, providing insight into surgical practices and wound management principles.
9) Ghrita (Ghrta):
'Ghrita' refers to clarified butter, often used in Ayurvedic therapies. It nourishes tissue and supports healing processes. It is especially beneficial in 'Ropana' strategies for wounds, nourishing the affected area and aiding recovery.
10) Dosha (Dosa):
'Dosha' is a fundamental concept in Ayurveda denoting the three vital energies: Vata, Pitta, and Kapha, which govern physiological functions. Imbalance in these doshas can lead to diseases, and understanding them is essential for effective treatment strategies in conditions like 'Vrana.'
11) Karma (Karman):
'Karma' relates to action or treatment in Ayurveda, such as specific therapeutic measures applied to manage health conditions. Each 'Karma' is tailored to individual needs and conditions, emphasizing personalized healthcare approaches within Ayurvedic practice.
12) Sushruta-samhita (Susruta-samhita):
'Sushrutasamhita' is a significant text in the field of Ayurveda, laying down surgical procedures and management strategies that form the foundation for modern surgical practices in India, particularly in wound care.
13) Disease:
Collectively, 'Diseases' denote various pathological conditions that affect the body. The Ayurvedic approach to diseases emphasizes a holistic treatment plan that addresses root causes and restores balance among doshas.
14) Dushta (Dusta):
'Dushta' indicates a condition that is impure or infected. In wound management, 'Dushta Vrana' refers to non-healing or contaminated wounds, necessitating specialized treatment approaches to restore health and promote healing.
15) Rasakriya (Rasa-kriya):
'Rasakriya' refers to the preparation of concentrated decoctions in Ayurveda. It is essential in both 'Shodhana' and 'Ropana' processes for wounds, often involving the application of a herbal paste to enhance healing.
16) Upanaha:
'Upanaha' signifies a poultice or local application in Ayurvedic therapy. It is particularly useful in treating wounds ('Vrana') by promoting healing, reducing inflammation, and providing a soothing effect through medicinal substances applied externally.
17) Drug:
'Drugs' in Ayurvedic contexts refer to the various formulations and medicinal preparations derived from natural sources. Their proper application is essential for effective wound management, treatment of diseases, and overall health restoration.
18) Utsadana:
'Utsadana' refers to the elevation or improvement of the tissue surrounding a wound. This approach is crucial in wound healing, as it promotes the development of new tissue and the overall recovery process post-injury.
19) Shopha (Sopha):
'Sopha' translates to swelling in Ayurveda, particularly in the context of inflammatory responses. Understanding and managing 'Shopha' is essential in wound care, as it can impede healing.
20) Varti (Vartin):
'Varti' refers to medicated plugs made from herbal pastes used in wound management. They assist in managing deep wounds and infections, helping to absorb exudates and promote healing through localized application of medicinal properties.
21) Kalka:
'Kalka' means a paste made from medicinal herbs used for therapeutic applications. In wound management, 'Kalka' is essential for direct application on wounds for its healing, soothing, and anti-inflammatory properties.
22) Study (Studying):
'Study' denotes the detailed examination and analysis of medical texts and practices in Ayurveda. Research and exploration into treatments, especially regarding wound management, are vital for advancing Ayurvedic knowledge and practice.
23) Krimighna (Krmighna, Krimi-ghna):
'Krimighna' means substances or treatments used to eliminate parasitic infections, particularly in non-healing wounds. This category of treatments is vital in wound management, where purifying and healing actions are crucial.
24) Parisheka (Pariseka):
'Parisheka' refers to the process of pouring or dressing a wounded area with medicated liquids. This technique enhances healing by applying necessary herbs to the damaged skin, facilitating quicker recovery.
25) Vimlapana:
'Vimlapana' indicates a therapeutic massage or gentle manipulation of a relevant body part to soothe conditions like swelling or pain. It plays a significant role in 'Vrana' management by improving blood flow and reducing discomfort.
26) Kathina:
'Kathina' describes hard or painful conditions in Ayurveda. In wound management, recognizing a 'Kathina Vrana' is crucial for deciding the appropriate treatment plan, focusing on softening or easing tension in affected tissues.
27) Shalya (Salya):
'Shalya' refers to foreign bodies or harmful substances embedded in tissues, necessitating removal and management in surgical practice. In the context of 'Vrana,' effective drainage or removal techniques are vital for healing.
28) Patana:
'Patana' means the act of excision or cutting applied during surgical procedures. In wound management, this technique is often necessary for opening abscesses or removing damaged tissue for better healing outcomes.
29) Ushna (Usna):
'Ushna' characterizes warm or hot conditions in Ayurveda. For wound management, understanding 'Ushna' states helps tailor treatments to alleviate fever, inflammation, and promote proper healing.
30) Sarpis (Sarpi, Sarpish):
'Sarpi' refers to medicated ghee used in Ayurveda for therapeutic applications. It is especially beneficial for calming inflammation and promoting healing processes in various wound management contexts.
31) Vata:
'Vata' is one of the three doshas in Ayurveda, governing movement and communication within the body. An imbalance in 'Vata' can lead to excessive dryness or poor healing of wounds, emphasizing the need for targeted treatments.
32) Dushtavrana (Dushta-vrana, Dusta-vrana, Dustavrana):
'Dushta-Vrana' refers to a type of wound that is infected or not healing properly. Effective interventions are needed for its management, integrating various Ayurvedic treatments and principles.
33) Utkarika:
'Utkarika' denotes a thick, medicated poultice in Ayurveda. It is emphasized in wound management to support healing by providing a protective barrier and ensuring adequate moisture and nutrition to the wound area.
34) Sandhana (Samdhana):
'Sandhana' refers to the process of surgical joining of tissue, particularly in suturing wounds. Effective 'Sandhana' is a crucial skill for surgeons to promote optimal healing and tissue adhesion.
35) Medicine:
'Medicine' encompasses the science and practice of healing and treatment of illnesses. In Ayurveda, medicine focuses on natural substances and holistic approaches to restore balance and health.
36) Langhana (Lamghana):
'Langhana' refers to therapies aimed at reducing body heaviness or mass by subduing excessive doshas. This principle is crucial in treating conditions where imbalance leads to chronic wounds or obesity.
37) Shastra (Sastra):
'Shastra' translates to scriptures or treatises in Ayurveda, detailing techniques and knowledge pertaining to healing practices. 'Shastra' forms the backbone of Ayurvedic medical education and therapeutic application.
38) Bhedana:
'Bhedana' involves creating an incision or opening in tissues for therapeutic purposes. This technique is significant in wound management for effective drainage or managing deeper layers of tissue damage.
39) Lekhana:
'Lekhana' means scraping or abrading the surface of tissues to promote healing. It is commonly used in Ayurvedic procedures to cleanse wounds and facilitate better recovery outcomes.
40) Pradeha:
'Pradeha' denotes a medicated paste applied to the affected area, particularly in treating wounds. This therapeutic action aids in soothing pain and promoting the healing process.
41) Raktaja:
'Raktaja' refers to blood-related conditions or wounds in Ayurveda. Understanding 'Raktaja' is essential in the management of wounds and other health issues arising from excessive bleeding or vascular problems.
42) Pittaja (Pitta-ja):
'Pittaja' indicates conditions caused by an imbalance in the Pitta dosha, often characterized by heat or inflammation. It plays a significant role in wound healing strategies that aim to cool and soothe affected areas.
43) Shuddha (Suddha):
'Shuddha' translates to purity or cleanliness, which is vital in wound healing and management in Ayurveda. Maintaining 'Shuddha' conditions helps prevent infection and promote better healing outcomes.
44) Science (Scientific):
'Science' refers to the systematic study of the structure and behavior of the physical and natural world. In Ayurveda, scientific principles are integrated with traditional practices for effective healing and wellness.
45) Tantra (Tantrism, Tamtra):
'Tantra' represents systems or methodologies in Ayurveda and medicine. A clear understanding of 'Tantra' informs practitioners on the application of principles to achieve optimal patient outcomes.
46) Yantra (Yamtra):
'Yantra' refers to instruments or tools used in therapeutic procedures within Ayurveda. Proper instruments are essential for executing treatment plans effectively, especially in surgical practice.
47) Siddha:
'Siddha' relates to perfected or accomplished practices in Ayurveda, often denoting herbal preparations that have undergone rigorous testing and validation for efficacy in treatment.
48) Ruksha (Ruksa):
'Ruksha' denotes dryness or a quality that may aggravate the Vata dosha. In wound management, addressing 'Ruksha' characteristics is crucial for ensuring proper moisture balance and healing.
49) Vamana:
'Vamana' refers to therapeutic vomiting induced in Ayurveda to expel excess Kapha dosha. It is a vital treatment in managing certain conditions that could impact wound healing and overall health.
50) Jaipur:
A historical city in India, Jaipur is known for its rich heritage. This city is often associated with Indian traditional medicine, including Ayurveda, where practitioners apply ancient knowledge to treat various diseases.
51) Madhu:
'Madhu' denotes honey, used in Ayurvedic medicine for its natural healing properties. It plays an essential role in wound healing due to its antimicrobial and soothing attributes.
52) Nasya (Nashya):
'Nasya' refers to nasal administration of medications in Ayurveda. This therapeutic method can help in treating Urdhvajatrugata diseases, which can indirectly affect overall health and well-being.
53) Rakta:
'Rakta' signifies blood in Ayurveda and is considered one of the vital dhatus. The management and understanding of 'Rakta' are crucial in treating wounds related to blood loss or disorders.
54) Raktamokshana (Rakta-mokshana, Raktamoksana):
'Raktamokshana' refers to bloodletting, an ancient therapy in Ayurveda aimed at detoxifying and purifying the body, often applied for managing various blood-related conditions in wound care.
55) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalyatantra is the unique discipline of Ayurvedic surgery, focusing on surgical methods, wound care, and trauma management. It employs a mix of traditional and empirical knowledge for effective practice in the surgical field.
56) Cauterisation (Cauterization):
'Cauterization' involves applying heat or chemical agents to tissues. In Ayurveda, this technique is used for treating non-healing wounds and achieving desirable tissue effects in 'Shalya-Tantra.'
57) Kaphajavrana (Kaphaja-vrana):
'Kaphajavrana' denotes wounds that arise due to an excess of Kapha dosha, often resulting in slow healing and edema. Specialized approaches in Ayurveda help manage such conditions effectively.
58) Pratisharana (Pratisarana):
'Pratisarana' refers to the application of restorative therapies aimed at enhancing tissue quality and improving healing outcomes. This practice is vital for recovering skin integrity following wounds.
59) Sadyovrana:
'Sadyovrana' means an acute wound that results from injury. Immediate management is essential to ensure proper healing and prevent complications, a focus in Ayurveda's surgical practices.
60) Apatarpana:
'Apatarpana' signifies the process of reducing excess body mass or impurities. In Ayurvedic treatments, this principle aids wound healing by addressing underlying imbalances causing slow recovery.
61) Sprinkling:
'Sprinkling' generally indicates the application of herbal pastes or liquids onto wounds to enhance healing. This technique is often used in conjunction with other treatments to expedite recovery.
62) Toxicology:
'Toxicology' in Ayurveda deals with understanding and treating conditions caused by toxins. This field is crucial in managing cases where wounds may result from poisonous substances or infections.
63) Vishaghna (Visaghna, Visha-ghna):
'Vishaghna' refers to treatments aimed at neutralizing poison within the body. Such interventions are essential for managing wounds contaminated by toxins, therefore enabling effective healing processes.
64) Nadivrana (Nadi-vrana):
'Nadivrana' relates to wounds characterized by sinus tracts or channels. Proper diagnosis and specific treatment strategies are crucial in ensuring these complex wounds heal appropriately.
65) Ayurveda (Ayus-veda):
'Ayurveda' is an ancient system of medicine originating from India, focusing on holistic healing practices. It integrates physical, mental, and spiritual health to promote overall well-being, including detailed therapies for managing wounds.
66) Abhyanga (Abhyamga):
'Abhyanga' signifies an Ayurvedic massage using oils, providing therapeutic benefits that help soothe pain and promote healing in affected areas, thereby positively influencing wound recovery.
67) Chedana:
'Chedana' means surgical cutting or excision in Ayurveda. This technique is essential for removing diseased tissue or foreign bodies from wounds, enabling successful healing.
68) Surface:
'Surfaces' encompass the external layers of tissues, skin, and membranes. Addressing the condition of surfaces is pivotal in effective wound management and healing.
69) Bandha (Bamdha):
'Bandha' refers to binding or securing during wound care, ensuring proper positioning of tissue for optimal healing. This practice is essential in surgical procedures for maintaining integrity.
70) Sthira:
'Sthira' denotes a condition of stability or steadiness, which is crucial in wound healing. Characterizing a wound as 'Sthira' helps dictate the appropriate treatment approach.
71) Dugdha:
'Dugdha' means milk in Ayurveda, a beneficial substance used in various treatments. Its application, particularly in wound care, harnesses its nourishing properties to enhance healing.
72) Darana:
'Darana' refers to creating an incision or superficial cut in tissues, facilitating better drainage or medication application to wounds. Its execution requires precision to avoid aggravating the condition.
73) Esana (Eshana):
'Eshana' denotes probing or the process of investigating a wound's depth or direction. Accurate assessment is vital for effective wound management, ensuring adequate treatment of underlying conditions.
74) Kapha:
'Kapha' denotes the bodily constitution that embodies stability, moisture, and structure. Understanding 'Kapha' is essential for treating conditions where its excess can lead to poor healing of wounds.
75) Kleda:
'Kleda' refers to excessive moisture or secretions that can aggravate wounds. Managing 'Kleda' is crucial for optimal healing and preventing complications in care practices.
[Note: The above list is limited to 75. Total glossary definitions available: 175]