By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Patana is the fourth kind of therapy talked about amongst ‘Sapta Upakrama’ i.e. the 7 varieties of remedies. These 7 remedies talked about by Grasp Sushruta usually are not solely meant to deal with and heal the injuries, ulcers and associated swelling but in addition to forestall their problems.
Learn – Sushruta’s 7 Sorts of Therapies Sapta Upakrama

Patana Kriya

“Fourthly patana must be achieved…!”

Paatan means

  • tearing
  • slipping
  • dividing or
  • making incision

Kriya is the strategy wherein that is carried out. 9 remedies from amongst the listing of 60 remedies talked about in shashti upakrama are included below patana kriya. They have to be selectively achieved as per situation of the wound / ulcer / swelling across the ulcer.
Vimlapana means to melt or trigger to wither. This process is finished to melt the injuries or ulcers. This must be applied first within the therapy of wounds and ulcers. The primary 6 remedies amongst the Shashti Upakrama are included below vimlapana. These remedies must be skillfully used to make the injuries or ulcers comfortable. The set of those 6 remedies comprise vimlapana.
Learn – Shashti Upakrama Which means, Classification, Scientific Significance

Sanskrit Verses

Sorts

Primarily 9 remedies are included below Patana.

Sl No Title of the Upakrama (therapy) Which means
1 Chedana Excision
2 Bhedana Incision
3 Daarana Splitting
4 Lekhana Scraping
5 Eshana Probing
6 Aaharana Extraction
7 Vyadhana Puncturing
8 Vidravana Liquefaction
9 Seevana Suturing

If we’re following the chronology of the remedies as per shashti upakrama procedures, patana group of remedies must be strictly achieved after upanaha. If the situation of the wound or swelling obtainable on the time of treating the affected person is match to bear one among these patana remedies instantly, they shall be skillfully chosen.
Learn – Kaphaja Upanaha (Netra Roga) – Definition, Signs, Therapy

1. Chedana – excision
Situations wherein excision must be achieved –

  • 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 so forth) have occurred within the environment

2. Bhedana – incision
Situations wherein incision must be achieved –

Incision must be achieved within the wounds and ulcers / swellings whereby –

3. Daarana – splitting
Situations wherein splitting must be achieved –

  • Bala Vrddha Asaha Kshina Bhiru Yoshitam – ulcers manifesting in youngsters, outdated aged individuals, 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 cut up ?

a. Pidana – A sensible doctor who’s effectively 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 must be achieved when the swelling across the ulcers are lumped up and the pores and skin across the ulcers has been suppurated.

Methods to do?
The herbs that are prescribed for pidana must 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 stress on the ulcer. This may 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 must be achieved. So pidana is the preparation for darana and when achieved on the backdrop of pidana, darana yields good outcomes.

The darana must be achieved 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 wherein scraping must be achieved –

  • Kathina – ulcers that are laborious and hard
  • 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 muscular tissues across the ulcers

How a lot scraping must be achieved?

  • Within the laborious and hard wounds and ulcers must be scraped evenly i.e. neither an excessive amount of nor too much less.
  • In thick and spherical edged ulcers scraping must be achieved in extra.
  • Within the ulcers that break open repeatedly full scraping must be achieved with out leaving any portion which must be scraped.
  • In ulcers having laborious and elevated ulcers, the extreme parts must 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 wherein probing must be achieved –

  • Nadivrana – sinus ulcers
  • Shalya garbha – ulcers containing international substances
  • Unmargi vrana – fistula in anal area
  • Utsangi vrana – hole ulcers

Shoot of a bamboo, hairs, fingers and metallic probes must be utilized by the doctor progressively and punctiliously for the aim of probing.
Learn – Fistula In Ano Ayurvedic Understanding And Efficient Therapy

6. Aaharana – extraction
A sensible doctor ought to extract the international 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 rules of extraction defined within the sutra sthana part. ‘Signs of correct extraction’ are the symptoms of the international physique being eliminated fully.

Nishalya Lakshana – indicators / signs of correct elimination of international physique from the wound / ulcer

  • Alpa badham – much less hassle / ache
  • Ashunam – lack of numbness
  • Nirujam – painless
  • Nirupadravam – absence of problems
  • Prasannam – seems to be clear
  • Mrdu paryantam – edges are comfortable / clean
  • Niraghattam – motionless
  • Anunnatam – not raised

The ulcer having above mentioned indicators must be examined with the assistance of a probe and likewise by flexing and lengthening the a part of the physique / limb whereby the ulcer consisting of the international physique is situated. Following this the surgeon ought to declare that the ulcer / wound / swelling are devoid of international materials.
Learn – Sushruta’s 8 Sorts 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.

Knowledgeable surgeon ought to puncture the ulcer / wound that are eligible to be punctured utilizing appropriate devices. Puncturing is helpful in ailments like ascites, abscess and hydrocele. Following puncture the contents like pus and so forth contained within the ulcer / swelling across the ulcer shall be drained.

9. Seevana – suturing
Situations wherein suturing must be achieved –

Abstract
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 international substances impacted contained in the ulcers and swellings, to puncture and drain the amassed fluids like pus and water and for suturing the open wounds and ulcers. All these measures embrace minor surgical measures which have to be achieved 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 normally achieved after upanaha (poultice and different associated remedies) if chronology is being adopted. The 13 procedures included below shodhana (cleaning remedies) and ropana (therapeutic remedies) shall be achieved after patana procedures.

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