Treatment of Nāḍī-vraṇa, Bhagandara, Upadaṃśa, Fractures, Kuṣṭha/Śvitra, Āmlapitta, ENT–Eye Disorders, and Bleeding Conditions
ध्वजमध्ये शिरावेधे विशुद्धिरुपदंशके / पाको रक्ष्यः प्रयत्नेन शिश्रक्षयकरो हि सः
dhvajamadhye śirāvedhe viśuddhirupadaṃśake / pāko rakṣyaḥ prayatnena śiśrakṣayakaro hi saḥ
Apabila urat ditusuk di bahagian tengah dhvaja (zakar), dalam kes upadaṃśa (penyakit ulser/kelamin) diperlukan penyucian dan pembersihan. Nanah hendaklah dicegah dengan bersungguh-sungguh, kerana jangkitan itu benar-benar menyebabkan kemerosotan dan penyusutan organ kelamin.
Lord Vishnu (in discourse to Garuda/Vinata-putra)
Dosha: Pitta
Concept: Pramāda-varjana (avoid negligence) in treatment; purity and careful procedure prevent harm.
Vedantic Theme: Ahimsa and responsibility toward the body as a vehicle for duty; restraint and cleanliness.
Application: If a vein is punctured in the mid-region of the dhvaja and in upadaṃśa, perform cleansing/purification and diligently prevent suppuration to avoid tissue wasting.
Primary Rasa: bhayanaka
Secondary Rasa: shanta
Related Themes: Garuda Purana 1.171 (upadaṃśa management; emphasis on śodhana and preventing pāka)
In this medical context, upadaṃśa refers to a genital/venereal ulcerative disorder requiring cleansing measures, especially if invasive procedures like venesection are involved.
It warns that suppuration (pāka) must be prevented with great care, because infection can lead to wasting or degeneration of the genital organ (śiśra-kṣaya).
It emphasizes infection control and cautious intervention: invasive procedures and genital ulcers require qualified medical care and vigilant prevention of secondary infection.