The Sushruta Samhita — trans. Bhishagratna

Sugandhikd, Mocharasa, f Ahi-pushpa (Ndgesvara), Rodhra and Dhdtaki flowers leads to a speedy healing up (granulation) of ulcers (Vrana) and traumatic sinuses. 15.

* Dallana's reading evidently is "Tali-lala" and he explains it as the roots of "Bhumyamalaki". Chakradalta also prescribes this oil but he takes "Nilika" instead of "Tali". S'ivadasa, again, in his commentary quotes from Sus'rula but reads "Nili-Nala* in place of "Tala-Nala."

t "Mocha-rasa" is explained by Dallana lo be "S'obhdnjana," but it generally means '*S'almaIi-veshta/'and S'ivadasa ejcplains it as such. — Ed.

Chap. XVII.] CHIKITSA STHANAM. 423

Treatment with Kshara-Sutra :— An

erudite surgeon should open a sinus, occurring in any of the Marmas, or in a weak, timid, or emaciated person with an alkalined string (KshaVa-Sutra\ and not with a surgical knife. The course of the sinus should be first ascertained with a director ; and a needle, threaded with a string of alkalined thread should be passed from one end of the sinus and quickly drawn out through the other. Then the two ends of the thread should be firmly fastened together. An intelligent surgeon should likewise pass another alkalined thread in the event of the alkali of the first thread being comparatively weak. This should be repeated till the sinus completely bursts out. The surgeon should know that the same procedure may be as well adopted in cases of fistula-in-ano. Similarly in cases of tumours (Arvuda), etc. they should be lifted up (with the hand) and tied round at their base with an alkalined thread, or it should be punctured around with a kind of needle with their mouth resembling a barley corn and then tied again at their base with an alkalined thread. After their bursting (and falling offj, they should be treated as common ulcers (Vrana\ 16.

The different kinds of Plug-Stick (Varti) described in the Dvi-Vraniya Chapter (Chikitsita—chap.-i.) may be similarly used with advantage in all cases of sinus. The use of a plug made of the following drugs, viz., the bark and fruit of the Ghonta, (the five officinal kinds of) salt,* LdksM, Puga and the leaves of the Alavand \ t *'Alavana" has been explained by Dallana as "Kaka-mardanika" and by S'ivadasa as "Jyotishmati". S'ivadasa is, however, followed in practice in this case,

* According to Chakradatta's reading and S'ivadas's commentary thereon, only the Saindhava (instead of the five officinal kinds of sail) should be taken. We, however, follow Dallana's inttrpretation with good results. -j^^.

424 THE SUSHRUTA SAMHITA. CChap. XVII.

-j^^.

t *'Alavana" has been explained by Dallana as "Kaka-mardanika" and by S'ivadasa as "Jyotishmati". S'ivadasa is, however, followed in practice in this case,

424 THE SUSHRUTA SAMHITA. CChap. XVII.

pasted together with the milky juice of the Snuhi and Arka leads to the speedy healing up of a sinus. The powdered* stones of Vibhitaka^ mangoe fruits, Vatasprouts, Harenu, S'amkhini-setd, V drdhi-kanda mixed with oil can also be used in a case of sinus. 17-19.

The seeds of the Dhustura^ Madana and Kodrava, Kos'dtaki, S'uka-nasd, Mriga-bhojani and the seeds and flowers of the ^f//>^^/<3; should be pounded together and applied to a sinus (Nddi) after having washed it with a decoction of Ldkshd. Cases of sinus speedily yield to the curative efficacy of the application of these powders mixed with oil. The use of the oil cooked with cow's urine and with the preceding drugs (as Kalkas) brings about the healing up of a sinus in seven nights. 20-21.

The application of the oil cooked with the roots of the Pinditaka treated with the expressed juice of the Vardha-kanda in the manner of a BhAvand saturation and with the bulbs of Suvahd brings about a speedy and effective remedy for a sinus. The same effect is produced by an application of the oil cooked with the bulbs of the the Vajra-kanda. 22.

Bhallatakadya Taila:— The use of the

oil cooked with the paste (Kalka) of Bhalldtaka,
Arka, Marichdi Saindhava salt, Vidanga, Haridrd,
Ddru-Haridrd and Chitraka and with the expressed
juice of the Bhringa-rdja readily cures cases of sinus,
Apachi and ulcer due to Vdyu and Kapha. 23.

Treatment of Stana-roga : - In cases of a derangement of the milk (of the breast) a draught of clarified butter should be quickly given to the Dhatri

* According to some different reading "burnt ashes" (instead of powders) of the drugs should be taken. In our humble opinion the reading in the text seems to be the correct one,

Chap. XVIL] CHIKITSA STHANaM. 425

In our humble opinion the reading in the text seems to be the correct one,

Chap. XVIL] CHIKITSA STHANaM. 425

(mother ov wet-nurse) by the physician ; and in the evening a draught composed of the decoction of Nimba, mixed with honey and Mdgadhikd, should be given to her for emetic purposes. Next day she should take a meal (of boiled rice) with the soup (Yusha) of Mudga pulse. The use of emetics should be continued for three, four, or six days ; or she should be made to drink a potion of clarified butter (cooked) with Triphald, A decoction of Bhdrgi, Ativishd, Vachd, Sura-ddru, Pdthd, the drugs of the Mustddi Gana, Murvd and Katu-rohini, or that of the drugs of the Ai^agvadhddi group mixed with honey, should be given to the Dhdtri ^wet-nurse) for the purification of her breast-milk. 26.

The above are the general remedial measures which are to be adopted in the affections of breast-milk. Any other defect in the breast-milk should be corrected specially with an eye to the nature of the Dosha involved in the case. In cases of inflammatory swellings of the breasts, the physician should remedy them by means of any one of the various measures laid down under the head of Vidradhi with a due consideration to the requirements of each particular case. Medicinal remedies should only be internally employed and no poultices should be applied for the speedy suppuration of the swelling of the breast, even if found to have already commenced to suppurate ; since the breasts are of an extremely soft and fleshy growth, any tight bandaging about those parts may be followed by local sloughing or even bursting. In a case where suppuration had already taken place, an operation should be made in the affected part, avoiding the milk-carrying veins as well as the nipple with its black surroundings. In all the cases of Stana-V id rad hi— whetherp. 54p. 426 non-suppurated, suppurating^, or suppurated— the milk should be pressed out from the breast of the Dhatri* 27-29.

Thus ends the Seventeenth Chapter of the Chikitsita Sthanam in the Sus'ruta Samhita which deals with the treatment of erysipelas, sinus and the diseases of the mammary glands.

* The milk should be pressed out of the Dhatri's breasts in the non-suppurated stage, to alleviate the burning sensation therein, in the suppurating stage for the avoidance of further suppuration, and in the suppurated stage for the prevention of sores, sinus, etc.

CHAPTER XVIII.