The Sushruta Samhita — trans. Bhishagratna

CHAPTER XVIII.

Now we shall discourse on the medical treatment of Glandular Swellings, etc. (Gratlthl), Scurvy (Apachi), Tumour, etc. (Arvuda) and Goitre

(Gala-g^anda). i

General treatment of Granthi :— In

the non-suppurated or acute (inflammatory) stage of Granthi, an experienced physician should prescribe the measures # laid down in connection with (inflammatory) swellings (Sopha) in general. As bodily strength arrests the progress of the disease, the strength of the patient should hence be always carefully guarded against suffering any diminution in that respect. The patient should be made to drink oil, or clarified butter, or both ; or he should be made to drink lard, oil and clarified butter, mixed together.f Apehivdtd (Prasarani) and Das'a-mula cooked with the four kinds of lardacious or emollient substances (oil, clarified

* Beginning with Apatarpana up to the purgative measures.

t Oil, clarified butter and lard mixed together is technically called the "Trivrita."— Dallana.

In the case of a Vataja Granthi, a potion of oil cooked with the decoction and paste (Kalka) of the Vayu-subduing drugs should be prescribed for the patient ; in the case of a Pittaja Granthi, clarified butter cooked with the decoction and Kalka of the Pitta-subduing drugs should be administered in the same manner ; while in the case of a Kaphaja Granthi, oil cooked with the decoction and Kalki of the Kapha-subduing drugs should be taken by the patient. But in a case of Granthi due to the concerted action of the two, or three of the Doshas, any compound medicated oil, prepared by cooking any two, three, or four of the oily substances, viz.^ oil, clarified butter, lard and marrow, with the decoction and Kalka of those drugs which are antidotes to the said Doshas, should be prescribed for the patient as drinks,p. 428 butter, lard and marrow), or with any two of them should be prescribed. 2-3.

Treatment of Vsitaja Cranthi :~A

[Chap. XVIII.

butter, lard and marrow), or with any two of them should be prescribed. 2-3.

Treatment of Vsitaja Cranthi :~A

medicinal plaster composed of Himsrd, Rohiniy Amritd, Bhdrgi^ S'yondka, Viha, Aguru, Krishna-gandhd, Goji and Tdla-patri (Tdla-parni — D. R ) pasted together, should be applied ito the inflamed gland) in the Vaitaja type of Granthi. Different kinds of fomentation (Sveda), poulticing (Upanahaj and medicinal plasters (Lepa), possessed of the efficacy of subduing the deranged Vdyu, should be likewise resorted to. A suppurated swelling should be opened and the pus drained. Then the incised wound should be washed with a decoction of Vilva^ Arka and Narendra (Aragvadha) and purified (disinfected) with a plaster consisting of sesamum and the leaves of the Panchndgula (castor oil plants), together with Saindhava salt. After the purification, it should be healed up by applying a medicated oil, mixed with the powders of Rdsnd and Sarald ; or by a medicated oil prepared by cooking it with Vidanga, Yashti-madhu and Amritd and cow's milk. 4.

Treatment of Pittaja Granthi:— In a

case of the Pittaja type of the disease, leeches should be applied to the affected part, which should be further affused with milk and water. The patient should be niade to drink a cold decoction of the drugs of the Kdkolyddi group with the addition of sugar ; or he should take the powders of Haritaki through the medium of grape-juice, or of the expressed juice of sugarcane. Hot plasters, prepared by pasting together the bark of the Madhuka (flower) tree, and of the Jambu

* Some read *'1%'^T^^^Tl%^ia:" and explain that the\decocUons of the Vilvadi and the Arkadi groups are to be taken for the purpose.

Chap. XVIII. ] CHIKITSA STHANAM. 429

tree, Arjuna tree, and Vetasa creeper. As an alternative, hot plasters compounded of the roots of the Trina-s'unya (Ketaki), or Muchukunda mixed with sugar, should be constantly applied to the affected part. The Granthi should be opened when fully suppurated, and the pus let out ; after which it should be washed with a decoction of the bark of the Vanaspati^ The incidental ulcer should then be purified with a plaster composed of sesamum and Yashtimadhu ; and lastly it should be healed up with clarified butter cooked with the drugs of the Madhii7'a (Kdkolyadi group. 5-6.

Treatment of Kaphaja Granthi :— In a

5-6.

Treatment of Kaphaja Granthi :— In a case of the Khaphaja type of the disease, the Doshas should be first eliminated from the system with the regular and successive measures. f The affected part (Granthi) should then be fomented and firmly pressed (Vimlapana) and rubbed with either the thumb, or a piece of iron rod, or stone, or with a bamboo rod in order to bring about its resolution. A plaster composed of the roots of the Vikamkata, J Aragvadha, Kdkananti (Gunja), Kdkddani (Vayasa-tinduka), and Tdpasa-Vriksha (Ingudi) and with Pinda-phala (Tiktdldvu), Arka, § Bhdrgi, Karanja, Kdld and Madana^ pasted together, should be applied to it by an erudite physician. A glandular swelling v Kaphaja Granthi) on any part of the body other than a vital and vulnerable one (Marma) and

* The Vanaspati class consists of Vata, Plaksha, As'vatlha and Udumbara frees.

t These are ihe applications of Sn^ha, fomentation, emetics, purgatives, Asihapana, S'iro-virechana and blood- letting.

X Dallana explains "Vikamkata" as "Kanta-karika," but it means Sruva (called Vainch in Bengal) and S'ivadasa also explains it as such,— i^r/.

^ Chakradatia does not read "Arka" in the list.

p. 430

not (otherwise) resolved and absorbed should be cut open even in its non-suppurated stage and the glands removed. The expert surgeon should then cauterize the incidental wound after the cessation of the bleeding and treat it in the manner * of the Sadyo-Vrana treatment. These remedies should be employed by the experienced physician, where the swelling would be found to have assumed a large, stiff, elevated and fleshy aspect (bulging from the deeper tissues of the flesh). A Kaphaja Granthi should be opened with an incision as soon as it becomes fully suppurated and should then be washed with a decoction of appropriate medicinal drugs. The incidental ulcer should be purified (disinfected) with a purifying remedy prepared with a profuse quantity of Yava-kskara, honey and clarified butter ; and finally it should be healed up by the application of an oil, cooked with Vidanga, Pdthd and RoJiini. 7-9.

Treatment Of Medoja Granthi : -In a