The Sushruta Samhita — trans. Bhishagratna

4.

A large polypus, appearing in a strong person, should be clipped off (with a knife) and cauterized with fire. As regards an external polypus full of extremely aggravated Doshas (Vdyu, Pitta, Kapha and blood) no

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Yantra should be used, but the treatment should consist of fomentation, anointing, poulticing, immersion, plastering, evacuating measures (Visrava), cauterization with fire and alkali and a surgical operation. Measures laid down under the head of Rakta-pitta should bs resorted to in cases of haemorrhage (from the seat of affection). Remedies mentioned in connection with dysentery (Atisdra) should be employed in cases of a looseness of the bowels ; whereas in cases of constipation of the bowels oily purgatives should be administered, or the remedies for UdAvartta should be adopted. These rules shall hold good in the cases of treating (cauterization, etc) a polypus occurring in any part of the body whatsoever. 5.

A polypus should be caught hold of and an alkali should be applied thereto with a Darvi, or a brush (Kurcha), or an indicator (Salaka). In a case of a prolapsus of the anus, cauterization should be made without the help of any Yantra (speculum).

Diet : — In all types of haemorrhoids, the diet should consist of wheat barley, Shashtika rice or S'dli rice, (boiled) and mixed with clarified butter, to be taken with milk, Nimba-soup, or Patola-soup. The patient should be advised to take (his meal) with Vdstuka, Tanduliyaka^ Jivanti, Upodikd, As'va-vald, tender Mulaka, Pdlanka, As ana, Chilli, Chuchchu, Kaldya, Valliy or any other S'dkas (pot-herbs;, according to the nature of rhe Doshas involved in the case Any other oleaginous, diuretic, laxative and appetising (Dipana) diet possessing the virtue of curing piles should also be prescribed. 6.

After the cauterization of the polypus, as well as in a case where no cauterization would be necessary, the body of the patient should be anointed with clarified

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6.

After the cauterization of the polypus, as well as in a case where no cauterization would be necessary, the body of the patient should be anointed with clarifiedp. 320 butter and oil, etc., and measures both general and specific (mentioned below and in accordance with the Dosha or Doshas involved) should be employed for the purpose of improving the digestive powers and to alleviate any aggravation of the Vaiyu. He should be made to drink a potion consisting of clarified butter cooked with the Vdyu-subduing and appetising (Dipana) drugs* (Kalka and Kvatha) mixed with the powders of Hingu, etc., (described in the treatment of Maha-VdtavyAdhl, chapter. V). In a case of Pittaji-Ars'as, clarified butter prepared by cooking it with the drugs of the Pippallyddi and Bhadra-ddrvddi\ groups, should again be cooked with the decoction of Prithakparnyadi group and the Kalka of the Dipaniya (Pippallyddi) group, and given as a potion to the patient. In a case of haemorrhoid due to the action of the deranged blood \ (Rakt^rsas), the clarified butter should be cooked with a decoction of Manjishthd, Murungi, (D. R. Surangi), &c., while in a case of one due to the action of the deranged Kapha, the clarified butter should be cooked with a decoction of the drugs constituting the Suras ddi group. The supervening distresses should be alleviated by the remedial measures peculiar to each of them . 7 .

Cauterization with fire or with an alkali or any surgical t The epithet "Bhadra-darvadi-pippallyddi" in the phrase "Bhadradarvadi-pippallyadi-sarpih" seems to be included into the body of the text through an accident. In our opinion, it is only an annotation of the phrase **Dipaniya-Vdta-hara-siddha" occurring in the last sentence. — Ei.

* Such as the decoction of the drugs of the Bhadra-datvddi (Vayusubduing) and Pippalyadi (Dipaniya) group?. This Ghrita should be prescribed in a VsCtaja Arsas.

X The Kalkas of the Pippallyadi group should also be taken in the preparation of the two kinds of medicated clarified butter to be used in Raktars'as, and Pittiis'as. ^Z)a//a»»a,

Chap. VI. J CHIKITSA STHANAM. 32 1

— Ei.

X The Kalkas of the Pippallyadi group should also be taken in the preparation of the two kinds of medicated clarified butter to be used in Raktars'as, and Pittiis'as. ^Z)a//a»»a,Chap. VI. J CHIKITSA STHANAM. 32 1 operation in the present disease should be effected by introducing the Yantra (speculum) into the rectum (with the utmost care, inasmuch as an error happening in any of these cases may bring on impotency, swelling (Sopha), a burning sensation, epilepsy, rumbling in the intestines, retention of stool and urine, dysenteiy, diarrhoea, or may ultimately end in death. 8.

Rectal Speculum :--Now we shall describe the dimensions of the Yantras (and the materials of which they are made of). The instrument may be made of iron, ivory, horn or wood. It should be made to resemble the teat of a cow. In the case of a male patient, it should be four fingers in length and five fingers in circumference ; whereas in the case of a female patient, the length should be commensurate with that of the palm of the hand (of the same length as before — D. R.) and six fingers in circumference. The instrument should be provided with two separate apertures in its inside, one for seeing the interior of the rectum and the other for applying an alkali, or actual cautery (Agni) to the polypus, since it is impossible to apply fire and alkali through the same aperture. The circumference of the aperture in the upper three fingers of the instrument should be like that of a thumb. There should be a bulb-like protrusion of the same width, at the bottom, and above it a space of half a finger's width. Thus we have briefly described the shape of the instrument. 9-10.

Alepa (plasters) :— Now we shall describe the plasters to be applied to the haemorrhoids (to cause their spontaneous dropping off). The first consists of pulverised turmeric mixed with the milky exudation of the Snuhi tree. The second contains of the cockevacuations and pulverised Gunjd, turmeric SLnd-Ptppa/t

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