The Sushruta Samhita — trans. Bhishagratna

p. 347

of either Mudga pulse or Adhaki pulse mixed with Nimba leaves and Arushkara are wholesome in a case of Kushtha. Preparations of any of the aforesaid grains may be taken with Manduka-parni^ Avalguja, Atarushaka and Rupikd flowers cooked in mustard oil or clarified butter, or with the soup prepared of the articles of the Tikta-varga (bitter group, mentioned in the Sutrasthdnam). The cooked flesh of Jdngala animals, devoid of all fatty matter, should be given to a patient, habituated to the use of meat diet. The medicated oil, known as the Vajraka-Taila should be used for anointing the body. A decoction of the drugs of the Aragvadhddi group should be used for rubbing (Utsadana) purposes. Decoctions of Khadira should be employed in drinks, baths, washes, etc. The preceding rules are intended to regulate the diet and regimen of one suffering from Kushtha (cutaneous affections). 4.

Preliminary Treatment :— in the premo-

nitary stages of the disease the system should be cleansed by the application of both emetics and purgatives. When the disease is found to invade the Tvak* only, a plaster prepared of the purifying drugs should be applied to the affected parts ; blood-letting and the use of medicinal decoctions and purifying and disinfecting plasters are the remedies to be employed when the desease would appear to infect the blood. The same remedies and Arishta, Mantha, Pras'a, etc , should be employed when the disease would be found to have invaded the principle of the Matmsa (muscles). Palliation and temporary respite are the only cure that can be offered in a case of the sin-begotten typef of the t The type of Kushtha affecting the principle of Medas (fat) is generally supposed to be sin-begotten.

* Tvak here means Rasa or serum.

p. 348

disease which is the fourth (in order of enumeration) and that even is purely contingent on the willingness and capacity of the patient to conform to a strict regimen of diet, conduct and dress. Blood-letting and purifying measures (emetics and purgatives) should be resorted to in such a case and then the special medicinal remedies prepared from BhallsLtakaf, Silaijatu, Gugguln, Aguru, Tuvaraka, Khadira, and Asana and the Ayaskriti should be used in accordance with the prescribed ; rules. The disease in its fifth form (is found to invade the bones and) should be given up as incurable. 3-6.

Treatments of Doshaja Types :— in

The disease in its fifth form (is found to invade the bones and) should be given up as incurable. 3-6.

Treatments of Doshaja Types :— in

the first stage of Kushtha, the patient should be treated in accordance with the prescribed maxims (rules) of Sneha-pana. In a case of Vattaja-Kushtha, cil or clarified butter, cooked with (a decoction and Kalka of) Mesha-s'ringi, S'wadamshtrd, S'arngashtd, Guduchi and the drugs included in the group of Das'anmla should be used as drink and ointment. In cases of the Pittaja type, the patient should be made to drink (a potion consisting of) clarified butter prepared with (a decoction and Kalka of) Dhava^ As'vakarna^ Kakubha, Palds'a^ Pichu-mardha, Parpataka, Madhuka, Rodhra and Sainangd. In the Kaphaja type, clarified butter cooked with (a decoction and Kalka of) Piydla, S' ditty Aragvadha, Nimha, Saptaparna, Chitrakay Maricha, Vacha and Kushtha should be prescribed.

* Bhallataka-preparations have been described in the treatment cf Ars'as, preparations of S'ilajatu, Guggulu, Aguru and Tuvaraka in the treatment of Prameha-pidaka, and Khadira, Asana and Ayaskriti preparations in the treatment of Maha-kushtha.

t Oil should be used in a case of Kapha-predominance, whereas clarified butter in that of Pitta-predominance. Others assert that clarified butter should be used for drinking purposes and oil for anointments.

p. 349

The clarified butter cooked with (a Kalka and a decoction of I Bhalldtaka.Ahhayd and" Vidanga^ or (the medicinal oils known as) the Tuvaraka Taila and the Bhallitaka Taila should be used in all types of Kushtha. 7-8.

The IVIaha-tikta Ghrita:-A paste or

Kalka should be made by pounding equal parts of Saptaparna^ Aragvadha, Ativishd^ Pdthd, Katu-rohini, Amritd, Trip/iald, Paiola, PicJiu-marda, Parpataka^ Durdlabhd, Trdyamdjid^ Mustd, Chandana, Padmaka^ Haridrd, Upakulyd, Vis'dld, Murvd, S'atdvari, S'drivd^ Indra-yava^ Atarushaka, Shadgranthd {I'achd), Mad/iuka, Bhu-ni7nha and Grishtikd*, This paste (Kalka) should be cooked with four times its own weight of clarified butter, with the juice of Amalaka, weighing twice as much as the clarified butter and with water weighing four times the quantity of the Amalaka juice. It should be constantly stirred (with a ladle), while being cooked. This medicated Ghrita is called the Maha(-tikta Ghrita, which proves curative in Kushtha, chronic fevers, haemorrhage, heart-disease, insanity, ApasmAra, Gulma, postular eruptions, menorrhagia, goitre, scrofula, elephantiasis, jaundice, erysipelas, impotency, itches and Pdma, etc. 9.

9.

The Tikta-Sarpih :— Two Pala weight of each of the following drugs, viz., Triphald, Patola, Pichumarda, Atanishaka, Katu-rohini, Durdlabhd^ Trdyamdnd and Parpataka-\ should be taken and boiled together in a Drona measure of water. The boiling should be continued till it is reduced to one fourth of its original quantity. Then half a Pala weight of each of the following drugs, viz., Trdyamdnd, Musta, Indra-yava, (red)

* Chakradatta does not read "Grishtika" but read "Us'ira" instead. He also takes both the kinds of "Haridrd," of "Upakulya" (Pippali) and of **Sariva".

t Chakradatta reads ''Nis'a" in addition to the above drugs.

p. 350

Chandana, Kirdta and Pippali should be pasted together. This pasted Kalka and the decoction should be cooked with a Prastha measure of clarified butter. The medicated Ghrita thus prepared is called the Tikta-Sarpih. Diseases such as Kushtha, chronic fever, Gulma, Haemorrhoids^ GrahanI, edema, jaundice, erysipelas and impotency readily yield to the curative efficacy of this Ghrita. lo.

Medicinal Plasters for Kushtha :—

Having first soothed the patient with any of the preceding medicated clarified butters and having his body fomented, the surgeon should have recourse to the venisection. One, two, three, four, or five s iras (veins) of the patient may be opened (according to the circumtances). The raised or elevated patches on the skin should be scraped off, or should be kept constantly covered with a medicinal plaster. As an alternative, the characteristic patches of the disease should be first rubbed with the substance known as the Samudra-phena or with the leaves of S'dka^ Goji, or Kdkodumbara and a plaster (Lepa) composed of Ldkshd, Sarja-rasa, Rasdnjana, Prapunndda, Avalguj'a, Tejovati and the roots of As'va-mdraka, Arka, Kutaja, and Arevata, pasted with the urine or bile of a cow, should be applied to them; or Svarjikd, sulphate of copper, sulphate of iron, Vidanga, Agara-dhuma, Chitfaka, Katuka, Sudhd, turmeric and Saindhava pounded together with the urine or bile of a cow should be applied to the diseased localities.

As an alternative, the alkali, prepared from the ashes of Palds'a wood in the prescribed manner, should be boiled with the powders of the preceding drugs ; it should be removed from the oven after reducing it to the thickness or consistency of a Phdnita and used in plastering (the diseased patches) ; or a plaster composed

Chap. IX.] CHIKITSA STHANAM. 35t