The Sushruta Samhita — trans. Bhishagratna
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16.
Treatment of Kaphaja Upadams'a : -
In a case of the Kaphaja type of the disease, a plaster composed of the barks of S^dla, As'va-karna, Aja-karna and Dhava pasted with Surd and mixed with oil, should be applied hot to the affected part. As an alternative, the drugs such as, Haridrd^ Ativishd, Mustd^ Sarald, Beva-ddru^ Patra, Pdthd, and Pattura should be used for similar purposes and the affected organ should be affused with a decoction of the drugs of the Suras ddi an d y4 'ragvadhddi groups. 17.
The above remedial measures, viz., plasters, sprinkling (Parisheka), blood-letting and Sams'odhana (^V., application of purgatives, emetics, etc) as well as those
* According to S'ivad^sa the Sneha to be used In the plaster should be clarified butter washed a hundred times.
p. 445
described in the Sutra Sthdnam (and the first Chapter of the Chikitsita Sthdnam), should be resorted to in a case of (non suppurated) Upadams'a. The physician should try his best to arrest the setting in of suppuration (in a case of Upadams'a) inasmuch as suppuration in (and consequent putrefaction of) the (local) veins, ligaments, skin and flesh would lead to the destruction of the organ (Dhvaja). An incision should be made as soon as suppuration would set in, and the pus and other putrid matters being drawn out, the incised part should be plastered with the paste of sesamum mixed with honey and clarified butter. The incidental ulcer should be washed with a decoction * of the leaves of Karavira, of Jdti and A'ragvadha, or of Vaijayanti and Arka. 18.
The use of a medicinal plaster composed of the fine powders of Saurdshtra-mrittikd^ Gairikay Tuitha, Pushpa-Kdsisa, Saindhava^ Rodhra^ Rasdfijana^ Ddru- Haridrd, Haritdla, Manahs Ud, Harenukd and Eld^ mixed with honey is highly recommended in all cases of Upadams'a. 19.
A decoction of the tender leaves of Jambu^ A'mra^ Sumanas, Nimba, S'vctd, and of Kdmboji f and the barks of S'allaki^ Vadara, Vilva, P aids' a, J mis' a and of the Kshiri trees, as well as Triphald should be used by the physician for constantly washing the ulcer. Oil cooked with the preceding decoction, with the Kalkas of Goji, Vidanga and Yashti-madhu, as well as with the different spices (Elad; group: should be used as the best remedy for the purpose of the healing up (Ropana) of
• According to Chakralatta the five kinds of leaves should be separately used in the preparations of the decoctions for washing, t "M^shaparni" according to Gayadasa.
44^ THE SUSHRUtA SAMHITA. [Chap. XIX.
44^ THE SUSHRUtA SAMHITA. [Chap. XIX.
ain Upadams'a-ulcer of whatsoever type. The use of a pulverised compound composed of Svarjikd, Tuttha, Kdsisa, S'aileya, Rasdnjana^ and Manahs'Ud taken in equal parts arrests the extension of an ulcer and Visarpa. Cises of Upadams'a and Visarpa readily yield to the application of a pulverised compound of the ashes of Gundrd, Haritdla and Manahs'Ud. An (external) application of Bhrimgardja^ Jriphald and Danti mixed with the powders of copper and iron, destroys Upadams'a just as the thunder bolt of Indra (complelely) destroys a tree. 20.
Treatment of Tridoshaja and Rak-
taja UpadamS'a:— The medical treatment of the two kinds of Upadams'a due to the concerted action of the three Doshas as well as that due to the vitiated blood (Raktaja) should be taken in hand without holding out any definite hope of recovery. The above-mentioned medicines specific to the different Doshas should be combinedly applied in these cases in consideration of the nature and intensity of the Doshas specifically involved in them. Now hear me discourse on the special treatment of Tridoshaja Upadams'a. It should be the same as in the case of a malignant ulcer (Dushta-Vrana). The putrid portion of the male organ should be cut off and the remaining portion should be fully cauterized (in the incised part) with a Jambvoshtha instrument, made red-hot in fire. Honey, and clarified butter should then be applied to the cauterized part, and medicinal plasters and oils possessed of healing properties should be applied to the incidental ulcer when it would be cleansed (disinfected). 21-22.
Treatment of ^lipada:— In a case of
Elephantiasis (Slipada) due to the action of the deranged and aggravated Va(yu, the vein (Sird) at a distancep. 447 of four fingers above the instep (Gulpha) should be opened after an application of Sneha and Sveda * to the patient. Vastis should be employed when the patient has been (soothed and) restored to his former condition (with appropriate and nutritious diet, etc.V He should be made to take continuously for a month, a potion consisting of castor-oil mixed with (an adequate quantity of cow's) urine The patient should take rice as his diet with milk duly cooked with S'unthi. The use of the Traivrita Ghrita as well as cauterization of the affected part with fire is also recommended in such a case. 23.
Treatment Of Pittaja ^Iipada:-ln a
The use of the Traivrita Ghrita as well as cauterization of the affected part with fire is also recommended in such a case. 23.
Treatment Of Pittaja ^Iipada:-ln a
case of Pittaja type of Elephantiasis, the vein ^^ird) below the instep (Gulpha) should be opened. Medicinal remedies mentioned in connection with the treatmeiit of the Pittaja type of tumours (Arvuda) and of Erysipelas (Visarpa) as well as other Pitta-subduing remedies and measures should be employed-f-. 24.
Treatment of Kaphaja ^Iipacla:-ln
a case of the Kaphaja type of elephantiasis the principal vein (Sird) of the first toe should be opened by an experienced surgeon and the patient should be made to take at intervals the decoction (of the Kapha-subduing drugs) with honey. As an alternative, the patient should be advised to take the powders (Kalka) of Abhayd mixed with any officinal kind of urine. The affected locality should be constantly plastered with the paste
* Chakradalta reads "^l^^iT*n^n'' in place of "^^^^i:^,:^^ g" meaning thereby that such Sveda and Upanaha should be applied before the incision of the vein. Gayadasa also supports this reading as is evident from Dallana's commentary. — Ed.
t The panicle ««=^" in the text shows that Kapha-subduing remedies and measures should also be used in all these cases.
p. 448
of Katukuy Amritd, S'unthiy Vidanga, Deva-ddru and Chitraka, or with Chitraka and Deva-ddru, An oil cooked with Vidanga, Markka, Arka, S'unthi, Chitraka, Deva-ddru^ Elakd and all the five officinal kinds of salt should be given him as a potion. Cooked barley is specially recommended as diet in the present case. 25. As an alternative, the patient should be made to drink a potion of mustard oil* or of the expressed juice of the leaves of /^//^/-A^^ra/^y^^ according to his capacity for the cure of Slipada. In the same wayf the juice of Putranjivaka should be prescribed by a physician after a due consideration as to the strength of the patient and of the time. The same juice {i.e., of Putranjivaka) should be taken along with the juice of the bulbs of Kechuka with Pakima (vit) salt. 26.
The Alkaline Remedies :— An alkali