The Sushruta Samhita — trans. Bhishagratna

An ulcer due to the concerted action of the deranged Vdyu, Pitta and blood (Va'ta-Pitta-Raktaja type) is maiked by a sort of throbbing, pricking and burning pain. It discharges a flow of thin yellowishp. 243 blood and produces a sensation, as if fumes were escaping (out of its cavity). An ulcer due to the concerted action of the deranged Vayu, Kapha and blood (Vaita-Sleshma-Raktaja type) is usually attended with itching, throbbing and tingling sensations and thick, grey, blood-streaked discharge. An ulcer associated with the deranged Kapha, Pitta, and blood (Kapha-Pitta- Raktaja type) is largely attended with redness, itching, suppuration and burning sensation. It emits a thick, greyish, bloody secretion. An ulcer marked by the concerted action of the deranged Vayu, Pitta and Kapha (Satanipaitika) is attended with diverse kinds of pain, secretion, colour, &c., peculiar to each of these types. An ulcer associated with the combined action of the deranged Vayu, Pitta, Kapha and blood (Va^ta-Pitta-Kapha-Raktaja type) is attended with a sensation, as if it were being burnt and lacerated. It is largely accompanied by throbbing, itchin^^ sensation, a sort of pricking and burning pain, with complete anaesthesia in the locality; redness, suppuration, various other kinds of colour, pain and secretion are its further characteristics. 10 — 20.

An ulcer (Vrana) which is of the same colour with the back of the tongue, soft, glossy, smooth, painless, well-shaped and marked by the absence of any kind of secretion whatsoever, is called a clean ulcer (Suddha- Vrana). 21.

Therapeutics :— The medical (and surgical) treatment of a Vrana (ulcer) admits of being divided into sixty * different factors, such as,— Apatarpana (fasting or low diet), Alepa (plastering), Parisheka (irrigating or spraying), Abhyanga (anointing), Sveda

* N.B. Authorities, however, differ in enumerating these factors, although every oiae of them sticks to the total number of sixty.

^44 THfe SUSHRUTA SAMhITA. fChap. t.

Authorities, however, differ in enumerating these factors, although every oiae of them sticks to the total number of sixty.

^44 THfe SUSHRUTA SAMhITA. fChap. t.

(fomentations, etc.), Vimldpana (resolution by massage or rubbing), Upanaha (poultice), Pdchana (inducing suppuration), Visrdvana (evacuating or draining), Sneha (internal use of medicated oils, ghrita, etc.), Vamana (emetics), Virechana (purgatives), Chhedana (excision), Bhedana (opening — e.g., of an abscess), Dirana (bursting by medicinal applications), Lekhana (scraping), Aharana (extraction^ Eshana (probing), Vyadhana (puncturing— opening a vein), Vidrdvana (inducing discharge), Sivana (suturing), Sandhana (helping re-union or adhesion), Pidana (pressing), Sonitasthdpana (arrest of bleeding), Nirvdpana (cooling application), Utkarikd (massive poultices), Kashaya (washing with decoctions), Varti (lint or plug), Kalka (paste), Ghrita (application of medicated clarified butter), Taila (application of medicated oil\ Rasa-kriya (application of drug-extracts), Avachurnana (dusting with medicinal powders), Vrana- Dhupana (fumigation of an ulcer), Utsddana (raising of the margins or bed of an ulcer), Avasddana (destruction of exuberant granulation), Mridu-Karma (softening), Daruna-Karma (hardening of soft parts), Kshdra-Karma (application of caustics), Agni-Karma (cauterization), Krishna-Karma (blackening), Pandu-Karma (making yellow-coloured cicatrices), Pratisarana (rubbing with medicinal powders), Roma-sanjanana (growing of hairs), Lomdpaharana (epilation), Vasti-karma (application of enemas), Uttara-Vasti-karma (urethral and vaginal injections\ Vandha (bandaging), Patradana (application of certain leaves — vide Infra), Krimighna (Vermifugal measures\ Vrimhana (application of restorative tonics), Vishaghna (disinfectant or anti-poisonous applications), Siro-virechana (errhines), Nasya (snuff), Kavaladharana (holding in the mouth of certain drug-masses for diseases of the oral cavity or gargling), Dhuma (smoking

Chap. 1.] CHIKLITSA STHANAM. 245

or vapouring), Madhu-sarpih (honey and clarified butter), Yantra (mechanical contrivances, e g., pulleys, &c.), Ahara (diet) and Raksha-Vidhana (protection from the influence of malicious spirits). 22.

p. 245

or vapouring), Madhu-sarpih (honey and clarified butter), Yantra (mechanical contrivances, e g., pulleys, &c.), Ahara (diet) and Raksha-Vidhana (protection from the influence of malicious spirits). 22.

Of these, Kashaya, Varti, Kalka, Ghrita, Taila, Rasakriya and Avachurnana are the measures for the cleansing (Sodhana) of an ulcer and for helping its granulation (Ropana). The eight acts (from Chhedana to Sivana) are surgical operations. We have already spoken of such acts as Sonitasthapana, Kshara-karma, Agnikarma, Yantra, Ahdra, Raksha-vidhana and Vandha- Vidhana (in the Sutra-sth^na). Later on, we shall discourse on Sneha, Sveda, Vamana, Virechana, Vasti, Uttara-vasti, Siro-virechana, Nasya, Dhuma, and Kavaladharana. Of the remaining measures we shall speak in the present chapter. 23.

There are six kinds of swellings (Sophas), as described before, and the following eleven measures., commencing with Apatarpana and ending in Virechana, should be regarded as their cure. These are the proper remedies for a swelling and do not (cease to be efficacious in, nor) prove hostile to cases of swelling which are transformed into ulcers. The other measures should be deemed as remedial to ulcers but Apatarpana is the first, general and principal remedy in all types of swellings (Sophas). 24.

Memorable Verses --—Apatarpana (fasting)

should be prescribed in the case of a patient, full of enraged Doshas, as well as, in one having his organic principles (Dhatus) and refuse matters (Malas) of the system, deranged by them, for the purpose of bringing them to their normal condition, with a regard both to their nature and to the strength, age, &c., of the patient. Persons afflicted with diseases which result

246 THE SUSHRUTA'SAMMITA. tChap. t.

from the up-coursing of the'deranged Vayu(Urdhva-vata) such as cough, asthma, &c., or with thirst, hunger, dryness of the mouth and fatigue, as well as old men, infants, weak persons, men of timid dispositions and pregnant vvom^n should' never fast. A swelling and an extremely painful ulcer should be respectively treated with a proper medicated plaster at the very outset. The pain in such a case will yield to the medicinal plaster as a blazing room or house is readily extinguished by means of steady watering. Such plasters not only give comfort to the patient (by removing the pain and leading to the absorption of the swelling), but heaves up the bed of the sore or the ulcer and contributes to its speedy purification and healing up (granulation). 25—28.