The Sushruta Samhita — trans. Bhishagratna

The medicine thus prepared should be applied to the ulcer on every third or fourth day. 59.

Deepf and foul-smelling ulcers covered with layers of deranged fat (phlegmonous ulcer) should be purified by the learned physician with the powders of the drugs with which the purifying plug or the lint has been enjoined to be plastered (Ajagandha, &c.). Decoctions of the drugs which are possessed of the virtue of setting in a process of granulation (Ropana) in an ulcer, sucn as Vata, &c., as stated before, should be used by a surgeon (Vaidya) after it had been found to have been thoroughly purified. Medicated plugs, composed of drugs possessing healing properties (such as, So7na,Amritd, As'vagandhd^ etc}) should be inserted in deep-seated ulcers, when cleansed and unattended with pain. 60-62.

* The total weight of the purifying drugs should be equal to that of the Karpasa-phala alone and they should be boiled together with four times their qnantity of clarified butter and with sixteen times of water.

t There is a difTerent reading of "Agambhira" in place of "Gabhira," but Gayi thinks the emendation undesirable.

Chap. I.] CHIKITSA STHANAM. 2^3

A Kalka or a levigated paste of sesamum and honey (mentioned in the Misraka Chapter) should be applied for the purpose of healing up an ulcer situated in a muscular part from which all putrid flesh has been removed or sloughed off and which exhibited a clear cavity. This paste (of sesamum) tends to allay the deranged Vayu through its sweet taste, oleaginousness and heat-making potency ; subdues the deranged Pitta through its astringent, sweet and bitter taste and proves beneficial even in the case of the deranged Kapha through its heat-producing potency and bitter and astringent taste. An application of the levigated paste of sesamum mixed with the drugs of purifying and healing properties tends to purify and heal up an ulcer. An application of the levigated paste of sesamum mixed with honey and Nimda-\es.ves leads to the purification of sores ; whereas an application of the same paste (?> , sesamum, honey and leaves of Nimbd), mixed with clarified butter tends to heal up the ulcer. Several authorities atribute the same virtue to a barley-paste.* Levigated pastes of barley and of sesamum (or a paste of barley mixed with sesamum) contribute to the resolution or subsidence of a non-suppurated swelling, fully suppurate one which is partially suppurated, lead to the spontaneous bursting of a fully suppurated one, and purify as well as heal up one that has already burst out. 63-65.

63-65.

An ulcer,whicb is due to the effects of poison, vitiated blood, or aggravated Pitta, and which is deep-seated oris of traumatic origin, should be healed up with a medicated clarified butter prepared with the drugs of healing virtues (Ropaniya— enumerated before) and milk. An ulcer marked by an aggravated condition of the deranged

Jejjada and Gayadasa interpret the term to mean '*barley-paste mixed with sesamum."

p. 254

Vayu and Kapha should be healed up with the application of an oil, boiled and prepared with the proper purifying drugs mentioned before. 66 6y.

Rasa-kriyat* with the two kinds of Haridrd should be resorted to for the purpose of healing up an ulcer, in which bandaging is forbidden (such as those due to the deranged Pitta or blood, or to blow, &c., or to the effects of poison), and an ulcer appearing on the moveable joints, which, though exhibiting all the features of a well-cleansed sore, has not been marked by any process of healthy granulationf. Healing medicinal powders should be used in the case of an ulcer which is confined to the skin, and is firm-fleshed and marked by the absence of any irregularity in its shape {i.e.^ not uneven in its margin). The mode of applying medicinal powders, as stated in the Sutra-sthana, should be adopted in the present instance. 68-69.

The healing and purifying measures described above should be deemed equally applicable to, and efficacious in cases of ulcers in general with regard to their Doshas (both idiopathic and traumatic). The success of these measures has been witnessed in thousands of cases and has been recorded in the Sastras (authorised works on medicine). Hence they should be used as incantations without any doubt as to their tested and infallible efficacy. An intelligent physician should employ the drugs, mentioned before, in any of the seven forms (either in the shape of a decoction, or a t Several editions read "though cleansed yet ungranulating ulcere."

* The decoction of IriphalA and the drugs of the Nyagrodhadi group should be duly prepared, filtered and then condensed to the consistency of tteacle. Powders of Haridrd and Daru-haridra should be then thrown into it. In the end, the whole preparation should be well-stirred, mixed with honey and applied. This is what is called Rasa-kriya.

Chap, t] CHlklTSA STHANAM. 2^5

plug, or a paste, or through the medium of medicated oils and clarified butter, or in the shape of Rasa-kriya, or as powders), according to the requirements of each case. 70.

2^5 plug, or a paste, or through the medium of medicated oils and clarified butter, or in the shape of Rasa-kriya, or as powders), according to the requirements of each case. 70.

The drugs which constitute the two groups ofPanchamulas (major and minor), as well as those of the Vayusubduing group, should be employed in the case of an ulcer due to the aggravated Vatyu in any of the seven forms — decoction, etc. Similarly the drugs which are included within the groups of Nyagrodhadi or Kakolyadi should be used in any of those seven forms, in the case of an ulcer due to the aggravated Pitta (for the purification and healing thereof). Drugs which form the group of Aragvadhadi, as well as those which have been described as heat-making in their potency, should be used in any of those seven aforesaid forms, in the case of an ulcer due to the deranged Kapha. The drugs of two or three of those groups, should be combinedly used in any of those seven forms, in connection with an ulcer marked by the aggravated condition of any two or three of the deranged Doshas respectively. 71-74.

Fumig'ation : — Vataja ulcers with severe pain and secretion should be fumigated with the fumes of Ks/iauma, barley, clarified butter and other proper fumigating substances [such as turpentine and resin (gum of Sdlatree)]. 75.

Utsadana-Kriya (Elevation) :— Medicated plasters (consisting of Apdmdrga, As'va^andhd, etc.) and medicated clarified butter (prepared with the same drugs should be used in ulcers (due to the aggravated Vayu and marked by the absence of any secretion, and affecting a considerably smaller area or depth of flesh, as well as in those (due to the deranged and aggravated Pitta and) seated deep into the flesh, for the purpose of raising up (filling up) the beds or cavities thereof. Meat of carnip. 256vorous animals should be taken in the proper manner by the patient, inasmuch as meat properly partaken of in a calm and joyful frame of mind adds to the bodily flesh of its partaker. J6.

Ava.Sada.na (destruction of super-growths) : — Proper drugs or articles (such as sulphate of copper, etc.) powdered and pasted with honey should be applied for destroying the soft marginal growths of an ulcer found to be more elevated than the surrounding surface of the affected locality. 77.