Charaka-Samhita — trans. Kaviraj Avinash Chandra Kaviratna

should be subjugated by means of caustic applications, by administration of ‘Arishtas’ (fermented liquors), and by application of fire (with heated irons, &c.). 54 The physician conversant with the measure of strength and of faults should administer caustic applications in the case of ‘Gulma’ in which the excited phlegm is ascertained to predominate. 55

Indeed, the physician skilled in the knowledge of the increase and decrease of the strength and of the faults of the body, should do this, at intervals of one day,- or two days, or three days. 56

The patient should be given milk, ghee , and meat to drink and eat. Caustic applications, repeatedly cutting and tearing off the phlegm, which is sweet, and oily, and displacing it from its site, cause the ‘Gulma’ itself to be expelled through the downward passage.

The very nature of ‘kshara’ (caustics) is such.f 57

* The boluses, powders, and decoctions, are those which are spoken of at the end of this Lesson.— T.

+ In the last portion of the second line, the etymological meaning of ‘kshara’ (caustics) is given, and its effects explained. It is called ‘kshara’ because of its nature as ‘kshara’ which etymologically implies something that cuts and tears and removes or dissolves away. — T.

p. 149

p. 1176

CHARAKA-SAMHITA.

Unto persons afflicted with phlegm-born ‘Gulma’, ‘Arishtas’ (fermented liquors, combined with medicinal substances) should be given, if their digestive fire becomes weakened, if they feel a disgust for food, and if they happen to be habituated to wine and oily food and . drink, the object being the clearing of the ductS* (in general, principally that which carries away the stools).* 58

If a person’s ‘Gulma’ born of phlegm does not abate, in “conse¬ quence of its roots being” deeply laid, by means of fasts, then administration of emetics, application of ‘sweda’, drinking of ghees, use of purgatives, as also of enemata, boluses, powders, caustics, and diverse ‘Arishtas’, should be prescribed ;

his blood should be let out, and cautery also, by means of rods, knives, &c., of iron, is regarded as the best treatment. 59-6°

In cases of ‘Gulma,’ phlegm and wind are subdued by fire (cautery) in consequence of its keenness and heating virtues.

Owing to the subjugation of these two, the compactness of the ‘Gulma’ gradually disappears. 61

When applications of cautery are needed, the field is for the exercise of skill by physicians of the Dhanwantari class.

When the application of caustics becomes necessary, the field is for the exercise of skill by those physicians who are conversant with the science of such applications.

If the case be one in which the morbid indications are of a mixed character, the course of treatment should be mixed, (that1 is, both the physician and the surgeon should be called in), 6z

I shall now speak of those combinations of tested efficacy which are curative of ‘Gulmas.’

TRYUSHANADI-GHRITA.

Tryushana (dry ginger, Piper longum and black pepper), TriphalS (the three myrobalans, viz., chebulic, emblic, and belleric), Dhanya ( Coriandrum sativum), Vidanga ( Embelia Ribes ), Chavya ( Chavica officinarum ), and Chitraka (. Plumbago Zeylanica ), — these should be

* 'Arishtas’ are fermented liquors. They may be given to persons that are habituated to wines and *ily food, &c.— T,

CHARAKA-SAMHITA.

» 77 reduced into a paste. Then ghee should be boiled with it. To the boiled product milk should be added.

This medicine, called ‘Tryushanadi-Ghrita’, is corrective of windborn ‘Gulma.’ 63

ANOTHER KIND OF TRYUSHANADI-GHRITA.

The same drugs which have been mentioned above should be reduced to paste. This paste should be boiled with the decoction of the five roots, or with that of the twice five (or ten) roots.*

The ghrita thus prepared is highly efficacious in curing ‘Gulma.’ 64 GULMA-SHATPALA-GHRITA.

That ‘Shatpala-Ghrita’ which is laid down in the treatment of ‘Raja-yakshma’ (phthisis) should be drunk by a person who is afflicted with ‘Gulma.’

Ghee, raised from milk, should be boiled with *the wine called Prasanna, or with the juice of pomegranate fruit, or with the cream of curds.

This ghee is beneficial for those persons that are afflicted with wind-born ‘Gulma.’ 65

HINGU-SAUVARCHALADYA-GHRITA.

Hingu (assafoetida), Sauvarchala (Sanchala salt), Ajaji (otherwise called Jiraka, that is, cumin seeds), Vidanga ( Embelia Ribes ), Dadima ( Punica Granatuni), Dipyaka (another name of Yamani, that is, Ptychotis Ajowan), Pushkara [Nelumbium speciosuni), Vyosha (other¬ wise called ‘Trikatu’, (or, the three acrids, viz., dry ginger, Piper longum, and black pepper), Dhanya (coriander seeds), Amlavetasa ( Rumex vesicarius), Kshara (meaning ‘Yavakshara’, that is, the ashes of green bla'des of barley incinnerated within covered vessels of earth), Chitraka ( Plumbago Zeylanicd ), £athi ( Curcuma Zerumbet ), VachS ( Acorus Calamus ), AjagandhS (otherwise called Vana-yamani, that is, Seseli Indicum ), ElS ( Eletteria cardamomum), and Surasa ( Ocimum sanctum ), — these should be reduced to a paste.

With the paste, ghee should be boiled, along with curds (of four times the measure of ghee.