An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)

of the deranged Pitta, or incidental to a vitiated condition of the blood, should be tied in the aforesaid manner with the leaves of the Kds'mari, the Kshira trees (milkexuding trees), and aquatic plants. An ulcer due to the deranged and aggravated Kapha, should be tied over with the leaves of the Pdthd, Murvd, Gudiichi, Kdkaindchi, Haridrd or of the S'ukandsd. Only those leaves which are not rough, nor putrid, nor old and decomposed, nor worm-eaten and which are soft and tender should.be used for purposes of Patradana.* The rationale of such a procedure (Patra-vandha) is that the leaves tied by an intelligent physician in the manner above indicated serve to generate heat or cold and retain the liniment or medicated oil in their seat of application. 99-102.

Vermifugal :— The germination of worms due to flies in an ulcer is attended with various kinds of extreme pain, swelling and bleeding in case the worms eat up the flesh. A decoction of the drugs of the Surasddi gana proves efficacious as a wash and healing medicine in such a case. The ulcer should be plastered with such drugs as the bark of Saptaparna, Karanja, Arka, Nimba, and Rdjddana pasted with the urine of a cow, or washed with an alkaline wash (for expelling the vermin from it). As an alternative, the worms should be brought out of the ulcer by placing a small piece of raw flesh on the ulcer. These vermin may be divided into twenty groups or classes, which will be fully dealt with later on. (Uttara-Tantram— ch. 54). 103.

Vrinhanam (use of restorative and constructive tonics) : — All kinds of tone-giving and constructive measures should be adopted in the case of a patient

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weak and emaciated with the troubles of a long-stand ins sore, taking full precaution not to tax his digestive powers. Anti-toxic (Vishaghna) medicines and measures and symptoms of poisonings will be described under their respective heads in the Kalpa-Sthanam. 104-105.

* The leaf which does not poison the Sneha and the essence of the medicinal drugs placed in a folded piece of linen (and applied over an ulcer is the proper leaf and) should be used for tying over the paste.

^iro-vircchana and Nasya : — s'iro-virechana measures (errhines) shou d be resorted to by skilful physicians in respect of ulcers situated in the clavicle regions and marked by itching and swelling. The use of medicated (fatty) snuff (Nasya) is recommended in cases where the ulcers would be found to be seated in the regions above the clavicles and marked by an aggravated condition of the deranged Vayu, pain, and absence of the oily matter. 106-107.

Kavala-CJharana : — Medicated gargles (consisting of decoctions of drugs) of purifying or healing virtues either hot or cold * (according to requirements) should be used in the case of an ulcer in the mouth, for the purpose of alleviating the Doshas therein, for allaying the local pain and burning, and for removing the impurities of the teeth and the tongue. 108.

Dhuma-pana :— inhaling of smoke or vapours (of medicated drug.s) should be prescribed in cases of ulcers of the deranged Vayu and Kapha attended with swelling, secretion and pain and situated in the region above the clavicles. Application of honey and clarified butter, separately or mixed together should be prescribed in cases of extended or elongated ulcers which are traumatic or incidental in their character (Sadyo-Vrana) for allaying the heat of the ulcer and for bringing about its adhesion. Surgical instruments should be used in conncc-

* Hot gargles are recommended in cases of ulcers of the deranged Vayu and Kapha while cold ones in cases of ulcers of the aggravated Pitta and blood.

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tion with an ulcer which is deep-seated but provided with a narrow orifice and which is due to the penetration of a Salya (shaft) and which could not be removed with the hand alone. 109-111.

The diet of an ulcer- patient should in all cases be made to consist of food which is light in quantity as well a.« in quality, demulcent, heat-making (in potency) and possessed of appetising properties.* Protective rites should be performed for the safety of an ulcer-patient from the influences of malignant stars and spirits with the m.ajor and the minor duties (Yama and Niyama) enjoined to be practised on his behalf. 112-113.

The causes of ulcers are six-}* ; their seats in the body number eighty in all ; the features which characterise them are five $. The medicinal measures and remedies in respect of ulcers are sixty Ij in number. And these ulcers are curable with the help or co-operation of the four necessary factors (the physician, the medicines, the nurse and the patient). 114.