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

But Gayi recommends only four seers of clarified butter prepared from goat's milk cooked wilh i6 seers of cow's milk and the four drugs as a Kalka.

Chap. II] CHIKITSA STHANAM. 2'J\

medicinally with Yashti maddu, Ldkshd and Gokshura, mixed with (a proper quantity of) sugar and castor oil (as Prakshepa)* is equally commendable for the alleviation of the pain and the burning sensation, (in the wound or ulcer). The fat-lump (pariental fat) aforesaid causes a rumbling sound with pain in the abdomen and may prove even fatal in the event of its being left uncut. The medicated oil to be mentioned hereafter in connection with Medaja-Granthi should be applied in such cases. 30-32

Foreign bodies (^Salya) piercing into any of the Koshthas after having run through the (seven layers ofj skin, whether passing through the veins, etc , (muscles, nerves, bones or joints or not, produces the distressing symptoms described before (^Ch. III. — Sutra). The blood (of the affected chamber or receptacle) in such case lies incarcerated therein in the event of its failing to find an outlet and causes a paUor of the face and a coldness of the extremities and of the face in the patient. Respiration becomes cold, the eyes red-coloured, the bowels constipated and the abdomen distended. The manifestation of these symptt)ms indicates the incurable character of the disease. 33-34.

• This explanation is given on the authority of old Vagabhata. Dallana, however, explains the verse in a different way. He explains it to mean two different preparations of milk — one with Yashti-madhu and mixed with sugar and castor oil as a Prakshepa and the other with Gokshura and mixed with Laksha and castor oil as a Prakshepa.

A thiid in'erprjtation would make three preparations of milk prepared separately with Yashli-madhu, Laksha and Gokshura — sugar and castor oil being mixed in the first (as Prak.hepa) and castor oil alone in the second and third.

A fourth preparation would be to prepare the milk separately wiih Yasblimadhu, Laksha and Gokshura as in the preceding case — without the addition of castor oil (as Prakshepa).

p. 272

Emesis is beneficial in the case where the blood would be found to be confined in the Amas'aya (stomach). Purgatives should unhesitatingly be prescribed where the blood would be found to have been lodged in the Pakvds'aya (intestines) and Asthapana measures without oil should be employed with hot, purifying i^Sodhana) substances (such as the cow-urine, etc.) The patient should be made to drink a Yavagu (gruel) with Saindhava salt and his diet should consist of boiled rice mixed with the soup of barley, Kola and Kulalttha pulse divested of oil. 35-36.

In a case of a perforation or piercing of any of the bodily Koshthas attended with excessive haemorrhage or bleeding, the patient should be caused to drink (a potion of animal) blood and such a case marked by the passage of stool, urine, etc., through their proper channels of outlet and by the absence of fever and tympanites and other dangerous symptoms, (Upadrava), may end in the ultimate recovery of the palient. 37-38.

In a case of a perforation of the Koshtha (abdomen) where the intestines have protruded or bulged out in an untorn condition, they should be gently re-introduced into the cavity and placed in their original position, and not otherwise. According to others, however, large black ants should be applied even to the perforated intestines in such a case and their bodies should be separated from their heads after they had firmly bitten the perforated parts with their claws. Aftei- that the intestines with the heads of the ants attached to them should be gently pushed back into the cavity and reinstated in their original situation therein. The bulged out intestines should be rinsed with grass, blood and dust, washed with milk and lubricated with clarified butter and gently re-introduced into the cavity ofp. 273 the abdomen with the hand with its finger nails cleanly paired. The dried intestines should be washed with milk and lubricated with clarified butter before introducing it into their former and natural place in the abdomen. 39-41.