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

Then after having cleansed the polypus, a fresh application should be made according to the strength of the alkali and the intensity of the aggravated Doshas involved in the case. Further application of the alkali should be stopped and the polypus washed with fermented rice-gruel (Dhanyamla), curd-cream, Sukta, or the juice of acid fruits, in the event of its having been found to have become a little flabby, bent down, and to have assumed the colour of a ripe Jambu fruit. After that it should be cooled with clarified butter mixed with Yashti-Madhu, the trappings should be removed and the patient should be raised up and placed in a sitting posture in warm water and refreshed with

3l8 THE SUSHRUTA SAMHITA. [Chap. VI.

sprays of cold water, or, according to some authorities, with warm water. Then the patient should be made to lie in a spacious chamber, not exposed to the blasts of cold winds (specially), and advised as regards his diet and regimen Each of the remaining polypii, if any, should be cauterized with the alkaline application at an interval of seven days. In case of a number of polypii, those on the right side should be first cauterized and then those on the left, and after that those on the posterior side ; and lastly those that would be found to be in front. 3.

Polypii, having their origin in the deranged V^yu and Kapha, should be cauterized with fire or alkali ; while those, which are the outcome of the deranged Pitta and vitiated blood should be treated with a mild alkali alone. A perfect and satisfactory cauterization (Samyag'- dag^dha) of a polypus should be understood from such symptoms as, restoration of the bodily Vdyu to its normal condition, relish for food, keenness of the appetite, lightness of the body and improvement in strength, complexion and pleasure. An over-cauterized (Atidagdha) polypus gives rise to such symptoms as, cracking of the region of the anus, a burning sensation (in the affected locality), fainting, fever, thirst, and profuse haemorrhage (from the rectum), and consequent complications ; while an insufficiently cauterized (Hinadagdha) polypus is known by its tawny brown colour, smallness of the incidental ulcer, itching, derangement of the bodily Vdyu, discomforts of the cognitive organs and a non-cure of the disease. 4.

A large polypus, appearing in a strong person, should be clipped off (with a knife) and cauterized with fire. As regards an external polypus full of extremely aggravated Doshas (Vdyu, Pitta, Kapha and blood) no

Chap. VI.] CHIKITSA STHANAM. 3I9

Yantra should be used, but the treatment should consist of fomentation, anointing, poulticing, immersion, plastering, evacuating measures (Visrdva), cauterization with fire and alkali and a surgical operation. Measures laid down under the head of Rakta-pitta should be resorted to in cases of haemorrhage (from the seat of affection). Remedies mentioned in connection with dysentery (Atisara) should be employed in cases of a looseness of the bowels ; whereas in cases of constipation of the bowels oily purgatives should be administered, or the remedies for Uddvartta should be adopted. These rules shall hold good in the cases of treating (cauterization, etc) a polypus occurring in any part of the body whatsoever. 5.

A polypus should be caught hold of and an alkali should be applied thereto with a Darvi, or a brush (Kurcha), or an indicator (Salaka). In a case of a prolapsus of the anus, cauterization should be made without the help of any Yantra (speculum).

Diet : — In all types of haemorrhoids, the diet should consist of wheat barley, Shashtika rice or ^A\i rice, (boiled) and mixed with clarified butter, to be taken with milk, Nimba-soup, or Patola-soup. The patient should be advised to take (his meal) with Vdstuka, Tanduliyaka^ Jivanii, Upodikd, As'va-vald, tender Mulaka^ Pdlanka, Asana, Chilli, Chiichchu, Kaldya, Valli, or any other S'dkas (pot-herbs}, according to the nature of rhe Doshas involved in the case Any other oleaginous, diuretic, laxative and appetising (Dipana) diet possessing the virtue of curing piles should also be prescribed. 6.

After the cauterization of the polypus, as well as in a case where no cauterization would be necessary, the body of the patient should be anointed with clarified

p. 320