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

Parisravi (exuding) type, where there is bleeding and secretion from the ulcer, the sinus and the cavities of pus should ba first removed and then cauterized with an alkali or with fire by an intelligent surgeon. The region of the anus should then be kept wet by the sprinkling of lukewarm Anu-toila (described in thechapteron Vata-vyddhi). Warm plasters, or poultices, mixed with Yavakshdra and the urine i_of a cow) should then be applied. Decoction of the emetic drugs as the seeds of Madana, etc.), should also be sprinkled slightly on the affected part. The ulcer when found to be softened and nearly free from pain and secretion (owing to the preceding measures) should be searched with a probe and the principal sinus should be cut open and againp. 342 completely cauterized wiih fire or with an alkali. The incisions should be made in the shape or form of a Kharjura-patra (leaf of the date-palm\ Ardha-chandra (half-moon\ Chandra-chukra (moon's disc), Suchi-mukha (needle's mouth), or Avammukha (with downward mouth). After that the ulcer should be purified with mild cleansing or disinfecting remedies (as described above) 7.

In the case of an infant cauterization with fire or with an alkali, the use of strong purgatives and surgical operations are forbidden in the case of the disease (Bhagandara), whether outer mouthed or inter-mouthed. Medicinal remedies calculated to be mild, though keen in their efficacy, should be used in such cases. A plug or a Varti in the shape of a wick and made of powdered Aragvadha, Haridrd and Kala, mixed with honey and clarified butter, should be inserted into the ulcer for purifying purposes. This medicinal compound speedily brings about the healing of a sinus, just as the wind will drive away a cloud. 8 — 9

Treatment of Agantuka Bhagandara : — -The sinus in a fistula of traumatic origin should be carefully cut open by a surgeon (with a knife) and cauterized, according to the rules laid down, with a red-hot Jambvoshtha (instrument) or with a redhot director (Saldka). Vermifugal remedies should be applied to it, and measures laid down in connection with the extraction of a Salya from the body should be carefully resorted to. 10,

Treatment of Tridoshaja Bhagandara:— A case of Bhagandara, due to the concerted action of the three Doshas, should be treated without holding out any hope of recovery tot he patient's people, or should be given up as hopeless. The measures and remedies mentioned above should be adopted in

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succession in all types of Bhagandara. In the event of there being any pain in it, owing to the insertion of a knife or to any other surgical operation, luke-warm Anu-taila should be applied. As an alternative, the drugs possessed of the virtue of subduing the deranged Vdyu i^Bhadra-darvadi and Erandadi groups) should be boiled in a pot covered by a lid having a hole or aperture on its top ; then the patient with his rectum anointed wjth oil, etc., should be made to sit in such a way over the said covered pot that the seat of the disease may be fomented with the warm fumes escaping through that aperture ; or Nadi-sveda should be applied to the affected region through a pipe in a recumbent posture to alleviate the pain. As an alternative, a hot bath should be prescribed for the alleviation of the pain. Salvana Upanaha (described in connection with the treatment of Vata-vyadhi and that with the skins of the Kadali Mriga, Lopaka and Priyaka, should be applied to the affected locality to subdue the pain. A potion of the drugs or substances such as, Trikatu, Vac/id, Hingu, salt (five kinds of salt) and Dipyaka, should be administered with wine, Kanjika, Sauviraka and Kulattha-Soup, etc 11-12.