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

and flics attracted to it (and so consume the ulcer). A small portion of the ulcer, left unconsumed (un-eaten) by worms and parasites, etc., should be scarified and the ulcer should then be cauterised with fire. 27-28.

A comparatively superficial tumour (Arvuda; should be covered with thin leaves of zinc, copper, lead, or of iron, and cauterization with fire or with an alkali as well as surgical operations should be carefully and repeatedly resorted to, so as not to hurt, nor in any way injure the body. The incidental ulcer should be washed with the decoction of the leaves of the Asphota, Jdti, and Karavira for the purpose of purification. A medicated oil, cooked with Bhdrgi, Vidanga, Pdt/id, and Triphald should then be used as a healing remedy. An experienced physician should treat a tumour, spontaneously suppurating, in the manner of a suppurated ulcer. 29-31.

Treatment of IVIedoja Arvuda :— A

Medoja Arvuda (fat origined tumour) should be first fomented and then incised. The blood in its inside having been cleansed it should be quickly sutured and then plastered over with a compound composed of Haridrd, Griha-dhuma (soot of a room), Rodhra, Pattanga, Manahs'ild and Haritdla pounded together and mixed with a proper quantity of honey After its purification, thus produced, it should be treated with the application of Karanja-Taila (prescribed before in cases of Vidradhi). Even the least particle of Doshas (pus, etc.) in a tumour, left unremoved, would lead to a fresh growth of the excrescence and bring on death just like the least particle of an unextinguished fire. Hence it should be destroyed in its entirety. 32-33.

Treatment of Vataja Gala-ganda : —

A case of the Vaitaja type of Gala-ganda (goitre) should

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be treated with fomentations of the vapours of the decoctions of tender leaves of the Vayu-subduing drugs prepared by boiling them with Kanjika, various kinds of urine and milk as well as with minced meat and oil, and should be applied in the manner of a Nadisveda. After this fomentation, the contents should be carefully drained ;from inside the goitre). Then after having duly purified (the incidental ulcer;, it should be plastered with a medicinal compound composed of (the seeds ofj the S'ana, Atasi, Mulaka, S'igru and sesamum and Kinva and the piths of the Piydla^ or with that composed of Kdld, Arnritd, S'igru, Punarnavd, Arka, Gaja-pippali, Karahdta , Madana) and Kushtha, or with that composed of Ekaishikd, V rikshaka and Tilvaka. All of them should be pasted with Sura and Kanjika and applied hot to the affected part. The internal u;e of a medicated oil, cooked* with Amritd^ Nimba, Hamsdhvd, Vrikshaka, Pippali, Vald, Ati-vald, and Deva-ddni, always proves efficacious in a case of goitre. 34-56.

Treatment of Kaphaja Cala-g^anda :

— A case of the Kaphaja type of goitre should be treated with applications of fomentation and poultice and should be duly drained (Visrava). Then a medicinal plaster composed of Aja-gandhd, Ati-vishd, Vis'alyd, Vishdnikd, Kushtha^ S'ukdhvayd, Gunjd (taken in equal parts) and pasted with the alkaline water prepared from the ashes of the Palds'a wood should be applied hot to the affected part. A medicated oil cooked with the drugs of the Pippalyddi group and mixed with the five officinal kinds of salt should

* Some say that the oil should be prepared with the decoction as well as with Kalka of the said drugs. Others, however, hold that water should be used in the preparation of the oil and the said drugs should be used only as a Kalka.

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be taken by the patient. Emetics, errhines and inhalations of Vairechanika-dhuma are beneficial in such cases. In the Va'taja and the Kaphaja types of goitre (Gala-ganda), the skilful physician should employ suppurating measures in partially suppurated cases. The patient's diet should consist of rice, barley and Miidga soup and should be taken with honey, Trikatu, cow's urine, fresh ginger, Patola and Nimba. 37-39.

Treatment of IVIedoja Gala-ganda :—

In a case of aMedoja goitre (due to the deranged fat\ the patient should be first made to use oleaginous substances (internally and externally) and venesection should then be resorted to, as advised before (S.-.rira-Sthdna. Ch VIII). A hot plaster composed of S'ydmd (Trivrit), Sudhd, Maudura, Danti and Rasdnjana pasted together should be applied to the seat of the disease. Powders of the essential parts (Sara) of a S'dla tree mixed with cow's urine may be given every morning with advantage

As an alternative, the Goitre (Gala ganda) should be opened, its fatty contents fully removed and the wound then sutured. Or it should be cauterised with the application of heated animal marrow, clarified butter, lard, or honey ; after which it should be lubricated with clarified bulter and honey (mixed together), and a pulverised compound of Kdsisa, Tuttha, and Gorochand, should be applied to it ; or after lubricating it with oil, it should be dusted with the ashes of cowdung and of S'dla-sdra. Daily washings with the decoction of Triphald, hard bandaging and a diet of barley, prove efficacious (in cases of goitre). 40,

Thus ends the Eighteenth Chapter of the Chikitsita Sthanam in the Sub'ruta Samhita, which deals with the medical treatment of Glands, Scrofula, Tumour and Goitre.

CHAPTER XIX.