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

Now we shall discourse on the medical treatment of hernia, hydrocele, scrotal tumour, etc. (Vriddhi), diseases of the genital organ (UpadamS'a) and elephantiasis (^lipada). i.

In the six types of Vriddhi other than the one known as the Antra- Vriddhi (Hernia), riding on horse back, etc., excessive physical labour, fastings, sitting in an unnatural position, constant walking, voluntary restraint of any natural urging (for stool and urine, etc.), sexual intercourse and eating of food difficult of digestion should be avoided. 2.

Treatment of Vataja Vriddhi :— In

the Vataja type of Vriddhi, the patient should be first soothed (Snigdha) with the application of Traivrita Ghrita (vide, Chap. V. Chikitsita Sthana). He should then be duly fomented and subjected to a proper course of purgatives. As an alternative, he should be made to drink the expressed oil of the Kos'dnira, Tilvaka, or Eranda (castor) oil (as a purgative) with milk for a month. A decoction of the Vayu subduing drugs mixed with the powders of the same drugs should then be employed by an experienced physician at a proper time * in the manner of a Niruha Vasti. The patient should then be made to take a meal (of boiled rice along with meat soup ; and oil cooked with Yashti mad/ni should be applied (in the manner of an Anuvasana measure).

* After a period of one week from the time of the application of purgatives and in case the patient is strong enough to undergo the Niruha Vasti measure.

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Applications of Sneha (oil, etc.), poultices (Upandha), and plasters (Pradeha) of the Vayu-subduing drugs should be applied to the affected part. If the tumour (Vriddhi) begins to suppurate, it should be made to do so fully. It should be then opened with an incision avoiding the median line (Sevant) of the perineum and the proper purifying (i.e., antiseptic and healing) measures should be resorted to in the usual way laid down (in the treatment of Dvi-vrana*). 3.

Treatment of Pittaja Vriddhi : — A case of the non-suppurated stage of Pittaja Vriddhi may be beneficially treated with the remedies laid down in connection with a case of the same type of glandular swelling (Pittaja Granthi). In the c?.se of it being suppurated, the surgeon should open it with a knife and purify it with the application of honey and clarified butter. The incidental ulcer should then be healed up with oils and pastes of healing virtues. 4.

Treatment of Raktaja Vriddhi :~In a

case of Raktaja Vriddhi (originated through the vitiated condition of the blood), the (vitiated) blood should be drawn out by the application of leeches. As an alternative, purgatives should be administered through the medium of honey and sugar Remedial measures described in connection with the Pittaja type of the disease should be employed both in the suppurated and the non-suppurated stages (of this type). 5.

Treatment of Kaphaja Vriddhi :— In

a case of the Kaphaja type of the disease, poultices with the heat-making f drugs (i.c , Vachadi, Pippalyadi t Some say that the heat-producing drugs are those comprised in the Aja-gandhadi group mentioned in the Mis raka chapter, Sutra Sihdnam.

* According to Gayadasa, the measures to be adopted should be those laid down in the Mi.s'raka chapter (Chap. XXV).

Chap. XIX.] (CHIKITSA STHANAM. 44.I.

and Mushkakadi groups, etc.) pasted with cow's ufinO) should be applied. The patient should be made ta drink a potion consisting of the decoction of DciniHaridrd mixed with the urine of a cow, and all the remedial measures with the exclusion of Vimlapana (resolution by pressure) laid down under the treatment of the Kaphaja Granthi should be employed. The tumour should be opened (with a knife) when suppurated and the oil cooked with Jdti, Arushkara, Amkota and Sapta-parna should be used for the purification (disinfection) of the incidental ulcer. 6.

Treatment of IVIedoja Vriddhi :— In

a case of the Medoja (fat-originated) type of the disease, the affected part should be (lightly) fomented, * and plasters composed of drugs (of the roots) of the Surasddi group or of the S'iro-vircchana group (Ch. XXXIX. Sutra Sthana) pasted with the urine of a cow should be applied to it in a lukewarm state. The inflamed and swollen scrotal tumour, (lightly) fomented as before, should be tightened round with a piece of cloth. Then having encouraged the patient, the surgeon should open the tumour with a Vriddhipatra (knife) carefully avoiding the two testes (lying within the scrotal sac) and the median line of the perineum (Sevani). Then having carefully removed all morbid products (Medas) from its inside, Saindhava and sulphate of iron should be applied to th2 incised part, and the scrotum should be carefully bandaged (in the manner of a Gophana bandage). After the proper purification (disinfection) of the ulcer, its healing should be effected with the application of an oil