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

* The fomentation should be applied according lo S'ivadas'a, with balls of cow-dung, etc., slightly heated. It should be noted in this connection that strong fomentations should not, in any case, be applied to the testes.

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cooked with Manahs'ild, Haritdla (yellow oxide of arsenic), rock-salt, and Bhalldtaka. 7.

Treatment of Mutraja Vriddhi : —

In a case of an enlargement of the scrotun (hydrocele) due to the derangement of urine, it should be first fomented and then a piece of cloth should be tightened rount it. A puncture should then be made in the bottom of the sac with a Vrihimukha instrument, on either side of the raphe of the perineum (Sevani), A tube open at both ends should be introduced (into the puncture) and the accumulated (morbid) fluid should be let out. The tube should then be taken off and the scrotum should be tied up with a bandage of the Sthagika pattern and the incidental ulcer should be purified and healed up with appropriate medicinal applications, 8.

Treatment of Antra-Vriddhi :— Acase

of Antra-Vriddhi i^hernia when strangulated) extending down to the scrotal sac (Kosha) should be given up as irremediable ; but, in the case of its not being so extended, it should be treated as a case of VdtajaVriddhi. If the colon be found to have descended down to inguinal region (Vamkshana), it should be cauterized with a heated crescent-mouthed rod (Arddha-Chandra S'aldka) to prevent its descending down into the scrotal sac. A case of hernia that, in spite of all these precautions, descends down into the scrotal sac (Kosha), should be given up as irremediable. The first finger of the hand opposite * the affected part {i.e., the affected testes) should be incised at its middle and cauterized.

* Incision and cauterization should be performed in the thumb of the right hand, if the left testis is affected, and in case the afifection is in the right testis, incision and cauleriza;ion should be made in the thumb of the left hand.

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In cases of hernia (Antra-Vrlddhi) of the V^taja and of the Kaphaja type the affected part should be carefully cauteiized in the above manner; but in these two cases, the SnAyu (ligamenis) should be cut off in addition .^before cauterization). In a case of Antra-Vriddhi the veins (S'ird) of the temples at the (upper) end of the ears on the opposite sides of the affection should be carefully opened avoiding the Sevani therein. 9-12.

Treatment of Upadams'a * :-in cases of the curable type of Upadams'a, Sneha (oleaginous substances) should be first applied, and the affected part should be fomented. Then the veins of the penis should be opened, or leeches should be applied (to the organ) for the elimination of the contaminated blood t (according as the affections are more or less severe), 13.

General Treatments :- The system of the patient should be cleansed with both emetics and purgatives in the event of an excessive aggravation of the Doshas inasmuch as the local pain and swelling would subside simultaneously with the elimination of the aggravated Doshas from the system Medicinal Vastis (enemas) should be injected (into the rectum) in the way of a Niruha-Vasti for the elimination of the aggravated Doshas, where the weakness of the patient would prohibit the application of purgatives. 14.

Treatment of Vataja Upadams'a :— In

a case of the Vataja type of the disease, drugs such as, Propaundarika, Yashti-madhu, Varshdbhii, Kushtha, Deva-ddru^ Sarald, Aguru and Rdsnd, should be used as a plaster (over the affected organ). Similarly

* See note, Chapter XII., Nidana Sthanam.

t Jejjata holds that leeches should be applied in a case of superficial Upadams'a.

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plasters composed of Nichula, castor-seeds, and pulverised wheat and barley grains pasted with Sneha (clarified butter, oil, etc.) should be applied lukewarm to the seat of the disease, which should also be affused with a decoction of the above-mentioned drugs, viz,, Prapaundarika, etc. i 5 •

Treatment of Pittaja Upadams'a : — in a case of the Pittaja type of the disease, a plaster composed of Gairika, Anj'ana, Yashti-madhu, S'drivd, Us'ira, Padmaka, (red) CJiandana and Utpala mixed with a Sneha (clarified butter),* or that composed of Padma, Mrindla, Sarjfa, Arj'una, Vetasa, and Yashtimadhu mixed with clarified butter should be applied to the affected organ which should be sprinkled with a solution of milk, clarified butter, sugar, sugar-cane juice and honey, or with a cold decoction of the drugs of Vata, etc. 16,

Treatment of Kaphaja Upadams'a : —

In a case of the Kaphaja type of the disease, a plaster composed of the barks of S'dla^ As'va-karna, Aja-karna and Dhava pasted with Sura and mixed with oil, should be applied hot to the affected part. As an alternative, the drugs such as, Haridrd, Ativishd, Mustd, Sarald, Deva-ddru, Patra, Pdtha, and Pattura should be used for similar purposes and the affected organ should be affused with a decoction of the drugs of the Surasddi and A'ragvadhddi groups. 17.