An English Translation of the Sushruta Samhita (Bhishagratna ed.)

purification of the sore of a long-standing ulcer which is of an indurated character with its margin raised higher (than the surrounding skin), and is marked by itching and a stubborn resistance to all purifying medicines. 80. Agni-Karma (actual cauterization) :— An ulcer incidental to an act of lithotomic operation allowing the urine to dribble out through its fissure, or one marked by excessive bleeding, or in which the connecting ends have been completely severed, should be actually cauter- ised with fire. 81 .

Krishna- Karma : -The blackening of a white cicatrix, which is the result of a bad or defective granulation, should be made (after the complete healing up of the ulcer) in the following manner. Several Bhalld' taka seeds should be first soaked in the urine of a cow (and then dried in the sun, this process should be repeated for seven days consecutively), after which they should be kept (a week) immersed in a pitcher full of milk. After that the seeds should be cut into two and placed in an iron pitcher. Another pitcher should be buried in the ground with a thin and perforated lid placed over its mouth, and the pitcher containing the seeds should be placed upon it with its mouth downward (so that the mouths of the two pitchers might meet), and then the meeting place should be firmly joined (with clay). This being done a cow-dung fire should be lit around the upper pitcher. The oily matter (melted by the heat) and dribbling down from the Bhallataka seeds into the underground pitcher should be slowly and care- fully collected. The hoofs of village animals (such as horses, etc.) and those which live in swamps (Anupas — such as buffaloes, etc.) should be burnt and pounded together into extremely fine powder. The oil (of the Bhalldtaka seeds collected as above) should then be

258 THE SUSHRUTA SAMHITA. [Chap. I.

mixed with this powder, and applied to the white
cicatrix. Similarly, the oily essence of the piths of
some kinds of wood, as well as of some kinds of fruit
{Phala-snehd) prepared in the manner of the Bhalldtaka
oil (and mixed with the powdered ashes of hoofs) should
be used for the blackening of a cicatrix. 82-83.

PandU-karana :— The natural and healthy
colour (Pdndu) of the surrounding skin should be im-
parted to a cicatrix which has assumed a black colour
owing to the defective or faulty healing up of the sore in
the following manner. The fruit of the Rohini* should be
immersed in goat's milk for seven nights and, afterwards
finely pasted with the same milk, should be applied
to the skin. This measure is called Fandu-karana
(imparting a yellow or natural skin-colour to the
cicatrix). To attain the same result, the powder of a
new earthen pot, Vetasa roots, S'dla roots. Sulphate of
iron, and Madhuka (Yashti-madhu) pasted together with
honey may be used. As an alternative, the hollow rind
of the Kapittha fruit, from which the pulp has been
removed, should be filled with the urine of a goat to-
gether with Kasisa (Sulphate of iron), Rockand, Tuttham
(Sulphate of copper). Haritdla^ Manahsild, scrapings
of raw bamboo skin, Prapunndda (seeds of Chakunde),
and Rasanjana and buried a month beneath the roots
of an Arjuna tree after which it should be taken out
and applied to the black cicatrix. The shell of a hen's
egg, Kataka^ Madhuka, (Yashti-madhu), sea-oysters and
crystalsf (pearls according to Jejjata and Brahmadeva)
taken in equal parts should bs pounded and pasted with

• Rohini, according to som^ co nmentators, means a kind of Haritaki ; according to others, it means Ka*u-tumbi.

I Burnt ashes of sea-oysters, and pearls etc., should be used.

Chap. I.] CHIKITSA STHANAM. 2^9

the urine of a cow and made into boluses which should be rubbed over the cicatrix * 84-87.

Roma-Sanjanana— hair-producers :— The

burnt ashes of ivory and pure Rasdnjana (black
antimony; pounded (and pasted with goat's milk) should
be applied to the spot where the appearance of hair
{Lomotpatti) is desired. An application of this plaster
would lead to the appearance of hair even on the palms
of the hands. Another alternative is a pulverised
compound consisting of the burnt ashes of the bones,
nails, hair, skin, hoofs and horns of any quadruped,
over a part of the body, previously anointed (rubbed)
with oil, which would lead to the appearance of hair in
that region. And lastly, a plaster composed of Sulphate
of iron, and tender Karanja leaves pasted with the
expressed juice of Kapittha, would be attended with
the same result. 88 — 90.

Hair-dcpilators '.—The hair of an ulcer- ated part of the body found to interfere with the satis- factory healing up of the ulcer, should be shaved with a razor or clipped with scissors, or rooted out with the help of forceps. As an alternative, an application of a plaster consisting of two parts of pulverised (burnt ashes of) conch-shell and one part oi Haritdla (yellow orpiment or yellow oxide of arsenic) pasted with Sukta (an acid gruel) over the desired spot, would be attended with the same result A compound made of the oil of Bhallattaka mixed with the milky exudation of Snuhi, should be used by an intelligent physician as a depila- tory measure. As an alternative, the burnt ashes of the stems of plantain leaves and Dirghavrinta (Syondka) mixed with rock-salt, Haritdla and the seeds of Sami,

* This also is a remedy for giving a natural colour to the skin.

26o THE SUSHRtJTA SAMHITA. [Chap. I.

pasted with cold water, should be deemed a good hair-
depilatory.* A plaster composed of the ashes of the
tail of a domestic lizard, plantain, Haritala (oxide of
arsenic), and the seeds of Ingudi burnt together: and
pasted with oil and water, and baked in the sun may
also be used for the eradicating of hair in the affected
locality. 94-95.

Vast! -Karma :— A medicated Vasti (enema)
should be applied to the rectum in the case of an ulcer
marked by an aggravated condition of the deranged
Vayu which is extremely dry and is attended with an
excruciating pain occurring specially in the lower region
of the body. A measure of Uttara-vasti (Vaginal or
Urethral syringe) should be adopted in the cases of
strictures and other disorders connected with urine,
semen and menstruation, as well as in cases ot
gravel ^ in case these are due to an ulcer. An ulcer is
purified, softened and healed up by bandaging leaving
no room for the apprehension of a relapse. Hence
bandaging is recommended. 96-98.

Patradana (application of leaves on an ulcer) : —
Leaves possessed of proper medicinal virtues taking
into consideration the particular Dosha and season of the
year should be tied (over the medicinal plaster applied)
over an ulcer of non-shifting or non-changing character
and not affecting a large depth of flesh and which
refuses to be healed up owing to its extreme dryness.
An ulcer of the deranged Vayu should be tied over with
the leaves of the Eranda, Bhurfa, Putika, or Haridrd
plants as well as with those of the Upodikd and
Gdmbhdri. An ulcer marked by an aggravated condition

* According lo seme this may be used internally for the purpose.

t D. R. Some read "Tathaiiiile" in place of ♦•As'mari-vrane."

."Taiharjile" means and in cases of (aggravated) Vayu.

Chap. I.] CHIKITSA STHANAM. 26l

of the deranged Pitta, or incidental to a vitiated condi- tion of the blood, should be tied in the aforesaid manner with the leaves of the Kds'mari, the Kshira trees (milk- exuding trees), and aquatic plants. An ulcer due to the deranged and aggravated Kapha, should be tied over with the leaves of the Pdthd, Murvd, Guduchi, Kdka- mdchi, Haridrd or of the S'ukandsd, Only those leaves which are not rough, nor putrid, nor old and decomposed, nor worm-eaten and which are soft and tender should.be used for purposes of Patradana.* The rationale of such a procedure (Patra-vandha) is that the leaves tied by an intelligent physician in the manner above indicated serve to generate heat or cold and retain the liniment or medicated oil in their seat of application. 99-102.

Vermifugal :— The germination of worms due
to flies in an ulcer is attended with various kinds of
extreme pain, swelling and bleeding in case the worms
eat up the flesh. A decoction of the drugs of the
Suras ddi gana proves efficacious as a wash and healing
medicine in such a case. The ulcer should be plastered
with such drugs as the bark of Saptaparna, Karanja,
Afka, Nimba, and Rdjddana pasted with the urine of a
cow, or washed with an alkaline wash (for expelling the
vermin from it). As an alternative, the worms should be
brought out of the ulcer by placing a small piece of raw
flesh on the ulcer. These vermin may be divided into
twenty groups or classes, which will be fully dealt with
later on. (Uttara-Tantram- ch. 54). 103.

Vrinhanam (use of restorative and constructive
tonics) : — All kinds of tone-giving and constructive
measures should be adopted in the case of a patient

The leaf which does not poison the Sneha and the esserxe of the medicinal drugs placed in a folded piece of linen (and applied over an ulcer is the proper leaf and) should be used for tying over the paste.

262 THE SUSHRUtA SAMHITA. [Chap. t.

weak and emaciated with the troubles of a long-standing
sore, taking full precaution not to tax his digestive
powers. Anti-toxic (Vishaghna) medicines and measures
and symptoms of poisonings will be described under
their respective heads in the Kalpa-Sthanam. 104-105.

^iro-vircchana and Nasya :-S'iro-vire-

chana measures (errhines) should be resorted to by
skilful physicians in respect of ulcers situated in the
clavicle regions and marked by itching and swelling.
The use of medicated (fatty) snufF (Nasya) is recom-
mended in cases where the ulcers would be found to be
seated in the regions above the clavicles and marked by
an aggravated condition of the deranged Vayu, pain,
and absence of the oily matter. 106-107.

Kavala-dharana :— Medicated gargles (^con- sisting of decoctions of drugs) of purifying or healing virtues either hot or cold * (according to require- ments) should be used in the case of an ulcer in the mouth, for the purpose of alleviating the Doshas therein, for allaying the local pain and burning, and for removing the impurities of the teeth and the tongue. 108.

Dhuma-pana : —inhaling of smoke or vapours (of medicated drugs) should be prescribed in cases of ulcers of the deranged Vayu and Kapha attended with swelling, secretion and pain and situated in the region above the clavicles. Application of honey and clarified butter, se- parately or mixed together should be prescribed in cases of extended or elongated ulcers which are traumatic or incidental in their character (Sadyo-Vrana) for allaying the heat of the ulcer and for bringing about its adhe- sion . Surgical instruments should be used in connec-

* Hot gargles are recommended in cases of ulcers of the deranged Vayu and Kapha while cold ones in cases of ulcers of the aggravated Pitta and blood.

Chap. I.] CHIKITSA STHANAM. 263

tion with an ulcer which is deep-seated but provided
with a narrow orifice and which is due to the pene-
tration of a Salya (shaft) and which could not be re-
moved with the hand alone. 109-111.

The diet of an ulcer-patient should in all cases be
made to consist of food which is light in quantity
as well a? in quality, demulcent, heat-making (in potency)
and possessed of appetising properties* Protective rites
should be performed for the safety of an ulcer-patient
from the influences of malignant stars and spirits with
the major and the minor duties (Yama and Niyama)
enjoined to be practised on his behalf. 112-113.

The causes of ulcers are sixf ; their seats in the
body number eight| in all ; the features which charac-
terise them are five $. The medicinal measures and
remedies in respect of ulcers are sixty Ij in number.
And these ulcers are curable with the help or co-opera-
tion of the four necessary factors (the physician, the
medicines, the nurse and the patient). 114.

The comparatively smaller number of drugs which
I have mentioned (under the heads of Ropana,
Sodhana, etc., in the present chapter) from fear of
prolixity, may be increased in combination with other
drugs or substances of similar virtue, (digestionary trans-
formation and potency, etc.) without any apprehension

* See Chap. XIX.— Sutra-Sthanam.

t The six causes of an ulcer are Vayu, Pitta, Kapha, Sannipdta, S'onita aud Agantu.

t The eight seats of an ulcer are Tvak, Mansa, S'ira, Snayu, Sandhi, Asthi, Koshlha and Marma.

§ The five symptoms of an ulcer are due to Vata, Pitta, Kapha, Sannipata and Agantu. The symptoms due to S'onita being identical with those due to Pitta, are not separately counted.

II The sixty medicinal measures and remedies are those describee^ before in the present chapter.

264 THE SUSHRUTA SAMHITA. [Chap. I.

of doing any mischief thereby. Recipes consisting
of rare or a large number of drugs or ingredients,
should be made up with as many of them as would be
available in the absence of all of them, as mentioned
in the present work. A drug belonging to any parti-
cular Gana or group if separately described as non-
efficacious to any specific disease, should be omitted
whereas a drug not belonging to a group may be added
to it if it is elsewhere laid down as positively beneficial
thereto. 11 5-1 17.