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

* Vriddha Vagbhata recommends external application with these lards.

Chap, v.] CHIKITSA STHANAM. 309

diet and regimen and who can afford to pay for the necessary accessories. The affected part should be first anointed and then fomented. Mild emetics and purgatives should be subsequently employed for the purpose of cleansing the system. Medicated Anuvdsana and Asthdpana measures should then be employed, after which the general directions and remedial measures, laid down under the treatment of Akshepaka^ should be followed and employed at the proper time Appli- cations of the Mastikya-Siro-vasti with the Anu-taila for anointing the body, of the articles of Salvana-Sveda for the purpose of poulticing, and of the Vahi-taila as an Anuvdsana measure, are the marked features of the medical treatment of this disease, and should be followed carefully for a continuous period of three or four months. 2g.

These preceding remedies as well as dry fomenta-
tions (Ruksha-sveda) and errhines, which possess
the virtue of subduing the deranged Vdyu and
Kapha should be likewise employed in cases of Manya-
stambha. 29

Treatment of Apatantraka : —Fasting

is prohibited in cases of patients suffering from Apa-
tantraka (Apoplectic convulsions). Emetic, Asthapana
and Anuvdsana measures are likewise forbidden. The
passage of respiration should be blown open by violent
breathings in the event of its being choked up with an
accumulation of the deranged Vayu and Kapha. The
patient should be made to drink a potion consisting of
Tumburu, Pushkara, Hingu, Amla-vetasa^ Haritaki and
the three (ofilicinal) kinds of salts, with a decoction
of barley.* As an alternative, four seers of clarified

* Chakradatta quotes this in the chapter on the treatment of colic (s'ula), but does not read *Amla-vetasa' there.

310 THE SUSHRUTA SAMHITA. [Chap. V.

butter, cooked in combination with sixteen seers of
milk, two Pala weight of Sauvarchala salt and fifty of
Haritakis should be prescribed for the use of the patient.
All other remedial agents, possessing the virtue of
subduing the deranged Vayu and Kapha should be
likewise employed. 30.

Treatment of Ardita :— A patient suffering

from Ardita f/acial Paralysis) should be treated with the measures and remedies laid down under the head of Vata-vyadhi in the event of his being found to be suffi- ciently strong and capable of affording the neces- sary expenses for his treatment. Errhines, Mastlkya- Siro-vasti, inhalation of the smoke (Dhuma-pdna) from medicated drugs, poulticing (Upandha), unguents and Nddi-sveda, etc., are the special features of the medical treatment of this disease. After that, a decoction should be made of the drugs constituting the groups of Trina- Pancha-mula, Mahd-Pancha-mula, Kdkolyddid^nd Viddri- gandhddi groups, aquatic bulbs, and the flesh of animals which are aquatic in their habits (Audaka) and those which frequent swampy places (Anupa), by boiling them together with a Drona measure of milk and double the quantity of water. The decoction should be considered boiled when three quarter parts of its original weight of the liquid has been evaporated and should then be strained. The decoction thus prepared should be boiled with a Prastha measure of oil (four seers) and be removed from the fire when the oil is well mixed with the milk. The compound (oil and milk) thus prepared should be allowed to cool down and then churned. The churned off cream (Sneha) should be again boiled wuth the drugs of the Madhura (Kdkolyddi) group, Mdsha-parni and milk (four times that of the original oil). This medicated oil is known as the Kshira-Taila and should

Chap, v.] CHIKITSA STHANAM. 3II

be administered as potions and unguents, etc, to an
Ardita-patient The above preparation with clarified
butter in the place of oil is known as the Kshira-
sarpih and it should be used as an Akshi-tarpana (eye-
lotion). 31—32.

Venesection should be duly resorted to in the affect ed parts, according to the directions given before, in cases of Sciatica, Gridhrasi, Vis'vachi (Synovitis of the knee- joints), Kroshtuka-sirah, Khanja (lameness), Pangula, Vata-kantaka, Pdda-ddha, Pada-harsha, Ava-vahuka and Vadhiryya and in cases where the deranged Vayu would be found to be seated in a Dhamani. Measures and remedies laid down under the head of Vata- vyadhi should be adopted, except in a case of Ava-vahuka 33.

The expressed juice of green ginger, made lukewarm after mixing it with (equal quantities of) oil, honey and Saindhava salt, should be poured into the cavity of the ear in a case of (acute) ear-ache. As an alternative, the urine of a she-goat, or oil and honey, or oil with the urine (of a cow) mixed with the expressed juice of Mdtulunga, pomegranate and tamarind, or the oil boiled and prepared with Surd, Takra, Sukta, salt and the urine (of a cow), should be poured into the cavity of the ear ; fomentation should be given (to the interior of the affected organ) after the manner of Nddi-sveda. The remedial measures for Vdta-vy^dhi should be re- sorted to. We shall, however, revert to the subject in the Uttara-Tantra. 34.

The patient should be made to drink a potion of
Sneha-Lavana* dissolved in an adequate quantity of
water, or the powders of the Pippalyadi group (with an

* Sneha-Lavana has been described in Chap. 4. (treatment of Vata-vyadhi) para. 24.

312 THE SUSHRUTA SAMHITA. [Chap. V.

adequate quantity of water), or clarified butter, thickened
or saturated with pulverised asafoetida and Yava-kshdra
(Carbonate of Potass), in cases of Tuni and Prati-tuni.
Applications of Vastis should also be resorted to. 35.

In a case of Adhmaina (Tympanites), the remedy should consist in the applications of powders of the Dipaniya (appetising) group, of suppositories (Phala-varti), Vastis and digestive drugs (Pachaniya group). The patient should also be advised to observe a rigid fast and his abdomen should be fomented with hot palms. After that he should break his fast with boiled rice pre- pared with appetising (Dipana) drugs such as, Dhanyaka, Jiraka, etc. Similarly, a case of Pratyafcdhmaina should be treated with fasting, emetics and appetising drugs. Cases of Ashthilat or Pratyashthilai should be treated as a case of Gulma and internal abscess, to all intents and purposes. 36-38.

Hingvadi-Vati : — A compound consisting of
asafoetida, Trikatu, Vachd, Ajamodd, Dhanyd, Aja-
gandhd, Dddimba, Tiniidi, Patha, Chitraka, Yava-kshara,
Saindhava salt, Vid salt, Sauvarchala salt, Svarjikd-
kshdra^ Pippali-mula, Amla-vetasa, S'athi^ Pushkara-mula,
Hapushd^ Chavyd, Ajdji and Pathyd, powdered together
and treated many times with the expressed juice of Mdtu-
lunga in the manner of Bhavana* saturation, should be
made into boluses, each weighing an Aksha (two ToUs)
in weight. One (such) pill should be taken (in an empty
stomach) every morning in all diseases of the deranged
V^yu. This compound proves curative in cough,
asthma, internal tumour (Gulma), ascites, heart-disease,

* '* Bhavana" consists in soaking a powder or a pulverised compound with the expressed juice or decoction of any drugs or with any liquid and in getting it dry (generally). This process should be cotinued many times (generally seven times) in succesion.

Chap, v.] CHIKITSA STHANAM. 3x3

tympanites, aching pain at the sides, in the abdomen
and in the bladder, in cases of an aversion to food,
retention of stool, strangunary, enlarged spleen, piles,
Tuni and Prati-tuni. 39.

IVIemorable Verses :— From the symptoms

or leading indications, exhibited in each case and from a
close examination thereof, it should be inferred whether
the Vayu alone has been deranged or whether it has
combined with any other Dosha, or has affected any
other fundamental principle (Dhdtu) of the organism as
well ; and the medical treatment should follow a
course, so as not to prove hostile to the Doshas or the
Dha'tus (organic principles) implicated in the case, in
its attempt to subdue the aggravated Vdyu. In a
case of cold, compact and painful swelling (appearing
in any part of the body) owing to the combination of
the deranged Vdyu with fat, the treatment should be
identical with that of a swelling in general. 40-41.

Uru-Stambha :— The deranged Vdyu, sur-
charged with the local fat and Kapha gives rise to a
swelling in the region of the thigh which is known
as Uru-stambha ; others designate it as Adhya-Vatta.
This disease is marked by lassitude and an aching pain
in the limbs, by the presence of fever, horripilation and
somnolence and by a sensation of coldness, numbness,
heaviness, and unsteadiness in the thighs, which seem
foreign to the body. 42.

Its Treatment :— The patient should be made
to drink a potion consisting of the pulverised compound
known as the Shad-dharana-yoga ; or of the drugs con-
stituting the Pippallyadi group, dissolved in (an adequate
quantity of) hot water without using any oleaginous
substance ; or a lambative, composed of pulverised
Triphald and Katuka mixed with honey, should be

314 THE SUSHRUTA SAMHITA. [Chap. V.

used ; or a potion, consisting of Guggulu or S'ildjatu
dissolved in cow's urine, should be administered. These
compounds subdue the aggravated Vdyu surcharged
with deranged fat and Kapha and prove curative in
heart-disease, an aversion to food, Gulma and internal
abscesses. A medicinal plaster composed of Karanja
fruits and mustard seeds, pasted with a copious quantity
of cow's urine should be applied hot to the affected part,
which may be as well fomented with cow's urine mixed
with alkali (Kshdra) ; or the locality should be sham-
pooed with articles devoid of any oily substance. The
diet of the patient should consist of old and matured
Sydmaka, Kodrava, Udd^la and Sdli rice with the soup of
dry Mulaka or Patola, or of the flesh of animals of
the Jdngala group cooked without clarified butter or
vegetables iS^dkd) cooked without salt. The use of oil
and of lardaceous substances in general (Sneha-karma)
should, however, be prescribed after the deranged fat
and Kapha have (totally) subsided. 43.

Therapeutic properties of Guggulu :

— Guggulu is aromatic, light, penetrating into the mi-
nutest parts of the body, sharp, heat-making in potency,
pungent in taste and digestion, laxative, emulsive, slimy,
and wholesome to the heart (Hridya). New Guggulu is
an aphrodisiac and a constructive tonic. Old GrUggulu
is anti-fat and hence reduces corpulency. It is
owing to its sharpness and heat-making potency
that Guggulu tends to reduce the Vdyu and the
Kapha ; it is its laxativeness that destroys the Malas
(refuge deposits in the Srotas) and the deranged
Pitta ; its aroma removes the bad odours of the
Koshtha ; and it is its subtle essence that improves
the appetising faculty. Guggulu should be taken
every morning with a decoction of Triphald^ Ddrvi and

Chap. V.J CHIKITSA STHANAM, 315

Patola or with that of Kus,'a roots* ; it may also be taken with an adequate quantity of cow's urine, or with alkalinef or tepid water. The patient should take boiled rice with soup, milk, or extract of meat after the Guggulu has been digested. Diseases such as internal tumour (Gulma), urinary complaints (Meha), Uddvarta, ascites, fistula-in-ano, worms in the intestines, itches, an aversion to food, leucoderma (Svitra), tumour and glands (Arvuda>, sinus, Adhya-Vdta, swelling (oedema), cutaneous affections (Kushtha) and malignant sores and ulcers readily yield to it, if used for a month (with the observance of the regimen of diet and conduct laid down previously). It also destroys the deranged Vdyu incar- cerated in the Koshtha, bones and joints, just as a thunderbolt will destroy trees. 44.

Thus ends the fifth Chapter of the Chikilsita Sthanam in the Sus'ruta* Samhita which deals with the medical treatment of Mahd-Vafa-Vyddhi.

* Some explain that a third decoction should be that of Triphala, Ddrvi, Patola and Kus'a grass taken together.— Dallana.

The decoctions may be prepared separately with Triphala, Darvi, Patola and Kus'a.— ^aT.

t Some read '^Kshira" (milk) in the place of ''Kshara" (alkali).

Chapter Vl

Now we shall discourse on the medical treatment of Haemorrhoids (A rsas). i.

The remedial measures in haemorrhoids may be grouped under four subheads ; namely, the employment of (active) medicinal remedies, the application of an alkali (into the seat of the disease), actual cauterization (of the polypii) and surgical operation. A case of recent origin involving the action of theDoshas to a slight degree and uncomplicated with any grave or dangerous symptom and complication may prove amenable to medicine alone. Deep-seated polypii. which are soft to the touch and markedly elevated and extended (external — D R.), should be treated with alkaline applications, while those which are rough, firm, thick and hard should be cauterized with fire. Polypii which are raised, exuding and slender at the roots should be surgically treated. Hcemorrhoids which are held amenable to medicine and are not visible (to the naked eye) should be treated with the help of medicines alone. Now, listen to the procedure to be adopted in the treatment of Ars'as which would require alkaline applications, a cauteriza- tion, or a surgical operation. 2.

Application of Kshara:— The body of

the patient suffering from haemorrhoids, in the event of
possessing sufficient strength, should be anointed and
duly fomented. He should be made to eat warm but
demulcent food (Anna) in a fluid state (of a gruel-like
consistency) to alleviate the excessive pain in-
cidental to the action of the deranged Vdyu. In a
season neither too hot nor too cold, and when the