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

Chapter Xil

Now we shall discourse on the medical treatment of
the abscesses or eruptions which mark the sequel of a
case of Prameha (Pramcha-PiClakgf). i.

The nine kinds of abscesses (Pidakas), such as
Sardvika, etc., have been described before. Of such
abscesses those, appearing in a strong person but
small in size, affecting (only) the Tvak (skin) and the
flesh, soft to the touch, slightly painful, easily suppura-
tive and after a time bursting, are curable. 2.

Patients suffering from Prameha and afflicted with the above kinds of abscesses (Pidakas) should be treated (in the following manner). Measures, such as fastings (Apatarpana), etc., decoctions* (of Vata, etc.) and the urine of a she-goat, should be employed in the incubative stage of the disease. The urine, perspira- tion and the Sleshma (sputum, etc.), soon acquire a sweetish taste, if the aforesaid preliminary measures are not resorted to and if the patient goes on using sweet articles of food in utter disregard of the instructions, thus developing fully the specific indications of Pra- meha. In this stage the system of the patient should be cleansed (Sams'odhana) with both emetics and purgatives. If the disease is not checked (even at this stage) with the aforesaid measures (emetics and purgatives), the aggravated Doshas of the body go on increasing in intensity and tend to affect or vitiate the flesh and the blood and produce an inflamatory swelling of the body, or bring on other supervening distresses

* Astringent drugs of fig»tree(Vata-tree), etc.— D. R.

38o THE SUSHRUTA SAMHITA. [Chap. XII.

in their train, venesection as well as the aforesaid
remedies and measures should be resorted to in such
cases. 3 .

The swelling increases in size attended with exces- sive pain and burning sensation, if the aforesaid remedies be not employed at this stage of the disease. Surgical operations and other remedial measures, described in connection with abscesses or inflammatory swellings (Vrana) in general, should be resorted to in such cases. If these be not done (at this stage), the pus eats into the deeper tissues of the locality, creates large cavities in its inside, and is accumulated there and the abscess (Vrana) becomes incurable. * Hence a case of Prameha should be remedied at its very outset. 4-6.

DhsCnvantara-Ghrita :— Ten Pala weight of

each of these drugs, viz,^ Bhalldtaka^ Vilva, Ambu, roots
of Pippaliy Ddakiryyd, Prakiryyd'\, Varshdbhu, Punar-
navdlt Chitraka^ S'athi, Snuhi, Varunaka^ Pushkara^
Danti and Haritaki and one Prastha measure of each
of the following, viz., barley, Kola and Kulattha pulse
should be boiled with a Drona measure of water. The
decoction should be boiled down to its quarter part,
removed from the fire, and strained. It should then be
cooked with a Prastha measure (four seers) of clarified
butter with half a Pala weight of each of the following
drugs, viz.f Vachd, Trivrit^ Kampilla^ Bhdrgi^ Nichula,
S'unthiy Gaja-Pippaliy Vidanga and S'irisha as Kalka.

* On the failure of the above treatment it would spontaneously burst out and secrete pus and force its way inside, which would lead gradually to widen its mouth or fissure, and help its running into an incuvable stage. — Dallana.

t **Udakiry^ and Prakiryd" are the two kinds of Karanja.

X "Varshabhu and Punarnava" are the two kinds of Punarnava (/.tf., red and white).

Chap. XII.] CHIKITSA STHANAM. 38I

It is called the Dhatnvantara-Ghrita* and covers within
the range of its therapeutic application Meha (urinary
diseases), swelling, (S'otha), Kushtha, Gulma, Ascites,
haemorrhoids, enlargement of the spleen, carbuncles
(Pidaka) and abscesses. 7.

Ordinary purgatives fail to produce any satisfactory
effect in cases of Madhu-Meha owing to the excessive
accumulation and pervasion of Medas (fat) in the or-
ganism of the patient. Hence strong Sodhana (pur-
gatives) should be employed in such cases. In all types
of Meha, attended with PidakSL (eruptions or abscesses)
and other complications, the perspiration and expectora-
tions, etc. of a Prameha-patient acquire a sweet taste
and smell like that of honey. Hence they are techni-
cally known as Madhu-Meha (to all intents and pur-
poses . romentation (of any kind) is forbidden in the
case of a patient suffering from Madhu-Meha, since it
might lead to the gradual emaciation of his frame by
drying up the organic fat (Medas), which is usually
found to abound in his organism. The aggravated Doshas
of the body fail to make an upward passage in the
organism of a Prameha-patient, owing to the weakness
of the channels of chyle, blood, Kapha and Pitta (as
well as for an exhausted condition of the nerves in his
body) and the Doshas are thus forced to course in and
confine themselves into the lower part of the body where
their incarceration helps the easy formation of Pidakais
(abscesses), etc. Such a Pidaka should be remedied with
the measures described in connection with Vranas, as
soon as the process of suppuration would set in; whereas

* According to Dallana, the introduction of this medicated Ghrila into the text is an interpolation. Since Jejjata has ftot explained it in his commentary, Dallana does not explain it. Chakradatta, however, mentions this Ghrita in his compilation, though with some additions and alterations under the treatment of Prameha.— Ed.

382 THE SUSHRUTA SAMIllTA. [C^hap. Xtt.

it should be treated as a swelling in its unsuppurated
stage. Medicated oils should be likewise employed
for the purposes of healing (Ropana), etc. 8.

A decoction of the drugs of the Aragvadhddi group should be used for the purpose of raising up (Utsadana) the cavity of the incidental ulcer \ that of the S'ala-sara'di group should be used for sprinkling purposes ; that of the drugs of the Pippalyddigrow^ should be given as food and drinks. A pulverised compound o{ Pdthd, Chitraka, S'drmgashtd, Kshudra, VriJiati, S*drivd Soma-valka^ Saptaparnay Aragvadha and Kutaja roots mixed with honey should be internally given to the patient.

S'ala-saradi Avaleha :— A decoction of (one

hundred Pala weight of) the drugs of the S'dla-sdrddi
group should be made by boiling it (in sixteen times the
weight of water) down to a quarter part (of the water) and
then duly filtered (through a piece of linen). It should
be cooked again very carefully, so that it may not be
burnt; powders of Amalakaf Rodhra, Priyamgu^ Danti,
black-iron and copper should then be added to it just
before the completion of the cooking, so that it may be
reduced to the consistency of an Avalcha (lambative).
It should then be removed from the fire and kept in a
closed earthen pitcher. The patient should take an
adequate dose of this medicine as it is a sovereign re-
medy for all types of Prameha. 9.

Navayasa-Churna :•— Equal parts of the

powders of the following nine drugs, viz., Triphald, Chitraka^ Trikatu^ Vidanga and Musta^ and nine parts

* Chakradatta reads '* S'ivd " in place of "Amalaka" and does not include " Priyamgu " in the list. According to some commentators the total weight of the after-throw (Prakshepa) would be a quarter part of the total weight of the drugs boiled ; whereas, according to others, the different drugs for Prakshepa would weigh one Pala each.

Chap. XII.] CHIKITSA STHANAM. 383

of powdered black- iron* should be mixed together and
taken in adequate doses with honey and clarified butter.
This is called the Navayasa Churna, which proves
curative in abdominal obesity, improves the impaired
digestion and acts as a prophylactic against haemor-
rhoids, swelling, jaundice, Kushtha, indigestion, cough,
asthma and Prameha, etc. 10.

LohariShta :— A decoction of the drugs of the
S'ald-sdrddi group should be made by boiling it down
to a quarter part (of the original quantity of water).
Then it should be duly filtered j when cooled, a quantity
[i.e., fifty Pala weight) of Makshika-honeyt should be
added to it. A quantity of purified treaclej reduced to
the consistency of Phanita as well as fine powders of
the. drugs of the Pippalyddi group should be mixed with
it. A strong and well cleansed (earthen) pitcher satu-

* Charaka and Chakrapani Datta insert this medicine among the curatives of " Pa'ndu-roga ". S'ivadasa (the commentator) advises to take " Manduia-iron" instead of " black-iron ". In the practical field also we derive great and good efTects in cases of spleen and liver diseases and specially in cases of infantile liver and heart diseases. — Ed.

t Dallana says that fifty Pala weight of each of the two substances — Madhva'sava and Pha'nita, and twenty-five Pala weight of each of the following substances., viz., the powders of the drugs of the Pippalyadi group and steel-foils, should be taken in preparing it. But Gayadasa explains that such a quanlity of old and matured honey should be mixed with the decoction as will sweeten it ; the same quantity of old and matured Phanita treacle should be taken ; the powders of Pippalyadi group should be added to it till it gets a slight astringent (Katuka) taste.

Some commentators, however, hold that the honey, the powders of the drugs of the Pippalyadi group and of the steel-foils should be each a quarter part of the decoction in weight.

Dallana explains the term "Madhu" as the A'sava prepared of honey. Gayadasa, however, explains it simply as honey.

t The Phanita should be refined by dissolving it in the decoction of the drugs of the S'ala-saradi group and then filtere . — Dajlan^,

384 THE SUSHRUTA SAMHITA. [Chap. XII.

rated with clarified butter should be purified (in the usual way) and its interior plastered with coating of honey and powdered Pippali made into a thin paste. The medicinal compound prepared as above should be kept in the pitcher. After that, thin foils of steel made red-hot in a fire of Khadira wood should be immersed into the compound prepared before. Then the pitcher with the steel-foils immersed into its contents should be kept buried in a heap of barley for three or four months or until the steel-foils are entirely eaten away by the medicine and the characteristic flavour is produced. It should be used in proper doses every morning and a suitable diet should be given to the patient after its use. It reduces fat, improves the impaired digestion and proves efficacious in cases of swellings, internal tumours, Kushtha,Meha, jaundice, dropsy of the spleen (Plihodara), chronic fever, and excessive urination (dribbling of urine). This preparation is called Loha^rishta* and it is a highly efficacious remedy. 11.

* The recipe of Loharishta, according to Vagbhata, is as follows : — The drugs of the Asanadi group (which corresponds with Sus'ruta's S'ala-saradi group), each weighing twenty Palas, should be boiled in eight Dronas of water down to a quarter part of its weight. Two hundred Pala weight of treacle and half an Adhaka (four seers) of honey and the powders of the drugs of the Vatsakadi group (which corresponds with the Pippa- lya'di group of Sus'ruta), each weighing one Pala, should be mixed with the abovei decoction when cooled. A (new earthen) pitcher should be plastered inside with (an adequate quantity of) Pippali-powder and honey, the outer side being plastered with shellac. The above prepara- tion should now be poured into this pitcher which should be kept in a heap of barley. A fire should be kindled with Khadira charcoal. Thin iron-foils should be alternately heated in this fire and immersed in the above preparation until the iron- foils are powdered. Vagbhata gives the name of Ayaskriti to this preparation.

We, however, follow Vagbhata in the preparation of this Arishta with pood results.. — Ed,

Chap. XII.] CHIKITSA STHANAM. 385

Traits of cure : -The cure of Prameha-patients
should be understood from the non-slimy and unturbid
condition of the urine and from its clear transparent
aspect and bitter or pungent taste. 12.

Thus ends the twelfth Chapter of the Chikitsita Sthanam in the Sus'ruta Sambita which deals with the medical treatment of Prameha-Pidaka.

Now we shall discourse on the medical treatment

of Diabetes (IVIadhu-IVIeha). I.

IVIetrical Text :— The intelligent physician
should adopt the following course of treatment in the
case of a Madhu-Meha-patient abandoned as incurable
by other physicians. 2.

^i lajatu , its origi n and properties :~

A kind of gelatinous substance is secreted from the sides
of the mountains when they have become heated by the
rays of the sun in the months of Jyaishtha and Ashadha.
This substance is what is known as the Silajatu and it
cures all distempers of the body.

The presence of the six kinds of metal, such as tin, lead, copper, silver, gold and black-iron, in their essen- tial form in the substance (Silajatu), may be detected by their respective smell and hence it is known to the people by the name of Shad-Yoni (lit. — having six different origins). The taste of this shellac-coloured substance has the same taste (Rasa) and potency (Virya) as the metal to whose essence it owes its origin. It should be understood that as tin, lead and iron, etc., are progressively more and more efficacious, so the different varieties of Sildjatu, ori- ginated from the essence of tin, lead, iron, etc., are pro- gressively more efficacious in their application.

All kinds of Silajatu have a bitter and pungent
taste with an astringent after-taste (Anu-rasa), are
laxative, pungent in their digestionary reaction, heat-
making in their potency and possessed of absorbing and
purifying (Chhedana) properties. Of these what looks