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

* If this be not done, the patient is sure to die j but it is not certain whether he would get any relief from this treatment. It being, however, possible in some cases to save the life of a patient by the application of this medicine, it should be used, as the last resort with the permission of the king.^Dallana.

Chap. XIV.] CHIKITSA STHANAM. 395

General Treatment :— Now we shall

describe a few general medicinal compounds (which may be used with advantage in cases of Udara). They are as follows ; — Castor oil with milk or with the urine of a cow should be taken for a month or two. No water should be taken during the period, or the patient should forego the use, of water and all other food, but drink only the urine of a she-buffalo and (cow's) milk ; * or he should live upon the milk of a she-camel alone, foregoing the use of rice and water and submit himself to a course of Pippali for one month in the manner described before (under the treatment of Mahd-Vatavyddhi),-|* or take the oil of the Nikumbha with Saindhava-salt and powdered Ajamodd dissolved in it. The said oil (of Nikumbha), cooked with a hundred Pdtra weight of the expressed juice of A'rdraka and S'ringavera (fresh ginger), should be applied in the event of there being any Sula (colic pain), due to the action of the deranged and aggravated Vdyu. Milk, boiled with the expressed juice of S'ringavera (fresh ginger), should be taken. A paste-compound of Chavya and S'ringavera, or a paste-compound of Sarala^ Deva-ddru and Chitraka (with milk), or a paste-com- pound of Murangi, S'dlaparni, S'ydmd and Punarnavd (with milk), or the oil of Joytishka seed, mixed with milk, Svarjikd and Asafoetida, should be administered to the patient. 9.

He should take Haritaki with treacle, or a thousand
Pippali soaked (twenty one times) with the milky juice
of the Snuhi plant \ys\ the manner of Bhavand saturation),
should be gradually consumed. Powdered Pippali and

* The milk here, says Dallana on the authority of Jejjata, should be buffalo's milk. But, according to Vagbhata and S'ivadasa, the commen- tator of Chakradatta, cow's milk should be used.— Ed.

t The Pippalis shohld be taken with milk only in the present instance,

396 THE SUSHRUTA SAMHITA. [Chap. XIV.

Haritaki should be soaked with the milky juice of the
Snuhi plant (and dried in the sun). Utkarika should
now be preapared with this compound and given to the
patient. lo.

The Haritaki Ghrita:--A Prastha mea- sure of powdered Haritaki should be mixed with an Adhaka measure of clarified butter and heated over a char- coal fire by stirring it up quickly with a ladle ; when well mixed, the compound should be poured into an earthen pitcher, which should be kept well corked and buried in a heap of barley for a fortnight. The pitcher should then be taken out and the compound should be strained and cooked again with an adequate * quantity of the decoction of Haritaki, Kdnjika (fermented rice-gruel) and curd. The patient should use this medi- cine for a month or a fortnight in proper doses and with adequate vehicles, ii.

The MahaL-vriksha Ghrita:— A quantity

of the milky juice (one fourth of the cow's milk in quanti- ty) of the Mahd-vriksha (Snuhi plant), should be boiled with cow's milk. Then it should be removed from the oven, cooled down and churned (with a churning rod). The butter thus prepared and cooked again with the milky exudations of the Mahd-vriksha (and an adequate quantity of water) should be given to the patient for a month or a fortnight in adequate doses and with proper vehicles. 12.

The Chavy^di Ghrita :— Half aKarsha (one Tola) measure of each of the following drugs,z'2>., Chavya, Chitraka^ Danti, Ativishd, Haridrd, S'amkhiniy Trivrit and Trikatu, together with an eight Karsha measure of the inner pulps of the fruit (seeds) of the Rdja-vriksha,

* Each of the three things (liquids) should be four times as much ag the clarified butter.

Chap. XIV.] CHIKITSA STHANAM. 397

two Pala weight of the milky juice of the Mahd-vriksha^
eight Pala weight of cow's milk and eight Pala weight of
cow's urine, shpuld be cooked* with a Prastha measure
(four seers) of clarified butter. The medicated Ghrita, thus
prepared, should be given in convenient doses to the
patient for the period of a month or a fortnight. 13.

The aforesaid three Ghritas (Haritaki-Ghrita, Mahd-
vrlksha-Ghrita and Chavyddi-Ghrita) and the Tilvaka-
Ghrita (mentioned in the chapter dealing with Vdta-
vyddi) should be employed, whenever purgatives would
be necessary in cases of Udara, internal tumour (Gulma),
abscess, AshthiU, Anaha, Kushtha, insanity and
epilepsy. 14.

Constant use of (cow's) urine or (any kind of) Asava,
Arishta or wine, cooked with the milky exudation of
Mahd-vrikshd, -j* is recommended. A decoction of
purgative drugs, thickened with an admixture, in
copious quantity, of powdered S'unthi and Deva-ddru,
may be used with advantage in this desease.

AnSlha Varti:— APala weight of the emetic and purgative drugs and the same weight of the fine powders of the drugs of each of the Vachddi^ Pippalyddi and the Haridrddi group, and all the officinal kinds of salt should be mixed (with four or eight times that of) the urine (of a cow, buffalo, etc.). Then this (^mixture) com- pound should be boiled and cooked over a gentle fire with a Prastha measure of the milky juice of Mahd-vriksha

* In the absence of any mention about the quantity of water to be added, four limes as much of water should be added for the completion of the preparation according to the general maxim. — Ed.

t Dallana explains the sentence as follows : —

Asavas, Arishtas and Suras should be prepared with urine (instead of the liquid i.e., water) and the milky exudation of Maha-vriksha (as ap after-throw), and should be constantly used.

398 THE SUSHRUTA SAMHITA. [Chap. XIV.

by constantly stirring it with a ladle. Precaution should
be taken so that the Kalkas may not be scorched
or burnt. This medicinal compound, when properly
prepared, should be removed from the fire and when
cooled should then be made into pills (Gutika), each
being an Aksha (two Tolds) in weight. These pills
should be given once, twice or thrice daily according to
the exigency of the case and the capacity of the patient
for a period of three or four consecutive months. The
medicine is known as the Anaiha-varti, and is specially
beneficial in cases of Mahd-vyddhi, and is equally
efficacious in destroying intestinal worms. These
pills, if regularly used, prove beneficial in cases pf
cough, asthma, Kushtha, parasites, catarrh, indigestion,
aversion to food and Udavarta. 15.

Second Anstha- Varti : —The inner pulp of

the seeds of Madana fruits with Kutaja, Jimutaka,
Ikshvdku (bitter gourd), Dhdmdrgava, Trivrit^ Trikatu^
mustard seed and rock-salt, should be pasted together
with either the milky juice of Mahd-vriksha or with the
urine of a cow ; and the paste should be made into
thumb-shaped plugs (Varti). In a case of Anaha of the
patient already suffering from Udara, the outer end of
his rectum should be lubricated with oil and salt and
one or two of the plugs should be inserted therein. The
application of this Anaiha-varti should as well be
applied in cases of Uddvarta, due to a suppression or
retention of stool, urine, and Vata (flatus) and in
cases of tympanites (Adhmdna) and distention of the
abdomen (Andha). 16.

Treatment of Plihodara :— In a case of

Plihodara, * applications of Sneha (oil, etc.) and Sveda

* Dropsical swelling of the abdomen owing to an enlargen^ent of the spleen^

Chap. XIV 3 CHIKITSA STHANAM. 399

( fomentations ) should be made and the patient
should be fed on boiled rice mixed with milk-curd.
Then the vein (Sira) inside the elbow of his left hand,
should be duly opened. The spleen should be rubbed
with the hand for the proper out-flow of its deranged
blood (for the relief of that enlarged organ). Then
having properly cleansed his system, the physician
should advise the patient to take the alkali of marine
oyster-shells through the medium of milk. As an alter-
nditive, Vava-ks/idra should be given to himwithSauvarc/i-
ikd and Hingu, or with filtered alkali (made with the
ashes) of Paldsa wood. As an alternative, the alkali
of Pdrijdtaka, Ikshvdku and Apdmdrga^ mixed with oil,
should be prescribed ; or the decoction of S'obhdnjana,
mixed with Chitraka^Saindhava d^adPippali, or the alkali
of Puti-karanja, filtered with Kdnjika and mixed with
a copious quantity of Vid salt (black salt) and
powdered Pippali should be administerd. 17.

Shat-palaka Ghrita :— One pala weight of

each of the following drugs, vizy Pippali^ Pippali-roots^ Chitraka, S'unthi, Yava-kshdra and Saindhava should be cooked with one Prastha measure of clarified butter and the same quantity of milk*. The medicated Ghrita thus prepared is called the Shat-palaka-Ghrita. It is high- ly efficacious in cases of an enlargement of the spleen, impaired digestion, Gulma, dropsy, Udavarta, swelling (Svayathu), jaundice, cough, asthma, catarrh, Urdhva- Vata and Vishama-Jvara. In cases of Udara attended with impaired digestion, the Hingva'di Churna should be prescribed. These measures should be as well employ- ed in a case of an enlargement of the liver (Yakrit), but the speciality is that the vein (inside the elbow) of

* The practice, in this case, is to add twelve Seers (three prastha measures) of water to the Prastha measure of milk at the time of cooking.

400 THE SUSHRUTA SAMHITA. [Chap. XIV.

the right hand (instead of the left hand) should be opened in this case. i8.

Metrical Text :— After slightly bending down
the wrist (of the left hand), the vein in connection with
the thumb of the left hand should be cauterized with
a (burning) Sara for the purpose of giving relief in a
case of enlarged spleen. 19.

Treatment of Vaddha-gudodara,

etc. : — In cases of the Vaddha-guda (Entertis) and
the Parisraivi types of Udara, the patient should be
first treated with emulsive measures and fomentations
and then anointed with a sneha. Then an incision should
be made on the left side of the abdomen below the um-
bilicus and four fingers to the left of the line of hair which
stretches downward from the navel. The intestine to the
length of four fingers should be gently drawn out ;
any stone, any dry hardened substance (Scybalum ?),
or any hair found stiffing to the intestine should be
carefully examined and removed. Then the intestine
should be moistened with honey and clarified butter.
It should then be gently replaced in its original
position and the mouth of the incision in the abdomen
should be sewn up. 20.

Treatment of Parisrsivi-Udara :— In

cases of the Parisrsivi type of Udara, the obstructing
matter should be similarly removed (from the intestines),
as in the preceding case, and the secreting intestine
should be purified. The (two ends of the severed
intestines should be firmly pressed and adhered toge-
ther and large black ants should be applied to these
spots to grip them fastly with their claws. Then the
bodies of the ants having their heads firmly adhering to
the spots, as directed, should be severed and the intes-
tines should be gently reintroduced into their original

Chap. XIV.) CHIKITSA STHANAM. 401

position (with the severed heads of the ants adhering to
the ends of the incision) and sutured up, as in the prece-
ding case. A union or adhesion of the incidental
wound should then be duly effected. The «=eam should
now be plastered with black earth mixed with Yashti-
madhu and duly bandaged. The surgeon should cause
the patient to be removed to a chamber protected from
the wind and give him the necessary instructions. The
patient should be made to sit in a vessel full of oil or
clarified butter and his diet should consist only of
milk. 2r.

Treatment of Udakodara :— A patient

afflicted with Jalodara (ascites) should be first anointed with medicated oils, possessed of Vdyu-subduing virtues, and fomented with hot water. Then his friends and relatives should be asked to hold him firmly by his arm-pits, when the surgeon would make a puncture with a surgical instrument, known as the Vrihi-mukha, on the left side of the abdomen below the umbilicus, to the breadth of the thumb in depth and at a distance of four fingers to the left of the dividing line of hairs in the abdomen, Simultaneously with that, a metal tube or a bird's quill, open at both ends, should be introduced through the passage of the puncture to allow the morbific fluids (Doshodoka), accumulated in the abdomen, to ooze out. And then having removed the tube or the quill, the puncture should be lubricated with oil and Saindhava salt and bandaged in the manner described in connection with the bandaging of ulcers.

The entire quantity of the morbific fluid should not
be allowed to ooze out in a single day, inasmuch as
thirst, fever, aching of the limbs, dysentery, dyspnoea
and a burning of the feet (Pdda-djiha) might supervene in
consequence, or as it might lead to a fresh accumulation