■* This shows that cleansing the system by means of emetics and purgatives, as well as with S'iro-virechana should be resorted to in a case of Pari-dara as well.
t The solution may be prepared with the drugs taken together or separately.
Chap, XXir.J CHIKITSA STHANAM. 465
group as errhine (Nasya) and gurgle (Kavala) is also recommended. 13-14.
Treatment of Danta Vaidarbha, etc.:
—In a case of Danta-Vaidarbha, the regions about the roots of the teeth should be cleansed by open- ing them with a (MandaUgra) instrument and sub- sequently treated with alkaline applications. Cooling measures should also be resorted to ^during the treatment of this disease). In a case of Adhika-danta, the additional tooth should be uprooted and removed ; then (in order to arrest the bleeding, if. any), the part should be cauterised with fire, and then an experienced physician should apply the remedies mentioned under the head of worm-eaten teeth (Krimi-dantaka), 15-16
Treatment of Adhi-mamsa :— in a case
of Adhi-mamsa, the additional fleshy growth about
the roots of a tooth should be removed (with
a knife) and treated with a compound of Vachd,
Tejovati, Pdthd, Sarjikd and Yava-kshdra, pasted
together with honey. Powdered Pippali^ mixed with
honey, should be used as a gurgle (Kavala); and a decoc-
tion of Patola^ Triphald and Nimba for washing the
affected part. Errhines (Siro-virechana) and inhalation
of Vairechana smoke, (that lead to the secretion of
mucus from the head), would likewise prove efficacious
in such cases. 17.
Treatment of Danta- Nad i :-ln a case of
Danta-Nadi, the treatment of Nadi (Sinus) about the teeth is identical with that of sinus in general. The specific remedial measure, however, is that the gum of the affected tooth should be incised, and the tooth should be extracted, if it be not in the upper jaw. The affected part should then be purified and cauterised with an alkali or fire. Hence in a case of Sinus (Nddi), a com-
466 THE SUSHRUTA SAMHITA. [Chap. XXH.
plete extraction of any fragment of the broken bone,
or tooth, is essentially necessary (for its cure), inas-
muc'i as, if left uiextracted, it may cause the sinus to
affect (run below I the jaw-bone. If the affected tooth
be in the upper jaw, and if it be found to be firm and
steady at its roots, though attended with tooth-ache,*
it should not be extracted, inasmuch as it might
produce an excessive haemorrhage from its roots,
and usher in blindness, facial paralysis, or other
dangerous affections (such as convulsion, etc.) due
to the excessive loss of blood. Hence in the case
of a looseness of such a tooth in the upper jaw, it should
not be extracted A decoction f of Jdti, Madana,
Svddu'Kantaka and Khadira should be used to wash
the mouth An oil cooked witn Jdti, Madana,
Katuki, Svddu-Kantaka. Yashti-madhu, Rodhra,
Manjishthd and Khadira should be used to cleanse and
heal a sinus invading the roots of a tooth. The re-
medial measures to be employed in the diseases affecting
the roots of the teeth have thus been described above.
* Both Vrinia an I Chakr^datta quote this passage from the text, but b )th of th-m r-a 1 "igrffijct ^^jf^W^" (excessive bleeding takes place) in place of "^^ 1%T?:^5q%" ('^ '^ be found to be firm and steady at its roots, though attended with tooth-achi) S'ri-kantha Datta, again, in his com- mentary quotes another reading "^r^S%^^^" ('fit be loose in its sockets and be extracted with its roots). In our humble opinion, however, the current reading of the text seems to be the correct one, inasmuch as both the leadings quoted above seem to be redundant in the presence of the two following sentences "?:iiTt%^^f[ " and ''^^?t^tK ^5ff'..."— Ed.
t According to S'rikantha and S'ivadasa, it appears that the applica- tion of this decoction as a wash is not to be found in all editions of the Sus'ruta Saiuhita, Imt they say that it is found only in Jejjata's reading. Jejjaia*s reading and explanation seem to be correct and have been followed by us in the translation.— Ed,
Chap. XXn.] CHIKltSA STHANAM. 4^7
We shall now proceed to describe the medicinal remedies
to be employed in the diseases which confine them-
selves exclusively to the teeth 18-21.
Treatment of the diseases of Tooth
proper :— A case of Danta-harsha yields to the
use of any lukewarm Sneha * or the Traivrita-ghrita
(mentioned in Chapter V), or of the decoction of the
Vdyu-subduing drugs as gurgles (Kavala). An applica-
tion of Snaihika Dhuma (^emulsive fumes) and the use
of snuff (Nasya), emulsive articles of food, meat soups,
gruel prepared with meat (Rasa-Yavdgu), milk, milk-
cream, clarified butter, Siro-vasti and the other Vayu-
subduing measures generally prove efficacious. 22.
In a case of Daata Sirkarai (^Tartar-calcareous
deposits on the teeth), the deposit should be removed
in such a way as not to hurt the roots of the tooth, after
which the part should be dusted (Prati-sarana) with
powdered Ldkshd with honey. All the remedies men-
tioned in connection with the treatment of Danta-
harsha may as well be employed in this disease. 23
Treatment of Kapalika, etc. : These
remedies are also efificacious in a case of Kapailikai (caries of the tooth) which is extremely hard to cure. In a case of Krimi-Danta (worm-eaten tooth) found to be firm and unloosed (in its socket), the affected tooth should be fomented, and the accumulation [i. e., the pus, blood, etc.) should be removed. It should then be treated with some Vdyu-subduing errhines of the Ava-pida form and with emollient gurgles (Gandusha), as well as with plasters, prepared with Varshdhhu and the drugs of the Bhadra-Ddrvddi group and with a diet of emulsive articles of food. In the case, however, where
* All the four kinds of Sneha should be used separately or combinedly.
468 THE StJSriRUTA SAMHITA. [Chap. XXlI.
the tooth is found to be loose (in the socket\ the
loose tooth should be extracted, and the cavity
cauterised with fire or an alkali (for the purpose
of arresting the bleeding). An oil cooked with the
pastes (Kalka) of Viddri, Yashti-madhu, S'ringdtaka,
and Kas'eruka and with ten times its own weight of
milk should be administered as an errhine (in such
cases). The course of treatment in a case of Hanu-
moksha is the same as in one of facial paralysis. 24-27.
A person suffering from any affection of the teeth
should refrain from taking acid fruits, cold water, dry
(Ruksha) food, excessively hard articles of food and
from brushing his teeth (with a twig). The treatment
fof the curable types of tooth-diseases has be^n thus
described above, we shall now (proceed to) describe the
treatment of the curable types of tongue-diseases. 28 29.
Treatment of Tongue-diseases :— In
the Vaitaja type of Jihvai-kantaka (,Papilla), the treatment should be the same as in the case of Vdtaja Oshtha-kopa. In the Fittaja type (of Jihva kantaka), the vitiated blood should be made to secrete from the affected organ by rubbing it with any article of rough surface (such as the leaves of S' dkhotaka, etc.), and the drugs of the Madhura (Kakoly^di) group should be used for gurgles and errhines, as well as for being rubbed over (Prati-sarana) the affected organ. In the Kaphaja type (of Jihva-kantaka). the organ should be bled by scarifying it (with a Mandala patra and such other instrument) ; it should then be rubbed with the powders of the drugs of the Pippalyddi group mixed with honey. A compound of powdered white mustard- seed and Saindhava should be administered as gurgles (Kavala), and the patient should be made to take his food with the soup of Patola, Nimba,
Chap. XXII.3 CHIKITSA STHANAM. 4^9
and Vdrtdku mixed with (a liberal quantity of) Yava-Kshdra 30.
Treatment of Upa-Jihva :— In a case of
Upa-jihvai(Raaula),the affected part should be scarified
and rubbed with an alkali, and the patient should be
treated with errhines (Siro-vireka), gurgles (Gandusha)
and inhalations of smokes (Dhuma). The treatment of
the tongue diseases has been thus described above.
We shall now describe the medical treatment of the
affections of the palate (Tdlu-gata Roga). 31-32.
Treatmentof the Talu-gata diseases:
— In a case of Grala-s'andika^, the Sundik^ (protuber- ance) should be drawn out along the tongue with the help of the thumb and the second finger of the hand, or with a Samdamsa (forceps) and then cut off with a Man- dalagra instrument. But it should be severed neither more nor less than three-quarters of the append- age, inasmuch as profuse haemorrhage might follow an excessive incision, and death might result therefrom ; whereas, a case of lesser severance is usually found to be attended with swelling, excessive salivation, somno- lence,* vertigo, darkness of vision, etc. Hence a surgeon, well-versed in the science of surgery and well- skilled in practical operations, should carefully operate a Gala-s'undika (with a knife) and subsequently adopt the following measures. The incidental ulcer should b3 treated with the pulverised compound of Maricha^ Ati'vishd.Pdthd, Vachd, Kushthadind Kutannata^ mixed with honey and rock-salt. A decoction of Vachd, Ati-vishd, Pdthd, Rdsnd^ Katuka-rohini and Pichu-marda should be used as gurgle (Kavala). The five drugs, viz.,
* 3'rikantha Datta, in his commentary on Vrinda's compilation, quotes this passage from the text, but does not include "somnolence" therein. He reads ♦•^mi^i^) H^r^Wt" in place of "^^^ f^r^T ^irewt " I
4}^0 THE SUSHRUTA SAMHITA. [Chap. XXIl.
Ingudi, Apdmdr^a, Danti^ Sarald and Deva-ddru
should be pasted together and made into Vartis (sticks),
well flavoured by the addition of perfuming drugs.
Twice every day (once in the morning and again in the
evening), should the patient be made to inhale the
fumes of these burning Vartis (sticks) which have the
property of subduing the (deranged) Kapha, and
should be made to take the soup of Mudga boiled in
alkaline water.* In cases of Tundikeri, Adhrusha,
Kurma, Maimsa samghatta and Tatlu pupputa, the pre-
ceding measures should be adopted, but the surgical
operation should vary with the nature of the particular
disease under treatment. 33-34.
Treatment of Talu-paka, etc- :—
Remedies which destroy the deranged Pitta should be
employed in Ta^Lu-pakka (suppuration of the palate) ;
while applications of Sneha (oil, etc.) and Sveda
(fomentations), as well as Vi^yu-subduing measures should
be the remedies in a case of a Tailu-oopha (swelling
of the palate). The remedies to be employed in the
diseases affecting the palate have been thus described
above. Now hear me discourse on the remedial
measures in Kantha-Roga (diseases of the throat).
35-36.
Treatment of Throat-diseases :- In
a curable type of RoMni, blood letting and the
applications of emetics, gurgles, inhalations (of medi-
cated fumes) and errhines (Nasya) are efficacious.
In cases of Vaitaja Rohini, blood letting should
be first effected, and the affected part should then be
* The alkaline water to be used in the Mudga-soup should be pre- pared from Yava-kshdra according to Dallana. But according to S iva* ddsa, alkaline water prepared from the ashes of Mushkaka, Apamarga, etc., should be used.
Chap. XXII.] CHIKITSA STHANAM. 4/1
rubbed with salts. Gurgles ^.Gandusha) of tepid
Sneha (oil, clarified butter, etc.) should be con-
stantly resorted to In cases of the Pittaja
Rohini, the powdered Pattanga^ honey and sugar
should be rubbed ^Prati-sjlrana) over (the affected part),
and the decoctions* of Drdkshd and of Parushaka,
should be used as gurgles (Kavala). In the Kaphaja
type of Rohini, the affected part should be rubbed
with Katuka and Agdra-dhuma (soot of a house —
chimney-soot). An oil properly cooked with S'vetd
Vidan^a, Danti and Saindhava should be employed as
(Nasya) and employed as gurgles (Kavala). In a case
of Riktaja Rohini, a physician shall employ the
same measures of treatment as in the Pittaja type of
the disease, ^y.
Treatment of Kantha-^aluka, etc.:
— In a case of Kantha-Saluka, it should be bled and
treated as a case of Tundikeri, and the patient should
be enjoined to take a single meal in the day consisting
only of a small quantity of Yavdnna (barley-rice) with
clarified butter. The treatment of a case of AdM-
jihvika^ should be the same as that of Upa-jihvika. In
a case of Eka-vrinda, blood-letting of the affected part
should be resorted to (by the application of leeches),
and Sodhanaf (purifying) remedies should be
employed. The medical treatment of a case of Gilayu
(Silatyu.-D.R.) consists of a surgical operation (on the
seat of thi disease). Incision should be made into a
* According to Chakra-pani, Draksha and Parushaka should be combinedly used in preparing the decoction.
t The "purifying remedies" here means S'iro-virechana, fumigation, plasters and applications of alkali, etc,, for purifying the Doshas in the throat,
472 THE SUSHRUTA SAMHITA. [Chap. XXII.
G-ala-Vidradhi (throat-abscess Mn its suppurated stage
and appearing at a part other than a Marma (vulner-
able part). 38-42.
