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Sushruta SamhitaChikitsasthanaKsudra Roga Chikitsa - Treatment of Minor Diseases - Sushrutasamhita Chikitsasthana Chapter...

Ksudra Roga Chikitsa – Treatment of Minor Diseases – Sushrutasamhita Chikitsasthana Chapter 20

विंशोऽध्यायः । अथातः क्षुद्ररोगचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥ :।।१।।

Now we shall discourse on the medical treatment of minor ailments or diseases (Ksudra-roga). 1

तत्राजगल्लिकामामां जलौकोभिरुपाचरेत । शुक्तिश्रुघ्नीयवक्षार – कल्कैश्चालेपयेद् भिषक् ॥ २॥

श्यामालाङ्गलकीपाठा-कल्कैर्वापि विचक्षणः । पक्वां व्रणविधानेन यथोक्तेन प्रसाधयेत् ॥ ३ ॥

Treatment of Aja-gallika : Leeches’ should be applied to the affected part in a case of non-suppurated Aja-gallika, it should be subsequently plastered with the alkalies (Kshara) of oyster-shells, Srughni (Svarjika), 2 and of Yava; as an alternative, it should be plastered with the paste compound (Kalka) of Syama, Langalaki and Patha. When suppurated it should be treated in the manner of an ulcer (Vrana). 2-3

अन्धालजीं यवप्रख्यां पनसीं कच्छपीं तथा । पाषाणगर्दभञ्चैव पूर्वं स्वेदेन योजयेत् ॥ ४ ॥

1. Gayadasa explains that a non-suppurated Aja-gallika should be first plastered witin Yava-kshara, oyster-shells and Saurastri. Leeches should be next applied to it.

2. Chakaradatta reads “शुक्तिसौराष्ट्रकाक्षार ” in place of “शुक्तिश्रुघ्नी- यवक्षार “, evidently, after the commentary of Gayadasa.

मनः शिलातालकुष्ठदारुकल्कैः प्रलेपयेत् । परिपाकगतान् भित्त्वा व्रणवत् समुपाचरेत् ॥ ५ ॥

Treatment of Yava-prakhya, etc. : Fomentation (Sveda) should be the first remedy to be resorted to in cases of Andhalaji, Yavaprakhya, Panasika, Kacchapika and Pasana-gardabha (in their nonsuppurated stages). They should then be plastered with the pastes (Kalka) of Manahsila, Haritala, Kustha and Deva-daru. An incision should be made as soon as suppuration would set in; and the treatment should be similar to that of an ulcer. 4-5

विवृतामिन्द्रवृद्धाञ्च गर्दभीं जालगर्दभम् । इरिवेल्लीं गन्धनाम्नीं कक्षां विस्फोटकांस्तथा ॥ ६ ॥

पित्तजस्य विसर्पस्य क्रियया साधयेद् भिषक् । रोपयेत् सर्पिषा पक्वान् सिद्धेन मधुरौषधैः ॥ ७ ॥

Treatment of Vivrta, etc. : The remedies mentioned in connection with the treatment of the Pittaja type of Erysipelas (Visarpa) should be employed in cases of Vivrta, Indra-vrddha, Gardabhi, Jalagardabha, Irivellika, Kaksa, Gandha-nama and Visphotaka. Clarified butter cooked with the drugs of the Madhura (Kakolyadi) group should be applied in healing up the ulcers in the suppurated stages. 6-7

चिप्पमुष्णाम्बुना सिक्तमुत्कृत्य स्रावयेद् भिषक् । चक्रतैलेन चाभ्यज्य सर्जचूर्णेन चूर्णयेत् ॥ ८ ॥

बन्धेनोपचरेच्चैनमशक्यञ्चाग्निा दहेत् । रोपयेत् ।। ९ ।। भवेत् । भिषक् ॥ १० ॥

मधुरौषधसिद्धेन ततस्तैलेन कुनखे विधिरप्येष कार्यो हि भिषजा उपाचरेदनुशयीं श्लेष्मविद्रधिवद्

Treatment of Cipya, etc. : In a case of Cipya, the affected part should be first washed¹ with hot water and (the incarcerated pus, etc.) drained (Visrava) by cutting it away (with a knife ). Then after anointing it with (the oil known as) the Cakra-taila it should be dusted over with the powders of Sarja (resin) and duly bandaged. If this process of treatment fails, the affected part should be cauterised with fire and an oil cooked with (a decoction of) the drugs of the Madhura (Kakolyadi) group should be applied to heal (the incidental ulcer ). The same course of treatment should also be adopted in a case of Ku-nakha (bad nail ). Anusayi should be treated like a slesmika abocess. 6-7

1. Vrnda and Cakradutta prescribed fomentation (Sveda), and not washing, with hot water and they do not prescribe secretion (Visrava).

विदारिकां समभ्यज्य स्विन्नां विम्लाप्य लेपयेत् । नगवृत्तिकवर्षाभू-बिल्वमूलैः सुपेषितैः ।। ११ ।।

व्रणभावगतायां वा कृत्वा संशोधनीं क्रियाम् । रोपणार्थं हितं तैलं कषायमधुरैः शृतम् ॥ १२ ॥

प्रच्छानैर्वा जलौकोभिः स्त्राव्याऽपक्वा विदारिका । अजकर्णैः सपालाशमूलकल्कैः प्रलेपयेत् ॥ १३ ॥

पक्वां विदार्य शस्त्रेण पटोलपिचुमर्दयोः । कल्केन तिलयुक्तेन सर्पिर्मिश्रेण लेपयेत् ॥ १४ ॥

बद्ध्वा च क्षीरवृक्षस्य कषायैः खदिरस्य च । व्रणं प्रक्षालयेच्छुद्धांततस्तां रोपयेत् पुनः ।। १५ ।।

Treatment of Vidarika: In a case of Vidarika, the affected part should be first anointed (with oleaginous substances) and then fomented. It should then be rubbed (with the fingers); and a plaster composed of Naga-Vrttika, Varsabhu and Bilva-roots, well pasted together, should be applied to it. Purifying and disinfecting (Samsodhana) remedies should be employed as soon as the affected part would be found to have been changed into the state of an ulcer (Vrana), and it should then be healed up with the application of an oil cooked with the decoction of (the drugs of the Kasaya (Nyagrodhadi) and Madhura (Kakolyadi) groups. In the non suppurated stage of Vidarika, the vitiated blood therein should be let out by means of Pracchana (scarification), or by applyiong leeches. The affected part should then be plastered with the roots of the Aja-karna and of the Palasa pasted together. A case of fully suppurated Vidarika should be lanced and plastered with a paste compound of Patola, Picumarda and sesamum, mixed with clarified butter and should then be duly bandaged. The incidental ulcer should then be washed with a decoction (of the barks) of the Ksira trees and Khadira. Healing remedies should be applied after it has been properly purified (disinfected). 11-15

मेदोऽर्बुदविधानेन साधयेच्छर्करार्बुदम् ॥ १६॥

कच्छू विचर्चिकां लेपश्च शस्यते वचादावसर्षपैर्वा सारतैलमथाभ्यङ्गे कुर्वीत कटुकैः पामां कुष्ठवत् समुपाचरेत् ।

सिक्थ-शताह्वागौरसर्षपैः ॥ १७ ॥ तैलं वा नक्तमालजम्। शृतम् ॥ १८ ॥

Treatment of Sarkararbuda, etc.: A case of Sarkararbuda should be treated like that of an Arbuda (tumour) of the fat-originedtype. Cases of Kacchu, Vicarcika and Pama should be treated in the manner of a Kustha. A medicinal plaster composed of Siktha (wax), Satahva and white mustard seeds, or of Vaca, Daru-haridra and mustard seeds, pasted together, should be applied (to the seat of the disease ). As an alternative, Naktamala (Karanja) oil, or Sara-taila (oil)’ boiled with (the drugs of) the Katuka (Pippalyadi) group should be applied for anointing purposes. 16-18

पाददार्यां सिरां विद्ध्वा स्वेदाभ्यङ्गौ मधूच्छिष्टवसामज्ज- सर्जचूर्णघृतैः यवाह्नगैरिकोन्मिश्रैः पादलेपः प्रयोजयेत् । कृतः । प्रशस्यते ।। १९ ।।

Treatment of Pada-dari: In a case of Pada-dari (Rhagadis), the prescribed vein should be opened, and the affected part should be treated with fomentations and unguents. The affected part should be plastered with (an ointment composed of) wax, lard, marrow, powder of Sarja (resin ), 3 clarified butter, Yava-Kshara and Gairika. 19

पादौ सिक्त्वारनालेन लेपनं ह्यलसे हितम् । कल्कीकृतैर्निम्बतिल-कासीसालैः ससैन्धवैः ।। २० ।। लाक्षारसोऽभया वाऽपि कार्यं स्याद्रक्तमोक्षणम्। सिद्धं रसे कण्टकार्यास्तैलं वा सार्षपं हितम् । कासीसरोचनशिला चूर्णैर्वा प्रतिसारणम् ।। २१ ।।

1. By Sara-taila” is meant the oil pressed from the Sara ( essential parts ) of Sinsapa, Aguru, Sarala, Deva-daru and such other trees. Some however. read “Sarala-taila” in place of “Sara-taila.” –Dalhana.

2. According to Dalhana and Sivadasa, fomentations and unguents should be first applied, and the vein should be next opened.

3. Cakaradatta also prescribes a similar remedy, but there he does not read “Sarja’ and ‘Gairika.’’-

उत्कृत्य दग्ध्वा स्नेहेन जयेत् कदरसंज्ञकम् ॥ २२ ॥

Treatment of Alasa and Kadara : In a case of Alasa (chilblain), the legs should be sprinkled with Aranala (a kind of Kanjika); and a plaster composed of sesamum, Nimba leaves, sulphate of iron (Kasisa), Haritala and Saindhava, or of Haritaki pasted with the decoction of Laksa (Laksa-rasa) should be applied to the affected parts or bloodletting should be resorted to. As an alternative, mustard oil boiled with the expressed juice of Kantakari should be applied to them or the affected localities should be rubbed or chafed (Pratisarana) with a pulverised compound of sulphate of iron (Kasisa), Gorocana and Manah-sila. In a case of Kadara (cornor Gokharu), the seat of the disease should be scraped off (with the aid of a knife) and cauterised with (the application of) heated oil 2. 20-22

इन्द्रलुप्ते सिरां मूर्ध्नि स्निग्धस्विन्नस्य मोक्षयेत् । कल्कैः समरिचैर्दिह्याच्छिलाकासीसतुत्थकैः ॥ २३॥

प्रशस्यते । कुटन्नटादारुकल्कैर्लेपनं वा प्रच्छयित्वाऽवगाढं वा गुञ्जाकल्कैर्मुहुर्मुहुः ॥ २४ ॥

लेपयेदुपशान्त्यर्थं कुर्याद् वाऽपि रसायनम् । मालतीकरवीराग्नि-नक्तमालविपाचितम् । तैलमभ्यञ्जने शस्तमिन्द्रलुप्तापहं परम् ॥ २५ ॥

Treatment of Indra-lupta : In a case of Indra-lupta (baldness or Alopecia), the bald part or seat should be anointed and fomented, and then bleeding (by venesection) should be resorted to, after this a plaster composed of Manah-sila, Kasisa, Tuttha and Marica, or of Kutannata and Deva-daru pasted together, should be applied to it. As an alternative, it should be deeply scraped and constantly kept covered with a paste of Guja-seeds. As an alternative, Rasayana medicines should be administered for its cure. An oil cooked with Mr fi, Karavira, Citraka and Naktamala is highly efficacious in curing a case of Alopecia, if used as an unguent. 23-25

1. Cakrapani reads “लाक्षाभयारसालेपः” in place of “लाक्षारसोऽभया वापि” Sivadasa explains “रस:” as “गन्धरस:”.–Ed.

2. Chakradatta prescribes cauterisation with fire as well, in such a case.

अरूंषिकां हृते रक्ते सेचयेन्निम्बवारिणा । दिह्यात् सैन्धवयुक्तेन वाजिविष्ठारसेन तु ॥ २६ ॥

हरितालनिशानिम्ब- कल्कैर्वा सपटोलजैः । यष्टीनीलोत्पलैरण्ड-मार्कवैर्वा प्रलेपयेत् ॥ २७ ॥ इन्द्र लुप्ता पहं तैलमभ्यङ्गे च प्रशस्यते ।

Treatment of Arurmsika : Blood-letting from the affected part should be first resorted to in a case of Arumsika (Eczema of the face and scalp) and it should then be affused with the decoction of Nimba. Medicinal plasters prepared with the Rasa (liquid) pressed from horsedung, mixed with Saindhava, should be applied to it. As an alternative, it should be plastered with the paste compound (Kalka) of Haritala. Haridra, Nimba and Patola, or with that of Yasti-madhu, Nilotpala, Eranda, and Markava. The oil mentioned for the cure of Indralupta may also be used with benefit. 26-27

सिरां दारुणके विद्ध्वा स्निग्धस्विन्नस्य मूर्धनि । अवपीडं शिरोबस्तिमभ्यङ्गञ्च प्रयोजयेत् ।

क्षालने कोद्रवतृण-क्षारतोयं प्रशस्यते ॥ २८ ॥

उपरिष्टात् प्रवक्ष्यामि विधिं पलितनाशनम् ।। २९ ।।

मसूरिकायां कुष्ठघ्न-लेपनादिक्रिया हिता । पित्तश्लेष्मविसर्पोक्ता क्रिया वा संप्रशस्यते ॥ ३० ॥

Treatment of Darunaka, etc.: Anointment and fomentation of the diseased patches are the (preliminary) remedies in a case of Darunaka, after which bleeding should be effected by opening the vein in the forehead. Remedial measures such as, Avapida-Sirovasti and Abhyanga (anointment) should be employed as well; and the affected parts should be washed with the alkaline solution of burnt Kodrava weeds. Measures for arresting the premature greyness of hair (Palita) will be described later on (in the Misraka Chapter XXV). Curative plasters and remedies, etc., mentioned in connection with the treatment of Kustha should be employed in cases of Masurika; or those, laid down under the treatment of Erysipelas (Visarpa) originated through the concerted action of the deranged Pitta and Kapha should be used. 28-30

1. Accrding to Chakradatta blood-letting should be resorted to in such cases only by means of venesection, or with leeches.

जतुमणिं समुत्कृत्य मषकं तिलकालकम् । क्षारेण प्रदहेद् युक्त्या वह्निना वा शनैः शनैः ॥ ३१ ॥

न्यच्छे व्यङ्गे सिरामोक्षो नीलिकायाञ्च शस्यते । यथान्यायं लालाट्यादिसिराव्यधः ॥ ३२ ॥

यथाभ्यासं घृष्ट्वा दिह्यात् त्वचं पिष्ट्वा क्षीरिणां क्षीरसंयुताम् । बलातिबलयष्टयाह्व-रजनीर्वा पयस्यागुरुकालीय-लेपनं प्रलेपनम् ।। ३३।।

सगैरिकम् । वा क्षौद्राज्ययुक्त्या लिम्पेद् दंष्ट्रया शूकरस्य च । कपित्थराजादनयोः कल्कं वा हितमुच्यते ॥ ३४ ॥

Treatment of Jatu-mani, etc. : The seats of affection should be scraped (with a knife) and gradually and judiciously cauterised¹ by applying an alkali or fire in cases of Jatu mani (congenital moles), Masaka and Tila-kalaka (freckles ). An opening of the local veins in the temporal region, etc., should be effected in cases of Nyaccha, Vyanga and Nilika, in accordance with the prescribed rules. The affected parts should be rubbed (with Samudra-phena, etc.) and plastered with the barks of Ksira trees pasted with milk; or with Bala, Ati-bala, Yasti-madhu and Rajani, pasted together. As an alternative, plasters composed of Payasya, Aguru and Kalıya pasted together with Gairika, or of a tooth of a boar pasted with clarified butter and honey, or of Kapittha and Rajadana pasted together, may also be used with benefit. 31-34

यौवने पिडकास्वेष विशेषाच्छर्द्दनं हितम् । लेपनञ्च वचारोघ्र-सैन्धवैः सर्षपान्वितैः । कुस्तुम्बुरुवचालोध्र-कुष्ठैर्वा पद्मिनीकण्टके रोगे तेनैव सिद्धं सक्षौद्रं सर्पि: पानं प्रदापयेत् । निम्बारग्वधयोः कल्को हित उत्सादने भवेत् ॥ ३६॥ लेपनं हितम् ॥ ३५ ॥ छईयेन्निम्बवारिणा ।

1. The cauterisation should be effected with an alkali, when the disease is superficial and with fire when it is deep-seated.

Treatment of Yauvana-pidaka, etc. : Emetics are especially efficacious in cases of Yauvana-pidaka (pimples) which disfigure the face in youth. The application of medicinal plasters composed of Vaca, Lodhra, Saindhava and (white) mustard seeds or of Kustumburu, Vaca, Lodhra and Kustha pasted together is also recommended. In a case of Padmini-Kantaka, a decoction of Nimba bark should be given as an emetic, and the patient should be made to drink a potion of clarified butter cooked with a decoction of Nimba and mixed with honey. A decoction¹ of Nimba and Aragvadha should be used for chafing (Utsadana) the diseased locality. 35-36

परिवृत्तिं घृताभ्यक्तां सुस्विन्नामुपनाहयेत् । ततोऽभ्यज्य शनैश्चर्म चानयेत् पीडयेन्मणिम् ॥ ३७॥

प्रविष्टे मणौ चर्म स्वेदयेदुपनाहनैः BI च त्रिरात्रं पञ्चरात्रं वा वातघ्नः शाल्वणादिभिः ॥ ३८ ॥

दद्याद् वातहरान् बस्तीन् स्निग्धान्यन्नानि भोजयेत् ॥ ३९ ॥ वपाटिकां जयेदेवं यथादोषं चिकित्सकः ॥ ४० ॥

Treatment of Parivartika, etc. : In a case of Parivartika (retroflexion of the prepuce) the glans penis should be rubbed with clarified butter and duly fomented and Salvana and such other Vayusubduing plasters (Upanaha) should be applied for three or five days. Then having lubricated the part (with Ghrita), the glans penis should be gently pressed and the prepuce should be smoothly drawn over the glans penis, so as to cover it entirely within its fold. The prepuce, being so drawn, should be fomented with warm poultices. Vayu-subduing Bastis (Clysters) should be employed and emollient diet should be prescribed (during the course of the treatment). A case of Ava-patika should be similarly treated, after a due consideration of the nature and intensity of the Dosas involved in the case. 37-40

निरुद्धप्रकशे नाडीं दारवीं वा जतुकृतां घृताभ्यक्तां प्रवेशयेत् ॥ ४१ ॥

लौहीमुभयतोमुखीम् ।

1. Cakrapani prescribes the powders (कल्क) in place of the decoction ( क्वाथ) of Nimba and aragvadha. He also reads “उद्दर्त्तन” in place of “उत्सादन”, but here they mean the same thing.

वसामज्जशिशुमारवराहयोः । वातघ्नद्रव्यसंयुतम् ॥ ४२ ॥ त्रयन्त्र्यहात् स्थूलतरां स्रोतो विवर्धयेदेवं सम्यङ्नाडीं प्रवेशयेत् । स्निग्धमन्नञ्च भोजयेत् । भित्वा वा सेवनीं मुक्त्वा सद्यःक्षतवदाचरेत् ॥ ४३ ॥ परिषेके चक्रतैलं तथा योज्यं

Treatment of Niruddha-Prakasa : In a case of NiruddhaPrakasa (constriction or stricture of the urethra, a tube (open at both ends) made of iron, wood, or shellac should be lubricated with clarified butter and gently introduced into the urethra. The marrow or lard of a boar, or of a porpoise, or the Cakra-taila, mixed with Vayu-subduing drugs should be sprinkled over the affected part. Thicker and thicker tubes should be duly introduced into the urethra every third day. The passage should be made to dilate in the aforesaid manner, and emollient food should be given to the patient. As an alternative, an incision should be made (into the lower part of the penis), avoiding the sevani (raphe of the perineum), and it should be treated as an incidental ulcer of recent origin. (Sadyo-vrana). 41-43

सन्निरुद्धगुदं रोगं वल्मीकं वह्निरोहिणीम् । प्रत्याख्याय यथायोगं चिकित्सितमथाचरेत् ॥ ४४ ॥

विसर्पोक्तेन विधिना साधयेदग्निरोहिणीम् । सन्निरुद्धगुदे योज्या निरुद्धप्रकशक्रिया ॥ ४५ ॥

Treatment of Sanniruddha-Guda, etc. : Cases of SanniruddhaGuda (stricture of the anus), Valmika and Agni-Rohini should be duly treated with regard to the nature and intensity (of the Dosas engendering the disease, but without holding out any definite hope of recovery. The tretment of a case of Agni-Rohini should be like that of Visarpa (Erysipelas), while the remedial measures, mentioned in connection with Niruddha-prakasa, should be employed in a case of SanniruddhaGuda. 44-45

शस्त्रेणोत्कृत्य वल्मीकं क्षाराग्निभ्यां प्रसाधयेत् । विधानेनार्बुदोक्तेन शोधयित्वा यस्य वल्मीकन्तु भवेद् तत्र संशोधनं कृत्वा शोणितं च रोपयेत् ॥ ४६॥ नातिवृद्धममर्मजम् । मोक्षयेद् भिषक् ॥४७॥ कुलत्थिकाया मूलैश्च गुडूच्या लवणेन आरेवतस्य मूलैश्च दन्तीमूलैस्तथैव

श्यामामूलैः सपललैः सुस्निग्धैश्च सुखोष्णैश्च च ॥ ४८॥ शक्तुमिश्रैः प्रलेपयेत् । तमुपनाहयेत् ॥ ४९ ॥ भिषक्प क्वं वा तद् विजानीयाद् गतीः सर्वा यथाक्रमम् । ततरिछत्त्वा प्रदहेन्मतिमान् भिषक् ॥ ५० ॥ क्षारेण अभिज्ञाय संशोध्य दुष्टमांसानि प्रतिसारयेत् ।

व्रणं विशुद्धं विज्ञाय सुमना रोपयेन्मतिमान् भिषक् ॥५१॥ ग्रन्थयश्चैव भल्लातक- मनः शिले। कालानुसारी सूक्ष्मैला

एतैः सिद्धं निम्बतैलं पाणिपादोपरिष्टात्च न्दनागुरुणी तथा ॥ ५२॥

वल्मीके रोपणं हितम् । छिद्रैर्बहुभिरावृतम् । तु वल्मीकं यत् सशोकं स्याद् वर्जं तत् तु विजानता || ५३ ||

Treatment of Valmika: The diseased patches should be scraped off in a case of Valmika and cauterised with fire or with an alkali; while the purification and healing up (of the incidental ulcer) should be effected as in the treatment of an Arbuda (tumour). A case of Valmika appearing in any part of the body other than a Marma, and not of a considerable growth should be duly treated with venesection after the application of Samsodhana measures ( purgative, emetic, etc.). The affected part should be plastered (Pralepa) with a medicinal compound composed of the roots of (Vana) Kulattha, Arevata, Danti and Syama, pasted together with Guduci, rock salt, Palala (pastes of sesamum ) and powdered barley. It should be poulticed (Upanaha) with the same compound, well mixed with clarified butter and made lukewarm (in case suppuration be desired). When found to be fully suppurated, the course of the pus-channels should be ascertained by an experienced surgeon. The ulcer should then be opened (with a knife) and cauterised, and after being fully purified of the putrid flesh (in its cavity), it should be again cauterised with an alkali. Healing (Ropana) remedies should be applied to it after it has been found to be thoroughly cleansed Nimba-oil cooked with Sumanas (Jati leaves, Granthi, Bhallataka, Manah-sila, Kalanusari, small Ela, Aguru and red Candana should be applied with advantage to heal up the (incidental ulcer in a case of)

532

Valmika. A patient suffering from an attack of Valmika appearing either on his hands or feet and attended with swelling and a large number of cavities should be abandoned by a wise physician. 46-53

धात्र्याः स्तन्यं शोधयित्वा बाले साध्याऽहिपूतना । पटोलपत्रत्रिफला-रसाञ्जनविपाचितम् पीतं घृतं नाशयति कृच्छ्रामप्यहिपूतनाम् ॥ ५४॥

त्रिफलाकोलखदिर कषायं व्रणरोपणम्। कासीसरोचनातुत्थ-हरितालरसाञ्जनैः लेपोऽम्लपिष्टो बदरीत्वग् वा सैन्धवसंयुता । कपालतुत्थजं चूर्णं चूर्णकाले चिकित्सेन्मुष्ककच्छूञ्चाप्यहिपूतनपामवत् ॥५५॥ प्रयोजयेत् ॥५६॥ ॥५७॥

Treatment of Ahi-putana, etc. : In the treatment of an infant laid up with an attack of Ahi-putana the breast-milk of its mother or nurse should be first purified. Cases of Ahi-putana yield to the use of a potion of clarified butter, cooked with Triphala, Rasanjana and Patola leaves, and a decoction of Triphala, kola and Khadira should be used (as a wash) to heal the ulcer. Plasters composed of sulphate of iron, Gorocana, sulphate of copper ( Tuttha), Haritala and Rasaftjana, pasted together with Kanjika, or of Badari bark and rock-salt, should be applied (to the diseased locality). It should be dusted as well with the pulverised compound of a burnt earthen pot and sulphate of copper. The preceding measures should be adopted in cases of Vrsana-Kacchu as well. 54-57

गुदभ्रंशे गुदं स्विन्नं स्नेहाभ्यक्तं प्रवेशयेत् । कारयेद् गोफणाबन्धं मध्यच्छिद्रेण चर्मणा । विनिर्गमार्थं वायोश्च स्वेदयेच्च मुहुर्मुहुः ॥ ५८ ॥

क्षीरे महत् पञ्चमूलं मूषिकाञ्चान्त्रवर्जिताम् । पक्त्वा तस्मिन् पचेत् तैलं वातघ्नौषधसंयुतम् । गुदभ्रंशमिदं कृच्छ्रं पानाभ्यङ्गात् प्रसाधयेत् ॥ ५९॥

Treatment of Guda-Bhramsa: In a case of Guda-Bhramsa, the protruded part should be fomented and lubricated with Sneha.¹

It should then be gently introduced. The region of the anus should then be bandaged with a piece of hide in the manner of a Gophana Bandha, ith an opening in it (lying immediately below the anus), so that it may not in any way interfere with the emission of Vayu. The affected part should then be frequently fomented. A quantity of milk, cooked with Maha-Pancha-mula and the body (flesh) of a mouse, bereft of its entrails should be first boiled together (with water). An oil cooked with the milk thus prepared (with water) and the Vayusubduing drugs should be administered as drink and unguents. By these measures the most difficult cases of prolapsus ani would be cured. 58-59

1. According to siva-dasa, cow’s fat only should be used.

इति सुश्रुत संहितायां चिकित्सितस्थाने क्षुद्ररोगचिकित्सितं नाम विंशोऽध्यायः ।। २० ।।

Thus ends the twentieth Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the treatment of minor ailments.

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