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Sushruta SamhitaChikitsasthanaVisarpa-Nadi-vrana-stana-roga-chikitsa- Treatment of erysipelas-Sinus-Mammary-glands- Sushrutasamhita Chikitsasthana Chapter 17

Visarpa-Nadi-vrana-stana-roga-chikitsa- Treatment of erysipelas-Sinus-Mammary-glands- Sushrutasamhita Chikitsasthana Chapter 17

सप्तदशोऽध्यायः । अथातो विसर्प-नाडी- स्तनरोगचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ः।।१।।

Now we shall discourse on the medical treatment of erysipelas, etc., (Visarpa), sinus, etc.. (Nadi-Vrana) and diseases of the mammary glands (Stana-roga ). As it was stated by Lord Dhanvantari. 1 साध्या विसर्पास्त्रय आदितो ये न सन्निपातक्षतजौ हि साध्यौ । साध्येषु

तत्पथ्यगणैर्विदध्याद् घृतानि सेकांश्च तथोपदेहान् ।। २ ।।

Of the types of erysipelas (Visarpa ) the first three (viz., the Vataja, Pittaja and Kaphaja ones ), are curable; the two remaining types, viz., those caused by the concerted action of the three Dosas (of the body) and those originating from wounds ( Ksataja) should be considered as incurable. In cases of the curable types, medicated Ghritas, plasters ( Upadehas) and affusions ( Seka) prepared with the drugs (antidotal to the specific aggravated Dosa or Dosas (involved in the case) should be prescribed. 2

मुस्ताशताह्वासुरदारुकुष्ठ – वाराहिकुस्तुम्बुरुकृष्णगन्धाः । वातात्मके चोष्णगणाः प्रयोज्याः सेकेषु लेपेषु तथा घृतेषु ।। ३ ॥

यत् पञ्चमूलं खलु कण्टकाख्यमल्पं महच्चाप्यथ वल्लिजञ्च | तच्चोपयोज्यं भिषजा प्रदेहे सेके घृते चापि तथैव तैले । ॥ ४ ॥

Treatment of Vataja Visarpa : In cases of the Vataja type of the disease, Musta, Sata Sura daru, Kustha, Varahi, Kustumburu (Dhanyaka) Krsna-gandha, and the drugs of a heat-making potency (Usna-gana)¹ should be used in preparing the medicinal washings (Seka), plasters and Ghritas. The drugs respectively included within the groups of the Vrhat Paica-mula and the Svalpa-Pancha-mula, the Kantaka-Pancha-mula and Valli Pancha-mula should be ( separately) used to prepare the medicinal plasters, affusions, medicated Ghritas and as well as the necessary oils. 3-4

कसेरुशृङ्गाटकपद्मगुन्द्राः सशैवला: सोत्पलकर्दमाश्च । वस्त्रान्तराः पित्तकृते विसर्फे लेपा विधेयाः सघृताः सुशीताः ॥ ५ ॥

हीवेरलामज्जकचन्दनानि स्रोतोजमुक्तामणिगैरिकाश्च । क्षीरेण पिष्टाः सघृताः सुशीता लेपाः प्रयोज्यास्तनवः सुखाय ।। ६ ॥

प्रपौण्डरीकं मधुकं पयस्या मञ्जिष्ठिका पद्मकचन्दने च । सुगन्धिका चेति सुखाय लेपाः पैत्ते विसर्पे भिषजा प्रयोज्याः ॥ ७॥

न्यग्रोधवर्गैः परिषेचनञ्च घृतञ्च कुर्य्यात् स्वरसेन तस्य । शीतैः पयोभिश्च मधूदकैश्च सशर्करैरिक्षुरसैश्च सेकान् ।। ८ ।।

Treatment of Pittaja Visarpa : In cases of Pittaja Visarpa, a plaster consisting of Kaseruka, Srnga-taka, Padma, Gundra (Guduci), Saivala, Utpala and clay pasted together and mixed with clarified butter, should be wrapped in a piece of linen, and applied cool to the affected part. A paste composed of Hrivera, Lamajjaka (Usira-mula), Candana, Srotoja (Rasainjana), Mukta, Mani and Gairika, pasted together with milk and mixed with clarified butter should be applied thin and cool to the affected part to alleviate the pain. Pittaja erysipeals readily yields to the application of a medicinal plaster composed of Prapaundarika, Yasti-madhu, Payasya, 3 Manjistha, Padmaka, Candana and Sugandhika pasted together. Decoctions of the drugs of the Nyagrodhadi group should be used in washing (the affected part; or clarified butter should be cooked with the expressed juice of the above drugs and employed in the case. The part may be affused (Seka) with cold milk (or water), or with water mixed with honey or sugar, or

1. Cakradatta reads “Arka Varnsa and Artagala instead of the drugs of a heat making potency. Dalhana explains the drugs of a heat-making potency to be the drugs of the Bhadra-darvadi and the Pippalyadi groups.

2. In order to facilitate its removal.

3. It means “Ksira-vidari”, Jejjata explains it as “Arka-puspi”. with the expressed juice of the sugarcane. 5-8

गौरीमधुकारविन्द पद्मकसारिवासु सचन्दनायां मधुशर्करायां घृतस्य तथार्षभे रोध्राम्बुराजादनगैरिकेषु । काकोलिमेदाकुमुदोत्पलेषु ।। ९ ।।

द्राक्षास्थिरापृश्निशताह्वयासु । कल्कीकृतासूदकमत्र दत्त्वा न्यग्रोधवर्गस्य तथा स्थिरादेः ।। १० ।।

गणस्य बिल्वादिकपञ्चमूल्याश्चतुर्गुणं क्षीरमथापि तद्वत् । प्रस्थं विपक्वं परिषेचनेन पैत्तीर्निहन्यात् तु विसर्पनाडीः ॥ ११ ॥

विस्फोटदुष्टव्रणशीर्षरोगान् पाकं तथाऽऽस्यस्य निहन्ति पानात् । ग्रहार्दिते शोषिणि चापि बाले घृतं हि गौर्यादिकमेतदिष्टम् ॥ १२ ॥

Gauryadi Ghrita : A Prastha measure of clarified butter should be cooked with the Kalka of Gauri, Yasti-madhu, Aravinda, Rodhra, Ambu, Rajadana, Gairika, Risabhaka. Padmaka. Sariva, Kakoli, Meda, Kumuda, Utpala, Candana, Madhu-Sarkara, Draksa, Sthira, Prsni-parni, and Satahva taken in equal parts (and weighing one seer² in all) and with the decoctions, weighing four times that of the Ghrita of the drugs of the Nyagrodhadi, Sthiradi (minor Pancha-mula) and Bilvadi (major Pancha-mula) groups together with the same weight (sixteen seers) of milk. The washing (of the affected part) with this medicated Ghrita proves curative in Pittaja erysipelas and sinus. Visphota (boils, head diseases, malignant sores and inflammatory affections of the mouth, yield to the internal use of this Ghrita. It is called the Gauryyadi Ghrita and is highly efficacious in the derangements to which children are liable, (commonly) attributed to the malignant influences of evil stars, as well as in cases of emaciated ones. 9-12

अजाऽश्वगन्धा सरला सकाला सैकैषिका चाप्यथवाऽजशृङ्गी । गोमूत्रपिष्टो विहितः प्रदेहो हन्याद् विसर्पं कफजं सुशीघ्रम् ॥ १३ ॥

कालानुसार्यागुरुचोचगुञ्जा रास्नावचाशीतशिवेन्द्रपर्ण्यः । पालिन्दिमुञ्जातमहीकदम्बा हिता विसर्पेषु कफात्मकेषु ॥ १४ ॥

गणस्तु योज्यो वरुणप्रवृत्तः क्रियासु सर्वासु विचक्षणेन । संशोधनं शोणितमोक्षणञ्च श्रेष्ठं विसर्पेषु चिकित्सितं हि ।

2. 1. Some explain it as “Haridra”, while others explain it as “Gorocana’. Dalhana, however, says that these drugs will weigh four Palas i.e., half a seer in all.

सर्वांश्च पक्वान् परिशोध्य धीमान् व्रणक्रमेणोपचरेद् यथोक्तम् ।। १५ ।।

Treatment of Kaphaja Visarpa : Cases of the Kaphaja type of Visarpa readily yield to a proper application of a medicinal plaster (Pradeha) composed of Aja-gandha, Asva-gandha, Sarala, Kala, Ekaisika and Aja-srngi pasted with the urine of a cow. Drugs, such as Kalanusarya, Aguru, Coca (cardamom), Gufija, Rasna, Vaca, Sitaiva, Indra-parni, Palindi, Munjata and Mahi-Kadamba (applied similarly) are also efficacious in the present type. Drugs of the Varunadi group may be used in any form (such as plasters, washes, etc.), for erysipelas. Blood-letting (by means of leeches) and Samsodhana (purifying) measures are the principal remedies in all cases of this disease (Visarpa). Suppuratted erysipelas should be first purified and then treated with the remedies described in the treatment of Vrana (ulcer). 13-15

नाडी त्रिदोषप्रभवा न सिध्येच्छेषाश्चतस्त्रः प्रतियत्नसाध्याः । पूर्वमशेषतः तत्रानिलोत्थामुपनाह्य तिलैरपामार्गफलैश्च पिष्ट्वा ससैन्धवैर्बन्धनमत्र पूयगतिं विदार्य । कुर्यात् ।। १६ ।।

प्रक्षालने चापि सदा व्रणस्य योज्यं महद् यत् खलु पञ्चमूलम् । हिंस्त्रां हरिद्रां कटुकां बलाञ्च गोजिह्विकाञ्चापि सबिल्वमूलाम् । संहृत्य तैलं विपचेद् व्रणस्य संशोधनं पूरणरोपणञ्च ॥ १७ ॥

Treatment of Nadi- Vrana : A Case of Nadi-Vrana (sinus) due to the concerted action of the three Dosas (Sannipataja) baffles all cures, while the four remaining types are amenable to careful medical treatment. Poultices (Upanaha) + should be applied at the outset in the Vataja Nadi-Vrana and then the course of the pus-channels should be (ascertained and) fully opened (with a knife) and bandaged with apaste of sesamum, Apamarga-seeds and Saindhava salt. A decoction of (the drugs of) the Vrhat-Pancha-mula group should be constantly used in

1. “Sarula” here means “Trivrt”. Cakradatta reads “सरणा” which also means “Trivrt”.

2. “Ekaisika”, according to Dathana, would mean Satavari but Sivadasa explains it as Patha.

3. Gayadasa explains it as Karkata-Srngi.

4. Poulticing with the drugs which induce suppuration is not approved of by Gayadasa. washing the ulcer. Oill duly cooked with the following drugs, viz., Himsra, Haridra, Katuka, Bala, Gojihvika and Bilva-roots should be used for the purification, filling up and healing of the sores of the sinus. 16-17

पित्तात्मिकां प्रागुपनाह्य धीमानुत्कारिकाभिः सपयोघृताभिः | निपात्य शस्त्रं तिलनागदन्ती – यष्ट्याह्नकल्कैः परिपूरयेत् ताम् । प्रक्षालने चापि ससोमनिम्बा निशा प्रयोज्या कुशलेन नित्यम् ॥ १८ ॥ श्यामात्रिभण्डीत्रिफलासु सिद्धं हरिद्रयो रोधकवृक्षयोश्च । घृतं सदुग्धं व्रणतर्पणेन हन्याद् गतिं कोष्ठगताऽपि या स्यात् ।। १९ ।।

Treatment of Pittaja Nadi: In a case of Pittaja sinus, an intelligent surgeon should employ a porridge (Utkarika) mixed with milk and clarified butter as a poultice. Then having opened the sinus with a knife. a plaster composed of Tila, Naga-danti and Yasti madhu should be applied to heal it. A decocion of Soma, Nimba and Haridra should be used by a skillful surgeon in washing the ulcer daily. A medicated Ghrita cooked with Syama, Trivrt, Triphala, Haridra, Daru-Haridra, Rodhra and Kutaja and with milk should be used to lubricate (Tarpana) the sinus. This Ghrita will even heal a sinus affecting the Kostha. 18-19

नाडीं कफोत्थामुपनाह्य सम्यक् कुलत्थसिद्धार्थकशक्तुकिण्वैः । मृदूकृतामेष्य गतिं विदित्वा निपातयेच्छस्त्रमशेषकारी ॥ २० ॥ दद्याद् व्रणे निम्बतिलान् सुपिष्टान् सुराष्ट्रजान् सैन्धवसम्प्रयुक्तान् । प्रक्षालने चास्य सुवर्चिकासैन्धवचित्रकेषु करञ्जनिम्ब – जात्यक्षपीलुस्वरसाः प्रयोज्याः ॥ २१ ॥ निकुम्भतालीनलरूपिकासु । फलेष्वपामार्गभवेषु चैव कुर्यात् समूत्रेषु हिताय तैलम् ||२२||

Treatment of Kaphaja Nadi : In a case of the Kaphaja type of the Nadi, the sinus should be duly poulticed (Upanaha) with Kulattha, white mustard seeds, Saktu and Kuva. When softened by its application, the direction of the sinus (with the help of a director) should be first ascertained; and an expert surgeon should then open in fully with a knife and plaster it with a compound composed of Nimba, sesamum,

1. Four seers of oil, the (Kalka) drugs combindely weighing one seer and sixteen seers of water are to be taken in its preparation– Dalhana.

Saindhava salt and Saurastra-mrttika. A decoction (Sva-rasa-lit.-expressed juice) of the Karanja, Nimba, Jati, Aksa and Pilu should be used in washing the incidental ulcer. Oil duly cooked with Suvarcika, Saindhava, Citraka, Nikumbha, Tali’, Nala, Rupika and Apamargaseeds and with cow’s urine should be used for healing purposes. 20-22

नाडीन्तु शल्यप्रभवां विदार्य निर्हत्य शल्यं प्रविशोध्य मार्गम् । संशोधयेत् क्षौद्रघृतप्रगाढैस्तिलैस्ततो रोपणमस्य कुर्य्यात् ॥ २३ ॥

कुम्भीकखर्जूरकपित्थबिल्व-वनस्पतीनाञ्च शलाटुवगैः । कृत्वा कषायं विपचेत् तु तैलमावाप्य मुस्तासरलाप्रियङ्गुः ॥२४॥

सुगन्धिका मोचरसाहिपुष्पं रोध्रं विदध्यादपि धातकीञ्च । एतेन शल्यप्रभवा च नाडी रोहेद् व्रणो वा सुखमाशु चैव ॥ २५ ॥

Treatment of Salyaja Nadi: In a case of Salyaja Nadi (incidental to any foreign matter into the body), the Salya should be first extracted by an incision into the sinus. Then having fully cleansed the channel, the ulcer should be purified with a plaster of sesamum profusely saturated with honey and clarified butter. It should be then healed up. Oil cooked with the decoction of the tender fruits of the Kumbhika, Kharjura, Kapittha, Bilva and the Vanaspatis (Vata, etc.), and with the Kalkus of Musta, Sarala, Priyangu, Sugandhika, Mocarasa, Ahipuspa (Nagesvara), Rodhra and Dhataki flowers leads to a speedy healing up (granulation) of ulcers (Vrana) and traumatic sinuses. 23-25

कृशदूर्बलभीरूणां नाड़ी मर्माश्रिता च या । क्षारसूत्रण तां छिन्द्यान्नतु शस्त्रेण बुद्धिमान् ॥ २६ ॥

एषण्या गतिमन्विष्य क्षारसूत्रानुसारिणीम् । सूचीं निदध्याद् गत्यन्ते तथोन्नम्याशु निर्हरेत् ॥ २७ ॥

सूत्रस्यान्तं समानीय गाढं बन्धं समाचरेत् । ततः क्षारबलं वीक्ष्य सूत्रमन्यत् प्रवेशयेत् ।। २८ ।।

क्षाराक्तं मतिमान् वैद्यो यावन्न छिद्यते गतिः ।

6 1 Dalhana’s reading evidently is “Tali- tala” and he explains it as the roots of “Bhumyamalaki”. Cakradatta also prescribes this oil but he takes “Nilika” instead of “Tali” Sivadasa, again, in his ocmmentary quotes from Susruta but reads ‘‘Nili Nala’ in place of Tala-Nala.”

2. ‘‘Moca-rasa’’ is explained by Dalhana to be “Sobhanjana’, but it generally means ‘‘Salmali-vesta” and Sivadasa explains it as such.

भगन्दरेऽप्येष विधि कार्यो वैद्येन जानता ।। २९ ।।

अर्बुदादिषु चोत्क्षिप्य मूले सूत्रं निधापयेत् । सूचीभिर्यववक्ताभिराचितं वा समन्ततः ।

मूले सूत्रेण बध्नीयाच्छिन्ने चोपचरेद् व्रणम् ।। ३० ।।

a Treatment with Kshara-Sutra: An erudite surgeon should excise a sinus, occurring in any of the Marmas, or in a weak, timid, or emaciated person with an alkalined string (Kshara-Sutra), and not with a surgical knife. The course of the sinus should be first ascertained with a director; and a needle, threaded with a string of alkalined thread should be passed from one end of the sinus and quickly drawn out through the other. Then the two ends of the thread should be firmly fastened together. An intelligent surgeon should likewise pass another alkalined thread in the event of the alkali of the first thread being comparatively weak. This should be repeated till the sinus completely cuts through. The surgeon should know that the same procedure may be as well adopted in cases of fistula-in-ano. Similarly in cases of tumours (Arbuda), etc. they should be lifted up (with the hand) and tied round at their base with an alkalined thread, or it should be punctured around with a kind of needle with their mouth resembling a barley corn and then tied again at their base with an alkalined thread. After their bursting (and falling off), they should be treated as common ulcers (Vrana). 26-30

या द्विव्रणीयेऽभिहितास्तु वर्चस्ताः सर्वनाडीषु भिषग्विदध्यात् ।। ३१ । ।

घोण्टाफलत्वग्लवणानि लाक्षा-पूगीफलं वालवणञ्च पत्रम् । स्नुह्यर्कदुग्धेन तु कल्क एष वर्त्तीकृतो हन्त्यचिरेण नाडीः || ३२ ।।

बिभीतकाम्रास्थिवटप्रवाला हरेणुकाशनिबीजमस्य । वाराहिकन्दश्च तथा प्रदेयो नाडीषु तैलेन च मिश्रयित्वा ।। ३३ ।।

The different kinds of Plug-Stick (Varti) described in the DviVraniya Chapter (Chikitsa–chap.-I) may be similarly used with advantage in all cases of sinus. The use of a plug made of the following drugs, viz.. the bark and fruit of the Ghonta (the five officinal kinds of) salt. Laksa pugi fruits and the leaves of the Alavana pasted

1. According to Cakradatta’s reading and Sivadas’s commentary there is only the Saindhava (instead of the five officinal kinds of salt) should be taken. We, together with the milky juice of the Snuhi and Arka leads to the speedy healing up of a sinus. The powdered³ stones of Bibhitaka, mangoe fruits, Vata-sprouts, Harenu, Sarinkhini-seed. Varahi-kanda mixed with oil can also be used in a case of sinus. 31-33

तथा च गोमांसमसीं हिताय कोष्ठाश्रितस्यादरतो दिशन्ति । वर्तीकृतं माक्षिकसंप्रयुक्तं नाडीघ्नमुक्तं लवणोत्तमं वा । दुष्टव्रणे यद् विहितञ्च तैलं तत् सर्वनाडीषु भिषग् विदध्यात् ॥ ३४ ॥

Furthermore, the ashes prepared from beef has been described to be efficacious for treating sinuses of the body cavities; or else, a wick prepared with salt and Maksika is also said to be curative for (such) sinuses. The oils which have been described for septic ulcers should also be used for treating all types of sinuses by the surgeons. 34

धत्तूरजं मदनकोद्रवजञ्च बीजं कोशातकी शुकनसा मृगभोजनी च । अङ्कोटबीजकुसुमं गतिषु प्रयोज्यं लाक्षोदकाहृतमलासु विकृत्य चूर्णम् ॥ ३५ ॥ चूर्णीकृतैरथ विमिश्रितमेभिरेव तैलं प्रयुक्तमचिरेण गतिं निहन्ति । एष्वेव मूत्रसहितेषु विधाय तैलं तत्साधितं गतिमपोहति सप्तरात्रात् ।। ३६ ।।

The seeds of the Dhustura, Madana and Kodrava, Kosataki, Suka-nasa, Mrga-bhojani and the seeds and flowers of the Ankota should be pounded together and applied to a sinus (Nadi) after having washed it with a decoction of Laksa. Cases of sinus speedily yield to the curative efficacy of the application of these powders mixed with oil. The use of the oil cooked with cow’s urine and with the preceding drugs (as Kalkas) brings about the healing up of a sinus in seven nights. 35-36

पिण्डीतकस्य तु वराहविभावितस्य मूलेषु कन्दशकलेषु च सौवहेषु ।

तैलं कृतं गतिमपोहति शीघ्रमेतत् कन्देषु चामरवरायुधसाह्वयेषु ।। ३७ ।।

The application of the oil cooked with the roots of the Pinditaka

however, follow Dalhana’s interpretation with good results. “Alavana’ has been explained by Dalhana as “Kaka-mardanika’ and by Sivudasa as “Jyotismati Sivadasu is, however, followed in practice in this care.

3. According to some different reading ‘burnt ashes’ (instead of powders) of the drugs should be taken. In our humble opinion the reading in the text seems to be the correct one.

treated with the expressed juice of the Varaha-kanda in the manner of a Bhavana saturation and with the bulbs of Suvaha brings about a speedy and effective remedy for a sinus. The same effect is produced by an application of the oil cooked with the bulbs of the Vajrakanda. 37

भल्लातकार्कमरिचैर्लवणोत्तमेन सिद्धं विड़ङ्गरजनीद्वयचित्रकैश्च ।

स्यान्मार्कवस्य च रसेन निहन्ति तैलं नाडीं कफानिलकृतामपचीं व्रणांश्च । ॥ ३८ ॥

Bhallatakadya Taila: The use of the oil cooked with the paste (Kalka) of Bhallataka, Arka, Marica, Saindhava salt, Vidanga, Haridra, Daru-Haridra and Citraka and with the expressed juice of the Bhrngaraja readily cures cases of sinus, Apaci and ulcer due to Vayu and Kapha. 38

स्तन्ये गते विकृतिमाशु भिषक् तु धात्रीं पीतां घृतं परिणतेऽहनि वामयेत् तु । निम्बोदकेन मधुमागधिकायुतेन वान्तागतेऽहनि च मुद्गरसाशना स्यात् ।। ३९ ।। एवं त्र्यहं चतुरहं षडहं वमेद् वा सर्पिः पिबेत् त्रिफलया सह संयुतं वा ।। ४० ॥ भार्गी वचामतिविषां सुरदारू पाठां मुस्तादिकं मधुरसां कटुरोहिणीञ्च । धात्री पिबेत् तु पयसः परिशोधनार्थमारग्वधादिषु वरं मधुना

कषायम् ॥ ४१ ।।

Treatment of Stana-roga : In cases of a derangement of the milk (of the breast) a draught of clarified butter should be quickly given to the Dhatri (mother or wet-nurse ) by the physician; and in the evening a draught composed of the decoction of Nimba, mixed with honey and Magadhika, should be given to her for emetic purposes. Next day she should take a meal (of boiled rice) with the soup (Yusa) of Mudga pulse. The use of emetics should be continued for three, four, or six days; or she should be made to drink a potion of clarified butter (cooked) with Triphala A decoction of Bhargi, Ativisa, Vaca, Suradaru, Patha, the drugs of the Mustadi Gana, Murva and Katu-rohini, or that of the drugs of the Aragvadhadi group mixed with honey, should be given to the Dhatri (wet-nurse) for the purification of her breast-milk. 39-41

सामान्यमेतदुपदिष्टमतो विशेषाद् दोषान् पयोनिपतितान् शमयेद् यथास्वम् । रोगं स्तनोत्थितमवेक्ष्य भिषग्विदध्याद् यद्विद्रधावभिहितं बहुशो विधानम् ॥ ४२ ॥ सम्पच्यमानमपि तन्तु विनोपनाहैः सम्भोजनेन खलु पाचयितुं यतेत | शीघ्रं स्तनो हि मृदुमांसतयोपनद्धः सर्वं प्रकोपमुपयात्यवदीर्यते च || ४३ ॥ पक्वे च दुग्धहरिणी: परिहृत्य नाडीः कृष्णञ्च चूचुकयुगं विदधीत शस्त्रम् । आमे विदाहिनि तथैव गते च पाकं धात्र्याः स्तनौ सततमेव च निर्दुहीत ॥ ४४ ॥

The above are the general remedial measures which are to be adopted in the affections of breast-milk. Any other defect in the breastmilk should be corrected specially with an eye to the nature of the Dosa involved in the case. In cases of inflammatory swellings of the breasts, the physician should remedy them by means of any one of the various measures laid down under the head of Vidradhi with a due consideration to the requirements of each particular case. Medicinal remedies should only be internally employed and no poultices should be applied for the speedy suppuration of the swelling of the breast, even if found to have already commended to suppurate; since the breasts are of an extremely soft and fleshy growth, any tight bandaging about those parts may be followed by local sloughing or even bursting. In a case where suppuration had already taken place, an operation should be made in the affected part, avoiding the milk-carrying veins as well as the nipple with its black surroundings. In all the cases of Stana-Vidradhi-whether non-suppurated, suppurating, or suppurated–the milk should be pressed out from the breast of the Dhatri.¹ 42-44

इति सुश्रुत संहितायां चिकित्सितस्थाने विसर्प नाडी स्तनरोगचिकित्सितं नाम सप्तदशोऽध्यायः ॥ १७ ॥

Thus ends the Seventeenth Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the treatment of erysipelas, sinus and the diseases of the mammary glands.

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