तमसो मा ज्योतिर्गमय

SANTINIKETAN VISWA BHARATI LIBRARY

817-613 K96 V.3

AN ENGLISH TRANSLATION

OF

THE SUSHRUTA SAMHITA

Vol. IIT.

UTTARA-TAŃTRA

AN ENGLISH TRANSLATION

THE SUSHRUTA SAMHITA

WITH

A FULL AND COMPREHENSIVE INTRODUCTION, ADDITIONAL TEXTS, DIFFERENT READINGS, NOTES, COMPARATIVE VIEWS, INDEX, GLOSSARY AND PLATES

(IN THREE VOLUMES)

EDITED BY KAVIRAJ KUNJA LAL BIISHAGRATNA, M. R. A. S. (LOND.)

Vol. III.

UTTARA-TANTRA

PUBLISHED BY

S. L. BHADURI, B. L. 10, KASHI GHOSE'S LANE, CALCUTTA

1916

All Rights Reserved.

PRINTED AT THE BHARAT MIIIR PRESS BY M. BHATTACHARYYA OF Messrs. SANYAL & Co., 25, ROY BAGAN STREET, CALCUTTA.

Kaviraj Kunja Lall Bhishagratna, M.R.A.S. (Lond.)

PREFACE.

It was some years ago that we took upon our- selves the rather ambitious task of bringing out the Sushruta Samhita in English. And we may mention that the appreciation the first instal- ment of our undertaking met with at the hands of scholars at home and abroad considerably encour- aged us in completing this huge undertaking. We desire to record here our deepest feelings of gratitude towards His Highness the Maharaja Sir Sawai Jai Singh Bahadoor, K. C. S. I., of Alwar (Rajputana), who has, by his princely donation, enabled us to bring this highly import- ant work to a completion. It is known through- out India that the illustrious Ruler of Alwar is a great patron of letters and a lover of Ayurvedic Science, and many noble undertakings in our country have depended largely upon his liberal support. No words of mine can adequately ex- press my admiration for the good he is doing to our country. Now that the whole work is before the public. its worth and importance will be duly judged Our translation does not claim to have fany liter- ary excellence, as our sole aim has been to render as faithfully as we could the original into one of the European languages. The technical terms occurring in the Sushruta Samhita cannot be

ii

accurately translated into English, as there are no corresponding words in that language which would convey the exact meaning of the orginal. We have therefore retained the Sanskrit terms, and have in some cases put within brackets such English words as may approximately render the meaning of the original. No apology is needed for placing before the learned world of the West a scientific treatise of ancient India. We may only mention that the Hindu system of medicine is not a thing of mere antiquarian interest. It is a living sys- tem, and even to-day millions of people in India are being treated according to this system. A system which has stood the test of centuries, and which still holds its own against rival systems of the day, cannot be lightly brushed aside as wholly unscientific. It has been said that a system which recognises prayer as one of the means of curing human ailments, can lay no claim to any scientific character. All that we need say in answer to this criticism is that humanity has not yet risen above prayer in any country in the world, and faith in the efficacy of prayer in curing diseases is, instead of dying out, gaining ground in the modern scientific world. Whatever that may be, in actual practice, Hindu medical men, like their brethren of Europe, rely chiefly upon medicine and surgery, but occasionally prescribe prayer also as an efficient form of remedy. While recognising the influence of mind on body, and the

111

efficacy of faith in certain forms of disease, they treat it as a special method, falling more properly within the province of priests. A few words, however. seem necessary to show what abiding interest there is for all time in such a work as the Sushruta Samhitá. We do not wish to enter into any historical criticism to prove that the different systems of medicine in other countries, new or old, have received more than a mere stimulus from the Indian System, and that many foreign discoveries may be traced to the work we are now presenting to the world. The opinions of some modern men of science, who cannot be accused of having any bias in favour of our system, will demonstrate its abiding value. Surgeon General Sir Pardey Lukis, M. D., I. M. S., K. C. S. 1., Director-General of Indian Medical Service, was pleased to remark in the course of his speech in the Imperial Legislative Council :- "Many of the so-called discoveries of recent years are merely re-discoveries of the facts known centuries ago to the ancients (Indians)." In noticing the first volume of this very work, the British Medical Journal observed in its issue of November, 1912 :- "It is certain that in this an- cient medical book there are traces of knowledge which is comparatively recent in the West." We do not know what reception will be ac- corded to this work by the public, but we may fairly hope that now that the ancient Indian Medical System and the Indigenous Drugs of

1V

this country are being investigated by scientific experts under the direction of the Government of India, this ancient system of Medicine and Surgery will attract the attention of those who have hitherto neglected it as unworthy of notice. The encouragement which we have received from the Governments of Bengal and Nepal and from the States of Baroda and Mysore, has helped us a great deal and we take this opportunity of expressing our gratitude towards them. The active help extended to us in the preparation of this work by Vaidyaratna Kaviraj Jogindra Nath Sen, Vidyabhusan, M. A., Kaviraj Madhav Chandra Tarkatirtha, Kaviraj Jnanendranath Sen, Kaviratna, B. A., Prof. Satyendranath Sen, Vidyá- vágis'a, M. A., and Babu Sachindralal Bhaduri, B. A., B. L., we also specially and thankfully acknowledge. We offer our sincerest thanks also to Dr. U. D. Banerjec, L. R. C. P., M. R. C. S. Dr. Y. M. Bose, M. D. (Chicago), and Kaviraj Surendranath Goswami, Vidyavinode. B. A., L. M. S. who have never failed to give us their valuable suggestions whenever we have sought their advice.

I0, KASHI GHCSE'S I.ANE, CALCUTTA, KUNJA LAL BHISHAGRATNA, May 25, 19r6.

CONTENTS.

(UTTARA-TANTRA.)

CHAPTER I. Diseases of the eyes, etc. :- Diseases of the eye and its append- ages-Description of Drishti-Mandalas and Sandhis-Description of Patalas-Premonitory symptoms-Causes of eye-diseases-Classification- Prognosis of Vataja-Pittaja-Kaphaja-Raktaja and Tri-doshaja eye- diseases-Seats of the eye-diseases. ... ... ... 1-8

CHAPTER II. Pathology of the diseases of the eye-joints :- Their nomencla- ture-Number-Symptoms. ... ... ... 9-11

CHAPTER III.

Pathology of the diseases of the eye-lids :- Causes and namcs -Specific symptoms of Utsangini-Kumbhika-Pothaki-Ars'ovartma- Anjana-Klishta-vartma-Vartma-bandhaka, ctc. etc. ... 12-15

CHAPTER IV.

Pathology of the diseases of the sclerotic coat :- Names and number-Symptoms of S'uklarma-Lohitarma-S'uktika-Arjuna-Pish- taka-Sirá-jála-Balása-grathita, etc. etc. ... ... 16-17

CHAPTER V. Pathology of the diseases of the black part of the eye :- Number-Names-Symptoms-Prognosis-A-vrana-s'ukra Jata-Sa-vrana- S'ukra-Akshi-pákátyaya-Ajaká. ... ... 18-19

ii CONTENTS.

CHAPTER VI. Pathology of the diseases affecting the eyes as a whole :- Names and Causes-Symptoms of Vataja-Pittaja-Kaphaja and Raktaja Abhishyanda-Causes of Adhimantha-Symptoms of Vataja-Pittaja- Kaphaja-and Raktaja Adhimantha-Prognosis-Symptoms of Sa-s'opha and A-s'opha Akshi-paka-Symptoms of Hatadhimantha-Váta-paryáya -S'ushkákshi-páka-Anyato-váta- Amlá-dhyushita - S'irot-páta-Sirá- harsha. ... ... ... ... 20~24

CHAPTER VII. Pathology of the diseases of the Pupil :- Description of Drishti -Symptoms-When first-second-third and fourth Patola attacked- Blindness-Specific symptoms of Vataja-Pittaja-Kaphaja and Sánni- pátika Timira-Parimláyi-Different colours of the pupil in cases of Linga-nas'a-Specific traits of Vataja-Pittaja-Kaphaja-and Sánnipátika Linga-nas'a-Traits of Vataja-Pittaja-and Kaphaja Vidagdha-Drishti- Smoky sight-Hrasva-Jatya-Nakulándhya,-Gambhiriká-Symptoms of traumatic Linga-nas'a. ... ... 25-31

CHAPTER VIII.

Classification and treatment of ocular affections :- Classi- fication-Namcs of Chhedya-Lekhya-Bhedya-Vyádhya eye-diseases -Names of eye-diseases where operation not to be risked-Names of curable and incurable eye-diseases. ... ... 32-33

CHAPTER IX.

Treatment of Vataja Ophthalmia :- Tarpana-Puta-paka- Fumigation-Snuff-Wash-Eye-drop-Collyrium-Treatment of Anyato- vata-Vata-paryaya-S'ushkakshi-páka. ... ... ... 34-37

CHAPTER X. Treatment of Pittaja Ophthalmia :- Tarpana measures-Wash -Snuff-Anjana-Rasa-kriya-A's'chyotana-Treatment of S'ukti-paka and Dhuma-dars'i. ... ... ... 38-40

CONTENTS.

CHAPTER XI.

Treatment of Sleshmaja Ophthalmia :- Fomentation-Anjana -Treatment of Balasa-grathita-Pishtaka-Praklinna-vartma. ... 41-46

CHAPTER XII.

Treatment of Raktaja Ophthalmia :- Venesection-Inhalation -Eye-drop-Snuffs- Plaster- Vartis- Treatment of S'irotpáta- Sirá- harsha-Arjuna .- Scarifying- Anjana-Treatment of S'ukra- Kshara. Anjana-Soothing applications-Treatment of Ajaka-Akshi-paka-Puyá- lasa-Praklinna-Vartma and Aklinna-Vartma. ... ... 47-53

CHAPTER XIII.

Treatment of Lekhya-roga :- Mode of treatment by Scarification -Satisfactory-defective and excessive scarification-Names of diseases amenable to scarification. ... ... ... 54-56

CHAPTER XIV.

Treatment of eye-diseases which require Incision :- Treat- ment of Visa-granthi-Lagana-Anjana-Krimi-granthi and Upanaha .- Application of Sneha and Sveda. ... 57-58

CHAPTER XV. Treatment of eye diseases which require Excision :- Treat- ment of Armans-Preliminary actions-Mode of operation-Medicinal treatment-Treatment of Sira-jala-Siraja-pidaká-Parvaniká .- Churna- Anjana-Treatment of the inner part of the eye-lids. ... 59-63

CHAPTER XVI.

Treatment of diseases peculiar to eye-lashes and eye-lids :- Surgical treatment of Pakshma-kopa-Preliminary actions-Mode of operation-Cauterisation and other measures. ... 64-65

iv CONTENTS.

CHAPTER XVII. Treatment of diseases of pupil and crystalline lens :- General treatment of Pitta and S'leshma-Vidagdha-Drishti .- Pushpanjana- Dravanjana-Gudikanjana - Treatment of Day-blindness - Nocturnal blindness-Application of Vartis-Rasa-kriyanjana-Kshudranjana- Treatment of a palliative type-Triphala-Ghrita-Navana-errhines-Puta- páka-Pratyanjana-Treatment of Pittaja-Vátaja-Kaphaja and Tri- doshaja Kacha-Fumigation-Treatment of Parimlayi-Diet-Blood- letting-Treatment of Timira-Prognosis-Surgical treatment of Kaphaja Linga-nasa-Its after-measures-Symptoms and treatment of the disorders resulting from an injudicious operation-Causes of relapse-Symptoms produced by the defects of the S'aláká-Description of the S'aláká- Derangements due to defective operations-Their treatment-Eye-sight- invigorating Anjanas and Vartis. ... ... ... 66-83

CHAPTER XVIII. Preparations and medicinal measures for ocular affections in general :- The Tarpana measures-Mode of application-Symptoms of satisfactory-excessive and defective Tarpana-Treatment of excessive and defective Tarpana-Cases of Tarpana-The Puta-páka measures- Emulsive-Scraping and Healing Puta-paka-Preparations of Snehana- Lekhana and Ropana Puta-páka-Prohibition and Remedies for infringe- ments-Symptoms of satisfactory-excessive-and defective applications of Puta-paka-Mode of preparing Puta-paka-Mode of application-As'chyo- tana and Seka-their classes-Maximum time for Seka-Time for appli- cation-S'iro-vasti-Lekhana-Ropana and Prasadana Anjana-Forms of Anjana-Their size and dose-Materials of vessels and rod for the use of Anjana-How to apply Anjana-Forbidden cases for the application of Anjana-Symptoms of satisfactory-excessive and deficient use of Lekhana Anjana-P'rasadana Anjana-Ropana Anjana-Recipe of several principal Anjana3-Bhadrodaya-Anjana-Vartis-Pindanjana. ... 84-101

CHAPTER XIX. Treatment of hurt or injnry to the eye :- General Treatment- Prognosis-Treatment of sunken eye-Symptoms and treatment of Kuku- naka-Conclusion. ... ... ... ... 102-105

CONTENTS.

CHAPTER XX.

Canses and symptoms of Bar-disease :- Classifications-Symp- toms of Karna-s'ula-Pranada-Vadhirya-Kshveda-Karna-srava-Karna- kandu-Karna-gutha-Karna-pratinaha - Krimi-karna-Karna-vidradhi- Karna-paka-Puti-karna. ... ... ... ... 106-108

CHAPTER XXI.

Medical Treatment of Ear-disease :- General Treatment- Treatment of Vataja ear-disease-Karna-s'ula-Pranada-and Vádhiryya. -S'iro-vasti-Dipika-Taila-Different kinds of Ear-drop-General and specific treatment of Pittaja car-ache and Kaphaja Karna-s'ula- Treatment of Deafness-General and Special Treatment of Puti-karna- Karna-srava Krimi-karna - Karna-kshveda - Vidradhi, etc. - Karna- kandu-Karna-paka. ... ... 109-117

CHAPTER XXII.

Causes and symptoms of diseases of the nose :- Nomenclature and Classification-Symptoms of Apinasa-Puti-nasya-Nasa-paka- Rakta-pitta-Puya-rakta-Kshavathu-Bhrams'athu - Dipti-Pratinaha- Parisrava-Pari-s'osha-Ars'as-S'opha-Arvuda-Pratis'yaya 118-120

CHAPTER XXIII.

Therapeutics of nasal diseases :- Treatment of Puti-nasya- Apinasa .- Diet-Errhines-Treatment of Nasa-paka-S'onita-pitta-Puya- rakta-Kshavathu-Bhrams'athu-Dipti-Nasanaha - Nasa-srava-Nasá- s'osha etc. ... ... ... 121-122

CHAPTER XXIV. Symptoms and treatment of Catarrh :- Causes-Premonitory symptoms-Specific symptoms of Vataja-Pittaja-Kaphaja-Tri-doshaja types-Raktaja-pratis'yaya-Prognosis-General treatment of Pratis'yaya- Regimen of diet and conduct-Treatment of Vataja-Pittaja-Kapbaja- and Tri-doshaja types. ... ... ... ... 124-130

vi CONTENTS.

CHAPTER XXV. Symptoms of diseases of the head :- Classification-Symptoms of Vataja-Pittaja- Kaphaja-Tri-doshaja-Kshayaja-Raktaja-Krimija S'iro-roga -- Symptoms of Suryavarta-Ananta-vata-Ardhava-bhedaka- and S'amkhaka. ... ... 131-133

CHAPTER XXVI. Treatment of diseases of the head :- Treatment of Vataja- Pittaja-Raktaja S'viroroga-Food-Treaiment of Kaphaja-Tri-dosbaja Kshayaja-Krimija-Ardhava.bhedaka- Ananta-vata-and S'amkhaka .- Conclusion ... ... ... 134-140

Here ends the Salakya-Tantra.

CHAPTER XXVII.

Specific feitures of nine malignant Grahas :- Different names -General course of attack-Symptoms of attack by Skanda-Skandápa- smara-S'akuni -Revati-Putana- Andhá-putana-S'ita putana-Mukha- mandika-Naigam sha - Prognosis-Rules to be observed. ... 141-144

CHAPTER XXVIII. Therapeutics of an attack by Skanda Graha :- General treat- ment-Fumigation-Mantras ... ... 145-146

CHAPTER XXIX. Therapeutics of an attack by Skandapasmara :- General treat. ment-prinkling-Ancintment- Utsadana-Fumigation-Religious pro- pitiation-Mantras. ... ... ... 147-118

CHAPTER XXX. Treatment of an attack by Sakuni graha :- Sprinkling-Anoint. ment-Pradeha-Fumigation-Religious propitiation-Mantras. 149-150

CONTENTS. V

CHAPTER XXXI. Theraputics of an attack by Revati-graha :- Sprinkling-Anoint- ment-Plaster-Religious propitiation-Mantras. ... ... 151-'52

CHAPTER XXXII.

Treatment of an attack by Putana-graha :- Washing-Anoint- ment-Fumigation-Religious propitiation-Mantras. ... 153-154

CHAPTER XXXIII. Treatment of Andha-putana-graha :- Sprinkling-Plaster-Fumi- gation-Religious propitiation-Mantras. ... 155-156

CHAPTER XXXIV. Treatment of an attack by Sita-putana :- Sprinkling-Fumi- gation-Anointment-Religious propitiation-Mantras. ... 157

CHAPTER XXXV.

Treatment of an attack by Mukha-mandika :- Sprinkling- Anointment-Fumigation-Religious propitiation-Mantras ... 158

CHAPTER XXXVI.

Treatment of an attack by Naigamesha :- Sprinkling-Anoint- ment-Utsadana-Fumigation-Religious propitiation-Mantras. 159-160

CHAPTER XXXVII.

Origin of nine Grahas :- The nine presiding deitics. ... 161-163

CHAPTER XXXVIII. Symptoms and Therapeutics of the diseases of the female organ of generation :- Causes .- Enumeration-Classification-Names -Symptoms of Vataja-Pittaja-Kaphaja-and Tri-doshaja types- Medical treatment .- Internal and External treatment. ... 164-168 Here ends the Kaumara-bhritya-Tantra.

viii CONTENTS.

CHAPTER XXXIX. Symptoms and Treatment of Fever :- Description of Jwara- Definition and classification-Pathology-Premonitory symptoms-Symp- toms of Vataja-Pittaja-Kaphaja and Tri-doshaja fever-Abhinyasa- fever-Hataujas - Sannyasa-Dwandaja fever-Váta-pitta-fever - Váta- S'leshma-fever-Pitta-S'leshma fever-Pralepaka-Tritiyaka (tertian) and Chaturthaka (quartan) fever-Vishama-fever-Seat and duration of Vishama- jwara-Satataka-Anyedyushka-Tritiyaka-Chaturthaka-Action-Influ- ence of Váyu on Vishama fever-Agantuka fever due to the effects of poison -HIay-fever-Gambhira fever and its prognosis-General treatment-Fast- ing-Prohibition of fasting-Effect of fasting-Satisfactory and excessive fasting-Tepid water-Cold water-Peya-Yavagu-Symptoms of Pakva and Ama-jwara-Time for administering febrifuge-Preliminary treatment -Application of Vasti and S'iro-virechana-Administration of Ghrita- Diet-Laja-tarpana-Milk as a diet-Meat-diet-Prohibitions in fever- Sams'amana decoctions for Vataja-Pittaja and Kaphaja fever-Treat- ment of Kapha-Vata-Pitta-S'leshma-Vata-pitta fever and Tri-doshaja fever-Treatment of Vishama-jwara-Ghrita in cases of Vishama fever- Guduchyádi-gbrita - Kalasyádi-ghrita - Mahá-kalyána-ghrita - Pancha- gavya ghrita- Triphala-ghrita-Pancha-sara-Medicated Tailas-Fumiga- tions and Anjanas-Treatment of shivering and burning sensation-General and specific treatment of the complications-Application of Vastis-Symp. toms of the remission of fever. ... 169-211

CHAPTER XL.

Symptoms and treatment of Diarrhœa, etc :- Causes-Patho- logy-Premonitory symptoms-Symptoms of Vataja-P'ittaja-Kaphaja and Tri-doshaja types-Symptoms of S'okaja and Amaja Atisara-Symp- toms of Ama and P'akva Atisara-I'rognosis-General treatment-Twenty different Recipes for Amatisara-Fasting-Six Yogas for Pittaja Atisára- Astringent remedies-Application of Ghrita-Putapaka-preparations- Peya-Treatment of thirst-Use of milk-Asthapana and Anuvasana Vastis -Pichchha-Vasti-Diet-Causes and symptoms of l'akvatisara-Treatment and Symptoms of Pravahika-General Treatment-Application of Vastis -Diet-Medical treatment-Yavagu-General principle of treatment- Indications of cure-Static or dynamic causes of diseases and treatment- Grahani-Premonitory symptoms of Grahani-Symptoms-Specific symptoms of Vátaja-Pittaja-Kaphaja and Tri-doshaja Grahani-Treat- ment and diet. ... ... .. 212-236

CONTENTS. ix

CHAPTER XLI.

Symptoms and Treatment of Phthisis :- Nomenclature-S'osha -Kshaya-Raja-yakshma-Etiology and general symptoms-Specific symptoms of Vataja-Pittaja and Kaphaja types-Prognosis-Other causes of S'osha and their symptoms-Premonitory symptoms-Prognosis-Treat- ment-Diet-Meat, etc -Utsadana-Medicated Ghritas-Eladi-mantha- Use of goat's flesh, milk, etc .- Rules of conduct. ... 237-245

CHAPTER XLII.

Symptoms and Treatment of Gulma :- Definition and Number- Localisation and Nomenclature-Premonitory Symptoms-Specific Symp- toms of Vátaja-Pittaja-Kaphaja and Tri-doshaja types-Symptoms of Raktaja Gulma-General Treatment of Vataja-Pittaja-Kaphaja-Tri- doshaja and Raktaja types - Uttara-Vasti - Anuvásana - Chitraka- ghrita - Hingvadi-ghrita - Dadhika-ghrita -Rasona-ghrita .- Ghritas in Pittaja-Raktaja and Kapbaja Gulma -Internal use of Kshara-Vris'chi- rarishta-Blood-letting-Diet and Sveda .- Peya-Khada-yusha-Fomenta. tion-Medicated plugs-Supervening symptoms - Prohibited articles- Causes and Symptoms of Sula-Symptoms of Vataja-Pittaja-Kaphaja and Sannipatika S'ula .- General treatment-Treatment of Vátaja- Pittaja-Kaphaja and Tri-doshaja S'ula .- Symptoms and treatment of Parsva-S'ula .- Symptoms and treatment of Kukshi-S'ula .- Symptoms and treatment of Hrich-chhula. -Sympton's of Vasti-S'ula-Mutra-S'ula -- Vit-S'nla and Annaja S'ula .- Then treatment. ... 246-264

CHAPTER XLIII.

Symptoms and Treatment of Heart-disease :- Etiology and Nomenclature-Number-Specific Symptoms of Vataja-Pittaja-Kaphaja and Krimija types -Supervening Symptoms-Medical trcatment of Vataja-Pittaja-Kaphaja and Krimija types. ... ... 265 -- 268

CHAPTER XLIV.

Symptoms and Treatment of Jaundice, etc. :- Etiology and Nomenclature-Premonitory Symptoms-Specific Symptoms of Vátaja- Pittaja - Kaphaja and Tri-doshaja types - Symptoms of Kamalá- Kumbba-Kamalá-Ligbaraka and Halimaka .- Supervening Symptoms-

CONTENTS.

General treatment -Treatment of - Kamalá-Kumbha-kámalá-Lágha- raka .- Articles of Diet-Treatment of Supervening Symptoms - Prog- nosis. ... ... ... ... ... 269-276

CHAPTER XLV. Symptoms and Treatment of Hæmorrhage :- Cause and Patho. logy-Prognosis-Premonitory Symptoms-Supervening Symptoms-Symp- toms of incurable types-General principles of treatment .- Emetic- Purgative-Fasting-Articles of fare-Diet-Lambatives-The best six Yogas-Asthapana and Anuvasana-Treatment of down-coursing typc- Uttara-vasti. ... ... ... 277-284

CHAPTER XLVI. Symptoms and Treatment of Fainting fits :- Definition-Classi- fication-Premonitory symptoms-Specific symptoms-General treatment -Specific treatment .- Symptoms of Sannyasa-Treatment-Incurable type-Diet. ... ... ... .. 285-288

CHAPTER XLVII. Symptoms and Treatment of Alcoholism :- Properties and action of wine-Evil effects of drinking-Three stages of Alcoholic intoxica- tion-Cases where wine is prohibited .- Specific symptoms of Panatyaya -symptoms of Vátaja-Pittaja - Kaphaja and Tri-doshaja types- Symptoms of Para-mada-Panajirna-and Pana-vibhrama -Prognosis- Treatment of Vataja-Pittaja-Kaphaja-Tri-doshaja and Dvi-doshaja types -Panaka-Treatment of Para-mada-Panajirna-Pána-vibhrama and Panatyaya-Treatment of Thirst-Remedies for Daha .- Symptoms and treatment of Raktaja -Dha .- Daha due to thirst-Accumulation of blood-Due to Kshaya-Due to hurt of Marma .- Their Treatment- Mode of drinking wine. ... ... 289-301

CHAPTER XLVIII. Symptoms and Treatment of thirst :- Etiology-Classification- Premonitory symptoms-Symptoms of Vátaja-Pittaja-and Kaphaja types .- Symptoms of Kshataja-Kshayaja-Amaja and Annaja thirst .- Prognosis-General treatment-Specific treatment-Treatment of Kshataja -Kshayaja and Amaja thirst .- General treatment. ... 302-308

CONTENTS. xi

CHAPTER XLIX.

Symptomsand Treatment of Vomiting :- Causes and Nomen- clature-Bremonitory symptoms-Specific symptoms of Vataja-Pittaja- Kaphaja-and Tri-doshaja types-Traumatic cases-Prognosis-General treatment-Treatment of Vataja-Kaphaja and Pittaja types .- Vomiting due to pregnancy .- Treatment of traumatic and Krimija types .- General treatment-Diet. ... ... ... 309-313

CHAPTER L.

Symptoms and Treatment of Hic-cough :- Causes-Derivation -Classification-Premonitory symptoms-Symptoms of Annaja-Yamalá -Kshudrika-Gambhirá-and Mahá-hikká .- Prognosis-Their treatment -Four liquid compounds-Meat as diet. ... ... 314-318

CHAPTER LI.

Symptoms and Treatment of Asthma :- Etiology-Classification -Premonitory symptoms-Specific symptoms of Kshudra-Tamaka- Pra-tamaka-Chhinna-Maha-and Urdhva-S'vasa .- Prognosis-General treatment. - IIinsradi-ghrita - S'ringvadi-ghrita-Suvahadi-ghrita-Tali- s'adi-ghrita - Meat as diet .- The five Lambatives-Utkariká-Articles recommended - Application of Sneha and Dhuma - Purging and Vomiting. ... ... ... ... 319-325

CHAPTER LII. Symptoms and Treatment of Cough :- Causes and Etiology- Classification-Premonitory symptoms -Specific symptoms of Vátaja- Pittaja-Kshataja and Kshayaja typcs .- General Treatment-Inhalation of Dhuma -Treatment of Vátaja - Pittaja - Kaphaja-Kshayaja and Kshataja Kasa. -Kalyana-guda-Agastya-Icha. ... ... 326 -- 337

CHAPTER LIII.

Symptoms and Treatment of Hoarseness :- Etiotogy -- Symptoms of Vátaja - Pittaja - Kaphaja and Tri-doshaja types. - Symptoms of Kshayaja and Medoja types -Prognosis-Gcneral Treatment-Treatment of Vátsja - - Pittaja - Kaphaja - Tri-doshaja - Kshayaja and Medoja types. ... ... ... ... ... 335-337

xii CONTENTS.

CHAPTER LIV.

Symptoms and Treatment of Worms :- Causes-Classification- Names and symptoms of Purishaja-Kaphaja -- Raktaja worms .- Specific causes-General symptoms - Prognosis-Their Treatment .- Treatment of Romada and Dantada worms-Diet. ... .. , ... 338-343

CHAPTER LV. Symptoms and Treatment of Udavartta :- Causes-Classifica. tion-Symptoms of Vataja-Purishaja-Mutraja Udavarta .- Repression of Yawning-Tears-Sneczing-Eructation- Vomiting - Seminal discharge -Hunger-Thirst-Breath and Sleep .- lhognosis-Their General Treat- ment-Their Specific treatment .- Treatment of Adhmana .- Udavartta due to errors of diet-Its treatment. ... . 344-351

CHAPTER LVI. Symptoms and Treatment of Visuchika :- Causes-Definiion -Symptoms-Alasaka-Vilambika -Prognosis - General Treatment -Ksharagada-Kalyana-lavana-Diet .- Causes and Symptoms of Anaha -Treatment. ... ... ... ... 352-356

CHAPTER LVII. Symptoms and Treatment of Arochaka :- Etiology-Classifica- tion-Symptoms of Vataja-Pittaja- Kaphaja and Tri-doshaja types. -Their Treatment - Four specific Lambatives - Regimen of diet - Use of decoction - Arishta and Asava. - Treatment of Manasa Arochaka. ... ... ... ... ... 357-360

CHAPTER LVIII. Symptoms and Treatment of suppression of Urine :- Classifica- tion-Symptoms of Vata-kundalika-Vatasthili-Vata-vasti-Mutratita -Mutra-jathara-Mutra-sanga-Mutra-kshaya - Mutra-granthi - Mutra- sarkara-Ushna-vata and two kinds of Mutrauka-sada .- General treatment -Application of Uttara-Vasti. ... ... 361-368

CONTENTS. xiii

CHAPTER LIX.

Symptoms and Treatment of the defects of Urine :- Classi- fication,Symptoms of Vátaja-Pittaja-Kaphaja and Sánnipátika types -Ulcer or injury in the Urethra-Mutra gháta due to Stone or Gravel- General Treatment-Treatmet of Vátaja-Pittaja-Kaphaja and Tri- doshaja types .- Treatment of Abhighataja and Purishaja types. 369-372

• Here ends the Kaya-chikitsa.

CHAPTER LX. Symptoms and Treatment of the diseases brought on through Superhuman influences :- Action of Graha-Causes of influence by a Graha-Indications of attack by Grahas-Deva-graha- Asura-graha-Gan- dharva-graha-Yaksha-graha-Pitri-graha- Bhujanga-graha - Rakshasa- graha and Pis'acha-graha .- Progonosis-Times of their Possession-Ex- planation of Bhuta-vidya .- General and religious treatment-Their specific religions treatment-Medical treatment-Special treatment. ... 373-380

CHAPTER LXI.

Symptoms and Treatment of Apasmara :- Derivative signi- ficance-Causes-Nomenclature-Premonitory Symptoms-Symptoms of Vátaja-Pittaja- Kaphaja and Sannipátaja types. - Discussion on its causes. - General treatment-Specific treatment - Siddhartha-ghrita- Pancha-gavya-ghrita-General treatment-Preparation of special wine- Venesection. ... ... ... ... .. 381-386

CHAPTER LXII. Symptoms and Treatment of Insanity :- Derivation-Classi- fications of Vataja-Pittaja-Kaphaja and Tri-doshaja types-Symptoms of S'okaja and Vishaja types-General treatment-Treatment by frighten- ing acts-Diet-Maha-Kalyana-ghrita - Kalyana-ghrita - Phala-ghrita- Vartis-Venesection. ... ... ... ... 387-391

Here ends the Bhuta-Vidya-Tantra.

xiv CONTENTS.

CHAPTER LXIII. Different Combinations of six different Rasas :- Taken two at a time-Three at a time-Four at a time-Five at a time-Six at a time- One at a time. .- ... ... ... ... 39-395

CHAPTER LXIV. Rules of Health :- Indications of Health-Its importance-Regimen of diet and conduct in the rainy season-Rules for autumn-Hemanta- Winter-Spring-Summer and for Pravrit .- Different kinds of food- When and how to be taken .- Ten proper times for administration of Medicines-Their names-Definitions and Effects-Proper time for taking food. ... ... ... ... 396-405

CHAPTER LXV. The Technical terms used in the treatise :- Names of the Technical terms-Necessity-Their definitions and examples. 406-413

CHAPTER LXVI.

The different Modifications of the different Doshas :- Number of different diseases .- Number of drugs .- Different combinations of the three Doshas-Their number. ... ... 414-416

End of the Contents of the Uttara-Tantra.

:0 :-

अ्रं

THE

SUSHRUTA SAMHITÁ.

UTTARA-TANTARAM.

(SUPPLEMENTARY PART OF THE TREATISE).

CHAPTER I.

Now we shall discourse on the chapter which deals with the diseases, viz., of the eye, etc. (Aupadravi- kam adhyayam). I. Here commences that portion of the Susruta Samhitá which is known as the Uttara Tantra (the supplementary part) to which references have been often made in the preceding one hundred and twenty chapters, as the fit place wherein to revert in detail to the topics cursorily mentioned therein. This part comprises within it the specific descriptions of a large and a varied number of diseases, viz., those which form the subject matter of the Salakya-Tantra (Diseases of the eye, ear, nose and throat) as narrated by the king of Videha; the ætiology and symptomatology, etc. of diseases peculiar to infants and women(Kaumara- bhritya), the pathology, etc., of those diseases mentioned in the six books of the Practice of Medicine par excellence (Kaya-chikitsa) compiled by the holy sages of pld and diseases known as Upasarga (e.g. Bhutopasarga

2 THE SUSHRUTA SAMHITÁ. [ Chap. I.

-Demonology) as well as discases of traumatic origin are also included in this supplementary text *. Herein are also mentioned the sixty-three combinations .of the six different Rasas (tasces) as well as the laws of health and hygiene with their rationale (rules, interpretation and reasonings) and the classifications of different Doshas and organic principles of the body and various accessories and remedial agents required for their successful treatment and curc. 2. I shall now begin with the description of the num- bers, the pathology and the curability or incurability of those specific aiiments of the body which are peculiar to the region of the head out of a myriad of other distempers reserved for treatment in this portion of the work (Uttara-tantra) which may be compared to the unfathomable deep in respect of the vastness of its depth and magnitude. 3. Diseases of the eye and its append- ages :- The cye-ball (Nayana-Budbuda) is two fingers (about an inch) in transverse diameter, about the breadth of onc's own thumb in depth (Sagittal diameter), and two fingers and a half all round (in circumference). The eye-ball is almost round in shape and resembles the teat of a cow. It is made up of all the (five) elements of which the universe is built up. The element of the 'soiid' earth (Bhu) contributes to the formation of its muscles, the elcment of 'heat' (Agni cr Tejas) is in the blood (that courses in its veins and arteries), 'the gascous element' (Vayu) contributes to the formation of the black part (Iris, etc.) in which the pupil is situated, the fluid element (Jala) preponderates in the 2lucid

(1) The text has A'gantuka (traumatic 'diseases). Gayadăsa explains it to mean Apasmára, Unmáda, etc. (Hysteria, insanity, etc.).

Chap. I. ] UTTARA-TANTARAM. 3

(white) part (Vitrcous body) and the void (ethereal) Space (Akâsa) is there to form lachrymal or the other ducts or sacs (Asrumarga) through which the secretions are discharged. 4. ' I shall now proceed to describe the Drishti (the cen- tral part of Retina-'Macula Lutea') as set forth by expert ophthalmic physicians. The black portion of the eye (Krishna-mandala-Choroid) forms one third part of its whole extent whilc the Drishti, according to them, occupies only one-seventh part of the Krishna-mandala. The Mandalas or sub-divisions or circles of the eye-ball, the Sandhis or Joints (parts where these sub-divisions meet with one another) and the Patalas (layers or coats) of the eye are respectively five, six and six in number. 5-6. Mandala and Sandhi :- The Mandalas of the eye are the following, viz., (1) the Pakshma-mandala (the circle of the cye-lashes), (2) the Vartma-mandala (the eye-lid) (3) the Sveta-mandala (the Sclerotic and Cornea), the Krishna-mandala (the choroid) and (4) the Drishti- mandala (the pupil). These circles are so arranged that the one preceding lies within the next in the list .* The Sandhis (which serve as lines of demarcation of the circles) already pointed out are six in number, the first binding the eye-lashes (Paksha-mandala) with the eye- lids (Vartma-mandala), the second the eye-lids and the Sclerotic coat (Sveta-mandala), the third binding the latter with the Krishna-mandala (choroid), the fourth situated between the latter and the Drishti-mandala, the fifth lying in the interior corner (Kaninakas) and the last (sixth) in the exterior (posterior) corner (Apángas) of the eye. 7-8. * Evidently some line or lines are missing here as the line cannot give a complete sense by itself. Ed.

4 THE SUSHRUTA SAMHITÁ. t Chap. I.

The Patalas :- Of the Patalas, two are in the eye-lid (Vartma-mandala) and four in the eye proper, wherein occurs the dreadful discase known as the Timira (loss of vision). Of these four the first or ante- rior coat (Patala) supports the humour Jala and light ( Tejas), * the second coat or Patala (choroid) is supported by muscles ; the third coat or Patala (Sceroim and Cornea) consists of Medas (lit. fat) and there is the fourth which is a fifth part of the whole and is known as the Drishti. There are, however, divisions and sub- divisions of these coats. 9. The different parts of the cye-ball are held together by the blood-vessels, the muscles, the Vitreous body and the choroid.+ Beyond the choroid, the eye-ball is held (in the orbit) by a mass of Śleshmá (viscid substance-capsule of Tenon) supported by a number of vessels. The deranged Doshas which pass upward to the region of the eyes through the channels of the up- coursing veins and nerves give rise to a good many dreadful diseases in that region. I0. Purva-rupa, etc. :- Cloudiness of vision, slight inflammation, lachrymation, mucous accumulation, heaviness, burning sensation, sucking pain (D. R .- aching pain) and redness in the eyes are indistinctly manifest (in the incubatory stage) in such cases. In cases of an in- flammation of the Vartmas (eye-lids) the eye seems as if studded with the bristles of worms (Suka) and attended with pain (as if pricked into with thorns) and a sensible impairment of the faculty of the eyes in detecting

• By "Jala" is meant here the serum (Rasa) in the skin, and by "Tejas" the blood in the veins (Sirá) carrying the (Tejas) known as the A'lochaka. t D. R. vessels, muscles and aqueous humour (Medas) are most important for the maintenance of Krishna-mandala.

Čhap. I. ] UTTARA-TANTARAM.

colours and in closing and opening the eye-lids freely. An intelligent physician will conclude from these symp- toms that the eyes have been affected by the (deranged) Doshas, with a due consideration whereof the remedies should be (carefully) administered, otherwise the eye- diseases might become too serious. The simple maxim or principle to be followed in the treatment of a disease is simply to forego the primary pathological causes of that disease. The spccial remedial measures that would pacify the different Doshas, Vâyu, etc. have been des- cribed in detail. 12-13. Causes of Eye-disease :- The local Doshas deranged and aggravated by such causes as diving in water immediately after an exposure to the heat and the glare of the sun, (constant) gazing at dis- tant objects, slecp in the day time and keeping up late hours in the night, fixed and steady gazc, excessive weeping or over-indulgence in grief, worry and fatigue, a blow or a hurt, sexual excesses, the partaking (in inor- dinate quantities) of Sukta, Áranála (fermented rice-water), acid gruel, Másha pulse, and Kulattha pulse, voluntary repression of any call of nature, exposure (of the eyes) to smoke or dust, trickling down of the drops of sweat (into the eyes), excessive or impeded vomiting, re- pression of tears, constant contraction of the eyes to adjust the sight to extremely small objects, etc., beget disorders of the organs of vision. 14. Classification of the Eye-diseases : -Seventy-six different kinds of eye-diseases have been come across in practice; of these ten are ofiginated by the deranged Vayu, ten by Pitta and thirteen by Kapha. Sixteen are produced by vitiated blood, and twenty-five by the concerted action of the deranged Doshas (Tri-Doshaja), and lastly, two are produced by

6 THE SUSHRUTA SAMHITA. [Chap. I.

external causes i. e., they are traumatio in their origin. 15. Prognosis of the Vataja Type :- Of the diseases of the eyes which are due to the actiòn of the deranged Váyu, those known as Hatádhimantha, Nimi- sha, Gambhirikâ affecting the vision, and Váta-hata- vartma (Váyu-afflicted Sclerotic coat) is said to be incur- able. A temporary cure (Yápya) is all that can be effected in a case of Kácha (cataract) duc to the action of the deranged bodily Váyu ; while the affection of the eyes known as the Anyato-Vata, Adhi-mantha (ophthalmia), Sushkakshi-páka, Abhishyanda and Maruta-Paryaya are curable. 16. Prognosis of the Pittaja Type :- Of the diseases due to the deranged action of the Pitta known as Hrasva-jádya and Jala-srâva should be deemed incurable; and palliative measures are the only remedies in cases of Kàcha, Parimlàyi and Nila, while Abhishynda, Adhi-mantha Amládhyushita, Sùktiká, Pitta-Vidagdha-Drishti, Pothaki and Lagana are cur- able. 17. Prognosis of Kaphaja Type :- Of the diseases due to the aggravation of Kapha, the one known as the Srava-roga is incurable and (Kaphaja) Kácha (cataract) admits of only palliative treatment, while a cure may be be cffccted in the following cases, viz,, Abhishyanda (conjunctivitis), Adhi-mantha, Balása- Grathita, Sleshma-Vidagdha-Drishti, Pothaki, Lagana, Krimi-granthi, Pariklinna-Vartma, Suklárma, Pishtaka, Śleshmo-panáha. 18. Prognosis of the Raktaja Type :- Of the diseases of the eyes due to the vitiated condition of the blood, those known as Raktasráva, Ajakájâta, Avalambita (pendent), Sonitársas and Sukra-roga should

Chap. I.] UTTARA-TANTARAM. 7

be regarded as incurable, and the type of sKácha (cata- ract) due to the same cause admits of only palliative measures, while the diseases known as Adhi-mantha, Abhishyanda, Klishta-vartma, Sira-harsha and Sirotpàta, Anjana, Sirâ-jàla, Parvani, Avrana (non-ulcerated), Sukra- roga, Sonitárma and Arjuna may be included within the group of curables. 19. Prognosis of the Tridoshaja Type, etc. i-Of the eye-diseases due to the concerted action of the three aggravated Doshas, those known as Puya- sráva, Nakulándhya, Akshipákátyaya and Alaji are incurable and palliative measures are only possible in cases of Kâcha (cataract) or Pakshma-kopa ; while those known as Vartmávabandha, Sırája-pidakâ, Prastár- yarma, Adhi-mánsárma, Snayvarma, Utsangini, Puyà- lasa, Arvuda, Syáva-vartma, Kardama-vartma, Arso- vartma, Sukrársas, Sarkará-vartma, the two forms of inflammation with or without local swelling known as) Sasopha-páka and Asopha-páka, Bahala-vartma, Kumbhiká and Visa-vartma yeild to the curative efficacy of appropriate remedial agents. Both the forms of eye-disease due to the external causes* should be considered as incurable. 20-21. Their Localities :- Thus we have finished enumerating the seventy-six types of eye-diseases, of which nine are confined to the Sandhis (binding unions), twenty-one to the Vartma (eye-lids), eleven to the Sukla-bhaga (the Vitreous body), four to the Krishna bhaga (the region of the Choroid), seventeen to the entire region (eye-ball) and twelve td the region of the Drishti (pupil or the "crystalline lens, etc.). The

*The one due to any external blow or hurt (Sa-nimitta) and the other originating from the sudden sight of any celestial being of extreme brilli- ancy (A-nimitta),

8 THE SUSHRUTA SAMHITA. [Chap. I.

two cases due to the extraneous cause (are chiefly located in the Drishti though affecting the whole of the eye-ball and) arc very painful and incurable, The characteristic symptoms of all thesc will be hereafter described in detail. 22-23.

Thus ends the first chapter of the Uttra-tantra in the Sus'ruta Samhitá which deals with the diseases, viz. of the eye, etc.

CHAPTER II. .

Now we shall discourse on the chapter which deals with the pathology of diseases which are peculiar to the joints or binding membranes of the eye (Sandhl- gata-Roga-Vijnaniya). The names of those diseases :- Diseases peculiar to the joining (Sandhi) of the eye are nine in number and are named Puyálasa, Upanáha, (the four kinds of) Sráva (viz. Puya-sráva, Sleshma-sráva, Rakta- sráva, Pitta-sráva), Parvani, Alaji and Krimi-granthi. 2. Symptoms of Puyalasa and Upa- naha :- A suppurated swelling occurring at any of these joining and exuding a sort of fetid and dense * pus is called Puyalasa. A painless cyst (Granthi) of considerable size occurring at the union of the pupil (with the Krishna-mandala) and attended with an itching sensa- tion and a little suppuration is called Upangha. 3. A. Symptoms of Srava :- The ( deranged ) Doshas + of the locality passing through the lachrymal ducts into the binding tissues of the four different Sandhis (joinings) set up a painless $ secretion (Sráva) from the localities characterised by the specific symp- toms of the different Doshas involved. These are known as Sravas, which according to some, are also called

• According to Mádhava's reading, the swelling should be painful (uare:). There is no mention whether the pus should be dense (arg) or otherwise. + The term "Dosha" here means S'leshmá, Pitta, Rakta (blood) and the concerted action of the above three Doshas. It should be noted that Vayu is excluded from the list as it does not produce any secretion, Mâdhava does not mention this (painlessness) to be a symptom. 2

IO THE SUSHRUTA SAMHITA. [ Chap. II.

Netra-nádi and are classified into four different groups, the different symptoms of which will be described presently. A suppuration (D. R. swelling) in any of the unions (Sandhi) of the eye marked by a discharge of pus is called Puya-srava. This is due to the concerted action of the Doshas (Kapha, Pitta and blood). The secretion of slimy, white and thick muco-purulent discharges marked by the absence of pain * is called Sleshma-srava. The flow of thin, warm+ and blood-streaked copious discharge due to a contaminated state of the local blood is called Rakta-srava. A warm, water-like and yellowish blue (D. R. reddish yellow) discharge from the middle part of the union (owing to the deranged condition of the Pitta) is called Pitta-srava. 3- Symptoms of Parvani, etc. :- A small, round and copper-coloured swelling occurring at the join- ing of the Krishna-mandala and Sukla-mandala, due to the vitiated state of the local blood and attended with a burning sensation and aching pain, is called Parvani. A swelling possessed of the preceding features and occurring at the very same joining is called Alaji (Kera- titis) t. A cyst or swelling (Granthi) characterised by an itching sensation appearing on the joining of the eye-lids and eye-lashes owing to the germination of parasites (Krimi) in those localities, is called Krimi-granthi. Parasites of different forms in such a case are found to infest the regions where the inner lining of the Vartma-

• According to Mâdhava's reading, the absence of pain is not a necessary concomitant in this case. + According to Mâdhava's reading thinness and warmness are not essential. $ The difference between a case of Parvani and that of Alaji is that the swelling in a case of Parvani is smaller, and that in the Alaji is larger.

Chap. If. ] UTTARA-TANTARAM. IT

mandala (eye-lid) is connected with the Sukla-mandala (Sclerotic coat) of the eye and to invade and vitiate the substance of the eye-ball. 4-5.

Thus ends the second chapter of the Uttara-Tantra in the Sus'ruta Samhitâ which deals with the pathology of the diseases peculiar to the Sandhi (unions) of the eye.

CHAPTER III.

Now we shall discourse on the chapter which deals with the pathology of diseases peculiar to the region of the eye-lids (Vartmagata-Roga-Vijnaniya). I. Causes and Names :- The Doshas of the body jointly or severally expanding through the nerves and veins, (Sira) of the eye-lids (Vartma) bringing about an augmentation of the quantity of the blood and the growth of the flesh in the localities (determina- tion of blood toward formation of fleshy growth in the affected parts) give rise to a host of local diseases which are known as Utsangini, Kumbhikâ, Pothaki, Vartma-Sarkara. Arso-vartma, Sushkârsas, Anjana, Bahala-vartma, Vartmâvabandha, Klishta-vartma, Kar- dama-vartma, Syáva-vartma, Praklinna-vartma, Pari- klinna-vartma, Vatáhata-vartma, Arvuda, Nimisha, Soni- tarsas, Lagana, Visha-vartma and Pakshma-kopa. These twenty-one diseases are restricted to the eye-lids (Vartma). 2. The Specific symptoms of the dis- eases of the eye-lids :- The names of these have been enumerated ; now hear me describe their specific symptoms. A (rolled up and indented) boil or eruption (Pidaka) appearing along the lower eye-lid on its exterior side with its mouth or head directed inward is called Utsangini. A number of boils or pustules (Pidakâ) to the size of a Kumbhika seed ap- pearing on the joint of the eye-lids and the eye-lashes and becoming inflamed after being burst is called Kumbhika *. 3-4. * This disease (Kumbhika) is due to the concerted action of the three Doshas.

t Chap. IIL. UTTARA-TANTARAM. 13

A number of red and heavy (hard) boils or pustules (Pidaká) resembling red mustard seeds attended with pain, itching and exudation is called Pothaki. A rough and large pustule (Pidaká) surrounded by other very small and thick erythematous pustules (covering the entire length of the eye-lid) is called Vartma-sarkara. 5-6. Vegetations of small (D. R. soft) and rough papilæ (Pidakâs) on the eye-lid resembling Erváruka seeds and attended with very little pain are called Arso-vartma. Long, rough, hard, and numbed papilæ (Amkura) on the eye-lid (2) are called Sushkarsas. 7-8. A small, soft, copper-coloured pustule (Pidakâ) appearing on the eye-lid and attended with burning, pricking sensation and a slight pain is called an Anjana. Vegetations of pustules (Pidaká) of equal size (D. R .- attended with hardness) occurring all along the eye-lid and resembling it (or each other) in colour are called Bahala-vartma. 9-10. Such swelling of the eye-lid attended with an itching sensation and a slight pain as impedes or interferes with its being evenly opened is called Vartma-bandha. A mild and copper-coloured inflammatory swelling of both the eye-lids simultaneously attended with a slight pain and changing suddenly into redness (D. R .- suddenly discharging blood therefrom) is called Klishta- vartma. 1I-12. A case of Klishta-vartma in which the Pitta has deranged and affected the blood and much dirty matter (mucus) is discharged as a consequence is called a case of Vartma-kardama. A dark brown colour of the eye-lids both internally and externally marked by a (2) According to Mâdhava, the papilæ in such cases occur in the inner side of the eye-lid.

14 THE SUSHRUTA SAMHITA. { Chap. IÍI.

swelling (D. R .- pain) and attended with a discharge of pus and with burning and itching sensations is called Sydva-vartma. 13-14. An external swelling of the eye-lid with a deposit of mucous matter in its inner surface accompanied with a little pain as well as a discharge, itching and pricking sensation, is called a Praklinna-Vartma. A sticking to- gether of the eye-lids even in the absence of any suppura- tion and in spite of the eyes being constantly washed (with water) * is called Pariklinna-vartma. 15-16. The drooping down (lit .- inactivity) of the eye-lids, whether attended with any pain or not, (so as to obstruct the opening of the eye-lashes) where the eye- lids seem to be out of joint is called Vatahata-vartma. A red and knotty swelling (Granthi) of an uneven size or shape, growing hastily on the interior side of the eye-lid and attended with a little pain is called an Arvuda or tumour. 17-18. Constant wrinklings of the eye-lids owing to the incarceration of the (deranged) Vayu within the nerves or veins (Sirâ) controlling their wrinkings (closing and opening) are known as Nimesha. Soft and fleshy growths (Amkura) on the eye-lid which reappear even after being removed with a knife, and are attended with pain, itching and burning sensation are called Sonitarsas and should be ascribed to the vitiated condition of the blood. 19-20. A thick, slimy, hard and painless nodular swelling (Granthi) on the eye-lid resembling a Kola fruit in size and marked by an itching sensation and absence of sup- puration is called Lagana +. An inflammatory swelling

• A different reading reads 'whether washed or not.' This, however, not a good reading. + Certain editions read Nagana.

Chap. III. ] UTTARA-TANTARAM. 15

of the eye-lid dotted with minute punctures like the pores in the stem of a water-soaked lotus plant is called Visa-vartma. 21-22. An accumulation of the deranged Doshas about the eye-lashes makes them rough and sharp-pointed, which give pain to the eye and give relief when drawn off. The disease is known as Pakshma-kopa in which the eye cannot bear the least wind or heat or the glare of fire. 23.

Thus ends the third chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the pathology of the diseases of the eye-lids.

CHAPTER IV. . Now we shall discourse on the chapter which deals with the pathology of diseases of the Sclerotic coat (white coat) of the eye (Suklagata-Roga-Vijnaniya). I. Names :- The eleven different forms of diseases which are peculiar to the Sclerotic coat (white) of the eye, are Prastâryarma, Suklârma, Kshatajàrma (Raktâ- rma), Adhimânsârma, Snáyvarma, Suktikâ, Arjuna, Pishtaka, Sirâ-jâla, Sirâ-pidakâ, and Balâsa-grathita. 2. Symptoms :- A thin and extended glandular swelling (Granthi) coloured reddish blue and apearing on the Sclerotic coat (Sukla) is called Prastaryarma. A crop of soft and whitish growths slowly extending over the entire length of the Sclerotic coat is called Suklarma. The fleshy growth on the white coat of the eye resembling a (red) lotus flower in colour is called Lohitarma. The soft, extended, thick and dark- brown and liver-coloured growth of flesh on the white coat is called Adhi-mansarma. The rough, yellowish (D. R. white) growth of flesh on the white coat, and gaining (slowly) in size, is called Snayvarma. 3-7. The appearance of dark brown specks resembling flesh in colour or of those having the colour of an oyster-shell on the white coat (Sukla) of the eye is called Suktika. The appearance of a single dot or speck on the Sclerotic coat (Sukla), coloured like a (drop of the) hare's blood, is called Arjuna. A raised and circular dot or speck appearing on the white coat and coloured white like pasted rice and (as transparent as) water is called Pishtaka. Red and extensive patches of hardened veins spreading over the white coat and looking like a net-work is called Sira-jala. The

Chap. IV. UTTARA-TANTARAM. 17

crop of white pustular growths (Pidaka) on the Sclerotic coat (Sukla), near the limit of the black coat (Iris) and covered over with shreds of veins are called the Sira- Pidaka. The disease in which a speck coloured like the Indian bell-metal (Kàmsya) and covered over with a vein (Sirá) appears on the region of the Scleratic coat is called the Balasa *. 8-13.

Thus ends the fourth chapter of the Uttara-Tantra in the Sus'ruta Sam- hita which treats of the pathology of the diseases of the Sceloretic region of the eye.

• The reading in Mâdhava's Nidâna is quite different here, and Dallana seems to support that. It is defined as the disease in which a hard speck appears like a drop of water on the white coat and looks like bell-metal in colour.

3 3

CHAPTER V.

Now we shall discourse on the chapter which deals with the pathology of the diseases of the black part of the eye-Choroid including the Iris (Krishna-gata- Roga-Vijnaniya). I. The diseases which are found to invade the region of the Choroid including the Iris (Krishna-mandala) have been briefly said to be four in number. Their names are Sa-vrana-Sukra, A-vrana-Sukra, Pakátyaya and Ajakâ, 2. Symptoms :- A puncture-like dip in the region of the (Krishna-mandala) with a sensation there as if the part has been pricked with a needle and attended with an excruciating pain and a hot exudation is called Sa-vrana-Sukra. If the seat of this disease consider- ably remote from the pupil-entire part of the Drishti (Retina) be marked by the absence of pain and discharge and be not deep-seated and if there be not double spots, it offers very little chance of remedy. 3-4. Symptoms and Prognosis of A-vra- na-Sukra :- A whitish film appearing on the region of the Choroid including the Iris (Krishna) like a speck of transparent cloud in the sky, and attended with lachrymation and slight pain due to the eye-disease known as Abhishyanda (Ophthalmia-lit. secretion) is called the A-vrana-Sukra. This is easily curable. A case of Avrana-Sukra (non-ulcerated film) which is thickened, deep-seated and long-standing, may be cured only with the greatest difficulty, while an long-standing case of this disease, if it is mobile, covered with shreds of flesh, vein-ridden, stretching down to the second layer of skin (in the eye) and obstructing the vision,

Chap. V.] UTTARA-TANTARAM. 19

severed in the middle and marked with a reddish tint in the extremities, should be deemed as incurable. Several authorities aver that the appearance of Mudga- like specks or films on the region of the Iris, attended with growths of pustules and hot lachrymations, should be like-wise regarded as incurable. The fact of its (speck) assuming the colour of the feather of a Tittira bird is an additional indication of the incurable nature of this disease. 5. The appearance of a whitish milky film over the black part of the eye slowly shrouding it entirly with its mass and attended with acute pain is known as the Akshi-Pakatyaya. This is invariably found to result from an attack of Akshi-kopa* and is due to the concerted action of all the Doshas. A painful reddish growth, like the head of a goat, found to shoot forth from beneath the surface of the black part and attended with reddish slimy secretion is called an Ajaka. 6-7.

Thus ends the fifth chapter of the Uttara-Tantra in the Sus'ruta Sam- hita which treats of the pathology of the diseases of the black part of the eye.

• According to Madhava's reading in his Nidâna, this disease need not necessarily result from an attack of Akshi-kopa, and there need not be an acute pain, and it would be incurable.

CHAPTER VI. D Now we shall discourse on the chapter which deals with the (symptoms and) pathology of the diseases affecting the eye as a whole (Sarva-gata-Roga- Vijnaniya). I. Names and causes :- The four types of Abhishyandha (Ophthalmatis), the four types of Adhi- mantha, the two forms of Akshi-páka (suppuration of the eye) attended with or without swelling, these ten, as well as Hatádhimantha, Anila-Parjáya, Suskákshi- páka, Anyato-váta, Amládhyushita, Drishti, Śirot- páta and Sirá-Harsha are the names of the (seventeen kinds of) diseases which affect the eye as a whole. Nearly all these forms of eye-diseases may result from the Abhishyanda (Ophthalmitis). Hence a wise physician shall try speedily to remedy a case of Abhishyanda (Ophthalmitis ) as soon as it is found out. 2. Specific symptoms of Abhishya- nda :- The symptoms which mark a case of Abhi- shyanda due to the action of the deranged Vayu are pricking pain (in the eyes), numbness, horripilation and irritation in the eyes, roughness and parchedness of the organ, cold lachrymations and headache. A case of Pittaja-Abhishyanda exhibits the following features, vis., burning and inflammatory suppuration of the eyes, longing for coldness (in the eyes), excessive hot lachry- mations, cloudy vision and a yellowness of the eye. In the Kaphaja type of the disease, the affected organ longs for the contact of warm articles and is attended with a heaviness, itching sensation, swelling, excessive whiteness and a constant deposit and discharge of slimy mucus. The special type of this disease which has

Chap. VI. ] UTTARA-TANTARAM. 21

its origin in the vitiated condition of the blood, i. e., the Raktaja type is marked by redness of the eyes, flow of copper-coloured tears, as well as the symptoms of the Pittaja type of the disease and the presence of deep red stripes all along. 3-6. Causes of Adhimantha :- All the (four) forms of chronic Abhishyanda, if not properly attended to and remedied at the outset, may run into as many cases of Adhimantha which is attended (invariably) with an excruciating pain in the eye, which seems as if being torn out, the pain extending upward to and crush- ing, as it were, the half the region of the head. The characteristic symptoms of the Doshas involved in each case are also seen to supervene. 7. Symptoms of Vataja Adhimantha :- In the Vataja typc of Adhimantha the eye becomes cloudy and seems as if being torn out and churned as with an Arani (fire-producing wooden stick) attended with an irritating, piercing and cutting pain, as well as with a swelling of the local flesh, and a half of the head (on the side of the affected eye) is afflicted with a twisting and cracking sensation as well as with local swelling, shivering and pain. 8. Symptoms of Pittaja Adhimantha :- The symptoms which mark the Pittaja type of Adhi- mantha are the blood-streaked eye attended with secre- tion and a sensation therein of being burnt with fire, as well as swelling, perspiration and suppuration in the affected organs, yellowish vision, fainting fits and a burning sensation in the head. The eyes in this case become liver-coloured and seem as if ulcerated or rubbed with an alkali. 9. Symptoms of Kaphaja Adhimantha : -In the Kaphaja type of Adhimantha the eye is

22 THE SUSHRUTA SAMHITÁ. [ Chap. VI.

swollen with a slight congestion (inflammation). Dis- charges with a sensation of itching, coldness and heavi- ness in the localities set in, and there is horripilation. The eye becomes slimy with deposit of mucous matter. The sight becomes cloudy, the nostrils are dilated, the head aches and all objects seem to be full of dust. I0. Symptoms of Raktaja Adhimantha : -A pricking pain in and a blood-streaked secretion from the affected organ which looks (bright red) like a Bandhujiva flower, are the symptoms which mark the type of Raktaja Adhimantha (due to the vitiated blood). The eye becomes painful and incapable of bearing the least touch or contact, and the objects of vision seem as if enveloped in flames. The extremities of the eye become red and the whole origin of the cornea (black coat of the eye) looks like an Arishta fruit submerged in blood. II. The prognosis :- A course of injudicious diet, conduct or medical treatment may usher in the blindness of vision in seven days from an attack of the Kaphaja type of Adhimantha (Ophthalmia) and in five days from that of the blood-origined (Raktaja) type, in six days in a case of the Vátaja Adhimantha and instantaneously within three days of the attack) in-the Pittaja type of (i. e., Adhimantha. 12. Symptoms of Sa-sopha and A-opha Akshi-paka :- A case of Sa-sopha-Netra-paka exhibits the following symptoms, vis., itching sensation, deposit of mucous matter (in the eye), lachrymation and a redness of the eye like the colour of a ripe Udumbara fruit. There is a burning sensation in the eye-ball which becomes copper-coloured, heavy, and attended with a pricking pain and horripilation. The eye becomes swollen and constantly secretes either cold or hot slimy

Chap, VI. ] UTTARA-TANȚARAM. 23

discharges, and ultimately suppurates. All these symp- toms except swelling mark the (non-swollen) A-sopha- Netra-paka type of the disease. 13. The deranged Vayu getting incarcerated in the optic nerve (Sirá) impairs the faculty of sight, and gives rise to an incurable disease which is called Hatadhimantha (blinding Ophthalmia). A shifting pain experienced sometimes in the region of the eye-lashes* or of the eye-brows and sometimes in the region of the eye, owing to the coursing of the deranged and incarcerated Váyu in those localities, is called Vata-Paryaya. 14-15. The disease in which the eye-lids become dry and hard and remain always closcd, the vision becomes cloudy and hazy, and it becomes very painful to open the eye-lids, is called the Sishkakshi-paka.+ The excessive pain in the eyes or in the eye-brows due to the action of the deranged Vayu incarcerated in the region of the head, the cars, the cheek-bones, the back of the neck (Avatu), the Manyá (a particular nerve on either side of the neck), or in any other (adjacent) place, is called the Anyato-vata. 16-17. The swelling of the eye attended with a bluish red tint all about, owing to the partakings of meals com- posed of an unduly large proportion of acid articles, or of such food as is followed by a digestionary acid re- action, is called the Amladhyushita-Drishti. The disease in which the veins all over the eye become copper-coloured and are frequently discoloured, whether attended with pain or not, is called the Sirotpata. 18-19.

• Mádhava in the Nidána does not mention the eye-lashes. t Mádhava in the Nidána reads "wa" which means that a highly burning sensation is produced in the affected eye, in place of "faein" -- a word which seems redundant.

24 THE SUSHRUTA SAMIIITA. [ Chap,, VI.

A case of Sirotpáta, if not attended to and remedied in time through ignorance, gives rise to transparent and copper-coloured discharges in copious quantities from the eyes and produce a complete blindness of vision. This is known as the Sira-harsha. 20.

Thus ends the sixth chapter of the Uttara-Tantra in the Sus'ruta Samhita which treats of the diseases affecting the eye as a whole.

CHAPTER VII.

Now we shall discourse on the chapter which deals with the pathology of the diseases which are peculiar to the Drishti (pupil) of the eye (Drishti-gata- Roga-Vijnaniya). I. Experts well-versed in the anatomy of the eye aver that the Drishti (pupil) of the eye is the quintessence of the five material clements with that of the eternal light predominating therein-this principle of light neither increasing nor decreasing in this case. It is naturally accustomed to cold from the very naturc of its tempera- ment and is covered by the outer coating (Patala) of the organ proper. It looks like a hole and is equal in dimension to that of a Masura sced or pulse *. The pupil of the eye resembles in its action the phosphores- cent flash of a glow-worm or that of a minute particle of fire (in not burning the things coming in contact with it). Now we shall describe the pathology of the twelve kinds of disease peculiar to the region of the Drishti (pupil), as well as of the one which is known as Timira (loss of vision) affecting the Patala (coating over the pupil). 2. All external objects appear dim and hazy to the sight when the deranged Doshas of the locality passing through the veins (Sirá) of the cye, get into and are incarcerated within the first Patala (innermost coat) of the pupil (Drishti). 3 Symptoms-when second , Patala attacked :- False images of gnats, flies, hairs, nets or cob-webs, rings (circular patches), flags, ear-rings appear

• According to Nimi, quoted in Mádhava's commentary by S'rtkantha, the dimension of the Drishti is equal to only a half of that of a Masura- pulse.

26 THE SUSHRUTA SAMHITA. [ Chap. VII.

to the sight, and the external objects seem to be enveloped in mist or haze or as if laid under a sheet of water or as viewed in rain and on cloudy days, and meteors of differ- ent colours scem to be falling constantly in all directions in the event of the deranged Doshas being similarly con- fined in the second Patala (coat) of the Drishti. In such cases the near appearance of an actually remote object and the contrary (Miopia and Biopia) also should be ascribed to some deficiency in the range of vision (error of refraction in the crystalline lens) which in- capacitates the patient from looking through the cye and hence from thrcading a ncedlc. 4. Symptoms-when third Patala attacked :- Objects situate high above are seen and those piaced below remain unobserved when the de- ranged Dosha are infiltrated into the Third Patala (coat) of the Drishti. The Doshas affecting the Drishti (crystal- line lens), if highly cnraged, impart their specific colours to the objects of vision. Even large objects seem to be covered with a piece of cloth. The images of objects and persons with ears and eyes, etc., seem to be otherwise i.e., bereft of those organs. The deranged Doshas situated at and obstructing the lower, upper and lateral parts of the Drishti (crystalline lens) respectively shut out the view of near, distant and laterally-situate objects. A dim and confused view of the external world is all that can be had when the deranged Doshas spread over and affect the whole of the Drishti (crystalline lens). A thing appears to the sight as if cutlinto two (bifurcated) when the deranged Doshas affect the middle part of the lens, and as triply divided and severed when the Doshas are scattered in two parts ; while a multifarious image of the same object is the result of the manifold distribu- tions of movability of the Doshas over the Drishti. 5.

Chap. VIİ. ] UTTARA-TANTARAM. 27

Symptoms-when fourth Patala attacked :- Loss of vision (Timira) results from the fact of the deranged bodily Doshas being confined within the fourth Patala (choroid) of the organ. When the vision is completely obstructed by the aforesaid cause, it is called a case of Linga-nasa (blindness). Only a faint per- ception of the images of the sun, the moon and the stars, the heaven, a flash of lightning or any other such highly brilliant objects is possible in a case of superficial (not deep-seated) Linga-nása. The Linga-nása (blindness) is also called Níliká and Kácha. 6. Specific traits of Timira :- All external objects are viewed as cloudy, moving, crooked and red- coloured in the Vataja type (of Timira), while in the Pittaja typc they appear to be invested with the different colours of the spectrum or of the rain-bow, of the glow- worm, of the flash of lightning, or of the feathers of the pca-cock, or with a dark blue tint bordering on black ; while in a case of Kaphaja Timira, a thick white coat like that of a pack of white clouds or a deep white chowri (Chámara) seems to intervene in everything which look white and oily and dull and appear hazy and cloudy in a finc day, or as if laid under a sheet of water. In a case of the Raktaja type of Timira, all objects appear red or envoloped in gloom, and they assume a greyish, blackish or variegated colour. In a casc of Sannipatika Timira, the outer world looks vareigatcd and confused, appears as doubled or trebled to the vision (of the patient), and stars and planets, either defective or supplied with addi- tional limbs, seem to float about in the vision. 7-II. Parimlayi :- The quarters of the heaven look yellow and appear to the sight as if resplendent with the light of the rising sun, and trees secm as if sparkling with the tangles of fire-flies in a case of Parimlayi,

28 THE SUSHRUTA SAMHITA. [ Chap. VII.

which should be ascribed to the action of the deranged Pitta in concert with the vitiated blood. 12. The different colours of the pupil in cases of Linga-nasa :- Now we shall describc the colours of the pupil in the six different types of Linga-nása. The pupil assumes a reddish (Aruna) colour in the Vataja type of the discase ; looks blue or bluish yellow in the Pittaja, white in the Kaphaja and blood- red in the blood-origined onc, while it assumes a varie- gated hue in the Sannipatika type of Linga-nása. A cir- cular patch (Mandala) tinged with a shade of bluish or bluish yellow colour and looking like fire or a piece of thick grass, is formed on the pupil owing to the discased and aggravated condition of the blood (with pitta) in a case of Parimlayi. In this case the patient is sometimes permitted to catch faint glimpses of the external objects owing to the spontancous and occasional filtering away of the deranged Doshas obstructing the vision. 13-15. Specific Traits of Linga-nasa :- The circular patch (over the pupil) in a case of Vataja Linga- nása is red-coloured, and is moving and rough to the touch, while that in a case of Pittaja Linga-nása is bluish or yellow or coloured like bell-metal. The circular patch in a case of Kaphaja Linga-nása is thick, oily and as white as a conch-shell, a Kunda flower or the moon- resembling a white drop of water on the moving lotus leaf and moving away to and fro when the eye is rubbed. The circular patch over the pupil in a case of Raktaja (blood-origined) Linga-nása is red-coloured like a coral or a (red) lotus-petal. A Sanuipatika type of the disease is marked by a variegated colour of the Drishti (pupil) and by the specific symptoms of the different Doshas. 16. The total number of diseases peculiar to the Drishti

Chap. VII. ] UTTARA-TANTARAM. 29

is twelve. The six types of Linga-nása (Drishti) have been described above. The six other forms of the disease, peculiar to the Drishti (pupil) are named as Pitta-vidagdha-Drishti, Sleshma-vidagdha-Drishti, Dhûma-darsin, Hrasva-Jatya, Nakulândhyatá and Gam- bhîriká. 17. The disease in which the region of the Drishti (pupil) assumes a yellowish colour, and all external objects appear yellow to the sight owing to the presence of the vitaited (and augmented) Pitta in the region of the Drishti is called Pitta-Vidagdha-Drishti. It is due to an accumulation of the deranged Dosha (Pitta) in the third Patala (coat) of the eye, and the patient cannot sce anything in the day, but can see only in the night. 18. The external objects appear white to the sight when it is affected by the accumulation of the deranged Kapha. The deranged Dosha (Kapha), in this case, is simulta- neously divided over all the three Patalas (coats) of the eye. In consequence of this the patient is attacked with nocturnal blindness, being able to see only in the daytime owing to the (melting and) decrease of the deranged Kapha through the heat of the sun. This is known as Sleshma-vidagdha-Drishti. 19. The external objects appear dusky or smoke-coloured when the sight is affected through grief, (high and pro- tracted) fever, over-straining or excessive physical exer- cise, or injury to the head, etc. The affection of vision thus engendered is called Dhuma-Drishti (smoky sight). 20. The disease in which small things can be viewed only with the greatest difficulty (even) in the daytime, but can be viewed (easily and clearly) in the night owing to the subsidence of the deranged pitta through the

30 THE SUSHRUTA SAMHITA. [ Chap. VII.

coldness of the atmosphere (and a general cooling of the Earth's surface)* is called Hrasva-jatyat. 21. The form of occular affection in which the colour of Drishti (pupil) of a man affected by the Doshas resem- bles (and is found to emit (luminous) flashes like) that of a mungoose in consequence of which the external objects appear multi-coloured in the day time,t is called Nakulandhya. The form of occular affection due to the action of the deranged Vayu, and in which the Drishti (pupil) is contracted and deformed and sinks into the socket, attended with an extreme pain in the affected parts, is called Gambhirika. 22-23. Besides the above, there are two more forms of Linga-nasa of traumatic origin, vis., Sa-nimitta (of ascer- tainable origin) and A-nimitta (without any manifest or ascertainable cause). Under the first group may be arranged those which are produced by such causes as an over-hcated § condition of the head (brain, etc.), and marked by the specific symptoms of (blood-origined) Abhishyanda, whilc the second comprises those in which the loss of one's vision is duc to causes, such as the witnessing of divine halo or cffulgence emanating from the cthereal person of a god, or a Gandharva (demi- god), a holy saint, a celestial serpent, or such other

• The latter part of the text here seems to be incongruous. Madhava does not read the last line in his Nidana, nor does Dallana include it in his commentary. Dallana, on the other hand, says that some read this line, but holds, on the authorityof Videha, that the reading is incongruous, in as much as "Hrasva-játya" is said to cause one of the four types of night-blindness. + Some read Hrasva-jádya in place of Hrasva-játya. $ This shows that a man affected with this form of disease cannot see anything in the night. § The head is liable to be over-heated by the smelling of poison or poisonous objects or any other strong-scented flower, etc.

Chap. VII ] UTTARA-TANTARAM. 31

highly bright object. In this case the eye is not out- wardly affected and the pupil (Drishti) looks as bright and clear as a Vaidûrya gem, while in the former case (of ascertainable origin) the eye is characterised by a sunken or pierced or impaired aspect of the pupil. 24. We have thus finished describing separately the diagnostic traits of the seventy-six forms of disease which affect the organ of vision. We shall hereafter separately deal with the nature of the medical treatment to be pursucd in cach case. 25.

Thus ends the seventh chapter of the Uttara-Tantra in the Sus'ruta Samhitá which treats of the pathology of the diseases peculiar to the pupil of the eye.

CHAPTER VIII.

Now we shall discourse on the chapter which deals with the classification of occular affection according to the different modes of treatment (Netra-Roga- Chikitsa-Vibhaga-Vijnaniya). I. Classification :- We have already described the names and symptoms of the seventy-six kinds of eye disease. We shall now briefly and severally deal with the nature of treatment to be pursued in them. Of these seventy-six kinds eleven should be treated with incision operations (Chhedya), nine with scarifica- tion (Lekhya), five with excision (Bhedya), fifteen with venesection (Vyadhya) ; twelve cases should not be operated upon and seven admit only of palliative measures (Yapya), while fifteen should be given up by an experienced physician (Ophthaimic surgeon) as in- curable. The two kinds of eye-discase of traumatic origin should be likewise held as incurable or admitting only of palliative measures at the best. 2. Names of the Chhedya and Lekhya eye-diseases :- Diseases which should be treatcd with incision are Arso-vartma, Sushkársas, Arvuda, Sirá- Pidaká, Sirá-jâla, the five types of Arman*, and Parvaniká (thus numbering eleven in all). Diseases in which scarification should be resorted to (numbering seven in all) are Utsanginî, Bahala-vartma, Kardama- vartma, Syáva-vartma, Vaddha-vartma, Klishta-vartma, Pothaki, Kumbhîkinî, and Sarkará-vartma. 3-4. Names of Bhedya and Vyadhya eye- diseases :- Optical diseases in which the affected

• See Chapter IV, para 2, Uttara-Tantara.

Chap, VIII. ] UTTARA-TANTARAM. 33

localities should be treated with excisions, are Śleshmo- panáha, Lagana, Visa-vartma, Krimi-granthi and Anjana-thus numbering five in all. The two kinds of eye disease beginning with Sirá vis., Sirotpáta and Sirá- harsha, the two kinds of Akshi-páka attended or un- attended with swelling, viz., Sasothakshi-páka and Asothákshi-páka, and Anyatováta, Puyálasa, Váta- viparyaya and the four types of Abhishyanda and the four types of Adhimantha should be treated with Venesection (Sirá-vyadhana). 5-6. Eye-diseases-not to be operated :- Operations should not be resorted to in cases of Sushká- kshi-páka, Kapha-Vidagdha-Drishti, Pitta-Vidagdha- Drishti, Amládhyushita-Drishti, Sukra-roga, Arjuna, Pishtaka, Aklinna-vartma, Dhuma-darsin, Suktiká, Prak- linna-vartma and Valása-thus making twelve in all. In the traumatic forms also of eye-disease surgical operations are not advised by experts. 7. Names of curable and incurable eye- disease :- Palliative or temporary relief is all that can be offered in any of the six types of Kacha described before, as well as in the affection known as Pakshma-kopa, if the patient retains the faculty of sight. Four of the Vâyu-origined, two of the Pittaja, one of the Kaphaja, four of the blood-origined and four of the types caused by the concerted action of the three Doshas, as well as the two traumatic forms of optical affections should be regarded as beyond all cure. 8-9.

Thus ends the eighth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the classification of eye-diseases according to the different modes of treatment.

5

CHAPTER IX.

Now we shall discourse on the remedial measures of Abhishyanda (Ophthalmia) due to the action of the deranged Vâyu (Vatabhishyanda-Pratish- edha)* The patient should be treated with old and matured clarified butter, both in a case of (Vátaja) Abhishyanda (Ophthalmia) and (Vátaja) Adhimantha (Conjunctivites). The diseased organ should be then duly* fomented and local venesection resorted to. Then after having effected full purging with the help of a Sneha-vasti (oleaginous enema), such measures as Tarpana, Puta- pâka, fumigation, sprinklings (Aschyotana) +, snuffing (Nasya), oily washings, Siro-vasti (errhines) or washing the organ with Kanjika (Amla) or with any decoction prepared with the drugs of the Váyu-subduing group or with that of the flesh of any aquatic (Jalaja) animal, or of one frequenting the marshy places (Anupa), should be resorted to. A compound consisting of clarified butter, curd, fat and marrow should be applied luke- warm to the affected organ, which should also be

• It should be noted that the part of the forehead adjoining the eye and not the eye itself-should be fomented, since fomentation should not be applied directly over the eye. + Ás'CHYOTANA (EYE-DROP)-Consists in dropping into the eye with the two fingers, honey, A'sava, drug-decoction or any oleaginous sub- stance. Its doses are eight drops for scarifying purposes, ten drops for lubricating the part with any oleaginous substance (Snehana), twelve drops for the healing of any local ulcer (Ropana). They should be dropped luke- warm in winter and cold in summer into the eyes. In diseases of Vátaja origin they should be of a bitter taste ; oleaginous in diseases due to the Pitta ; and bitter,-warm and parching in diseases due to Kapha. -VAIDYAKA NIGHANTU as quoted in the Vaidyaka-S'abda-Sindhu. Cf. also Chapter XVIII, Uttara-Tantra.

Chap. IX.]. UTTARA-TANTARAM. 35

covered with a compress or linen soaked with the preced- ing lardacious compound. Milk, Vesavára, Salvana Poultiee, Porridges (Páyasa), etc., should be used by a physician in poulticing the affected organ. A portion of clarified butter cooked with the decoction of Triphala, or simply old and matured clarified butter, or milk duly cooked with the drugs of the Vâyu-subduing group, or of the first group (viz., Vidári-Gandhádi Gana) should be taken after the meal. 2. A. The application of any lardacious substance other than oil cooked with the admixture of the Váyu-sub- duing drugs will prove beneficial for Tarpana purposes in such cases. The use of medicated Sneha in the shape of Putapaka, Dhuma (fumigation) and Nasya (snuffs) is likewisc recommended. Oil (duly) cooked with Sthird, milk and the drugs of the Madhura group should be employed as a snuff (in such cases). The milk of a she-goat duly cooked with the admixture of the leaves, roots or barks of Eranda plants, or with the roots of Kantakari, should be employed lukewarm in washing (Sechana) the affected organ. A liquid compound con- taining half milk and half watcr, and boiled together with Saindhava, Vala, Yashti-madhu and Pippali, should be used in washing the eye as well as an Aschyotana (eye-drop). A liquid compound consisting of the milk of a she-goat diluted with the addition of water, boiled with the admixture of Hrivera, Chakra (Tagara), Man- jishthá, and Udumbara-barks is considered to be the best eye-drop in cases of there being any pain (Sula) in the eye. 2. B. A thin plaster compound of Yasthi-madhu, Rajani, Pathyá and Devadáru, pasted together with the milk of a she-goat should be used as an Anjana (collyrium) in a case of acute Ophthalmia (Abhishyanda), and it proves

36 THE SUSHRUTA SAMHITA. [ Chap. IX:

very effective. Gairika-earth, Saindhava, Krishná, (Pippali) and S'unthi-the quantity of each subsequent one being double of that of the one preceding ite in the order of enumeration, should be pasted together with water, made into Gutiká (a large pill) and be likewise applied (to the eye) in the manner of the application of an Anjana. The use of Snaihika (lardacious) Anjana (Collyrium) is beneficial in such cases. These will be duly dealt with later on. 2. Physicians should likewise adopt this method in treating cases of Anyato-vata and Vata-paryaya. Draughts of (medicated) clarified butter and of milk before the meal, are highly efficacious. Clarified butter duly cooked with (two parts of) Vrikshádani, Kapittha and major Pancha-mula, (one part of) the expressed juice (or decoction) of Karkata and (one part of) milk should be taken in such cases *. In the alternative, Ghrita duly cooked with (the decoction of) Pattura, Agnika (Ajamodá) and Artagala and with milk, or clarified butter duly cooked with milk and (the decoc- tion of) Mesha-s'ringi, or of Viratara should be simi- larly taken. 3. Treatment of Sushkakshi-paka :- Saindhava, Devadaru and S'unthi and the expressed juice of Matulunga, water, breast-milk and clarified butter mixed together and duly prepared (in the manner of Rasa-kriyá) should be prescribed as an Anjana in cases of Sushkakshi-paka. The taking of clarified

• According to Dallana and Gayadása, this Ghrita should be pre- pared without any Kalka. S'rikanta holds that the drugs Vrishadani, Kapittha and the Pancha-mula should be taken as Kalka and the Ghrita . prepared with three parts of milk. S'ivadása also seems to support this view.

Chap. IX.1 UTTARA-TANTARAM. 37

butter cooked with the drugs of the Jivaniya group and the filling of the cavity of the eye with the same, as well as snuffing with the Anu-taila* are also efficacious in such cases. Washes composed of cold milk with the admixture of Saindhava salt or of milk cooked with Rajani and Deva-daru and mixed with (a little quantity of) Saindhava are efficacious. Mahaushadha (Sunthi) rubbed over a stone-slab with clarified butter and breast- milk is also recommended as an Anjana (eye-salve)+. The Vasá (essence of the flesh) of aquatic animals or of those which frequent swampy grounds, mixed with a little quantity of powdered S'unthi and Sanidhava salt (and rubbed on stone-slab) should be applied to the eyes as an Anjana (collyrium) in a case of Sushkâkshi- pâka (Non-secreting type of conjunctivites). Let the intelligent physician treat the sight-destroying Vátaja affections of the eye of what-soever kind in accordance with the principle herein inculcated. 4-5.

Thus ends the ninth Chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the medical treatment of Vataja Abhishyanda.

• According to Dallana, this Anu-taila is not the one described in Chapter V of the Chikitsita Sthána ; but the one described in the S'álákya- Tantra. t This couplet may also be translated as follows :- Anjana (black- antimony) rubbed over a stone-slab with clarified butter and breast-milk is also recommended as a best remedy in such cases.

CHAPTER X.

Now we shall discourse on the curative treatment of Abhishyanda (Ophthalmia) due to the action of deranged Pitta (Pitta-bhishyanda-Pratishedha). I. General Treatment :- Blood-letting and purgatives, eye-washes and plasters round the eyes, medicinal snuffs and Anjana (collyrium), as well as the remedial measures for Pittaja-Visarpa (Erysipelas) should be employed in a case of Pittaja Abhishyanda (Ophthalmia) and Pittaja Adhimantha (Conjunctivites). 2. Clarified butter or goat's milk duly cooked with Gundrá, S'áli (paddy), S'aivála, S'aila-bheda, Dáru- haridrá, Elá, Utpala, two parts of Lodhra, Abhra (Mus- taka), Padma-leaves, sugar, Durvá, Ikshu, Tála, Vetasa, Padmaka, Drákshá, honey, (red) Chandana, Vashti- madhu,breast-milk, Haridra and Ananta-mula, should be employed as a Tarpana measure* or as a wash or snuff in the present case. As an alternative, all the preceding drugs or as many of them as would be avail- able should be daily used in the manner of any of the four forms of Nasyat. 3. Anjanas :- All the Pitta-subduing measures, may be employed in such cases. Application of medi- cinal snuffs (as well as eye-drops, etc.) with Kshira- Sarpik (clarified butter churned from milk) at the interval of three days, as well as that of Anjana (colly- rium) with the expressed juice of Palás'a or of S'allaki, mixed with honey and sugar, should be likewise resorted

• See Chapter XVIII, ibid. t The four forms of Nasya are (1) Pratimarsha. (2) Avapida (3) Nasya (snuff) and (4) S'iro-virechana.

Chap. X. ] UTTARA-TANTARAM. 39

to. The thick liquid extract (Rasa-Kriyá)* of Palindi or Yashti-madhu mixed with honey and sugar, should be likewise employed. As an alternative, a com- pound consisting of Musta, Samudra-phena, Utpala, Vidanga, Eld, Dhatri and Vijaka and prepared in the manner of Rasa-kriyá should be employed (as an Anjana). 4. Acompound of Tálisa (D. R .- Kásisa), Elá, Gairika, Us'ira and S'amkha (conch-shell) pasted with breast- milk should be applied to the affected organ in the manner of an Anjana (eye-salve). As an alternative, the powder or the Rasa-kriya of Dhataki and Syandana (D. R .- Chandana) mixed with breast-milk should be used as an Anjana. Gold-leaf rubbed with breast- milk, or the flowers of Kims'uka rubbed with honey, or of a compound of Rodhra, Drákshá, sugar, Utpala, Vacha and Yashti-madhu rubbed with breast-milk should be used as an Anjana. Barks of Varnakat pasted in cow's milk, or (red) Chandana wood, Udumbara and Toya (Válá) pasted in the same, or Samudra-phena rubbed either in honey or breast-milk should be like- wise applied to the eyes in the manner of an Anjana. 5. Áschyotana :- Rodhra, Yashti-madhu, Drákshá, sugar and Utpala should be soaked in breast-milk. It should then be folded inside a piece of silk (Kshauma) and employed as an Aschyotana (eye-drop). A compound of Yashti-madhu and Rodhra rubbed in clarified butter should be similarly used. A compound of Kás'mari (Gámbhári) Dhátri, Pathyd (Haritaki) and Tbya (Vâlà),

• For preparation of Rasa-kriyá see Chapter XVIII, ibid. + According to Dallana, 'Varnaka' Imeans 'Rochanika'. It may also mean 'Karnika'ra' which is not accepted either by Gay or by Dallana. It may also mean 'Chandana' which is most probably the meaning here.

40 THE SUSHRUTA SAMHITA. [ Chap, X.

as well as that of Katphala and Ambu (Vala) should be similarly* prepared and applied. 6. All the above remedial measures with the exception of blood-letting should be resorted to in a case of Amlá- dhyushita-Drishti and Sukti-paka. The medicated Ghritas known as the Traiphala Ghrita or the Tilvaka Ghritat should be prescribed, or simply old and matured clarified butter should be given in such cases. 7. In a case of Sukti-paka an Anjana with cooling drugs should be speedily employed in the event of the Doshas being located in the lower part of the eye. Fine powder of Vaidurya gem, Sphatika (crystal), Vidruma (coral) and Mukta (pearl), Samkha (conch-shell), silver and gold mixed with sugar and honey and used as an anjana would prove a speedy remedy in a case of Sukti-pâka. 8. Clarified butter should be administered in a case of Dhuma-darsin and the procedure and the remedial mea- sures laid down in connection with Rakta-pitta and Pitta-origined Visarpa (Erysipelas) as well as the Pitta- sub-duing remedies t should be likewise employed there- in. 9.

Thus ends the tenth chapter in the Uttra-Tantra of the Sus'ruta Samhitá which deals with of the curative treatment of Pittábhishyanda.

• In the first two compounds, some take 'Toya' and 'Ambu' for water. But Dallana having explained 'Toya' as 'Valaka' in a preceding compound we adopt that meaning of the word here also. + Traiphala-Ghrita is piepared by duly cooking clarified butter with the Kalka and decoction of Triphala'. For Tilvaka-Ghritaisee chapter III. Chikistsita-Sthána. By Pitta-subduing remedies Dallana means the remedial measures laid down in connection with the treatment of Pitta-Vidagdha- Drishti.

CHAPTER XI.

Now we shall discoursc on the chapter which deals with the curative treatment of Abhishyanda due to the deranged action of Sleshma (Śleshmabhishya- nda-Pratishedha). I. General Treatment :- An attack of Slesh- maja Abhishyanda or Adhimantha during the stage of acute aggravation should be treated by opening a local vcin* or by the employment of fomentation, Avapida- Nasya, Anjana, fumigation, washes, plasters, gargles or non-fatty (Ruksha) eyc-drops (Aschyotana) and Puta- páka. The patient should be made to fast on each fourth day and to take a potion of Tikta-Ghrita+ in the morning, and his diet should consist of such articles as do not lead to the aggravation of the bodily Kapha. 2-3. Tender twigs or leaves of Kutannata, Ashpotá, Phanijjhaka, Vilva, Pattura, Pilu, Arka and Kapitthat should be employed in (mildly) fomenting the affected eye. A thin plaster composed of Válaka, S'unthi, Deva- dáru and Kushtha, should be likewise applied to the affected eye. 4. Hingu, (Asafœtida), Triphalá, Yashti-madhu, Sain- dhava, Prapaundaika, Anjana (black Antimony), Tuttha (Sulphate of copper), and copper pasted together with

• The word 'Atha' (a) in the text means says Dallana, that the local vein should be opened as the best resource, when fomentation, etc. would fail to effect a cure. + See Chikitsita-sthána, chapter IX. $ In place of "Kutannata" and "Arka" both Vrinda and Chakrapáni read "Surasa" and "Arja". S'rikantha the commentator of Vrinda how- ever is of opinion that Arka should be better reading in place of that of "Arja". 6

42 THE SUSHRUTA SAMHITA. [ Chap. XI.

water and made into a stick (Varti) should be applied a; an Anjana to the affected eye. As an alternative, sticks (Varti) composed of Pathyá, Haridrá, Yashti-madhu and Anjana should be similarly applied. Compounds made of the equal parts of Pippali, Maricha, S'unthi, Haritaki, Amalaki, Vibhitaka, Haridrá and Vidanga-seeds, or of Valaka, Kushtha, Deva-daru, (burnt) conch-shell, Pathd (Ákanidhi), Anala (Chitraka roots), Pippali, Maricha, S'unthi and Manah-s'ila (Realgar) and the flowers of Jati, Karanja and Sobhánjana* pasted together with water should be applied to the eye. The seedst of Prakirya (Karanja), or of S'igru with the seeds and flowers of the two kinds of Vrihati mixed with Rasán- jana, Chandana, Saindhava-salt, Manah-s'ila, Haritaki, and garlic taken in equal parts and pasted together with water should be made into sticks (Varti) and used as an Anjana in all forms of Kaphaja eye-diseases. 5. The following medicinal compounds should be pres- cribed by experts as an Anjana (eyc-salve) in a case of Valasa-Grathita after the system of the patient had been properly cleansed by means of blood-letting. A quantity of blue barley with the horns should be soaked (for a week or two) in milk and dried (after the manner of Bhávaná saturation). It should then be burnt into ashes. These ashes should then be mixed with an equal part of burnt ashes of Arjaka, Ashphotaka, Kapittha, Vilva, Nirgundi and Jati flowers and an alka-

• Dallana quotes the reading of "Panjika'ku'ra" (another commen- tator of Sus'ruta) according to whom Murva' and the flowers of Ja'ti only should be taken instead of the flowers of Jati, Karanja and Sobha'njana. This reading seems to be the correct one inasmuch as this makes the number of the drugs in the list twelve in all, as given by Dallana himself. t According to some commentators both the seeds and flowers of Prakirjd and of S'igru should be taken.

Chap. XI. ] UTTARA-TANTRAM. 43

line solution should be duly prepared therewith. Sain- dhava, Tuttha (Sulphate of copper) and Rochand should now be added to the above a'kaline soluticn and duly boiled. The compound thus prepared should ! e applicd as an Anjana with an iron pipe (Nâdi). This is pres- cribed in a case of Va'asa-Grathita. Alkaline prepara- tions may be similariy prepared with (the flowers, etc. of) Phanijjhaka etc., and may be cmployed in a simi.ar manner. 6. A (thin) plaster composed of S'unthi, Piptali, Musta, Saindhava and white Maricha* pasted with the expressed juice of Mátulunga and applied to the eye as an Anjana, would bring about a speedy cure of the eye- disease known as Pishtaka. 7. Vrihati fruits shou'd be gathered whe ripe and a paste compound of (the equal parts of) Pippali and Srotánjana should be kept inside those seedless fruits for seven nights. The (preserved) paste should then be taken out and applied to the eye as an Anjana. It proves beneficial in a case of Pishtaka. Pastc may similarly be preserved inside a Vartaku (brinjal), S'igru, Indra-Varuni, Patola, Kirata-tikta and Amalaki and used for the same. 8 Kâsisa (Sulphate of iron), Samudrat, Rasánjana and buds of Jati-flowers pasted together and rubbed in honey, is advised to be prescribed as an Anjana in a case of Praklinna-Vartma. 9 A single application as an Anjana of the compound composed of excellent Nádeya (Saindhaya) # salt,

• Dallana explains white Maricha as S'igru seeds. t Samudra may either mean Samudra-phena or Samudra salt, i. e. Karakacha salt. The commentators are silent on this point. ¢ Dallana explains Nádeya as meaning Saindhava, but it generally eans Srotanjana (black antimony).

44 THE SUSHRUTA SAMHITÁ. [ Chap. XI.

white pipper* and Nepala-jata (Realgar-lit., that which is produced in Nepála) taken in equal parts and pasted together with the expressed juice of Matulanga, would alleviate the itching sensation (Kandu) in the eyes. Similarly a compound of S'ringa-vera, Dera-dáru, Musta, Saindhava salt and buds of Jati flowers pasted together with wine and used as an Anjana would prove effica- cious in a case of swelling (Sopha) and itching sensa- tion of the eyes. The above eye-diseases should be judiciously treated in accordance with the principles laid down in the treatment of the cases of Abhi-shyanda and Adhi-mantha. IO.

Thus ends the eleventh chapter of the Uttara-Tantra in the Sus'ruta Samhita which treats of the curative treatment of S'leshmâbhishyanda.

Dallana explains "S'veta-Maricha" as "S'igiu-seeds", but there is a * particular kind of Maricha which is white in colour and this is also supported by some commentator.

CHAPTER XII.

Now we shall discourse on the curative treatment of the type of Abhishyanda (Ophthalmia) which has its origin in the vitiated condition of the blood (Raktabhishyanda-Pratishedha). I. General Treatment :- A wise physician shall pursuc the same course of medical treatment in those four diseases known as Adhimantha, Abhishyanda, Sirotpáta and Sirá-harsha due to the vitiated condition of the blood. Persons suffering from any of the afore- said four complaints should be first anointed and lubri- cated with old and matured clarified butter technically known as Kaumbha Ghrita*, or with a copious quantity of clarified butter. Venesection should then be resorted to. The patient, having been madc thus to blced as much as required, should be treated with clarified butter duly ccoked with Siro-virechana drugs and mixed with sugar, as an errhine for cleansing the hcad. Plasters, washcs, snuffs (Nasya), inhalations (Dhuma) of medicated smokes, eye-drops (Aschyotana), Abhyanjanat. Tarpana (sooth- ing measures), Sneha-karma (emulsive mcasures) and Puta-pâka should then be prescribed according to the nature of the deranged Dosha involved in cach case. 2 5. A plaster (Pralepa) composed of Nilotpala, U's'ira, Dâru-haridra, Kaliya, Yashti-madhu, Musta, Lodhra and Padma-Kâshtha (taken in equal parts and) mixed with Ghrita-duly washed, should be applied round the region

• See Chapter XLV, Sutra-Sthána. + Dallana explains "Abhyanjana" as collyrium, but he also says that some commentators take it in its usual sense of anointment with clarified butter washed hundred times in water, or such other Sncha.

46 THE SUSHRUTA SAMHITA. [ Chap, XtI.

of the affected cye. Mild fomentations (Sveda), or leeches should be applied to the region around the eye in the event of there being intolerable pain (due to any defect in bleeding) in the affected organ. Large draughts of clarified butter tend to alleviate the pain. Remedial measures and agents mentioned in connection with l'ittabhishyanda, should be as well employcd. 6-7. Rain-water with powdered Kas'eru and Yashti-madhu added thereto may be squeezed with benefit through a piece of linen into the affected organ* as an Aschyotana. Flowers of Pâtala, Arjuna, S'riparni, Dhâtaki, Dhátri, Vilva, the two kinds of Vrihati, and of Vimbi-lota and Manjishthå taken in equal parts and pasted together with honey or expressed juice of sugar-canc and applicd to the affected organ as an Anjana (Collyrium) is said to be a curative in cases of Raktábhishyanda. 8 9. A similar compound consisting of Chandana, Kumuda, Patra, S'ilá-jatu, Kumkuma, powders of dead iron and dead copper, Tuttha (Sulphate of copper), lead, bell-metal, Rasânjana and the resinous exudation of a Nimba tree taken in equal parts should be pasted with honey and made into large Vartis (sticks). Thesc arc always recommended to be applied to the affected eyc as an Anjana. I0. Treatment of Śirotpata :- A compound consisting of honcy and clarificd butter and applicd as an Anjana should be regarded as a patent cure in cases of Sirotpata eye-disease. A compound composed of Saindhava (salt), Kás'is'a (Sulphate of iron) and pasted together with breast-milk should be similarly used. The

• Both Dallana and S'ivadàsa say that pure transparent water may be used in preparing the compound if rain-water is not available. Dallana says further that the affected eye should also be washed with the liquid compound thus prepared. S'ivadasa, however, supports this latter view.

Chap. XII ] UTTARA-TANTRAM. 47

application as an Anjana, of S'amkha (ccnch-shell), Manah-s'ila, Tuttha, Dáru-haridrá, and Saindhava pasted with honey, or of (white) Maricha pasted with the juice of S'irisha flowers, honey and wine, or of Svarna-Garika pasted with honey would be attended with beneficial results in cases of Sirotpata. II. Śira-harsha :- A compound consisting of Phánita ( treacle boiled down to a sticky consistency) and honey should be applied to the affected organ as an Anjana in a case of Sira-harsha. Similar applications of compounds composed of Rasánjana (Antimony) pasted with honey, or of Saindhava and Kas'is'a (Sulphate of iron) pasted with honey, or of Vetramla* and Saindhara pasted with Phanita and breast-milk would likewise prove highly efficacious. I2. Treatment of Arjuna :- All the measures and remedies for Pittabhishyanda should be employed in cases of Arjuna eye-discasc. The expressed juice of sugar-cane, honcy, sugar, breast-milk, Dáru-haridra, . Yashti-madhu and Saindhava should be used in combi- nation as a wash (Seka), or as an Anjana. Amla (Kánjika, &c.) should also be used as an Aschyotana (eye- drop) in such cases. The following drugs, vis., sugar, Yashti-madhu, Katvanga, Mastu, Amla, honey, Saindhava, Vija-puraka, Kola and Dádimba of acid taste and other acid fruits cither singly or in combination of two or three should be judiciously used (as an Aschyotana with a due consideration of the vitiated Dosha in each case). 13-14. These two following compounds viz., of Sphatika

• Dallana explains "Vetramla" as "Amla vetasa". Some, however, divide it into two words vis., "Vetra" and "Amla" meaning thereby sprouts of Vetra (cane) an ì Amla-vetasa respectively.

48 THE SUSHRUTA SAMIIITÁ. [ Chap. XHI.

(crystal), Vidruma (coral), " S'amkha (conch-shell), and Yashti-madhu, pasted with honey, as well as of S'amkha, sugar, and Samudra-phena pasted with honey, if used as an Anjana would prove curative in a case of Arjuna eye- disease. Saindhava and Kataka pasted with honey, or Rasánjana pasted with honey, or Kás'isa (Sulphate of iron) pasted with honey, shouid constantly be applied as an Anjana to the affected organ. 15. Scarifying-Anjana :- All kinds of powder- ed (dead) metals (Gold, Silver, Iron, Copper, etc.) and metallic substances (Manal-s'ila, Gairika, etc.), (the five officinal kinds of) salt, all kinds of gems (Vaidurya, coral etc.), the teeth (of cows, horses, etc.), the horns (of cows, etc.), the drugs of the sedative (Avasádana) * group, pulverised shells of hen's eggs, Las'una (garlic), Trikatu, Karanja sceds and Elá (cardamom) mixed together and uscd as an Anjana, should be regarded as Scarifying (Lekhya) in their action. 16. Treatment of Sukra :- In a case of non- ulcerated (A-vrana) Sukra (milky film or white fleshy growth in the eye) a skilful physician shall (first) adopt all the preceding measures prescribed in the treatment of (Blood-origined) Abhishyanda,+ beginning with Rakta-visrávana (Vencsection) and ending with Puta-pâka (and these failing, the Lekhyánjana- collyrium for scarifying) should be adopted. A case of ulcerated (Sa-vrana) Sukra whether superficial or deep- scated $ or rough should be treated in the same manner. 17-18.

• The group beginning with Kas'is'a-See Chapter XXXVI, Sutra- Sthana, page 334, Vol. I, t See paras 3 and 4 of this Chapter. $ "Superficial" (Uttâna) is here used in the sense of "seated in the first layer" and "deep seated" (Avagadha) 'seated in the second layer'.

Chap. XII. ] UTTARA-TANTRAM. 49

In a case of Sukra the affected part should be rubbed (scarified) with a compound consisting of S'irisha- seeds, Maricha, Pippali and Saindhava pounded together, or with Saindhava alonc. A compound composed of powdered copper, Manah-s'ilá, Maricha and Saindhava each preceding drug being taken in a quantity double the one immediately succeeding it in the order of enu- meration*, should be pounded together and made into a thin paste. Applied as an Anjana to the seat of the disease, it will cure a case of Sukra. As alternatives, the two compounds composed of S'amkha, stones of Kolas, Kataka, Drákshá, Yashti-madhu, Mákshika (honey), or of tceth (of cows, etc.), Samudra-phena and S'irisha flower and honey should be applied to the affected locality inthe manner of applying an Anjana. The Ksha- ranjana (alkalinc collyrium) mentioned in connection with the medical treatment of Valása-grathita, may as well be profitably cmployed as an Anjana (eye-salve) in the present disorder. Eyc-salves made of fried husk- less Mudga pulse, (burnt) S'omkha and sugar mixed with honcy, or of the pith of Madhuka pasted with honey, or of the inner pulps of the stones of Vibhitaka pasted with honey should be constantly used as an Anjana, in cases of the eye-disease known as Sukra. A compound consisting of conch-shell, oyster-shell, Drákshá, Yashti- madhu, Kataka and honey may be used and soothing application (Tarpana) antidotal to the deranged bodily Váyu, should be resorted to in cases of Sukra, if the second layer (Patala) of the eye is attended with pain (Sula). 19-21.

• One part of Saindhava, two parts of Maricha, four of Manahs'ila, eight of S'amkha and sixteen parts of copper should be taken in the pre- paration of the compound. t See Chapter XI, para 6.

THE SUSHRUTA SAMIITA. [ Chap, XII.

Young bamboo-sprouts, Arushkara, Tála (palm) and Nárikela (cocoanut)* should be burnt to ashes and alkaline water should be duly prepared therewith. The burnt ashes of elephant's bones should be soaked several (seven) times with the above alkaline preparation in the manner of Bhávana saturation. The application of this preparation in the manner of an Anjana tends to remove the discolouring nature (whiteness) of a case of Sukra +. 22. Treatment of Ajaka :- The thin watery matter accumulated in the cye in a case of Ajaka should be drained by making a puncture on either side ( of the cornca ) with a needle after which the incidental ulcer should be filled with powdered beef mixed with clarified butter. Scarification should be many times made in the event of the ulcer bccoming raised. 23. Treatment of Akshi-paka :- Applica- tions of Sncha and of Sveda (fomentation) to the affected locality should be made in cases of the two kinds of eye- disease known as Sa-sopha and A-sopha Akshi-paka (inflammation of the eye-lid whether attended with any local swelling or otherwise). Venesection should then be resorted to. Eye-washes, eyc-drops (Aschyotana), errhi- nes (Nasya) and Puta-páka measures should also be employed. 24. After having cleansed the system of the patient both internally and externally the following compounds should be used as an Anjana (in cascs of the two kinds

• The spathe (Jata) of the palm tree and the shell of the cocoanut fruit should be taken in preparing the compound -S'ivadása. t The prepared powder of elephant's bone should be mixed with honey and rubbed over the affected part (S'ukra) with the tip of the finger or with a S'alaka (rod). The eye should then be washed with the in- fusion of Triphala -Dallaną.

Chap. XII ] UTTARA-TANTRAM. 51

of Akshi-paka). Saindhava and clarified butter pasted together in a copper vessel with flesh or Maireya or curd or with curd-cream should be used as an Anjana. As an alternative, the rust of bell-metal pasted with clarified butter, or Saindhava pasted with breast-milk, or equal parts of the pith of Madhuka tree and Gairika pasted with honey, or Saindhava and copper pasted with breast-milk and clarificd butter should be used as Anjanas. The compounds of Dadimba, Araveta, As'- manta, Kola, and Saindhava pasted with any acid juicc* should be applied to the affected organ in the manner of a Rasa-kriya measure for the cure of (the two kinds of) Akshi-pika. 25-26. Animal flesh and Saindhava salt soaked in clarified butter and mixed with S'unthi and breast-milk should be applied to the affected organ in the manner of an Aschyotana or as an Anjana. A compound consisting of Játi flower, Saindhava, S'unthi, Pippali and huskless Vidanga pasted together with honcy, may as well be used as an Anjana with advantage in a case of Akshi-paka. 27-28. Treatment of Puyalasa :- Blood-letting (after the application of Sncha and Sveda) and poultic- ing (Upanáha) of the affected locality arc efficacious in the affecticn of the eyc, known as Puyalasa. The measures and remedies which prove curative in cases of Akshi-páka should as well be cmploycd with dis- cretion in this casc by a physician. An Anjana (eye-salve) composcd of Ardraka, Saindhava and Kás'isa (Sulphate of iron), or Kás'isa Saindhava, Ardraka, iron and copper dust pasted together with honey, should be applied to the affected eye in the manner of an Anjana (in a case of Puyálasa). 29-30. * Some add honey in the list.

52 THE SUSHRUTA SAMHITÁ. [ Chap. XÍI.

Treatment of Praklinna-vartma :- The deranged Doshas of the system should be duly* removed (corrected) and the patient should be duly soothed in a case of Praklinna-vartma, after which washes, eye-salves, eye-drops (Aschyotana), snuffs (Nasya) and fumigation (Dhuma) should be resorted to according to the Dosha involved in cach case. A compound composed of Musta, Haridra, Yashti-madhu, Priyangu, Siddhártha, Rodhra, Utpala-sárivá + pasted together + should be employed in the manner of an Aschyotana measure. As an alternative, the compound consist- ing of Rásánjana and honcy should be used as an Anjana. 31-32. The decoction of the leaves and fruits of Amalaka should be duly prepared (in the manner of Rasa-kriyá) and used as an Anjana. Rasa-kriya preparations pre- pared with (the expressed juice of) the roots of bamboo, or Vartis prepared with the same by (condensing it by) cooking it (again) in a copper vessel, should be used for the above purpose. Rasa-kriyá preparations prepared with Triphala, flowers of Palasa, or Khara-manjari, should be simiiarly applied to the affected organ. Eyc- salves made of powdered Kams'ya-mala and cotton fibres (Tantu) burnt together and pasted with the milk of a she-goat and mixed with (white) Maricha and powdered copper should bc used as a Pratyanjana to the cyc (already weakencd by the use of Anjana.) 33-34.

• Dallana says that the deranged Doshas of the system should be cleansed with the application of Sneha, Venesection, purgative, errhines and A'sthápana. + In place of 'रोधोत्पलसारिवाभि:' some read 'लोभासतितसारिवाभि:'maing in this case 'Syama-lata' by the term 'Asita-sariva'. Others again mean 'Rasanjana' by the term 'Asita' .- Dallana. $ Dallana recommends 'rain water' as the liquid for the preparation.

Chap. XII. 1 UTTARA-TANTRAM. 53

An eye-salve or an Anjana made of Samudra-phena, Saindhava, conch-shell, Mudga and white Maricha mixed together (in the shape of a powder) should be prescribed in a case of Aklinna-vartma as it would promptly alleviate the local itching. The foregoing measures and remedies should be likcwise employed in a case of Praklinna-vartma according to the nature of the deranged Doshas involved therein. An Anjana pre- parcd with the admixture of Kajjala and Tuthhaka (Sulphate of copper) rubbed in clarified butter on the surface of a copper vessel, would be similarly used (in such cases). 35-36.

Thus ends the twelfth chaptet of the Uttara-Tantra in the Sus'ruta Samhita which treats of the curative treatment of Raktabhishyanda.

CHAPTER XIII.

Now we shall discoursc on the curative treatment of eye-diseases in which Scarification should be resorted to (Lekhya-Roga-Pratishedha). I .. The general course of treatment to be adopted in the nine kinds of eye diseases which are amenable to Scari- fying (Lekhana) opcrations is as follows :- The patient should be laid in a chamber not exposcd to the sun and the gales of wind, after having been treated with proper emulsive measures (Sneha-karma)* and sub- jected to a course of emetics and purgatives. The eye- lid should be over-turned with the thumb and the indcx finger and should be very carefully fomented with a piece of linen soaked in lukewarm water and squeczed. The eyc-lid should be covered with a picce of linen and over-turned with the thumb and the index finger at the time to guard against its movement and enclosing. The (part of the) eye-lid to be scraped, should be wiped with a linen and marked with a surgical instrument and the scraping should be effected therein with a scraping knife or any (rough) icaf according to the exigencies of the casc. After the subsidence of the. bleeding, the part should be fomentcd and then gently rubbed (Prati- sárana) with a medicinal compound consisting of Manah- s'ilá (Realgar), Kás'isa (Sulphate of iron), Trikatu, Anjana (black antimony), Saindhava salt and Mâkshika finely pounded together. After this the part should be washed with lukewarm water and lubricated with clarified buttcr. The subsequent treatment thercof should be

• It should be noted that the patient shotld also be fomented (Sveda) after being treated with the emulsive measuires.

Chap, XIII. ] UTTARA-TANTRAM. 55

like that of an ulcer (Vrana) .* Fomentations, Avapida, etc., should also be employed after three days, Thus I have described to you the general measures to be observed in scraping an affected locality in the eye. 2. Satisfactory and deficient scari- fication :- Stoppage of bleeding, subsidence of the swelling and itching, a smooth level aspect of the part like the surface of a finger nail are the features, which mark a proper and satisfactory scarification. Red- ness of the cyes, swelling and discharge of blood from the operated locality, occurrence of Timira (blind- ness or darkness of vision), non-ameliorations of the disease under treatment, brownness, heavincss, numb- ness, itching, horripilation and coating (as if with foreign matter) of the eye-lids and a consequent high inflamma- tion of the eye if not attended to in time, are the symp- toms which attend an incomplete and unsatisfactory scarification, and this should be remedicd by anointingt and scarifying the affected part again. 3-4. Excessive Scarification :- Excessive dis- charge and pain in the locality togcther with an upturning of the cye-lids and spontancous uprooting of the eye-lashes should be ascribed to excessive scraping. Fomentation, application of Sneha and employment of Vayu-subduing measures should be resorted to in such cases. 5. In the following discases of the eyc, vis., Vartmá- vabandha, Klishta-vartma, Bahala-vartma and Pothaki, the affected part should first be gently scraped and then

• For the first seven days the treatment should be like that of an incidental ulcer (Sadyo-vrana) after which period, the case should be treated, if necessary, as a case of S'árira-Vrana. t Dallana says that some read 'aafarar' (fomenting) in place of 'सोइयित्वा' (anointing).

56 THE SUSIRUTA SAMIIITA. [ Chap XIII.

scarified. In Syava-vartma and Kardama-vartma, the intelligent physician will gently scarify the affected part neither deeply nor superficially. In cases of Ut- sangini, Sarkara and Kumbhikini, the seat of the disease should be first cut (with a knife) and then carefully scarified. An incision should be followed by a scarifica- tion in the case of small, very hard, supperated, copper- coloured, Pidakás (pustules) occurring on (the inner membrane of) the eye-lid. Small and slightly swelling Pidakás (pustules) occurring on the exterior surface of the cye-lid should be remedied with fomentations, plasters and the general corrective remedies. 6.

Thus ends the thirteenth chapter of the Uttara-Tantra in the Sus'ruta Samhita which treats of the curative treatment of (eye-) diseases amenable to scarification.

CHAPTER XIV.

Now we shall discourse on the curative treatment of eye-diseases which require surgical incisions (Bhedya- Roga-Pratishedha). Treatment of Visa-granthi :- In a case of suppurating Visa-granthi, it should be first fomented, and its puncture-like holes should be completely incised (so as to remove any swelling in the affected part). It should then be dusted with Saindhava, Kâs'is'a, Magadhi, Pushpanjana, Manah-s'ila and Ela pounded together *. Honcy and clarificd butter should then be applied (over the dusted part), and it should be duly (loosely) bandaged (for the complete union of the parts). 2. Lagana :- An incision should be made into the affected part in a case of Lagana, and any of the following drugs, vis., Rochand, Yava-kshára, Tuttha, Pippali and honey should be applied to the incised part ; while in serious (lit .- big) cascs cauterization with alkali or with fire will be the remedy. 3. Anjana :- In a casc of Anjana, the affected part should be duly fomented and if it spontaneously bursts open, it should be well pressed and rubbed (Pratisárana) with a plaster-compound of Manah-s'ila, Ela, Tagara- páduká and Saindhava, pasted together with honey. If, however, the surgeon wants to open it, it should be rubbed with honey and Rasanjana mixed together and

• Both Vrinda and Chakradatta read only the first two lines of the text and hold that the incision should be dusted with Saindhava only. Their commentators, however, accept the reading there to be Sus'ruta's. They supply the next two lines of Sus'ruta, and notice the consequent alteration in the sense. 8

58 THE SUSHRUTA SAMHITÁ. [ Chap, XIV.

then coated with a warm collyrium made with the lamp-black collected from a burning lamp flame. 4. Krimi-granthi :- In a case of Krimi-granthi, the affected part should be duly fomented after it has been incised and it should then be treated with the Rasa-kriyá solution prepared with (the decoction of) Triphala (with the addition of) Tuttha", Ka-sisa and Saindhava. In a casc of Upanaha (in the eye) due to the action of the deranged Kapha, the affected part should be opened and rubbed with powdered Pippali and Saindhava mixed with honey. It should then be scraped with a Mandalagra instrument. The surrounding parts should also be gently scratched all around. 5. In the foregoing five cases of incisable eye-disease, until the setting in of suppuration therein, the affected eye should first be treated with Sneha and then with light fomentation with (the help of) tender leaves (as a cover over the eye). In all the remedies to be adopted in the treatment of thesc (incisable eyc) diseases, the application of a Sneha should be first adopted. In cases, however, where suppuration had already sct in, the remedies for the hcaling up of the ulcer, should bc carefully adopted. 6.

Thus ends the fourteenth chapter of the Uttara-Tantra of the Sus'ruta Sambita which deals with the curative treatment of (eye-) diseases requiring incisions.

• Both Vrinda and Chakrapáni read 'Mulra' (cow's urine) in place of 'Tultha'. Both of them also recommend the addition of Rasanjana in the compound.

CHAPTER XV.

Now we shall discourse on the curative treatment of cyc-diseases, which should be cured with excisions (Chhedya-Roga-Pratishedha). I. Treatment of Armas :- The patient should be first treated with a Sneha-predominating food before being surgically operated upon in a case of Arman marked by the manifest vegetation or polypus (on the affected eye). The patient should then be made carc- fully to sit at ease and the affected eye should then be irritated by casting powdered Saindhava-salt into its cavity after which the eye-ball, without any loss of time, should be duly fomented and rubbed with the hand. The intelligent physician will then ask the patient to look at his Apánga (the interior corner of his own affect- cd cye) and the cyst or the polypus (thus turned up), should be carefully secured with a hook (Vadisa) and held with a Muchundi instrument or with a thread- ncedle. It is dangerous to suddenly uplift the cye-lid under the circumstances. The two eye-lids should be firmly drawn asunder so as to guard against their being anywisc hurt during the operation. The polypus, thus made flabby and pendent with the means of thc three aforesaid accessories, should be fully got rid of by scraping it with a sharp Mandalágra instrument. The root of the polypus should be pushed asunder from the Krishna-mandala (Sclerotic region) and the Sukla-mandala (region of the cornea), to the extremity of the Kaninaka (pupil) and then removed. The Kaninaka (pupil) should be duly guarded so as not to be hurt. A quarter layer of the flesh (of the polypus) should be left back and then the operation would not in any way hurt or injure the eye. An operation at

60 THE SUSHRUTA SAMHITÁ. [ Chap, XV.

a point beyond the aforesaid limit of the Kaninaka (might hurt the pupil and) would set up a hœmorrhage and beget a sinus (as well as pain) in the locality. The vegetation or polypus is sure to grow up again to its former size if it is cut off insufficiently. 2. A shreddy or netted Arman in the form of a mem- branous growth (Jála) in the eye should be made pen- dent by rubbing it (with Saindhava-salt) and then cut with a bent Vadisa instrument at the junction of the Sukla-mandala (cornea) and the Vartma-mandala (con- junctiva or eye-lid). The affected part should then bc rubbed with a compound consisting of Yava-kshara, Trikatu and Saindhava-salt (pounded together) and then (duly) fomented and bandaged up by the skilful physician. Lardaceous or oily (Sneha) application should thercafter be prescribed with due regard to the nature of the place*, the season, the time (day or night) and the strength of the patient, and the incidental wound should be treated as an ulcer. The bandage should be removed after threc days and the affected part should be (mildly) fomented with the application of heated palms of the hands and treated with correctivc or purifying remedies. 3. Milk duly cooked with Karanja seed, Amalaka and Yashti-madhu and mixed with honey (when cold), should be dropped twice a day (morning and evening) into the affected eye in the event of there being any pain in it. A cold plaster composed of Yashti-madhu, polens of lotus (Utpala) and Durvd-grass pasted together with milk and mixed with clarified butter is recom- mended in such cases to be applied to the scalp. 4.

' In place of 'u'-the particular part and nature of the country, som . read 'r-the particular Dosha involved in each case.

Chap. XV. ] UTTARA-TANTRAM. 61

Any residue of the Arman, left after the excision, should be removed with the application of Lekhya* (scraping) Anjana or eye-salve. An Arman (Cyst-like papilla or protruberance) which is as white as curdled milk (Dadhi), or which looks blood-red or bluc or grey, should be treated like a case of Sukrárman (Opacity of the cornea or a flimy and fleshy growth in the eye). An Arman which is very thick and looks like a piece of skin and covered over with fibres of flesh and nerves +, as well as one occurring on the Krishna-mandala (region of the iris) should be excisioned. The eye assu nes its former and natural colour and function, and becomes free from pain and other complications by the proper excision of an Arman. 5-8. Treatment of Sira-Jala and Sira- pidaka :- In a case of Sira-Jala, the hardened veins (Sirá) should be hung down with a hook (Vadisa) and scraped with a Mandalagra (round-topped) instrument. Cysts or pimples (Pidakás) appearing on the diseased veins in a case of the aforesaid Sirá-Jála and not prov- ing amenable to the application of medicincs, should be excisioned as in a case of Arma with a Mandalâgra instrument. Pratisárana (rubbing) as in a case of Arma and Lekhana (scraping) with due regard to the nature of the deranged Doshas involved in each casc, are also recommendad in both the discases (Sirá-Jála and Sjrá-Pidaká) under discussion. 9. Treatment of Parvanika :- In a case of Parvanika the place of junction # (of the lachrymal

• For Lekhya Anjana see Chapter XII, Fara 16 of this Uttara Tantra. + Some here read 'fertr' (veins) in place of '' | + The 'junction' is the junction of the Krishna-mandala and the S'ukla-mnandala of the eye .- Dallana.

62 THE SUSHRUTA SAMHITÁ. [ Chap. XV.

sac and the cornca) should be duly fomented. A quarter part only of the protuberance or growth should be kept apart, while the remaining upper three quarters should be secured with a hook and cut with a knife. Half of the aforesaid quarter part should then be cut away (very carefully), as lachrymal sinus (and conse- quent lachrymation) would otherwise set in. The seat of operation should be subsequently rubbcd (Prati- sarana) with a compound of honey and Saindhava-salt. Scarifying (Lekhana) powders should then be applied to the affected part for the complete recovery of the discase (any complaint still remaining). IO. Churna-Anjana :- Powders of S'amkha (conch-shell), Samudra-phena, marine oyster-shell, crystal, ruby, coral, As'mantaka, Vaidurya (Lapis lazuli), peari, iron, copper and Srotonjana (antimony) taken in equal parts and mixed togcther, should bc stuffed in a ram's horn* and then let the intelligent one apply this Churna- anjana (powder) to the affected locality, morning and evening everyday, as such applications are extremcly efficacious in all types of Armans, Pidakás, Sirá-jála, Arsás, Sushkársas and Arvuda, etc., in the eyc. II. Treatment of inner part of the eye- lids :- The mode of treatment in a case of any affec- tion in the inner lining of the Vartma (eye-lid) is given below. The affected part should be first fomented and then the eye-lid should be over-turned (held at an angle), and the discased growth or swelling should be carefully lifted up with a needle, when an experienced physician should cut it at its root or base with the help of a sharp Mandalagra instrument. After that the affected part should be rubbed with a pulverised compound consist-

• Dallana explains 'Mesha-s'ringa' as a kind of Ingudi tree.

Chap. XV. ] UTTARA-TANTRAM. 63

ing of Saindhava, Kasisa (Sulphate of iron) and Pippali. The affected eye-lid should then be carefully cauterised with a (red-hot) rod after a (complete) cessation of the bleeding. The residue of its root or base, if any, should be scarified with a scarifying alkaline (caustic) prepara- tion. Decoctions of strong emetic and purgative drugs* should be (internally) administercd for the elimination of the Doshas (from the Vrana-ulcer). The measures and remedies mentioned in connection with Abhi- shyanda (Ophthalmia) should also be prescribed with regard to the nature of the bodily Doshas involved in the case. The patient shall observe strict regimen of diet and conduct for a month after the surgical opera- tion. 12.

Thus ends the fifteenth chapter in the Uttara-Tantra of the Sus'ruta Samhita which treats of the remedies of eye-diseases requiring excisions or surgical operation.

• Some commentators say that emetics and purgatives should be inter- nally administered, but Dallana and the Panjika. kara oppose this view.

CHAPTER XVI.

Now we shall discourse on the curative measures for the remedy of diseases occurring on the cye-lashes and hence on the eye-lid (Pakshma-kopa Prati- shedha). I. Surgical Treatment :- In a case of Pakshma-kopa which is an affection of the eye-lid and which has been described before as admitting only of palliative treatment, the patient should be first trcated with a Sneha and made to take his seat (in a proper position). A cut in the shape and size of a barley corn should be made in the eye-lid horizontally parallel to (the part of the cye-ball lying between) the Kaninaka (pupil) and the Apánga (exicrior corner of the eyc) leaving two parts bclow the eyc-brow and one part above the cye-lashes. The surgcon should then diligently suture up the two edges of the incisions with (horse's) hair. After the application of honcy and clarified butter to the operated part, it should be treated in the manner of an (incidental) ulcer. A piece of linen should be tied round the forchead and the horse's hair sewing up the operated part should be attached thereto. The stitching hair should be carefully removed after the complete adhesion of the two edges of the incidental ulcer. 2. Cauterisation :- In case of the failure of the preceding measure, the eye-lid should be carefully exa- mined and lifted up in an inverted posture and the diseased cyst (Bali) should be very carefully cauterised with firc or alkali. As an alternative, the Pakshma-

• According to Vagbhata, the stitching hair should be removed on the fifth day.

Chap. XVI. ]' UTTARA-TANTRAM, 65

mala (eye-lashes)'should be all removed and the affected eye-lid having been carefully secured with three hooks (Vadisa) should be rubbed with pasted Haritaki and Tuvaraka (Lodhra). The four aforesaid measures* as well as purgatives, eye-drops (Aschyotana), medicinal snuffs, inhalations (fumigations), Plasters, Collyrium, Sneha and Rasa-kriya, should be likewise held as beneficial+ in cases of Pakshma-kopa. 3-5.

Thus ends the sixteenth chapter of the Uttara-Tantra in the Sus'ruta Samhita which treats of the remedies of Pakshma-kopa.

• The four measures are (a) operation, (b) cauterisation with fire, (c) cauterisation with alkali, and (d) application of medicinal drugs. + It should be noted that this disease cannot be radically cured, but is amenable only to palliative treatments (1v).

9

CHAPTER XVII.

Now we shall discourse on the curative treatment of the diseases of the pupil and the Crystalline lens (Drishti-gata-Roga-Pratishedha). I. Of the diseases included within the present group, three are curable, three are incurable, while the remain- ing six admit only of palliative treatment. The cura- tive remedies of the disease known as Dhuma-darsi (smoky or dusky vision) has bcen already described (in connection with the medical treatment of Pittaja Ophthalmia) *. All the remedies applicable in cases of deranged Pitta and Kapha as well as application of Nasya (snuff), Seka (sprinkling), Anjana (Collyrium), A'lepa (plaster), Puta-páka and Tarpana (soothing) remedies with the exception of surgical operation should be respectively administered in cases of Pitta-affected (Pitta-vidagdha) and Kapha-affected (Slcshma-vidagdha) vision. Traiphala-Ghrita should be prescribed in a case of Pitta-vidagdha-Drishti and Traivrita-Ghrita in a case of Sleshma-vidagdha-Drishti. Potions of old and matured clarified butter as well as of Tailvaka-Ghrita are equally efficacious in both cases +. Collyriums (Anjanas) should be prepared with Gairika, Saindhava, Pippali, and the charred remains (Masi) of cow's teeth, or with beef, Maricha, S'irisha-sceds and Manah-s'ila, or with the stalk of a Kapitthr fruit together with honey, or with Atmagupta pasted with honey ; these four

• See Chapter X, 9, Uttara-Tantra. + Traiphala-Ghrita, Traivrita-Ghrita and Tailvaka-Ghrita should be prepared with both the decoction and Kalka of Triphala, Trivrita and of Tilvaka respectively.

Chap. XVII. 1 UTTARA-TANTRAM. 67

Anjanas may be used with advantage in both the types under discussion. 2-3. Pushpa'njana :- Powders of the flowers of Kubjaka, As'oka, S ala, Amra, Priyangu, Nalini and of Utpala, as well as powdered Renuká, Pippali, Haritaki and Amlaki mixed with honey and clarified butter, should be kept inside a hollow bamboo and applied to the eye in the manner of a collyrium (Anjana) in cases of Pitta-vidagdha and Sleshmá-vidagdha eye- diseases. 4. Dravanjana and GudikanJana :- As an alternative, Renuka pasted with the expressed juice of the flowers of Amra (mangoc) and Jambu (black-berry) and mixed with honey and clarified butter, should be used in both the above cases as an Anjana. Pollens of Nalini (red lotus) and of Utpala (bluc lotus) as well as Gairika * pasted together with the Rasa (watery secrc- tions) of cow-dung + and made into large pills (Gudiká) may be profitably applied to the eye as an Anjana alike in cases of day-blindness and night-blindness. This Anjana is called the Gudikanjana. 5. Treatment of Day-blindness :- Rasan- jana, Rasa (Juice) , honey, Talis'a-patra and Svarna- gairika should be pasted together with the Rasa of cow-dung and applied (in the manncr of an Anjana) in cases of Pitta-affected vision re. day-blindness. S'ita

• Chakradatta does not read 'Gairika' in the list. + In place of "गोभऋत्" some read "गोयक्त्" i.e., the liver of a "मो" which may mean a cow or any animal, such as goat, sheep, etc. $ According to Dallana, Rasa (lit :- Juice) means the juice of A'malaka. According to others, however, it means the juice of the leaves of Játi flower. Chakradatta, however, reads "ga" (clarified butter) in place of "ra".

68 THE SUSHRUTA SAMHITK. [ Chap. XVIİ.

(Rasánjana, or according to some Camphor), and Sauvira should be soaked in Rasa (meat-juice) * and then pasted together. It should then be soaked again in the bile of a tortoise or of a Rohita fish and dried and reduced to powder. The present compound is called the Churna-anjana (powdered Collyrium) and may be used beneficially for the pacification of Pitta (in cases of Pitta-vidagdha-Drishti). Kas'mari flowers, Yashti-madhu, Dárvi, Rodhra and Rasanjana, should be pounded together and mixed with honey. Used as an Anjana it is always efficacious in the affections of the eye. 6-8. Treatment of nocturnal blindness : -The application of a medicinal Varti (stick) composed of Sauviranjana, Saindhava, Pippali and Renuká pasted together with the urine of a she-goat would prove highly beneficial in cases of nocturnal blindness. Simi- larly the application of a medicinal Varti (stick) com- posed of Kálánu-Sárivá, Pippali, S'unthi, Yashti-madhu, Tális'a-patra, the two kinds of Haridra, and Musta, pasted with the Rasa of cow-dung + and dried in the shade, proves beneficial in such cases. Manal- s'ilá, Haritaki, Trikatu, Balá, Kálánu-sárivá and (S'amu- dra-) Phena pasted together with the miik of a she-goat and similarly prepared in the shape of a Varti is also recommended. 9-II. Rasa-Kriya'njana :- The urine, bile and dung of a cow $ together with wine, should be boiled (in the manner of Rasa-kriyánjana preparation) in the

• Rasa may also, from the context, mean the watery secretions of cow-dung. t Dallana's reading is evidently 'iornara' which he explains as meaning the juice or serum of the liver of a goat, &c. + The text has "गोभूवपित्त"। The term "गो" which literally means a cow, here stands for any female quadruped, such as a she-goat, etc.

Chap. XVII. 1 UTTARA-TANTRAM. 69

expressed juice of Dhátri, or in the Rasa (serum) of the liver of an animal (e.g. a goat), or in the decoction of Triphala. It is called the Kshudranjana, and should be applied to the affected organ in the manner of an Anjana (collyrium). An Anjana consisting of cow's urine, clarified butter, Samudra-phena, Pippali, Katphala, Saindhava and honey mixed together should be first kept inside a hollow bamboo and subsequently applied (in night-blindness) as a collyrium. The Medas (fat) and liver of a goat, together with a quantity of clarified butter skimmed out of the milk of a she-goat, mixed with Pippali and Saindhava should be boiled and cook- ed with the (expressed) juice of Amalaka (in the manner of Rasa-kriyá preparations). It should then be mixed with honey and kept in a closed vessel made of Khadira (Catechu) wood. The use of this (com- pound), known as the Kshudrânjana, as an Anjana (collyrium) would be attended with good results. Harenu, Pippali-seeds (without pericarps), Ela and the liver (of a goat, etc.) should be pasted with the Rasa of cow-dung. Used as an Anjana, it would prove efficacious in a case of Kapha-affected vision (Sleshma-Vidagdha- Drishti). 12-14. The liver of a Godha (a kind of wild lizard) should be partially opened and stuffed with Pippali and roasted in fire (having been coated with clay ). The use of the compound * for only once + as an Anjana (with honey)

• According to Dallana the Pippali so roasted should be used with honey as an Anjana. t Both Vrinda and Chakradatta read 'aaa' in place of 'Haq' and the commentators of both of them say that the sentence means-the liver should be taken internally and the Pippali should be used as an Anjana. The commentator of Vrinda further says that the practice is to use both of them together as an Anjana.

70 THE SUSHRUTA SAMHITA. [ Chap. XVII.

would be found to be highly beneficial in cases of night-blindness. Similarly a single application of an Anjana made of a goat's liver stuffed with Pippali * and roasted in fire as in the preceding case would speedily and certainly cure an attack of night-blindness. As an alternative, both the spleen and the liver (of a goat or of a lizard) would be cut into pieces, mixed with oil and clarified butter, and roasted on a spit. Used internally or uscd as an Anjana with mustard oil, it would specdily cure an attack of night-blindness. 15-17. An Anjana or a pill composed of Nadija (Saindhava), S'imbi (D. R .- Samkha-conch-shell), Kataka, Anjana (Rasánjana), Manah-s'ilá, the two kinds of Nis' á, pasted together with the juice of the liver + (of a cow) and mixed with red-sandal paste is recommended in a case of day-blindness. 18. Treatment of palliative types :- Bleeding by opening the (local) veins should be resorted to in the six kinds of ocular affections in which the palliative treatment is all that is open to us. The patient should be as well kept constantly purged with draughts of matured clarified butter duly cooked with the admixture of suitable purgative drugs. In a Vátaja

• Both Vagbhata and Dallana plainly say that the roasted Pippali only should be used with honey as an Anjana in cases of night-blindness. t There is a confusion in the reading of this couplet. In place of "a' i.e. pasted with the juice of the liver (of a cow or any other animal), Chakradatta reads "nat aaa" i.c. to say-the liver. of a cow (and of no other animal) should be taken. Vrinda, however, reads and his commentator accepts the reading "ai aa' (the liver of an animal other than a cow) ; but this reading is objectionable on the ground of a faulty construction. "ma' i. e. pasted in the watery secretions of cow-dung, is yet another variant noticed by both the commentators of Vrinda and of Chakradatta.

Chap. XVII ] UTTARA-TANTRAM. 71

type (of any of these six affections) purging should bc induced with castor oil taken through the vehicle of milk. Administration of Traiphala-Ghrita is also recommended for purgative purposes, especially in the Pittaja blood-origined types. Purging with (clari- fied butter duly cooked with) Trivrit should be induced in types having their origin in the deranged Kapha, whilc oil duly cooked with Trivrit should be adminis- tered (for the purpose) in cascs of affections having their origin in the concerted action of all the three deranged Doshas. The use in any shape of old and matured clarified butter, kept in an iron vessel, proves beneficial in cases of Timira of any type. Clarified butter cooked with (the Kalka and decoction) of Triphalá or Mesha- s'ringi always proves efficacious in Timira of any typc. The patient should be made to lick a compound of powdered Triphald with a copious quantity of clarified butter in cases of Pittaja blindness, with oil in the Vataja type, and with a copious quantity of honcy in the Kaphaja type, of this disease (Timira-loss or darkness of vision). 19-21. The use as a Navana (errhine) of a medicated oil cooked and prepared with the decoction of cow-dung would be attended with beneficial results in all types of Timira. Clarificd butter * alone is beneficial in the Pittaja type ; similarly clarificd butter prepared by churning the milk of a ewe or a she-goat and cooked with the admixture of the drugs of the Madhura (Kákolyádi) group would prove bencficial in the Pittaja type of Timira. Oil cooked with the drugs of the Sthiradi (Vidari-gandhadi) or the Madhura

• Some say that this clarified butter is to be prepared from the milk of a ewe or she-goat

72 THE SUSHRUTA SAMHITA. [ Chap. XVII.

group * as well as the Anu-taila (see Chapter V, Chikitsita Sthána), might be prescribed with the greatest advantage in the types of the disease due respectively to the action of the deranged Vayu and vitiated blood of the system. A medicated oil duly cooked with an admixture of Sahá, As'va-gandhá, Ati-valá, S'atávari, Trivrit and the three fatty substances, Ghrita, lard and marrow, mentioned before (in connection with the treatment of Mahá-Váta-Vyádhi, Chapter VI, Chikitsita Sthána) might be advantagcously employed as an errhine in cases of Vátaja Timira. Butter churned out of the milk duly cooked with the flesh of any aquatic or marsh-frequenting fowl or beast should be cmploycd as an errhinc ; it would prove curative in cases of Vátaja Timira (loss of vision). 22-23. The flesh of a vulture and of a decr of the Ena species, Saindhava salt, honey and clarified butter should be prepared and applied (to the affccted eye) in the manner of Puta-paka (see next Chapter). The lard of vultures, snakes and cocks and Yashti-madhu should be pasted together (with honey) and applied (to the affected organ) in the manner of an Anjana (eye-salve)+. 24. Antidotes :- Srotonjana should be successively soaked in meat-juice, + milk and clarified butter in

• The part of the text within the two *s from 'Similarly' in the last page to 'group' in this page is not to be found in either Vrinda or Chakradatta. The commentator of Chakradatta, moreover, does clearly say that this part is an interpolation and cannot be found in some of the Mss. of Sus'ruta Samhitá. + According to Dallana the lards of vultures, snakes and cocks may be jointly or separately used-taken either one, two or all the three at a time. But in all cases they should be mixed with honey and Yashti- madhu. It should be noted that the lard of a Krishna-Sarpa (venomous serpent) should be used. # Flesh of those animals which give strength to the sight should be used in the preparation of meat-juice.

Chap. XVII. ] UTTARA-TANTRAM. 73

the manner of Bhávana saturation and uscd as a Praty- anjana * (in cases of Vátaja Timira unattended with redness). In cases of Vátaja Timira attended with red- ness of the eye, however, the Srotonjana should be placed inside the blades of Kus'a grass and preserved for a month insidc the mouth of a (dead) black cobra. Then it should be taken out and mixed with Saindhava salt and the burnt ashes of Malati (Jati) flowers. It should then be applied as an Anjana to the affected organ. As an alternative, Srotonjana should be soaked in milk for three successive days and applicd to the seat of the discasc in a case of (Vátaja) Kacha (cataract) which is said by experts to be remediable by this Anjana. 25. Treatment of Pittaja-Kacha :- Clari- fied butter skimmed from milk (and not from curd) and duly cooked with the drugs of the Madhura (Káko- lyâdi) group + should be employed as a snuff (Nasya), or as a Tarpana in the Pittaja typc of this disease. The flesh of Jangala animals (deer, ctc.) and the drugs of the Kákolyådi group should be used in the manner of Puta-paka in the Pittaja type of Kácha. A Kshudrán- jana composed of Rasanjana, sugar, honey Manah-s'ilá, and Yashti-madhu may likewise be applied. The use of an Anjana composed of Rasanjana and Tutthaka taken in equal parts and finely pounded, is also recom- mended by experts t in such cases. Powdered Tutthaka soaked in the decoction of Bhillota and the drugs of

• Pratyanjana (secondary eye-salve) is an antidote for the over-use of an Anjana. + According to some commentators the milk should be first cooked with the drugs of the Madhura group, and butter should then be churned out of that milk. # A benumbed condition of the eye through the abuse of eye- salves calls for the use of this Anjana as an antidote. IO

74 THE SUSHRUTA SAMHITA. [ Chap, XVII.

the Eladi-gana would be used as a Pratyanjana, and would be found beneficial in such cases. The use (as an Anjana) of Mesha-s'ringi and Srotonjana taken in equal parts and two parts of conch-shell pounded together is efficacious in the Pittaja type of this disease (Kâcha). The juice of Palas'a, Rohita and Madhuka (flower) mixed with honey and the surface layer of wine (taken in equal parts) should be prepared (in the manner of Rasa- kriyá and applied as an eye-salve in this type). 26-27. Treatment of Kaphaja Type :- The drugs known as Us'ira, Rodhra, Triphala and Priyangu duly cooked together (with Tila oil) should be employed for the purposes of snufing (Nasya) in the Kaphaja Typc. Fumigation (Dhumana) with the vapours of Vidanga, Páthá, Kinihi and Ingudi-bark would also prove beneficial in the Kaphaja type of cataract (Timira). The affected part should be likewise lubricated with the medicated Ghrita duly cooked with the decoction of Vanaspati (the milk- exuding trees, e. g., those of the specics of Indian holy fig) with pasted Haridra and Us'ira (as Kalka). The essence of the meat of Jángala (forest) animals, mixed with Pippali and profusely saturated with Saindhava and honey, should be prepared in the manner of Puta-paka (and applied to the affected part). Manah-s'ila,, Trikatu, Saindhava, Mákshika (honcy), S'amkha, Kásisa and Rasánjana should bc combinedly used for the purposes of Rasa-kriyá (in the typc under discussion). Kásisa, Rasánjana, Guda (old and matur- ed treacle) and Nágara, may be likewise used with benefit. 28. Treatment of Tri-doshaja Ka'cha :- Anjana (Antimony) many times heated and (subsequently) soaked in the decoction of Triphala prepared with (the

Chap. XVII.] UTTARA-TANTRAM. 75

oight kinds of) urinc, should be put inside the hollow (marrowless) bonc of a nocturnal bird (such as the vulture, etc.) and kept immersed for a month in unruffled (currentless) water. The Anjana thus prepared may be used with advantage, in combination with Madhuka (Yashti-madhu) and the flowers of Mesha- s'ringi in the Tri-doshaja types of Kacha. As an alter- native, all the measures and remedies (e. g., Tarpana, Puta-páka, etc.) * applicable in all the three Doshas should be employed in such cases. 29. Treatment of blood-origined Pari- mlayi :- Measures and remcdies mentioned in con- nection with the Pittaja type of Timira should be em- ployed in a casc of blood-origincd Parimlayi. In the alternative, the remedial agents prescribed for the treatment of the different kinds of Ophthalmia (Abhi- shyanda) should be as well prescribed according to the nature of the deranged Doshas involved in the casc. In case the deranged Doshas are not thereby subdued, Nasyas of the proper drug, as well as the many other Anjanas (collyrium) mentioned in the (next) Chapter on Kriyá-kalpa should be employed. 30. Diet :- A person carefully partaking of old and matured clarificd butter, Triphala, S'atávari, Patola, Mudga, Amalaka, Yara (barley) as diet enjoys immunity from all attacks of the dreadful Timira. Simply the Páyasa + prepared with S'atavari, or with Amalaka or a meal of barley corns cooked with the decoction * According to some, the measures and remedies to be applied in such cases are the measures of Rasa-kriyá applicable in cases of Vátaja, Pittaja and Kaphaja Timira. t The Payasa of S'ata'vari and A'malaki should be prepared by duly cooking S'ata'vari or A'malaki, as the case may be, with milk and sugar. According to others, however, it means the gruel (Yavagu) prepared with the expressed juice of S'ata'vari or A'malaki.

76 THE SUSHRUTA SAMHITÁ. Chap. XVII.

of Triphald and a copious quantity of clarified butter would remove (an attack of) Timira. The use of such edibles as Jivanti, Sunishannaka, Tanduliyaka, Vástuka, Chilli, Mulaka as well as meat of birds (such as Làva, etc.) and Jángala animals (eg. deer, etc.) should be con- sidered as invigorating to eyc-sight. The use of the leaves or fruit (as the case mnay be) of Patola, Karkotaka, Káravella, Vártáku, Tarkári, Karira (tender bamboo plants), S'igru or Artagala, cooked with clarified butter, proves beneficial (invigoratiog) to the sight. 31. Blood-letting (venesection) should never be resorted to in a case of Timira, marked by the redness of the affected eye in as much as it might bring about an aggravation of the deranged Doshas ending in blindness of the patient. 32. Prognosis :- A case of Timira marked by the absence of any redness of the eye and in which the first Patala (coat) of the organ is the seat of the discase, is curable (Sadhya). The case in which the eye assumes a bright red hue and the second coat or Patala of the organ is the seat of the disease, may be regarded as a curable one though only with the greaterst difficulty (Krichchhra-Sadhya). The case in which the third coat or Patala of the organ is the seat of the discase (charac- terised by the redness of its outer coat) should be re- garded as (an incurable affection) admitting only of palliative trcatment (Yapya). Proper palliative measures and remedies mentioncd before should be employed in cases of Timira marked by a redness (of the affected organ), and leeches may also be applied to the region of the affection (to relieve it of its exuberance of the Dosha in cases of emergency). 33. Surgical treatment of Kaphaja Linga-nas'a :- Now we shall describe the (surgi-

Chap. XVII.] UTTARA-TANTRAM. 77

cal) measures to be employed for curing a case of Linga- nasa (obstruction or choking up at the pupil with a cataract) due to the action of the deranged Kapha. In cases where the deranged Dosha in the organ, i.e., the affected part of the organ does not appear semi- circular or thin in the middle, nor, fixed, (hard) nor irregular (in shape), nor marked by a large number of lines or a variety of tints, or where it docs not resemble a pearl or a drop of water in shapc, or if it does not become painful and red coloured, the patient should be first treated with Sneha and Sveda at a season of the year which is neither too cold nor too hot for the purpose. Then the hands, etc., of the patient should be secured with proper fastcnings and he should be made to sit, looking simultancously (with his two eyes) at (the tip of) his nose. Then the intelligent surgeon leaving off two portions of the white part of the eye-ball from the end of the Apánga (the end of the eye) and having fully and carefully drawn apart the eye-lids with his thumb and the index and the middle fingers, should insert the Yava-vaktra (needle) instrument* through the sides of the natural apperture- like point near the external angles of the cye, neither above nor below, care being taken not to pierce the veins. The left cye should be pierced with the right hand, and the right with the left. The satisfactory nature of the operation (perforation) should be pre- sumed from the characteristic report or sound and the emission of a drop of water + from the affected region, following upon the perforation. 34-35.

• Both S'rikantha Datta and S'ivadasa, the commentators respect- ively uf Vrinda and Chakradatta, read 'पलाकया ताम्मय्या' meaning that the S'aláká (rod) should be made of copper. t Blood would come out if the perforation be not satisfactorily done.

78 THE SE ARUTA SAMHITA. [ Chap. XVII.

Instantly with the perforation the affected organ should be sprinkled over with breast-milk. The Saláká should be retained in its place and the diseased growth or appcarance (cataract), whether fixed or mobile, should be duly fomented from the outside with the help of the tender leaves of Vayu-subduing efficacy, and the region of the Drishti-mandala should be subsequently scraped with the (pointed) end of a Saláká. The mucus or phlegm (Kapha) accumulated in the affected eye should be removed by asking the patient to snuff it off by closing the nostril on the other side of the operated eye- ball. The part should be regarded as properly scraped when it would assume the glossiness of a resplendent cloudless sun and would be free from pain. Then the Saláká (rod) should be gently withdrawn as soon as it would be able to perceive vision, and then the (affected) eye should be sprinkled over with clarified butter and bandaged with a piece of linen. During this period * the patient should be laid on his back in a comfortablc chamber (free from dust and smoke), and be warned against indulging in all those bodily functions such as eructation, coughing, yawning, spitting, sncezing, etc. The regimen of diet and conduct thereafter should be the same as observed by one internally treated with a Sneha (See Chapter XXXI, Chikitsita-stha'na). 36-A. The bandage should be removed on every fourth day, and the organ should be washed with the decoction of the drugs of Vayu-subduing properties and bandaged again with a fresh one. The eye should be (mildly) fomented on every fourth day as before, so that the bodily Vayu might not be aggravated. This rule should be

t The period during which these rules should be followed is 'seven days' according to Vágbhata. But according to Dallana it is only the period during which the operation lasts.

Chap. XVII.] UTTARA-TANTRAM. 79

followed for ten days, as it would impart a fresh vigour to the sight. After-measures (such as snuffs, errhines, Tarpanas, etc.) should then bc employed and the Diet should consist of light articles of food and be given only in moderate quantities. 36. Persons declared unfit for venesection (viz., infants, old men, etc.) in the chapter on venesection * should not be subjected to any surgical operation, in cases of Nilika except at the placc mentioned beforc (viz. the natural aperture-Daiva-krita Chhidra). 37. Symptoms and treatment of the disorders resulting from an injudici- ous operation :- If the incidental hæmorrhage (from a puncture in a wrong place) fill in the cavity of the eye, in that case the eye should be beneficially sprinkled over with clarified butter duly cooked with Yashti-madhu and breast-milk. An incision (puncture) close to the exterior corner (Apanga) of the cye would usher in swelling, pain, lachrymation and redness of the eye, which should be remedied by poulticing (Upanáha) the part between the arches of the eye-brows, and sprinkling (Sechana) the eye over with tepid clarified butter. In the event of the organ bring punctured near the Krishna-mandala (region of the iris) and the Krishna-mandala being affected thereby, the affected part shoud be sprinkled over with clarified butter, pur- gative should be administered and blood-letting (by means of lecches) should be resorted to. A distressing pain ensues from the puncture being made on the upper part of the cyc (Krishna-mandala) and this should be cured by sprinkling drops of lukewarm clarified butter on the scat of affection. Excessive lachrymation sets in

• S'árira-Sthána, Chapter VII.

80 THE SUSHRUTA SAMHITA. [ Chap. XVII.

with pain and redness of the eye in the event of the puncture being made on the lower part of the eye (Krishna-mandala) and such cascs should be treated in the preceding manner. Emulsive (Sneha) application and fomentation (Sveda) of the parts as well as applica- tions of Anuvâsana enema should be considered as remedies in cases of redness, lachrymation, pain, numb- ness and bristling (of the eye-lashes) in the eye, as the result of an excessive and improper handling of the instrument during the opcration. 37-38. If removed in its acute stage (in a case of Linga- nása) the Dosha is liable to have an upward coursc and produce relapse in the red-coloured specks or films (opacity) in the Sukra (white part of the cye), and it tends to give rise to an excruciating pain in the locality and completely obstruct the vision. The remedy in such a case consists in sprinkling the eye with clarified butter duly cooked with the drugs of the Madhura-gana, and in the application of the same in the manner of Siro-vasti (errhine). Meat dict should be prescribed for the patient in such cases. As a full-bodicd cloud coming in contact with the wind meets its destruction, so the fully aggravated Dosha meets its doom, if operated upon with the surgeon's Saláka (rod). . 39-40. causes of Relapse :- A relapse of the de- ranged Dosha is caused by a blow on the hcad, physi- cal exercise, sexual excesses, vomiting, epileptic fits, or by an act of piercing the Linga-nása (cataract) during its partially developed (D. R. immature) stage. 41. Symptoms produced by the defects of the S'alaka' :- Care should bc taken not to remove the cataract with a roughly shaped Salaka (rod) as it might usher in an acute and aching pain in the affected organ. A rod with an unsmooth body might

Chap. XVII. UTTARA-TANTRAM. 81

lead to an aggravation of the deranged Doshas. A thick- topped rod would necessarily create an extensive ulcer, whcreas a sharp one begets the apprehension of hurting the eye in many ways. An excessive lachrymation scts in from using a rod with an unequal or irregu- lar top or mouth, whereas its unsteadiness (in the course of the operation) makes the operation an abortive one, Hence a Saláká (rod) should be constructed and used for the purpose in such a manner as to preclude the possibility of the foregoing defccts and injuries. 42. Description of the Salaka :- The Saláká (rod) should be made to measure eight fingers in length, its middle part being covered with strings of thread and resembling the upper section of the thumb in circumference and its ends terminating in the form of a bud. The rod (Saláká) should be prepared of copper, iron or gold. 43. Derangements due to defective operation :- Redness of the eye, local swelling, sucking pain, (appearance of) Arvuda or Vudvuda, hog- like eye (Sukarákshitá) * and ophthalmia &c. are due to the improper handling of the rod or to the use of improper regimen of diet and conduct. These should be remedied according to the nature of the deranged Dosha involved in each casc. 44. Their treatment :- Now again hear me discourse on the (specific) medicines to be employed in cases of pain or redness in the eyes. A medicinal plaster composed of Gairika, S'árivá, Durvá, and barley pasted with milk + and clarified butter, should be

• Both Virinda and Chakradatta reads "Kekarákshitá" i. c. a squinting look. + Vrinda and Chakradatta following Vágbhata do not read "Payas" (milk) and they read the first line of this couplet in a different form.

82 THE SUSHRUTA SAMHITA, [ Chap. XVII.

applied lukcwarm (about the eyes) for the subsidence of pain and redness. A plaster (Lepa) prepared of Siddharthaka (white mustard seeds) and slightly fried sesamum seeds pasted with the expressed juice of Mátulunga, or one prepared of Payasyá (Kshira-kákoli), Sárivá, Patra, Manjishthá and Yashti-madhu pasted together with the milk of a shc-goat, if applied luke- warm to the affected region, removes the pain and redness of the eyes. A plaster composed of Dáru, Pad- maka, and S'unthi, prepared and uscd in the same way is likewise recommended for the purpose. A plaster of Drákshá, Yashti-madhu, Kushtha and Saindhava should be likewise used. Cow's milk cooked with Sain- dhava should also be used for the alleviation of pain and redness of the eye. Clarified butter duly cooked with the admixture of S'atavari, Prithak-parni, Musta, Amalaka, Padmaka and the milk of a she-goat, should be applied (cold) to the affected organ (cye) for the alleviation of pain and burning sensation therein. Clarified butter duly cooked with the Kalka of the drugs of the Kákolyádi group with a quantity of milk four times the weight of the clarified butter, previously cooked with the drugs of the Váyu-subduing (Bhadra- dárvådi) group (in the manner of Kshira-páka) should be considered as efficacious in any form (internally or externally. in cases of ocular affections. The affected organ should be treated with Sncha emulsive (applica- tions) and (Sveda), fomentation and opening of the veins (Sirá) or cauterisation (by honey, clarificd butter, or treacle) as described before, should be resorted to in cases where the foregoing remedics would fail to pro- duce any effect. 45-46. Eye-sight-invigorating Anjana :- Now hear me describe two bencficial recipes of Anjana

Chap. XVII. ] UTTARA-TANTRAM. 83

which would invigorate the eye-sight and impart a clear- ness of vision. Flowers of Mesha-S'ringi, S'irisha, Dhava and of Málati together with pearl and Vaidurya (ruby) should be pounded and made into a paste with the addition of the milk of a she-goat. The compound thus prepared should be kept in a copper vessel for a week and then made into Vartis (sticks) of convenient lengths and applicd to the eyes in the manner of an Anjana. A Varti (stick) should be similarly prepared with Srotonjana, coral, Samudra-phena, Manah-s'ild and Maricha and used similarly as an Anjana (eyc-salve). It imparts stcadiness of vision. The many other Anjanas to be described in the next Chapter (Kriya-kalpa) may also be beneficially applicd for the purpose. 47-48.

Thus ends the seventeenth chapter in the Uttara-Tantra of the Sus'ruta- Samhita which treats of the curative measures of the diseases of the Drishti (pupil).

CHAPTER XVIII.

Now we shall diseourse on the Chapter which treats of the preparations and uses of the medicinal measures (external applications) to be adopted or employed in treating ocular affections in general (Kriya- kalpa). I. Here follows a general cxposition of the instructions which the sainted lord of Benares, the holy Dhanvantari of profound intellect imparted to his disciple the son of Visvámitra (Susruta) regarding the different medicinal measures (Kriyá) such as Tarpana (soothing), Seka (sprinkling), A'schyotana (eye-drops), Puta-pakas Anjanas (eye-salves), etc., mentioned before in different places to be employed in diseases of the eye. 2-3. The Tarpana Measure :- The measure known as Tarpana should be employed in respect of an affected eye either in the forc-noon or in the after-noon under the auspices of propitious astral combinations, after having purged the head and bowels of the patient and subsequent to the digestion of any food previously taken. The patient should be laid on his back in a chamber not exposed to the rays of the sun, and the gust of the wind, and where the atmosphere is not charged with minute particles of floating dust. The region of his eye (i. e. cye-lids) should be thickly coated with powdered Masha pulse, pasted (with water) in the form of a circular wall which should be even, hard and compact. Then a quantity of the transparent upper layer of clarified butter should be stirred with the admixture of a quantity of lukewarm water and poured (Purana) into the cavities of the eye up to the eye-lashes and retained therein for as

Chap. XVIII. ] UTTARA-TANTRAM. 85

long a period as one would take to count five hundred, six hundred, eight hundred, and ten hundred syllabless respectively in cases of healthy persons and persons with Kapha-origined, Pitta-origined and Váyu-origined diseases of the eye. According to certain authorities, the periods of such retention (of clarified butter) should vary with the seat of the affection (in the eye-ball). The clarified butter mentioned above should, according to them, be retained in the cavities of the eye for as long a period as one would take to utter three hundred, five hundred, seven hundred, one thousand, or eight hundred syllables respectively in cases of the diseases confined to the region of the Sandhi, Vartman, Sukla, Krishna, the eye in gencral (Sarva-gata) and the Drishti of the eye *. The clarified butter should then be secreted through the interior corner of the affected organ which should be purified by applying poultices of pasted barley. The Kapha, deranged by the use of this Sneha-Purana should be then conquered by making the patient inhale some kind of Kapha-subduing Dhuma (smoke). This rule + should be observed for onc, three or five days in succes- sion. 4. Symptoms of satisfactory, excess- ive and defective Tarpana :- Sleep at the first call, unembarrassed waking, cessation of secre- tion, clearness of vision, agreeable sensation, perceptible amelioration of the discase, and lightness of the organ

• Accordtng to some, the 'Purana' should be retained in the eye for a period required to count one thousand syllables in cases of Sarva-gata and eighteen hundred words in cases of Drishti-gata eye-diseases. + According to Gayadasa, this rule should be observed for one, three, or five days in cases of the preponderance of Váyu, Pitta and Kapha res- pectively, and according to Jejjata, in cases of mild, moderate and severe attack respectively.

86 THE SUSHRUTA SAMHITA. [ Chap. XVIII.

are the symptoms which result from a proper and satisfactory Tarpana of the cye. Cloudiness of vision, a sensc of heaviness in the affccted organ, excessive glossiness (of the eyc), lachrymation, itching, sliminess and an aggravation of the Doshas are the features which mark a case of severc and excessive Tarpana. A sensc of dryness in the affected organ, cloudiness of vision, profuse lachrymation, sensitiveness to light and an aggravation of the disease are the evils which follow an act of defective Tarpana (of the eye). 5. Treatment of excessive and defect- ive Tarpana :- Cases of defcctive and cxcessive Tarpana should be remedied with the application of medicinal snuffs, Anjanas, washes and inhalations of smoke and by adopting dry or emulsive measures, (as the cases may require). 6. Cases for Tarpana :- Shrivelling and dc- pilation of the eye-lashes, cloudiness and darkness of vision, archedness of sight, absolute want of lachryma- tion, parchedness of the eye, hardness of the cyc-lid and a severely diseased condition of the cye are amenable to the application of the Tarpana mcasure as giving tone to the eye. The Tarpana measure should not to be applied in a cloudy day, nor in a day excessively hot or celd. It should not be applied to the eye of a person engrossed by anxiety or fear, nor before the subsidence of the supcrvening symptoms (Upadrava) of the eye-diseasc. 7-8. The Puta-pa'ka :- The Puta-paka measure should be applied in the aforesaid cases. The Puta-páka is not applicable in cases where Nasya (errhines), Tarpana and the internal application of Sncha (Sneha-pána) are forbidden. After a complete subsidence of the Dosha, the Puta-páka should be applied to the (affected) eye

Chap. XVIII. UTTARA-TANTRAM. 87

in cases where the patient would be found capable of being treated with it. The Puta-páka measure may be divided into three classes, viz., Snehana (emulsive), Lekhana (scraping) and Ropana (hcaling) Puta-páka. The Snehana (emulsive) Puta-páka is recommended in cases marked by the cxtreme parchedness of the affected organ or locality, and Lekhana (scraping) ones are efficacious in cases of excessive applications of the Sneha to the cyc; while the eye-sight is invigorated by the Ropana (healing) Puta-páka, which restores the Váta, * the Pitta and the blood of the affected locality to their natural conditions, and (conscquently) heals the ulcer. 9-10. Preparation of Snehana, Lekhana, and Ropana Puta-pa'kas :- The Snehana (emulsive) Puta-páka should be prepared with the flesh (of animals frequenting marshy places) abounding in Sncha + and with the Vasa (lard), Majjan (marrow), and Medas (fat), and the drugs of the Madhura group and it should be retained in the eye so long as one would take to utter two hundred syllables. The scraping or Lekhana Puta-paka should be preparcd with the flesh and the liver of an animal of the Jángala species and the drugs possessing the Lekhana or scraping properties, as well as powders of black iron (steel), copper, conch- shells, Vidruma (corals), Saindhva salt, Samudra-phena, Kâsisa (sulphate of iron) and Srotonjana (pasted to- gether) with the cream of curd. The affected locality should be exposed to a Lekhana Puta-páka as long as

• A different reading, mentioned by Dallana, does not read "Váta." t In place of "awia" meaning flesh abounding in Sneha, a different reading "afuerta" (i. e. clarified butter and flesh) is quoted by Dallana.

88 THE SUSHRUTA SAMHITA. [ Chap. XVIII.

one would take to utter a hundred syllables at most. The healing or Ropana Puta-pâka should be prepared by cooking the flesh of an animal of the Jangala group with breast-milk, honey*, clarified butter and the bitter drugs, and should be retained in the affected eye for a period three times as much as the Lekhana-Puta-páka should be retained i.e., for a period as long as one would require to utter three hundred syllables. 1I-13. The fumigating measures mentioned in connection with the Tarpana of an affected cye, as well as the appli cations of Sneha and Sveda, should be resorted to in the cases of the application of the Puta-pâka measures, except in cases of the application of the Ropana Puta-páka. Puta-páka applications may be made on one day only or may be continued for two or three days.+. A strict regimen of diet and conduct should be observed for a period twice as long as the preparatory period (beginning with the time of administering the Sneha to the patient for preparing him for the application of the Puta-páka till the time of actually administering the Putapáka itself). 14-15. Prohibition and Remedies for in- fringement :- After the application of Tarpana and Puta-páka (to the affected eye) the patient should not catch glimpses of the light, fire, sky, looking-glass or any other luminous object ; nor he should expose the eye

• In place of 'es" (honey and clarified butter) Dallana quotes a variant "Aena"-lit. sacred clarified butter i e., clarified butter pre- pared from cow's milk. + Dallana explains that the application of the Puta-páka measure should be made for one day only in Kaphaja eye-diseases, or if the Puta-páka be a Lekhana one ; and it should be continued for two days in Pittaja eye-diseases, or if it be a Snehana one ; and for three days in Vátaja eye-diseases, or if it be a Ropana Puta-páka.

Chap. XVIII.] UTTARA-TANTRAM. 89

to the blast of the wind. The unfavourable symptoms incidental to and induced by an infringement of the rules to be observed after the application of these two (Tarpana and Puta-pâka) measures should be remedied with the applications of Anjana (collyrium), A'schyotana and Sveda (fomentation) to the deranged bodily Doshas, underlying each particular case. 16-17. Satisfactory, excessive and defec- tive application of Puta-paka :- Fresh- ness and clearness of the colour (of the cornea), capa. bility of the organ (eye) to bear heat, light and wind, refreshing sleep and an unembarrassed gladsome waken- ing and a lightness of the organ are the benefits which are derived from Satisfactory Puta-páka applications. Darkness of vision, pain and swelling of the eye and the appearance of eruptions (Pidaká) in the affected organ, arc the evils which mark an excessive applica- tion of the Puta-páka measure ; while suppuration and lachrymations of the eye and a thrilling ensation (Harsha) in the affected organ, as well as a further aggravation of the Dosha (involved) are the characteris- tic features of a deficient Puta-páka application. 18. Mode of preparing Puta-paka :- Now I shall describe the mode of preparing a Puta-paka remedy. Two Vilva (Pala) measures of cleansed and pasted meat, one Pala measurc of the medicinal drugs pasted together and onc Kudava (half a scer) measure of liquid ingredients should be mixcd together (and made into a ball), well covered with the leaves of Kadali, Kásmari, Eranda, Kumuda or of Padma plant. Coated with clay, it should be duly scorched in the burning charcoal (fire) of catechu wood or in that of Kataka, As'mantaka, Eranda, Pátalâ, Vásaka, Vadara, Kshira-exuding trees, or in the fire of the dried cakes I2

90 TIE SUSHRUTA SAMHITÁ. [Chap, XVIII.

of cow-dung. When well cooked the ball should be taken out of the fire and broken and its contents with- drawn and squcezed. The fluid extract should then be collected and applied (to the affected organ) in the manner of applying a Tarpana. I9. The mode of application :- The patient being laid on his back at the time, the fluid extract in both the cases (Tarpana and Puta-páka) should be dropped cold into the Kaniniká (Cornea) of the eye in cases of derangement of the blood and the Pitta; it should be used lukewarm when the Váyu and the Kapha would be found to have been aggravated. A burning sensation in the affected eye as well as its consequential inflammation would result from the usc of too hot (warm) or strong or keen-potencied (Tikshna) extract for the purposc. A thrilling sensation (Harsha), pain and numbness in the locality and lachrymation from the affected organ originate from the use of a cold and mild-povencied Puta-páka or Tarpana eye-drop. Red- ness and contraction of the eye attended with a jerking and throbbing sensation therein are the effccts of an excessive (over-dose) application of the Puta-páka and Tarpana, whereas a deficient (under-dose) use of them produces an aggravation of the deranged bodily Doshas in the locality. Properly applied, they alley the burning and itching sensation, swelling, pain, lachrymation and mucous secretion, as well as the (unnatural) coating and redness in the affected eye. As every one is desirous of avoiding the aggravation of Doshas, so the Puta-páka and Tarpana measures should be applied in such a way as would give health and happiness (to the eye). The evils resulted by a course of injudicious application of Puta-páka or Tarpana, are to be remedied with the application of errhines ( Nasya), Dhuma and Anjana

Chap. XVIII.] UTTARA-TANTRAM. 91

remedial to the specific deranged bodily Dosha or Doshas involved in each case. 20. The affected eye should be fomented before the use of a Puta-páka or a Tarpana measure with a piece of cloth soaked in hot water (and rinsed). Fumigation of the affected organ in the end should be prescribed in a case marked by an aggravation of the deranged Kapha of the locality. 21. Ás'chyotana and Seka :- Properly pre- pared and applicd, the Aschyotana and Seka measures would respectively subdue cases of slight and violent attacks of the cye. Like the Puta-páka measure thesc two also are devided into three classes vis., (Lekhana, Snehana and Ropana). Seven or eight drops of the medicinal fluid should be used in Lekhana-Aschyotana (for the purpose of scraping the affectcd eye) ; ten drops in the Snehana (for emulsive purposes) and twelve drops in the Ropana Aschyotana ( for the purpose of setting up a granulative process in a local sore or wound). The maximum period for which an (affected) eye should be subjected to the Seka measure is twice as long as is enjoined in respect of a Puta-páka measure,* or until the disease is gradually and wholly removed.+ Both the Aschyotana and the Seka applications should be made in the morning or evening or at noon (in accord-

• The period for which an affected eye should be subjected to the As'chyotana measure, is not given in the text, but Dallana says that it should be the same as observed in cases of Puta-paka. Some, however, hold that in cases of both Seka and As'chyotana the period would be twice as that for Puta-páka. + This rule for subjecting the affected eye to the measure till the disease is gradually and wholly removed is for Seka and As'chyotana only; but according to some it is a general rule which applies also to cases of Puta-páka and Tarpana, etc.

9₺ THE SUSHRUTA SAMHITA. [Chap. XVIIİ.

ance with the aggravation of the deranged Doshas),* or whenever there would be pain (in the affected eye). + The symptoms of proper and improper (excessive and deficient) applications of a Sneha (emulsive) Seka are identical with those of Tarpana. 22-23. Śiro-vasti :- The serious diseases peculiar to the head readily yeild to and are conquered by the application of Siro-vasti, which also produces the very good effects known as the Murdha-tailika ones peculiar to the use of (emulsive) Siro-vasti. The patient having been treated with purgatives and emetics (accord- ing to requirements ) should be given a proper diet according to the nature of the disease, and made to sit erect in the evening, when an animal bladder (the bladder of a goat being usually used for the purposc) filled with the proper Sneha, should be placed on his crown and firmly tied up with a bandage. The Sneha- filled bladder should be so retained on the head ten times as long as is necessary for Tarpana mcasure, according to the nature of the discase. 24-25. Anjana :- Proper Anjana for Lekhana (scraping), Ropana (healing), or Prasádana (invigorating) purposes should be applied after the clcansing (purging, etc.) of the system in cases where the dcranged bodily Doshas would manifest themselves in the region of the eye oniy. 26. A Lekhana-Anjana should bc prepared with the

• The Lekhana-seka and As'chyotana should be applied in the morning in the aggravation of Kapha, while the Snehana one should be applied in the afternoon in the aggravation of Vayu,-the Ropana ones being applied at noon in the aggravation of Blood and Pitta. t Dallana holds, that both the Seka and As'chyotana measures may be applied when ver there is pain in the affected eye, but others hold that this rulc applies only in cases of Seka.

Chap, XVIII.] UTTARA-TANTRAM. 93

drugs of one or more tastes (Rasa) except the sweet one and should be used in five different ways accord- ing to the nature of the Dosha or Doshas involved in each case .* The Dosha accumulated in the regions of the eye and the eye-lids, in the ball, the passages, and in the capillaries of the eyc, as well as in the gristle of the nose would be secreted through the mouth, the nostrils and the corners of the cyes by the application of a Lekhana Anjana. A Ropana- Anjana should be prepared with the drugs of bitter and astringent tastes ( Rasa ) mixed with ( a little quantity of ) clarified butter and is good for healing purposes. Owing to the presence of the Sneha, it is cooling in its effect and conscquently gives natural colour and vigour to the eyc. A Prasadana-Anjana, pre- pared with the drugs of sweet taste and with (a profuse quantity of) Sneha, imparts tone and vigour to the eye- sight and should be used with advantage for all sooth- ing purposes connected with the organ. The application of the different kinds of Anjana should be made in the morning, evening or in the night + in accordance

• In cases of the derangement of the local Vayu, the Anjana should be prepared with the drugs of acid and saline tastes (Rasa) ; in the derangement of the Pitta with those of astringent taste ; in Kapha with those of astingent, bitter and pungent tastes In cases of the derange- ment of the blood, the Anjana should be like that in the derangement of Pitta, and in cases of the derangement of two or three Doshas simul taneously, the Anjana should be prepared with drugs of two or three of the tastes required. + The Anjana should be applied in the morning, in the evening and in the night respectively in the cases of the derangement of the Kapha Vayu and the Pitta. According to the others, the S'odhana, the Ropana and the Snehana Anjanas should be respectively used in the morning, in the evening and in the night. Others, however, are of opinion that these different times should be judiciously selected in the different seasons of the year according to requirement.

94 THE SUSHRUTA SAMHITÁ. [Chap. XVIII.

with the nature of the deranged bodily Dosha or Doshas involved in each case. 27-30. Forms of Anjana :- The forms in which an Anjana may be, are those of pills, liquid (Rasa-kriyá) and powder * each succecding, one being more effica- cious than the onc preceding it, in the order of enu- meration. 31. Their sizes and doses :- The size (dose) of a Lekhana, Prasádana and Ropana Varti (Pill) should be equal to that of one and a half and twice as much as a Kaláya pulse for ocular affections in general. As regards the application of Rasa-kriyá-Anjana in these disorders the quantity to be uscd in a dose should be cqual to that of the Varti in the different cases respectively. As regards the dose of the powders (to be used in cye- diseases) it should be respectively twice, thrice and four times as much as would be contained at the end of a Salâkâ (rod). 32. The materials of the vessel and rod for the use of an Anjana :- The vesscls containing the different kinds of Anjana should be according to the different kinds of Anjana themselves, and thesc vessels as well as the Saláka (rod) for the use should be made of gold, silver, horn, copper, Vaidurya (a kind of precious stone), bell-metal and iron respectivcly (in accordance with the different tastes of the drugs the Anjanas arc madc of). + The end of the

• Dallana says that Pill-Anjanas, Liquid-Anjanas and Powder- Anjanas should be preseribed in cases of severe, intermediate and mild attacks respectively. + According to Dallana the Anjana of sweet taste should be placed in a golden vessel, that of acid taste in a silver vessel, that of saline taste in a vessel made of horn (of a sheep), that of astringent taste, in a vessel either of copper or iron, that of pungent taste in a vessel made of Vaidurya,

Chap. XVIII.] UTTARA-TANTRAM. 95

rod should terminate in a bud-shaped ball with the girth of that of a Kalâya pulse, its entire length measuring eight fingers only. It would be well polished, slender at the middle and capable of being easily handled. A rod prepared of copper, precious stones such as Vaidurya, etc., and horns or bones, etc.,* will prove beneficial. 33. How to apply an Anjana :- The lids of the affected eyc (of the patient) should be slantingly drawn apart with the left hand, and the Anjana should be carefully applied by holding the rod with the right hand and by constantly moving the rod from the Kaniniká to the Apânga and vice versa ( along the inner side of the eye-lid ). This process should be repeated (twice or thrice ) according to requirements. The Anjana should be applied with the finger when it would be nccessary to use it on the outer side of the eye-lid. The Anjana in no case should be thickly paint- ed in the corners of the eye (i.c., in the Kaniniká and the Apanga from fear of hurting them), nor the organ should be washed till all the aggravations of the derang- ed (bodily) Dosha in the locality are completely removed thereform, in as much as it might bring on a fresh aggravation and impair the strength of the eye- sight. After the subsidence of the deranged local Dosha

and that of bitter taste should be placed in a vessel made of bell-metal. The S'alaka (rod) for the use of the different kinds of Anjana should be also accordingly prepared. According to Nimi, however, as quoted by Dallana and S'rikantha Datta, in their commentaries, the Ropana, Lekhana 'and Prasádana Anjanas should be placed in a vessel and used with a rod prepared respect- ively of iron, copper and gold. The other materials may be, however, used with discretion by an experienced physician. * The word 'ufq' in the text shows that a rod of gold may also be used with benefit-Dallana.

96 THE SUSHRUTA SAMHITA. [Chap. XVIII,

and of lachrymation, the eye should be first washed with water, and Pratyanjana should then be used in accor- dance with the nature of the specific deranged bodily Dosha or Doshas underlying in each case. 34. Forbidden Cases :- The application of Anjanas is prohibited in cases of persons suffering from fever, Udávarta, and the diseases of the head and during fits of anger, grief, fear, weeping and intoxication, as well as in cases of the retention of stool and urine, in as much as it might produce (in these cases) lachry- mation, Sula (aching pain), redness, pain, blindness (Timira), swelling in the locality, as well as giddi- ness. An application of the Anjana in a case of insomnia might be followed by the loss of the eye- sight *. The application of an Anjana in a windy day may impair the eye-sight. Application to the eyes affected with dust or smoke, may bring on redness, Adhimantha (Ophthalmia) and local secretion. Applied after the use of an errhine (Nasya) it may usher in an aching pain and swelling in the eyes. It leads to the aggravation of the disease, if applied in any disease of the head. The application of an Anjana would be abortive, nay, it would rather aggravate the Dosha, if applicd before sun-risc, after a bath, or in a very cold day, owing to the fixedness of the deranged bodily Dosha. Similarly, the application of an Anjana would fail to produce any effect in a case of indigestion, owing to the sluggish condition of the internal passages of the body (during the continuance of the disease).

• In some editions there is an additional text-"ननिद्राचयं च कुरुते frfa ynenq" which supplies a complete verb and makes the sense complete. The line means-the application of an Anjana in a forbidden case produces loss of sleep (insomnia) in addition (to redness, pain etc, mentioned in the preceding line).

hap. XVIII.] UTTARA-TANTRAM. 97

The application of an Anjana in an aggravated stage of the deranged bodily Doshas, ushers in the distressing symptoms peculiar to each of them. Hence, the applica- tion of an Anjana should be carefully made in such a manner as not to induce any of the aforesaid cvils, and these rules should be specially observed in connection with a Lekhana-Anjana. These distressing symptoms should be treated with washes (lotions), Aschyotana, plasters, Dhuma (fumigation), Nasya and Kavala (gurgle) with due regard to the specific nature of the deranged bodily Dosha or Doshas involved in each casc. 35-36. Symptoms of satisfactory, excess- ive and deficient use of a Lekhana- Anjana :- Lightness, whiteness and pristine clear- ness of the eye, marked by the improved power of vision and absence of secretion and all other dis- tressing symptoms, are the indications which point to the fact that the eye has been satisfactorily purged of the accumulated Doshas (by the proper application of a Lekhana Anjana). An excessivc purging of the cye (by the excessive use of a Lekhana Anjana) begets such local evils as the deep discolouration of the external coat of the eye, its sense of looseness in the socket, lachrymation, archedness of the organ and a sense of constant dryness in its cavity. The medical treatment in such instances consists in the employment of soothing (Santarpana) and other Váyu-subduing remedies. An insufficient or deficient application of the Lekhana Anjana leads to the aggravation of the local deranged bodily Dosha which should be fully secreted out by employing medicinal errhines, Anjana and local fumigation. 37-39. Symptoms of satisfactory, excess- ive and deficient use of Prasadana I3

98 THE SUSHRUTA SAMHITA. [ Chap, XVIII.

(Snehana) and Ropana Anjanas :- The action of the satisfactory application of a Prasadana (Snehana) Anjana is to soothe the eye, to impart a healthy tone to the organ of sight, to restore its natural colour and gloss, and to make it strong and unclouded and free from the aggravation of any Dosha. Any excess in the application is followed by results identical with those of excessive application of Tarpana (soothing measures)* to the organ, and the remedy con- sists in employing mild but parching remedics antidotal to the deranged bodily Dosha (Kapha) involved in the case. The symptoms which mark a satisfactory and excessive application of a Ropana (hcaling) Anjana, as well as the medical treatment to be applicd in cases of excess, are identical with those mentioned in connec- tion with the satisfactory and cxcessive application of the Prasadana (soothing) Anjanas (respectively). Deficient applications of both the Snehana (soothing) and the Ropana (healing) Anjanas (in respect of ocular affections) are sure to prove abortive in their effects. Care should, therefore, be taken to apply it properly, if it is hoped to get the wished-for result. 40-43. Thousands of remedial measures and remedies may be devised and employed in the manner of the Puta-páka and other measures on the basis of the fundamental principles herein inculcated. 44. Now we shall describe the recipes and preparations of several principal Anjanas fit for the use of kings and crowned heads for the purpose of giving strength to the eye-sight and for the amelioration of ocular affections (Kácha, etc.) amenable only to the palliative measures. Eight parts of Rasanjana (Antimony) having the hue of

• See S'loka 5 of this Chapter,

Chap XVIIİ.] UTTARA-TANTRAM. 99

a (full-blown) blue lotus flower, as well as one part each of (dead) copper, gold and silver should be taken together and placed inside an earthen crucible. It should then be burnt by being covered with the burning charcoal of catechu or As'mantaka wood, or in the fire of dried cakes of cow-dung and blown (with a blow-pipe till they would glow with a blood-red effulgence) after which the expressed juice (Rasa) of cow-dung, cow's urine, milk-curd, clarified butter, honey, oil, urine, lard, marrow, infusion of the drugs of the Sarva-gandhá group, grape-juice, sugar- cane-juice, the expressed juice of Triphala and the com- pletely cooled decoctions of the drugs of the Sárivádi and the Utpaládi groups, should be separateiy sprinkled over it in succession alternately each time with the heating thereof, (or to put it more explicitly, the crucible should be taken down after being heated and then one of these draughts should be sprinkled over its contents and then again heated and again sprinkled over with another draught, and so on). After that, the preparation should be kept suspended in the air for a week, so as to be fully washed by the rains. The compound should then be dried, pounded and mixed together with propor- tionate parts (quarter part) of powdered pearls, crystals, corals and Kálanu-sárivâ. The compound thus prepared is a very good Anjana and should be kept in a pure vessel made of ivory, crystal, Vaidurya, S'amkha (conch-shell), stone, gold or silver or of Asana wood. It should then be purified (lit. worshipped) in the manner of the purification of the Sahasra-Paka-Taila described before. It may then be prescribed even for a king. Applied along the eye-lids as a collyrium, it enables a king to become favourite with his subjects and to continue invincible to the last day of his life free from ocular affections. 45.

100 THE SUSHRUTA SAMHITA. [ Chap. XVIII.

Bhadrodaya-Anjana :- The drugs known as Kushtha, Chandana, Elá, Patra, Yashti-madhu, Rasánjana, flowers of Mesha-s'ringi, Chakra (Tagara), the seven kinds of jewels*, the pollens of the flowers of Utpala, Brihati, Kantakári and of lotus, Nága-kes'ara, Us'ira, Pippali, the shells of hen's eggs, Dáru-haridra, Haritaki, Gorochona, Maricha, marrow or kerncl of Vibhitaka-seeds and the flesh of lizards (which are found to scale the walls of rooms), should be powdered together in equal parts and should be preserved in a vessel and purified (sanctified) in the preceding manner. This Anjana is called the Bhadrodaya-Anjana and should always be used by a king. 46. Equal parts of Chakra (Tagara), Maricha, Jata-mámsi and S'aileya with Manah-s'ila cqual to the combined weight of the preceding drugs, four parts of Patra with Rasánjana (antimony) twice the combined weight of all the preceding drugs and Yashti-madhu of equal+ weight with the last-named drug (Rasanjana) should be powdered together and used as an Anjana in the forc- going manner. 47. Manah-s'ilá, Deva-dáru, the two kinds of Rajani, Tri- phalá, Trikatu, Lákshá, Lasuna, Manjishthá, Saindhava, Elá, Mákshika, Sávaraka Rodhra, dead iron and copper, Kálanu-sárivá and the outer shells of hen's eggs taken in equal parts should be powdercd together, resolved into a paste with milk and made into pills of ade- quate size. Diseases of the eyc such as the itching sensation in the eye, Timira, Suklárma and Raktaráji readily yield to the curative efficacy of this Anjana. 48.

• The seven kinds of gems are (1) Padmarága, (2) Marakata, (3) Nila, (4) Vaidurya, (5) Muktá (pearl) (6) Pravála and (7) Hema (gold). + According to some the weight of the Vashti-madhu to be used in this Anjana should be equal to that of all the other drugs combined.

Chap. XVIII. ] UTTARA-TANTRAM.

An Anjana should be prepared by collecting lamp- black on a vessel made of Indian bell-metal, and mix- ing it with one part each of Yashtimadhu, Saindhava, Tagara and roots of Eranda, as well as two parts of Brihati. This compound should be pasted together with goat's milk and thinly plastered on a copper platc. This process should be continued for seven times in succession and dried in the shed. It should then be made into Vartis and (uscd as such) would relievc pain in the eye. 49. One part each of Haritaki, Yashti-madhu with sixteen parts of Maricha should be pounded and pasted together with cold water. It should then be made into Vartis and would be efficacious in all sorts of ocular affections. An experienced physician may with care and discretion prepare Pindanjanas with the drugs anti- dotal to the specific Dosha or Doshas involved in the case, in the manner of preparing the Rasa-kriya preparations. 50-51.

Thus ends the eighteenth chapter of the Uttara-Tantra in the Sus'ruta Samhita whieh deals with the preparations and uses of the medicinal measures to be used in different ocular affections.

CHAPTER XIX.

Now we shall discourse on the medical treatment to be adopted -in cases of hurt or injury to the eye (Nayanabhighata-Pratishedha). I. A violent and intolerable pain in the eye accom- panied by redness and swelling therein, resulting from a blow or from any sort of hurt or injury to the organ, should be remedied with the application of medicinal Nasya (errhines), plasters, sprinkling and Tarpana (soothing measures), and other measures mentioned before, as well as the measures prescribed in cases of Pittaja and Raktaja Abhishyanda-lit. remedial to the pain (Sula) caused by the deranged blood and Pitta in the locality. The affected eye (Drishti) should also be soothed with the help of cool, sweet and fatty drugs. This kind of treatment should also be followed in cases where the eye would be hurt or oppressed by (excessive) fomentation, smoke or glare-fire, or affected on account of fear, mental agony, pain or injury. These measures should also be resorted to in the first stage (i. e., during the first week) of the hurt or injury in the cye. After this period the affected eyc should be treated as a case of an Abhishyanda with due regard to the nature of the specific deranged bodily Dosha or Doshas involved in the case. A slight hurt in the eye may be instantaneously relieved by the application of warm breath-fomentation. 2-4 Prognosis :- Any ulceration restricted to one Patala (coat) only of the eye may be easily cured ; an ulcer invading two Patalas of the organ may be healed only with the greatest difficulty, while the one affect- ing three Patalas should be regarded as incurablc.

Chap. XIX. ] UTTARA-TANTRAM. 1O3

Palliative measures are all that are possible in cases of looseness, dislocation, sunkenness and the thiashed condition (Pichchita) of the eyes as well as in a case of Hata-drishti (loss of eye-sight). Cases of wrong or erroneous vision, marked by the dilation of the pupil, absence of any considerable redness and those cases where the eye (eye-ball) is in its proper place and is not affected in its power of vision prove amenable to. medical treatment. 5-6. A sunken eye may be uplifted either by holding the breath (Prána-váyu) or by inducing vomiting or sneez- ing, or by throttling or obstructing the wind-pipe. Where the eyes would be found to be hanging down from the sockets, the measures and remedics prescribed before* should be resorted to, and the patient should be made to take in long breaths of air (through the nostrils) and cold water should be poured on his head. 7. Symptoms and treatment of Kuku- naka :- The seventy-six kinds of eye-diseases herein mentioned before, occur to adults as well as to infants, but a peculiar disease, due to the action of deranged Váyu, Pitta, Kapha and blood, sometimes manifests itself in (the inner lining of) the eye-lids of an infant and this is known as Kukunaka. Its exciting cause is the vitiated condition of the breast-milk of the mother. In this disease, there is excessive itching in the eyes, and the child frequently rubs his eyes, nose and forehead with his fist ; there is constant lachrymation and the child cannot bear the least light of sun's rays. The organ should, in such cases, be speedily bled (by applying leeches) and be scraped (with rough leaves). The organ should further be rubbed with Tri-katu and honey pasted together.

• See Chikit-ita-sthána, Chapter II, Para 29.

104 THE SUSHRUTA SAMHITA. [ Chap, XIX.

The mother (or the nurse) should also be treated in the manner prescribed before (in cases of an affection of the breast-milk). Compounds of Saindhava salt, honey and powdered Khara-manjari (Apámárga) seeds, as well as those of powdered Pippali, Saindaava-salt and honey with the vehicle of breast-milk should be given to the child for emetic purposes, but this should be discontinued as soon as vomiting would set in. 8-I0. To a child who takes both breast-milk and other solid food, the emetic should be administered with the admixture of Vachá, and to a much older child (i.e., one who has given up taking breast-milk) the emetic should be given with the admixture of Madana fruit. II. Decoction of the tender leaves of Jambu, Amra and Amalaki should be used for washing and sprinkling purposes. Clarified butter duly cooked with Tri-phala or with Guduchi should be dropped into the eye as an Aschyotana measure. 12. Anjanas composed of Manah-s'la, Maricha, S'amkha (conch-shell), Rasánjana and Saindhava pounded to- gether and pasted with honey and treacle should be applied to the affected organ. Compounds of Murva, honey and powdered copper should also be used as Anjana. The compound prepared by burning black iron (steel), clarified butter, milk and honey mixed together should be similarly used as an Anjana. As an alterna- tive, the Gutikanjana made up of Trikatu, Palándu (onion), Yashti-madhu, Saindhava, Lákshá (lac) and Gairika (earth) pasted together, should be used. The Anjana made of Nimba-leaves, Yashti-madhu, Dárvi, *

• "Dárvi" generally means Dáru-haridrå ; but, here, on the authority of Videha, Dallana takes it to mean the two kinds of Haridra, viz., Haridrá and Da'ru-haridra.

Chap. XIX. ] UTTARA-TANTRAM. I05

copper (powdered) and Lodhra taken in equal parts and pounded together, is also efficatious. 13. An Anjana prepared with Rasanjana (Antimony), S'amkha, curd and Saindhava kept together for a period of half a fortnight, * should be applied to thc affected organ of the child in cases of Sukra, and the directions given under the head of Kaphaja-Abhishyanda should also be followed by experienced physicians in such cases of the eye-disease of children. 14. Conclusion :- The Scicnce of medicine is as incomprehensible as the ocean. It cannot be fully described cven in hundreds and thousands of verses. Dull people who are incapable of catching the real import of the Science of reasoning would fail to acquire a proper insight into the Science of medicine if dealt with elaborately in thousands of verses. The occult principles (of the Science of mcdicine), as explained in these pages, would, thereforc, sprout and grow and bear good fruits only under the congenial heat of a (medical) genius. A learned and experienced (medical) man would therefore try to understand the occult principles herein inculcated with due caution and with reference to other Sciences. 15.

Thus ends the nineteenth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the medical treatment to be adopted in cases of hurt or injury to the eye.

• The method of preparing this Anjana, as explained by Dallana on the authority of Videha, is as follows :- S'amkha (conch-shell) and Saindhava should be first pasted together with curd (Dadhi) and then a quantity of Rasanjana should be soaked with this preparation for seven days and a half and Varti should then be prepared therewith and applied to the eye as an Anjana.

I4

CHAPTER XX.

Now we shall discourse on the chapter which treats of the causes and symptoms of the diseases peculiar to the ear-the organ of hearing (Karna-gata- Roga-Vijnaniya). I. Classification :- Twenty-eight different forms of ear-diseases are noticed in practice, viz., Karna-Sula (ear-ache), Pra-náda (ringing or noise in the ear), Vádhirya (dcafness), Kshveda, Karna-Sráva (discharge of pus, etc., from the ear), Karna-Kandu (itching in the car), Karna-gutha, Krimi-karna (vermin-infested cars), Prati-náha, the two kinds of Vidradhi (local abscess), Karna-páka (suppuration of ear), Puti-karna (fetor in the car), four kinds of Arsas (Cysts or polypuses in the car), seven kinds of Arvuda (tumour) and four kinds of Sopha (swelling). 2. Symptoms of Karna-Sula and Pra- nada :- The violent aching pain in the region of the ear and inside the tympanum caused by the deranged local Váyu, aggravated and obstructed by the other deranged Doshas in the locality is called the Karna-Sula (ear-ache). Ringing and various other sounds in the ear are heard when the deranged Váyu of the locality gets into the wrong way and remains there stuffed in the sound-carrying channels of the organ. This disease is called the Pra-nada. 3-4. Symptoms of Vadhirya and Kshve- da :- Vadhirya (deafness) results from the conti- nuance in the sound-carrying channels of the deranged local Váyu in combination with the deranged local Kapha in those localites without anyway being remedied or subdued. An attack of Karna-kshveda (expresing a

Chap. XX. ] UTTARA-TANTRAM. 107

peculiar sound in the ear) may be attributed to such causes, as to the use of any cold thing or exposure to cold after being treated with a head-purging remedy (errhines), or to the continuance of the deranged local Váyu in the sound-passage, aggravated by excessive labour, by any wasting process in the system or by taking articles of fare of astringent taste or of parching (Ruksha) property .* 5-6. Symptoms of Karna-Srava and Karna-kandu :- Any discharge or secretion of pus from the ear caused by the deranged bodily Váyu stuffing the ear-cavity, owing to a blow on the head or a long immersion in water or a spontaneous suppuration (and bursting) of an abscess in the inner ear, is called Karna-srava. The excessive itching sensation in the ear due to the aggravation of the local Kapha is called Karna-kandu. 7-8. Symptoms of Karna-gutha and Karna-Prati-naha :- Any mucous accumulation in the ear dried and hardened by the heat of the local Pitta is called Karna-gutha ; when the dried accumu- lation of the ear in cases of Karna-gutha becomes liquefied, (and comes out through) the cavity of the nose + and produces head-disease $ it is called Karna- Prati-naha. 9-I0.

• Tha difference in the "Karna-nada" and "Kshveda" is that in the. former the sound in the ear is produced by the deranged Vayu alone and is of various kinds, whereas, in the latter it is of a special kind, viz., that of a wind-pipe-the exciting cause being the deranged local Pitta, Kapha and blood .- Videha. + Some explain "sTw" to mean the cavity of the nose and of the mouth. $ In place of "farratsforaq":" (producer of head-disease) Madhava in his Nidana reads "farresaaq" i.e,, producer of the head- disease known as Ardha-vedhaka (see chapter XXV).

1o8 THE SUSHRUTA SAMHITA. [ Chap, XX.

Symptoms of Krimi-karna and Karna-Vidradhi :- Germination of vermins or of other local parasites in the cavities of the ear com- pletely impairs the faculty of hearing and is called Krimi-karna from the existence of worms in the ear. Any abscess caused by any local ulcer or by a blow, as well as any idiopathic abscess in the cavity of the ear is known as Karna-vidrathi. It is marked by a choked and burning sensation, and piercing and suck- ing pain, and it secretes red, yellow or reddish bloody discharges. 1I-I2. Symptoms of Karna-paka and Puti- karna, etc. :- A process of suppuration setting in (in any of these boils) in the car through the aggravated condition of the deranged Pitta is marked by a blockcd and putrid condition of the passage of the ear. The disease is called Karna-paka (suppuration of the ear). A discharge of condensed and fetid pus whether accom- panied or not with pain is set up by the local mucous accumulation in the passage of the ear having been liquefied by the heat of the aggravated Pitta. This disease is called Puti-karna (pus in the ear). The symptoms of swelling (Sopha), tumours (Arvuda) and polypoid growths (Arsas) * in gencral as have been described before should be carcfully understood by an experinced physicain to be the symptoms of these diseases in the region of the ear. 13-15.

Thus ends the twentieth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the causes and symptoms of the diseases peculiar to the ear.

• See chapter VI, XVIII and XXIII, Chikitsita-Sthána.

CHAPTER XXI.

Now we shall discourse on the chapter which treats of the medical treatment of the diseases peculiar to the car (Karna-gata-Roga-Pratishedha). I. General treatment :- Potions of clarified butter (after meal), use of Rasáyana-measures, re- nunciation of all sorts of physical exercise, baths without immerging the head, absolute sexual abstinence and abstinence from talkativeness are the general remedies and rules to be prescribed in the affections of the ear in general. 2. Treatment of the Vataja Ear-di- seases :- The course of medical treatment to be pursued in the four forms of the ear-diseases (all due to the action of Vayu) vis., Karna-sula, Pranada, Vadhirya and Karna-kshveda is the samc and is as follows, Sneha should be first administered (both internally and cxternally) and the patient purged with emulsive purga- tives after which the affected locality should be fomented with Váyu-subduing drugs administered in the manner of Nadi-sveda or Pinda-sveda. 3. A case of Karna-sula (ear-ache), due to the concerted action of the deranged Vayu and Kapha of the locality yield to the application of fomentation to the affected part with (the fumes of) Vilva, Eranda-roots, Arka, Var- shábhu, Kapittha, Dhustura, S'igru, Ajagandhá, As'va- gandhá, Jayanti, barley and bamboo, boiled in Áranála (fermented rice-gruel) and administered in the manner of Nádi-sveda (fomentation through a pipe). An attack of Karna-sula (ear-ache) yieds to the application of * In place of "Rasáyana" (use of tonic) some read "Rasás'anam" (use of meat-soup with meal).

THE SUSHRUTA SAMHITA. [ Chap. XXI.

Pinda-sveda made with pieces of boiled flesh of fish, cock or Láva (jointly or severally), or with (balls of condensed) milk. 4-5. A bowl-shaped cup should be made of the leaves of the As'vattha soaked in oil and Dadhi-mastu* and it should be heated by means of charcoal-fire. The oil, thus heated and made to drop into the affected organ, gives instantaneous relief in a case of ear-ache. The affected organ should be fumigated with the fumes of burning pieces of Kshauma (linen cloth) as well as with clarified butter, Aguru and Guggulu mixed together. Draughts of clarified butter as well as the application of Siro-vasti after meal are also found beneficial. 6-7. A rice diet should be foregone in the night, and draughts of clarified butter followed by potions of milk should be taken in its stcad. The Sata-paka Vala-Taila+ should also be prescribed as Siro-vasti, crrhine, as well as Mastikya-Sirovasti and sprinkling. It may also bc given internally. Goat's milk first cooked with Kanta- kári (in the manner of Kshira-páka) and then with the fat (Vasá) of a cock is extremely efficacious (in cases of ear-ache) if used as an ear-drop. 8-9. The four kinds of Sneha (oil, clarified-butter, lard and animal marrow) duly cooked together with the Kalka of Tanduliyaka, Amkota fruits, Ahimsrá, Kendraká- roots, Sarala, Deva-Dáru, Las'una (garlic), S'unthi and the scrapings of bamboo-skin and with the liquids of acidt

• "Mastu" (curd-cream) is mentioned neither by Vrinda nor by Chakrapáni. According to Videha's recipe, clarified butter should be used in place of oil in cases of the aggravation of the Pitta.) + For "Vala-Taila"-See chapter XV, Chikitsita Sthána. $ The liquid acids here are Dadhi, Takra, Sura, Chukra (a kind of Kánjika) and the expressed juice of Mátulunga.

Chap. XXI.] UTTARA-TANTRAM. III

taste (instead of water) should be used as an ear-drop in order to alleviate the aching pain therein. IO. The expressed juice of Las'una, S'igru, Árdraka, Murangi, Mulaka and (branch of) Kadali jointly or severally poured lukewarm into the cavity of the organ acts as an excellent ear-drop (in case of acute ear-ache). As an alternative, the expressed juice of S'ringa-vera mixed with honey, Saindhava, and oil should be used lukewarm as an car-drop to alleviate the pain therein. Clarified butter* duly cooked with the scrapings of bamboo-skin and the urine of a ewe and of a she-goat+ should also be used as an ear-drop in cases of ear- ache. 11-13. Dipika-Taila :- Pieces of the roots of the major Pancha-mula measuring eighteen fingures in length should be covered (extending only to three- fourths of the whole) with a piece of linen and then soaked in oil. The stick so formed, should then be lighted and the oil pouring in drops therefrom should be used lukewarm (as an car-drop). It instantaneously removes the pain, and is known as the Dipika-Taila. Different kinds of Dipiká-Taila may be likewise pre- pared with pieccs of Deva-dáru, Kushtha or Sarala wood, and used in the samc manner in cases of ear-ache. 14-15. Tender sprouts of Arka plants pasted with Kánjika (Amla) should be mixed with oil and salt. The paste thus prepared should be placed inside the hollow made in a branch of Snuhi tree and wrapped up with the

• Both Vrinda and Chakrapáni read "Taila" (oil) in place of "Sarpih" (clarified butter). But we have the authority of Videha (as quoted by S'rikantha Datta in his commentary on Vrinda) in favour of clarified butter. + Clarified butter should first be cooked with the urine of a ewe and then with that of a she-goat .- Dallana.

II2 THE SUSHRUTA SAMHITA. [ Chap. XXI

leaves of the same plant. It should then be scorched in fire in the manner of Puta-pâka. The juice should then be squeezed out of it and used lukewarm as an ear-drop to alleviate the pain in the ear. 16. Different kinds of Ear-drops :- The expressed juice of Kapittha, Matulunga and Ardraka mixed together and made lukewarm, or the lukewarm Chukra (a kind of Kánjika) should be used as ear-drops in a case of ear-ache. As an alternative, the affected ear should be judiciously dusted with powdered Samudra- phena in such a case. As an alternative, the eight kinds of officinal urines made lukewarm and used as an car- drop may prove efficacious in removing an ear-ache. Similarly, a case of an ear-ache yields to the curative virtue of an car-drop, composed of the four officinal kinds of Sneha duly cooked with the different kinds of officinal urine and acids (winc, sour-grucl, etc.,) as well as with the Vayu-subduing drugs. 17. General and Specific treatment of Pittaja Ear-ache :- The above-mentioned mode of treatment (car-drops and fomentations, ctc.) with the Pitta-subduing drugs should be followed in Pittaja- Karna-sula (ear-ache). The use of the medicated Ghrita duly cooked with milk weighing ten times as much and with the drugs of the Kakolyadi group, as well as the Ghrita* duly cooked with the drugs of the Tikta (bitter) group would be found beneficial in such cases. Clarified butter duly cooked with the tender sprouts of Kshira-vriksha (milk-exuding trees), as well as with Yashti-madhu and Chandana wood, or that cooked with the decoction of Vimbi with (the Kalka of) sugar, Yasthi-

• Dallana says that Jejjatáchárya holds these two recipes as unauthoritative.

Chap. XXI. ] UTTARA-TANTRAM. 1I3

madhu and the purgative drugs would also be found beneficial. 18-20. Treatment of the Kaphaja Karna- sula :- In cases of Kaphaja-Karna-sula mustard oil or Ingudi oil will be found beneficial if used as an ear-drop. Decoctions (Yusha) of the drugs of the bitter group, fomentation (Sveda) with Kapha-subduing drugs, as well as the oil cooked with the drugs of the Surasádi, or the major Pancha-mula group would be found bene- ficial. The expressed juice of Matulunga, Las'una and Årdraka, as well as S'ukta, or the oil cooked with any of them should be used as ear-drops in such cases. The use of strong head-purgatives (errhines), or of gurgles is, likewise, recommended in such cases. 21-24. The medical treatment in a case of ear-ache due to the vitiated condition of the blood should be just the same as that in the case of a Pittaja Karna- sula. 25 Thus we have given a general outline of the course of treatment and remedial measures to be adopted in the four kinds of ear-affections, viz., Karna-sula (ear- ache), Pra-náda, Vádhirya and Karna-kshveda. Now we shall deal with the special recipes and preparations of ear-drops to be employed in cases of deafness (Vadhirya). 26. Treatment of deafness :- The oil duly cooked with water, milk and Vilva pasted with cow's: urine (as Kalka) should be used as an ear-drop in cases of deafness. Oil should be first cooked with goat's milk or the decoction of Vimbi fruit with sugar and Yashti- madhu and Vimbi fruit (as Kalka). When cooled down (it should be churned with the hand and) the Sneha (oily portion) should be separated. This oily part, after being stirred in the decoction of I5

II4 THE. SUSHRUTA SAMHITA. [ Chap. XXI.

.Vilva* should again be cooked with milk weighing ten times and with (the Kalka of) sugar, Yashti-madhu and (red) sandal wood. It should then be thickened and used as an ear-drop in cases of deafness. Measures and remedies, which will be mentioned in connection with Pratisyáya+ (catarrh) or have been already des- cribed in the chapter on Váta-Vyádhi t Chikitsá may be as well employed with benefit in the present instances. 27-30. Treatment of Puti-karna, Karna- srava and Krimi-karna :- The general mode of treatment to be employed in cases cf Karna-sráva, Puti-karna and Krimi-karna is the same as above. Now here (me describe) the general mode of treatment to be employed in them. Errhines, fumigating, filling up the cavity of the ear (as with an ear-drop), cleansing and washing should be employcd according to the cxigencies of each case. The affected ear should be washed with the decoction of the drugs of the Rája-vrikshadi or the Surasádi group and filled with the powders of those drugs. In a case of Karna-Srava, the cavity of the affected organ should be filled in with the powders (D. R: decoction) of the Pancha-Kashaya § drugs mixed with honey and the expressed juice of Kapittha. 31 -- 32.

• In place of "Vilvambu-gadham" some read "Vimbi-gádham" ,i. €,, mixed with an abundant quantity of powdered Vimbi fruit .- Dallana. + Chap. XXIV, Uttara-Tantra. t Chapter V and VI, Chikitsita-Sthána. § According to some, "Pancha-Kasháya" means the barks of A'ragbadha, S'irisha, Jambu,. Sarja and of Asvamara (Palás'a), but Dallana, on the authority of the authors of the Tiká and the Panjika, (the two commentaries) refutes this and holds that "Pancha-kasháya" means the barks of Tinduka, Abhaya, Lodhra, Samanga' and of A'malaka enumerated below in this chapter.

Chap, XXI. ] UTTARA-TANTRAM.

The use of the powders of Sarja-bark mixed with honey and expressed juice of the Kárpási fruit is recom- mended in cases of Karna-Srava. A compound con- sisting of pulverised Láksha and Sarja-rasa (D. R. Rasanjana) should be used in filling up the cavity of the affected organ in the said disease. The oil duly cooked with the tender sprouts of S'aivala, Maha-rriksha, Jambu and of Amra, as well as with Karkata-S'ringi honey and Manduki is highly efficacious in these cases. Powders of the barks of Tinduka, Abhayá, Rodhra, Samanga and of Amalaka mixed with honey* and the cxpressed juice of Kapittha should be similarly uscd. 33-36. The expressed juice of Amra, Kapittha, Madhuka flower, Dhava and of S'ala, or an oil duly cooked with these is likswise recommended as ear-drops in these cascs. The oil cooked with Priyangu, Yashti-madhu, Ambáliká, Dhátaki, S'ita-parni, Manjishthá, Lodhra, and Lákshá (as Kalka), and with the expressed juice of the sprouts of Kapittha as the liquid, if used as an ear-drop, arrests the secretion in a casc of Karna- srava. 37-38. Treatment of Puti-karna :- Rasánjana rubbed and dissolved in the breast-milk and mixed with honey proves highly efficacious even in chronic and long- standing cases of Puti-karna attended with fetid dis- charge. The use as ear-drops of the compound composed of oil, the expressed juice of Nirgundi and honey mixed together arrests an attack of Puti-karna. 39-40. Treatment of Krimi-karna :- Vermi- fuges should be employed for the treatment of a case

• S'rikantha Datta in his commentary on Vrinda quotes this couplet, but does not read 'honey' there. He reads "er" in place of "ny" I

116 THE SUSHRUTA SAMHITA. [ Chap. XXİ.

Krimi-karna. Fumigation* of the affected parts with the fumes of (dried) Vártáku, or (the pouring of) mustard oil (into the cavity of the affected organ) is also beneficial in such cases. Vidanga and Haritála (yellow orpiment) mixed with cow's urine (and used as an ear-drop) as well as fumigating the affected organ with the fumes of (burnt) Guggulu tends to destroy the fetor in the ear due to local parasites. Administra- tion of emetics, smoke-inhalation and gurgles are also beneficial in such cases. 41-42. Treatment of Karna-Kshveda, Vi- dradhi, etc. :- Use of mustard oil as an ear-drop is efficacious in cases of Karna-kshveda.+ An abscess (Vidradhi) in the ear should be treated as an ordinary abscess. The affected ear should be sufficiently fomented after being filled in with oil so as to soften the filthy deposit in the cavity of the ear, after which the filthy matter should be extracted with a probe or a director (Saláká). 43-45 Treatment of Karna-kandu and karna-pratinaha :- Fumigation of the parts with the help of a tube (Nadi-sveda), exhibitions of emetics, smoke-inhalations, head-purging (errhines), as well as all kinds of Kapha-subduing measures should be resorted to in cases of Karna-kandu. Application of Sneha and of Sveda and then of head-purgatives (errhines) should be made in cases of Karna-pratinaha,

• Dallana explains this to mean fumigation of the affected organ, as well as the use of the same in the manner of smoking. + The use of oil is also recommended in cases of abscess in the ear. In cases of acute and painful Vâtaja Vidradhi sesamum oil should be used, whereas in cases of Kaphaja Vidradhi the use of mustard oil is recommended .- Dallana.

Chap. XXI. ] UTTARA-TANTRAM. 117

and the treatment thereafter should conform to the nature of the specific deranged Dosha of the body involved in the case. 46-47. Treatment of Karna-paka, etc. :- Remedies and remedial measures described in connection with Pittaja Visarpa* should be used with equal profit in a case of Karna-paka (inflammatory suppura- tion of the car). Any filth or vermin, etc., lodged in the cavity of the ear should be removed with the help of a probe, or (by cutting it) with a horn. Cures for the remaining cases of affections in the ear have been described before ( in the Chikitsita-sthána, Chapters XVIII, VI and XXIII). 48-50.

Thus ends the twenty-first chapter of the Uttara-Tantra in the Sus'ruta Samhita which' deals with the treatment of the diseases pecu- liar to the ear.

• In place of 'Pittaja-Visarpa', both Vrinda and Chakradatta read 'Kshataja-Visarpa'.

CHAPTER XXII.

Now we shall discourse on the chapter which deals with the causes and symptoms of diseases of the nose (Nasa-gata-roga-Vijnaniya). I. Nomenclature and Classification :- Discases which are specifically found to affect the organ of smell may be classified into Thirty-one different groups, viz.,-Apinasa, Puti-nasya, Násá-páka. Sonita- Pitta,Puya-sonita, Kshavathu, Bhramsathu, Dipta, Násá- náha, Pari-sráva, Násá-sosha, the four kinds of Arsas. (polypoids ), the four kinds of swelling, the scven types of tumours and the five types of Prati-syáya which will be described hereafter with the specific treatment of each. Thus the diseases of the nose arc said to be thirty-one in all. 2. Symptoms of Apinasa and Puti-na- sya :- Chokedness and burning sensation in the nostrils attended with dryness and deposit of filthy slimy mucus in their passages, thereby deadening the faculty of smell and taste for the time being; are the specific indications of Apinasa, (obstructions in the nostrils) which are identical with the symptoms (of the same type) of Pratisyáya (catarrh). It is due to the concerted action of the deranged Váyu and Kapha. The disease in which the fetid breath is emitted through the mouth and the nostrils owing to the presence of the deranged Váyu mixed up with the other Doshas ( Pitta, Kapha and blood ) in the throat and about the root of the palate is called Puti-nasya. 3-4. Symptoms of Nasa-paka, Rakta- Pitta and Puya-rakta :- A purulent inflam- mation and the presence of pimples (Arush) in the

Chap. XXII. ] UTTARA-TANTRAM. 119

nostrils owing to the vitiated condition of the local Pitta attended with sliminess and fœtid odor is called Nasa- paka .. The four kinds of Rakta-Pitta ( hæmorrhages) with the two different origins and two different courses will be dealt with again later on .* The disease in which bloody or blood-streaked pus is discharged through the nostrils either as the effect of a blow on the region of the fore-head or through the highly heated condition of the local blood, Pitta and Kapha is called Puya-rakta ( bloody pus ). 5-7. Symptoms of Kshavathu :- The disease in which the Váyu charged with Kapha repeatedly gushes out of the nostrils accompained by loud reports or sounds, owing to the fact of the nasal Marma being anywise affected, is called Kshavathu (sneezing).+ A trickling sensation in the gristle of the nose owing to the insertion of a thread, etc., into the nostrils, or to the action of any strong (Tikshna) articles of fare, or of any pungent smell, or of looking to the sun causes sneezing. 8-9. Symptoms of Bhramsathu and Dipta :- The disease in which the deranged undigested thickened and saline Kapha previously accumulated in the region of the head is dissolved or disintegrated and dislodged from its seat through the heat of Pitta and is expelled (sneezed off) through the nostrils is called Bhram athu. The affection in which

• The four kinds are due to vitiated Váyu, Pitta and Kapha as well as their concerted action. The two origins are (a) the spleen and the liver, or (b) the Amas'aya (stomach) and the Pakvas'aya (intestines). The two courses are (a) the upper and the lower orifice, or (b) the mouth and the nostrils. (2) t The sneezing is here said to be of two kinds (1) Doshaja and (2) trau- matic. Here the former is Doshaja, while the latter is of traumatic origin.

Í20 THE SUSHRUTA SAMHITA. [ Chap. XXII.

the Váyu, in the shape of warm vapour-like breaths, comes out of the nostrils accompanied by an excessive burning sensation in the locality is called Dipta. 10-II Symptoms of Nasa-Pratinaha, Nasa- parisrava and Nasa-Parisosha :- The condition under which the up-coarsing Udána Váyu of the region of the head is deranged in its passage by a surcharge of Kapha, seems to stuff the passages of the nostrils, and is called Nasa-Pratinaha. The disease in which there is constant, transparent, slightly discoloured water-like secretion (of Kapha) through the nostrils, more particularly at night, is called Nasa-Parisrava (fluent coryza). Difficulty of respira- ting (inhaling and exhaling) caused by the drying up and consequent thickening of the Kapha (mucus) accu- mulating in the passages of the nostrils, through the action of the deranged Váyu and Pitta, is called Nasa- Parisosha (parchedness of the nostrils). 12-14. Local Arsas (polypoids) as well as local Sopha (four each) are due to the action of the three deranged Doshas of the locality jointly and separately. The differ- ent kinds of Arvuda (nasal tumour) as mentioned in the Sálákya-Tantra, with the one of Sánnipátika origin are seven in all. The five types of Pratisyaya (catarrh) mentioned here will be dealt with in chapter XXIV. Remarks made in the chapter on the causes and symptoms of swellings in general (Sopha-Vijnána), as well as those of Arsas (hæmorrhoid growths) in the Nidána-sthána should be understood to apply to those diseases affecting the locality of the nose as well. 15-18.

Thus ends the twenty-second chapter in the Uttara-Tantra of the Sus'ruta Samhitá which deals with the causes and symptoms of the diseases of the nose.

CHAPTER XXIII.

Now we shall discourse on the chapter which deals with the therapeutics of nasal diseases (Nasa-gata- Roga-Pratishedha). I. Treatment of Apinasa and Putl- nasya :- In cases of the first-mentioned disease (i.e. Apinasa) and in those of Puti-nasya, applications of Sneha and of Sveda to the affected part, and application of emetics and purgatives should be made. The diet should be light and moderate in quantity. The water for drinking should be boiled before usc, and inhalation of smoke (Dhuma-pána) should be indulged in at the proper time. Hingu, Tri- katu, Indra-Yava, S'iváti*, Lákshá, Katphala, Vacha, Kushtha, S'obhánjana, Vidanga, and Karanja should be used daily with benefit in the manner of Avapida- Nasya. Mustard oil should be duly cooked with the aforesaid drugs together with cow's urine and be used as an errhine (Nasya). 2-3. Treatment of Nasa-paka, etc. :- In cases of Nasa-paka, all the Pitta-subduing measures both for internal and external use should be duly employed. Barks of the Kshiri (milk-exuding) trees mixed with clarified butter should be duly employed as wash and plaster after a local bleeding. The medical treatment of Sonita-pitta (Hæmorrhaege) from the nose shall be hereaftert described. A case of Puya-Rakta ( dis- charge of bloody pus from the nose ) should be treated

• S'ivdti may mean either white Punarnavd or S'ephalikd. Neither Chakrapáni nor Vrinda reads it in the text. t See ch. XLIV of the Uttara-Tantra. 91

I22 THE SUSHRUTA SAMHITK. [Chap. XXIII.

as a case of sinus (Nádi) * for all practical purposes, and Avapida-nasya as well as inhalations of smoke (Dhuma) of keen-potencied drugs and Nasya (snuff or errhines) of drugs of correcting or purifying virtues should be used after the satisfactory exhibition of emetics. 4-5. Treatment of Kshavatu and Bhram- s'athu :- Powders of head-purgaing drugs in the form of snuff should be administered into the nostrils through a pipe in cases of Kshavathu and Bhram- sathu. The head should be duly fomented with Váyu- subduing drugs and inhalation of Sneha-Dhuma+ as well as similar other medicinal measures remedial to the deranged bodily Váyu should be resorted to. All the Pitta-subduing measures should be employed in a case of Dipta, and all cooling remedies and the drugs of sweet taste should also be prescribed. 6-7. Treatment of Nasa-naha, etc. :- The internal use of Sneha (Sneha-pána) forms the principal remedy in a case of Nasa-naha, in which fumigations with lardacious drugs as well as head-purgings may be likewise employed. The use of Balà-Taila or any other Vàyu-subduing remedy mentioned in the chapter on the treatment of Váta-vyádhi (Ch. V. Chikitsita Sthána) may be similarly used with beneficial results. Pow- dered snuff should be introduced into the nostrils through a pipe or tube, and strong and keen Avapida- Nasya should be used in cases of Nasa-Srava. Strong fumes of (burnt) Deva-dáru and Chitraka should be applied to the affected part. Goat's flesh is also found beneficial in such cases. 8-9.

• See ch. XIV of the Chikitsita-Sthána. + See ch. XVII of the Chikitsita-Sthána,

Chap. XXIII.] UTTARA-TANTRAM. 123

Treatment of Nasa-Sosha :- The use of clarified butter churned out of milk, as well as that of the oil as an errhine prepared in the manner of Anu-taila are pre-eminently the best cures in a case of Nása-Sosha. Potions of clarified butter, meals with Jangala meat-soup, applications of Sneha and of Sveda, and fumigating the affected part with lardacious drugs may be similarly prescribed with best advantage. The remaining nasal diseases should be duly treated accord- ing to the specific treatment of each case as described before. I0-II.

Thus ends the twenty-third chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the treatment of the diseases of the nose.

CHAPTER XXIV.

Now we shall discourse on the chapter whlch deals with the (symptoms and) medical treatment of catarrh (Pratisyaya-Pratishedha). I. Causes :- Excessive indulgence in sexual inter- course, heating of the head, entrance of the minute particles of dust or smoke into the nostrils, excessive application of cold or heat, voluntary retention of stool and urine are the causes which may instantly usher in an attack of nasal catarrh (Pratisyáya). The fundamental principles of Váyu, Pitta and Kapha, jointly and separately, as well as of blood becoming aggravated by various aggravating causes, bring on an attack of nasal catarrh in course of time. 2-3. Premonitary Symptoms :- Heaviness of the head, sneezing and aching in the limbs, appearance of goose-flesh upon the body, as well as many other different kinds of supervening symptoms are seen to precede an attack of nasal catarrh (Pratisyáya). 4. Specific Symptoms :- Hoarseness of voice, a sense of stuffedness and obstruction in the nostrils accompanied by a thin mucous secretion, dryness of the throat, of the palate and of the lips, a pricking, and pierc- ing pain in the region of the temples, as well as excessive sneezing and a bad taste in the mouth are the character- istics of Vataja type of catarrh (Pratisyáya). A hot and yellowish secretion from the nose, heated skin, thirst, emaciation and yellowness of the complexion, as well as the secretion being sudden, hot and smoky-these are the characteristics which mark the Pittaja type of catarrh. Constant running at the nose, the secretion being white and cold, paleness (of the skin) and swelling (D. R.

Chap. XXİV. ] UTTARA-TANTRAM. 1ż5

whiteness) of the eyes, heaviness of the head, flabbiness of the face* and tickling and itching sensation in the regions of the head, throat, lips and of the palate are the features which mark the Kaphaja type of the disease. 5-7. The spontaneous disappearance, as well as re- appearance of Pratisyaya-be it acute or chronic-is the charracteristic symptom of Tri-doshaja Pratis'yáya, wherein the specific symptoms of all (the three) kinds of Apinasa are present. 8. Symptoms of Raktaja Pratisyaya :- Discharge of blood (from the nose), redness of the eyes, a bruised pain in the chest which seems as if struck with a blow, fetid smell in the breath and the mouth, and loss of the faculty of smelling are the characteristic symp- toms of the Raktaja type of Pratisyáya which has its origin in the deranged condition of the blood. In these cases + hosts of extremely small worms of whitish or blackish t hue are found to infest the affected loca- lities (vis., the nostrils) which show symptoms identical with those of the head-disease due to the germination of parasites in that region. 9. Prognosis :- The malignant nature of the disease (Dushta-Pratisyáya) should be inferred from the constant alternate sliminess and dryness, as well as cons- tant alternate contraction and expansion of the nostrils,

• In place of "भवेद्गुकु शिरोमुख:'-some read "भवेद्गुरुशिरा नरः"- i. e. "the man (patient) gets heaviness of the head." In this case the flabbiness of the face is not seperately mentioned. + According to some this is the characteristic symptom of another kind of Pratis'yaya, and not one of the symptoms of the Raktaja type as appears at the first sight. $ Mádhava Kar reads 'ar: fermr.' i. e., glossy white in hue, in place of "e: Wr.' i. e. whitish and blackish in hue.

İ26 THE SUSHRUTA SAMHITÁ. [Chap. XXIV.

fetour in the breath and loss of the faculty of smell. Such a case of Pratisyáya should be regarded as extremely hard to cure. Neglected and not properly remedied at the outset of an attack, any type of catarrh (Pratisyáya) may bring on cases of malignant Pinasa, which in time gives rise to a number of diseases and produces in its train deafness, blindness, loss of smell, violent ocular affections, cough, dulness of appetite, and Sopha (swelling). I0-II. General Treatment of Pratisyaya :- Potions of clarified butter, various sorts of emetics, and fomentations (Sveda) may be prescribed in nasal catarrh (Pratisyáya), except in fresh and acute cases. Errhines (Nasya) of Avapida type may also be employed in time, if required. Fomentation should be applied and diet should be taken in a tepid state with articles of acid taste, and draughts of milk should be administered with green ginger* and with any modification of the expressed juice of sugar-cane+ for the purpose of thick- ening and maturing the secreted mucus, in cases where that maturing process has not already spontaneously set in. The mucus found matured, thick and pendent should be made to secrete by applying head-purgatives (Siro-vireka). Purgatives, Vasti of the Asthápana kind, smoke-inhalations and medicinal gurgles should also be prescribed according to the exigencies of each case under treatment and in consideration of the nature and intensity of the deranged Dosha involved therein. 12 -- 14.

• Some explain "A'rdraka" to mean the expressed juice of fresh ginger, while others explain it to mean the powder of dried ginger. t In place of "rfaarratf:"-with any modification of the expressed juice of sugar-cane, such as treacle, sugar, etc , some read "tuarn." i c., with articles of pungent taste.

Chap. XXIV.] UTTARA-TANTRAM. I27

Regimen of diet and conduct :- In a case of Pratisyaya the patient should sit, lie, or move about in closed and windless rooms and wear warm and thick turban on his head. He should take Vijaya (Haritaki) and partake of meals consisting of Palánna* cooked without clarified butter. He should also be subjected to a course of strong head-purging as well as of smoke-inhalations. Use of new wine and cold drink, cold baths, sexual intercourse, anxious cares, lamenta- tions, voluntary retention of stools and urine, as well as partaking of fares which are excessively dry (and beget dryness in the system), should be foregone by a person suffering from an attack of Pinasa. 15-16. Fastings and employment of digestive (Páchana) and appetising (Dipaniya) remedies should be the medical treatment in cases of Pinasa (nasal catarrh) accompanied by such distressing symptoms as vomiting, aching, heaviness in the limbs, feverishness, non-relish for food, apathy, and Atisara (diarrhœa). In case of an adult person suffering from an attack of Pinasa due to the concerted action of Váyu and Kapha, the patient should be made to vomit by taking in a large quantity of any liquid substance. The complications (Upadrava) in- volved therein should be remedied by appropriate diet and remedial agents and after their subsidence, the patient should be treated according to the instructions given before. 17-18. Treatment of VataJa Type :- In cases of Vataja-Pratisyaya clarified butter duly cooked with the drugs of the Vidari-gandhadi group or with the five officinal salts should be prescribed for internal

• Palánna is generally prepared by cooking together rice, meat and clarified butter as well as other spices, but in this case clarified butter should not be used.

128 THE SUSHRUTA SAMHITA. [Chap, XXIV.

.use, according to the rules of taking Sneha (see chapter XXXI., Chikitshita-Sthana). The process of snuffing, etc., should also be resorted to, if necessary, as in a case of Ardita (Facial paralysis). 19. Treatment of Pittaja and Raktaja types :- In the Pittaja and Raktaja types (of Pratisyaya) the patient should be given draughts* of clarified butter duly cooked with the drugs of the Kakolyádi group. Cold+ washes and plasters should also be used. Sarjarasa (Resin), Pattanga (red-sandal), Priyangu, honey, sugar, Drákshá, Madhuliká (Guduchi), Goji, S'ri-parni and Yashti-madhu should be pres- cribed as gurgles, and purgings (errhines ?) should be induced with the help of the drugs of sweet potency (such as Dråkshá, Aragbadha, honey, sugar, etc.). Oil duly cooked with (a paste composed of) Dhava-bark, Tri-phala, S'yámá, Tilvaka, Yashti-madhu, S'ri-pavni, Rajani, and with milk weighing ten times as much as oil, should be preserved for a time and used as an errhine (Nasya) in either of these cases. 20. Treatment of Kaphaja Type :- In a case of the Kaphaja-Pratisyaya, emulsive measures (Sneha-karma) should be performed with clarified butter, and the patient should be made to vomit by using Yavagu (gruel) prepared with Masha-pulse and Tila, (sesamum-seed), after which the general Kapha-subduing measure should be employed. Oil duly cooked with the two kinds of Bald, the two kinds of Brihati,

• Some read "faah;' in place of qan. This word means that the clarified butter for use in this case should be duly cooked with the fera (bitter) drugs, viz., the leaves of Patola, etc. t Both the commentators of Vrinda and Chakradatta explain the term ar (cold) to mean 'prepared with the drugs of cold potency such as the drugs of the Nyagrodhadi and Utpaladi groups.'

Chap. XXIV.] UTTARA-TANTRAM. I29

Vidanga, Tri-kantaka, S'veta-roots, Sahá (Mudga- parni), Bhadrá (Gámbhári) and Varshábhu should be employed as an errhine. Sarald, Kinihi, Dáru, Nikumbha (Danti) and Ingudi should be pasted together and duly formed as Vartis. These Vartis should be duly used for the purposes of smoking (Dhuma-pána) 21-22. Treatment of Tri-doshaja Type :- Clarified butter duly prepared with the drugs of bitter and pungent tastes, inhalation of the smoke of strong- potencied drugs as well as the use of articles of pungent taste and other appropriate medicinal preparations would prove curative in a case of Tri-doshaja Pratis'yáya (nasal catarrh) brought about by the aggravation of all the three Doshas. An intelligent physician should prescribe as an errhine the medicated oil duly cooked and prepared with the admixture of Rasánjana, Ati-visha, Musta and Bhadra-dáru. Gargles prepared with the decoction of Musta, Tejovati, Páthá, Katphala, Katuka, Vachá, Sarshapa (mustard), Pippali-mula, Pippali, Saindhava, Agnika (Ajamodá), Tuttha, Karanja-seeds, Salt and Bhadra-dáru should be prescribed. Oil duly cooked with the preceding drugs is recommended for purging (Siro-vireka) the head of the patient. 23-24. Flesh of birds and beasts of the Jangala group, aquatic flowers and the Váyu-subduing drugs (Bhadra-dárvádi) should be duly cooked in milk mixed with water weigh- ing half as much as the milk. * The liquid in this case should be reduced to the original quantity of milk, when it should be taken down and allowed to cool. Clarified butter should then be prepared from this milk and should be agair duly cooked with the drugs of the Sarvagandhá (Eládi) group, sugar, Ananta, Yashti-

• Some say that milk and water in equal parts should be taken. I7

130 THE SUSHRUTA SAMHITA. [ Chap. XXIV.

madhu and (red) Chandana and with a quantity of milk ten times its own weight. All types of nasal catarrh, yield to the curative efficacy of this medicated Ghrita, if used as an errhine (Nasya). Oils medicated with the drugs remedial to the specific deranged Dosha involved in each case under treatment should also be pres- cribed. 25-26. All the foregoing preparations should be surcharged with the urine and bile of a cow and uscd in cases due to the existence of local parasites, and vermifuges (e. g., drugs of the Surasadi group) should be administered as a palliative measure .* 27.

Thus ends the twenty-fourth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) medical treatment of Pratis'yáya.

• In places of "यापनार्थं' Chakradatta reads "नावनार्थ' ie., as an errhine. He also reads "aafqer:" i.e., pasted with the urine (of a cow), and thus does not read the bile of a cow (fqn) in the text. Vrinda, however, reads "चावनानि" in place of "यापनाथे" which means that vermifuges should be used for washing purposes.

CHAPTER XXV.

Now we shall discourse on the chapter which deals with the symptoms of diseases peculiar to the region of the head (Siro-roga-Vijnaniya). I. Classification :- Diseascs which are peculiar to the region of the head number eleven in all, vis., the four kinds respectively duc to the action of the deranged Váyu, Pitta, Kapha, and their combination, as well as those which are respectively incidental to any bodily waste (Kshayaja), or to the vitiated condition of the blood (Raktaja), or to the existence of parasites (Krimija), the remaining four being known as Suryávarta, Ananta- váta, Ardhávabhedaka and Samkhaka. 'The symp- toms of these eleven kinds of head-diseases are given below. 2. Symptoms of Dosha-origined types : -A fit of violent headache without any apparent cause and which becomes worse in the night and is relieved by pressure or by being bandaged or by an application of fomentation round the head, should be ascribed to the action of the deranged Vayu, and is known as the Vataja-Siroroga. A violent burning and aching pain in the .head, in which the scalp secms to have been strewn over with bits of live charcoal, accompanied by a sense of scorching vapour being emitted from the nostrils, and which ameliorates in the night or on the application of cold, should be ascribed to the action of the deranged Pitta, and is known as the Pittaja- Siroroga. A fit of headache in which the head (palate) and the throat* seem to be covered with a coat of sticky * In place of "(शरोगलं" some read "शिरी भबेत्". This reading is adopted by Mádhava. There seems to be no difference in the meaning s the word farra (head) may include both the palate and the throat.

Í3ż THE SUSHRUTA SAMHITÁ. [ Chap. XXV.

mucus, and feel cold and heavy, and cannot be turned about, and the face and the eyes look swollen or flabby, should be attributed to the action of the deranged bodily Kapha, and is called the Kaphaja-Siroroga. A case marked by the concerted action of all the three preceding Doshas exhibits all the symptoms peculiar to all of them, and is known as the Tri-doshaja-Siro- roga. 2-6. Symptoms of Raktaja, Kshayaja and Krimija types of Siro-roga :- A case of headache due to the vitiated condition of the local blood manifests all the symptoms of the Pittaja type, and the head becomes incapable of (bearing) the least touch. This is known as the Raktaja-Siroroga. A case of headache incidental to the waste of the local Vasá (fat) or Kapha* is marked by an intolerable pain (Abhi-tápa) in the head which is aggravated by the appli- cation of fomentation, fumigation, errhine, emetic and blood-letting. This is known as the Kshayaja-Siro- roga. The disease of the head in which a pricking and tingling pain is felt inside the head as if being stung, (by some poisonous insect), and which is accompanied by a watery discharge mixed with blood (D. R. pus) from the nose, should be attributed to the existence of local parasites. This disease is a dangerous one and is known as the Krimija (Parasitic) Siro-roga. 7-9. Symptoms of Suryavarta Siro- roga :- The disease of the head in which a severe pain is felt in the eye and the eyebrow just at sunrise, and

• Dallana here comments that the term "Vasa" means all the fatty substances in the body, e. g., the brain substance, Medas, semen, Majjan, etc. There is a variant which is not recognised by Gayi. That reading is भछृम्व सात्र मसमीर णारना (i. c., by the waste) of blood, Vasa Kapha and Vayu. This, however, seems to be the better reading.

Chap. XXV.] UTTARA-TANTRAM. 133

which goes on growing worse with the progress of the day and begins to abate only when that great luminary begins to set in the western sky, is called Suryavarta. It (generally) abates on the use of cold articles but some- times on that of warm things as well. It is ascribed to the concerted action of the three Doshas. IO. Symptoms of Ananta-vata Siro- roga :- The disease of the head in which a violent pain is felt at the Manyá and the Ghátá (the two nerves on the backside of the neck) which ultimately affects the region of the eye, the eyebrow and the temples and specially produces a throbbing of the cheek, as well as paralysis of the jaw-bone and the eye. The disease is known as Ananta-vata and is due to the concerted action of the three Doshas. II. Symptoms of Ardhavabhedaka and Śamkhaka :- The disease of the head in which a violent and excruciating pain of a piercing or aching nature is felt in one half of the cranium which makes the patient feel giddy, and which either follows no distinct periodicity or recurs at a regular interval of ten days or of a fortnight, is called the Ardhava- bhedaka and is due to the concerted action of the three Doshas. A violent pain caused in the head and more especially in the temples by the local Váyu in combination with the deranged Kapha, Pitta and blood is designated by the holy sages of Ayurveda as the Samkhaka. It produces a very great pain, and is very hard to cure even by the joint advice of thousands of physicians and is as fierce as death itself. 12-13.

Thus ends the twenty-fifth chapter in the Uttara Tantra of the Sus'ruta Samhita which deals with the symptoms of the diseases of the head.

CHAPER XXVI.

Now we shall discourse on the chapter which deals with the therapeutics of the discases of the head (Siro- roga-Pratishedha). I. Treatment of Vataja-Siroroga :- Re- medial mcasures described in connection with the treat- ment of Váta-Vyádhi should be employed in their entirety in the Váyu-origined types of the diseases of the head, and all medicinal compounds of oil or clarified butter should be followed by a potion of milk. Mudga, Kulattha, or Masha pulse, unmixed with any other thing, as well as pungent and hcat-making articles, saturated with clarified butter and followcd by potions of tepid milk should be taken in the night. Sesamum oil or the paste of sesamum may also be taken. Milk duly boiled with the Váyu-subduing drugs should be employed in a lukewarm state in washing the diseased locality, and a plaster composed of the powders of the same drugs boiled with milk should be applicd luke- warm to the scalp. In the alternative, the scalp may be plastered over with the boiled flesh of fish or with Kris'ará (preparation of rice and sesamum) saturated with Saindhava salt, or with (the paste of) Chandana, Utpala, Kushtha and Pippali, finely powdered together (all in a lukewarm statc). 2-3. Oil duly prepared with Kulira (crabs) should be used for Nasya (snuffing) purposes subsequent to the employ- ment of the (above) fomentation. A quantity of milk diluted with the addition of half as much of water should be duly boiled with the paste of the drugs of the Varunádi group and taken down from the fire when the water has evaporated. Butter should be skimmed out

Chap, XXVI.] UTTARA-TANTRAM. 135

of it when cool and clarified butter prepared therefrom should be again duly cooked with the paste of the drugs of the Madhura group. The use of this Ghrita as a Nasya (snuff) is highly efficacious in the type under discussion. Clarified butter duly cooked with the decoc- tion of the preceding drugs (of the Varunádi group) and with milk should be taken with sugar. Snaihika Dhuma (Chikitsá, XL.) should be administered in time when required, and Traivrita Ghrita and Bala Taila should bc prescribed as a draught and as an errhine, as well as for the purposcs of anointing, sprinkling and Vasti-Karma. The food in the present type of the disease should be taken with milk cooked with Váyu- subduing drugs and with mcat-soup saturated with Sneha (clarified butter). 4-5. Treatment of Pittaja and Raktaja Siro-roga :- Cooling plasters saturated with clari- ficd butter should be applied to the scalp and cooling head-washes should be prescribed in the Pittaja and Raktaja types of Siro-roga. Milk, the expressed juice of sugarcane, fermented rice-grucl (Dhányámla), curd-cream (Mastu), honey and sugar mixed in water-these should be used for sprinkling purposes. Plaster for the hcad should be prepared with Nala, Vetasa, Kahlára (red lotus), Chandana, Utpala, S'amkha (conch-shell), S'aivala, Yashti-madhu, Musta and lotus taken together and mixed with clarified butter, and the plasters described in connection with the treatment of Pittaja and Raktaja Visarpa (Erysipelas) should also be used. The drugs of the Madhura group should be used in a tepid state as plasters and the Sneha (oil or clarified butter) duly cooked with the same drugs should be uscd as an errhinc, and appropriate medicincs should be used as purgatives as well as in Asthapana and Sncha-Vasti measures,

136 THE SUSHRUTA SAMHITA. [ Chap. XXVI.

Clarified butter skimmed from milk, and fresh Vasá (lard)* of Jángala animals should be used as errhines, and, cooked with the drugs of the Utpaládi group, should be used in the manner of Asthapana-vasti. Food should be taken with meat-soup of Jangala ani- mals, and clarified butter should be used in the manner of an Anuvásana Vasti. Clarified butter skimmed from milk and du'y cooked with the drugs of the Madhura group and mixed with sugar should be used for emulsive purposes (Snehana), and all measures and remedies which are remedial to the deranged blood and Pitta may be likewise employed with profit in these cases. 6-7. Treatment of Kaphaja Śiro-roga :- In a case of Kaphaja-Siroroga, the Kapha-subduing measures, such as strong emetics, head-purgatives (Siro- vireka) and gargling should be resorted to. The trans- parent upper part of clarified butter + should be given to drink, and fomentation should then be frequently applied to the head. Head-purgatives should then be administered with the pith of Madhuka wood, or with Mesha-s'ringi and Ingudi bark. Vartis (sticks) made of Mesha-s'ringi and Ingudi barks should be used in smoking. Snuffs of powdered Katphala should be taken, and gargles with Kapha-subduing drugs should be used. Plasters prepared with Saralá, Kushtha, S'árn- gashtá, Deva-dáru, and Rohisha pasted together with the alkaline water and mixed with Saindhava salt should be applied lukewarm to the head. The diet should consist of cooked barley or Shashtika rice, which should

• In place of 'aar (lard) some read 'ra' which means meat-soup. t1 According to a variant matured clarified butter should be used in this case.

Chap, XXVI. ] 'UTTARA-TANTRAM. 137

be judiciously taken with Yava-kshara and powdered Tri-katw and with the soup of Mudga, Patola and Kulattha pulse. 8. Treatment of Tri-doshajaand Kshay- aja S'iroroga :- The Measures which are severally remedial to the three deranged Doshas of the body should be employed in a case of Siroroga marked by the concerted action of the three Doshas (Tri-doshaja) and draughts of old and matured clarified butter are said to be specially efficacious in such instances. Em- ployment of nutritive (Vrimhana) measures and reme- dies is recommended in cases of the diseases of the head due to any waste or atrophy of the local fat, etc. (Kshay- aja Siroroga). Clarified butter duly cooked with the admixture of the drugs of the Vâyu-subduing and the Madhura groups* should be given as drinks and errhines. Any medicated Ghrita which acts as a remedy in cases of consumptive cough would be found most cfficacious in the present (Kshayaja) type. 9-10. Treatment of Krimija S'iroroga :- In a case of hcad-disease (head-ache ?) due to the germi- nation of parasites (Krimi) in the head, the patient should bc made to snuff in a quantity of animal blood. The worms or parasites lured with the smell of the blood, would grecdily come down (into the passages of the nostrils) when they should be carefully extracted (by means of tongs, etc). Head-purgatives composed of the pulverised secds of Hraswa (small) S'igru mixed with Kânsya (dcad brass) and Nili (indigo) pounded together should then be uscd, if necessary, or any vermifuge drug (Vidanga, etc.) pasted with the urinc of a cow should be

• According to Videha the clarified butter in this case should be cooked with the decoction of the Vayu-subduing drugs and with the Kalka of the Madhura drugs .. .18

138 THE SUSHRUTA SAMHITA. [ Chap, XXVI.

stuffed into the nostrils in the manner of an Avapida Nasya. Fumigations should be applied into the nostrils with the fumes of burnt sordid fishes and vermifuge foods and drinks of various kind should be given. 11. Treatment of Suryavarta and Ardha- vabhedaka :- Errhines ctc. (plaster, gargle, etc.) should be prescribed in cases of the Suryavarta type of Siroroga. The diet should principally consist of boiled rice and milk with clarified butter and the essence or extract of the meat of Jangala animals, These and similar other suitable remcdial agents should be employ- ed in cases of the Ardhavabhedaka type of Siroroga. Sirisha* and Mulaka seeds or bamboo-roots camphor, or Vacha and Magadhi, or Yashti-madhu and honey, or Manah silá, pasted with honey, or (pasted) Chandana should be stuffed into the nostrils in the manner of an Avapida Nasya in a casc of the Suryá- varta type of Siroroga as well as in a case of Ardháva- bhedaka headache. After the usc of the above, the patient should be made to snuff in the medicated clarified butter cooked with the drugs of the Madhura + (Káko- lyádi) group, in both the above cases. Plasters com- posed of Sårivå, Utpala, Kushtha and Yashti-madhu past- ed with Kanjika(acid gruel) and surcharged with oil and clarified butter are to be found efficacious in both the cases, if applied to the affectcd region. This may be employed with equal success in the cascs of the Kaphaja type $ of Siroroga. 12-14. * Sripati Datta, the commentator of Vrinda, prescribes the bark and S'ivadása Sen, the commentator of Chakrapáni, prescribes the seeds of S'irisha. + Some take "मधुरसा" to mean "मूर्वा"। + In place of the Kaphaja type some read the Kshayaja type. But it is not accepted by Jejjata. Others again read "Anilatmake" i.c. in the Vataja type.

Chap. XXVI. UTTÁRA-TANTRAM. 139

Treatment of Ananta-vata :- Cases of Ananta-váta Siroroga should be treated like those of Suryavarta. Moreover blood-letting should be effected (by opening a local vein) and the diet should be such as to subduc the Váyu and the Pitta and should cossist of Madhu-Mastaka, Sangyáva and Ghrita-pura (different kinds of confectionery made of wheat, sugar, milk, clari- fied butter, etc.). 15. Treatment of Śamkhaka :- Clarified butter churned from milk should be given for a drink and used as an errhine in a casc of Samkhaka and the diet should consist of (boiled rice mixed with) clarified butter and the essence of the meat of jángala animals. Plasters composed of S'atavari, black sesamum, Yashti-madhu, Nilotpala, Durvá and Punarnavá pasted together, or of Mahá-sugandhá (Utpla-asárivá) or Pálindi pasted with Kánjika should be applied to the affected locality. Cooling washes and plasters as well as different Avapida Nasyas prescribed in cases of Suryávarta should also be prescribed for this diseasc (Samkhaka). 16. Strong head-purgatives (errhines) composed of oil and honey should be first administered in cases of Siro- roga with the exception of the Krimija and the Kshayaja types. Then the patient should be made to snuff in drops of mustard oil. In cases where the preccd- ing remedics would fail to produce any relief, the patient should be treated with Sneha and Sveda, and bleeding should then be cffected by opening a local vein. 17-18. The Conclusion :- The causes, symptoms and the therapeutics of the seventy-six kinds of ocular affection, of the twenty-cight kinds of the disease of the ear, of the thirty-one kinds of nasal disease, of the eleven kinds of the disease of the head as well as

140 THE SUSHRUTA SAMHITA. [Chap. XXVI.

of the sixty-seven (sixty-five) kinds of the affection of the mouth have been described in detail in other treatises (e.g. those of Videha, etc. dealing with this special subject-the diseases of the over-clavicular region). The number, symptoms and therapeutics of these diseases of the over-clavicular region are herein briefly described in accordance therewith. 19.

Thus ends the twenty-sixth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the treatment of the diseases of the head.

Here ends the Salakya Tantra (Surgery Minor).

CHAPTER XXVII.

Now we shall discourse on the chapter which deals with the specific features (of the nine diseases of infant life, which are attributed to the influences) of the nine malignant Grahas (Nava-Grahakriti-Vijna- nam). I. Different Names :- Attentively hear me des- cribe, Susruta, the origin, cause and medical treatment of the discases of infancy which are due to the influences of malignant stars (Graha) or demons as well as the characteristic symptoms by which each can be accurate- ly diagonosed. The diseases number ninc in all and are called Skanda-Graha, Skandápasmára, Sakuni, Revati, Putaná, Andha-Putaná, Sita-Putaná, Mukha- mandiká and Naigamesha or Pitri-Graha. 2-3. General course of attack :- These malig- nant stars (Graha) or demons affect the person of a child in the cases where the directions laid down before (in the Sárira-sthána) in respect of the conduct of the mother or the nurse during the time the child is brought- up on the breast are not followed, and consequently where proper benedictory rites arc not performed and the child is allowed to remain in an uncleanly state, or where the child becoming anyhow uneasy gets fright- ened, is rebuked, or begins to cry. They (demons) make their appearance for the purpuse of getting proper respect and worship. They being omnipotent and omnipresent are not capable of being scen by man when they enter the person of a child. I should, there- fore, discourse on the symptoms of their presence, as derived from the authority of the sages of yore. 4.

142 TIE SUSIRUTA SAMIIITÁ. [ Chap. XXVII.

Symptoms of attack by Skanda- graha and Skandapasmara-graha :- Swelling of the eyes and distorted features of the face and an aversion to the breast-milk are the indications of an attack by the Skanda-graha. The body of the chiid emits a bloody smell and onc of the eyelids becomes fixed or motionless. The child looks frightened, closes his fists (as in a fit of convulsion) and moans a little. The eyes become highly rolling and the stool becomes hard and constipated. Alternate fits of fainting and cons- ciousness, convulsive jerks of legs and hands like those in dancing, foaming (at the mouth), yawning and the passing of stool and urine with the passage of wind are the characteristic features of an attack by the Skanda- pasmara-graha. 5-6. Sakuni and Revati :- Looseness of limbs which cmit a peculiar bird-like* smell are the indications of an attack of the child by the Sakuni Graha. The child in such a casc starts up in terror and its body is covered with a large number of secreting ulcers (Vrana), or of eruptions of vesicles attended with a burning sensation subsequently suppurating and bursting of themselves. The face assumes a blood-red hue, the stool (as well as the urine) becomes green and the body of the child looks as if of deep yellow or dark brown colour, fever ensucs with an inflamation of the mouth, a bruised pain is felt all over the body and the child frequently rubs its nose and ears-these are the features which mark a sure attack of Revati-Graha. 7-8. Putana and Andha-putana :- Loose- ness of the limbs, disturbed sleep whether by day

• By the word fewyr (lit. a bird) in fawwufar, is here meant meat- eating aquatic birds.

Chap. XXVII. 1 UTTRA-TANTRAM. 143

or at nighe, loose stools, emission of a crow-like smell from the body, vomiting, appearance of goose-flesh on the skin and thirst are the specific symptoms of an attack of the child by the Putana-Graha. Dislike for the breast-milk as well as an attack of dysentry, (Atisára), cough, hic-cough, vomiting, fever, discolouring of the complexion, and swelling in the skin as well as an inclination to lie always on the face are the symp- toms which are exhibited in a casc of an attack by the Andha-Putana-Graha. 9-I0. Śita-putana and Mukha-mandiká :- Constant and frightened startling up, excessive shivering, comatose sleep, constant diarrheic stools and bloody smell of the limbs are the symptoms which characterise a casc of an attack by S.ta-Putana. The child in this case cries almost unceasingly, and a rumbling sound is heard in the intestines. Palencss (emaciation) of the body (trunk) and a glossy line (swelling) of the face and the extremities attended with frightfulness, voracious appetite, appear- ance of net-like veins on the abdomen and the emission of urinc-like smell from the body are the symptoms of an attack of the child by Mukha-mandika Graha. 1I-12. Naigamesha-Graha :- Frothy vomits, bend- ing of the middle of the trunk, anxious appearance, loud crying, upward gaze of the eyes, constant emaciation (fever-D. R.), a fatty smell in the body and unconscious- ness are the symptoms which mark a case of an attack by the Naigamesha. 13. Prognosis :- A stupified state of the child attended with anaversion to breast-milk and constant fits of fainting as well as the full development of all the specific symptoms show the imminent fatal termination of the disease. Otherwise it may prove amenable to medical treatment, if it be not a case of long standing. 14.

$44 THE SUSHRUTA SAMHITA. [ Chap. XXVII.

Rules to be observed :- The child should be kept in a clean and purified chamber and its body should be rubbed or anointed with old and matured clarified butter. Mustard sceds should be strewn all over the floor (by a person) in a clean state and a lamp of mustard oil should be kept perpetually burning therein. Libations of clarified butter with the drugs of the Sarva- gandha and Sarvoushadhi * groups and garlands of flowers as well as sandal paste should, be cast into the fire and kept continually burning by reciting the following incantations, "Obeisance to thee, O fire-god, obeisance to thee, O goddess Krittiká, obeisance to thee, O Skanda, obeisance to thee, O lord of the Grahas (which has cast this malignant influence). With head down with deep humility, I supplicate thy favour. Dost thou accept the offerings I have made to thee. May my child get rid of the discase it has been suffcring from. Makest it hale and hcarty again." 15.

Thus ends the twenty-seventh chapter of the Uttara. Tantra in the Sus'ruta-Sambita which deals with the specific features of an attack by the nine (malignant) Grahas.

• The drugs of the Eladi 'group are known as Sarva-gandha. Sarvaaushadhi drugs here mean Yava, Dha'nya, Tila, etc.

CHAPTER XXVIII.

Now we shall discourse on the chapter which deals with the Therapeutics (and remedial measures) of an attack by Skanda-Graha (Skanda-Graha-Pra- tishedha). I. Decoctions of the leaves of the trees (Vilvádi) possess- ed of Váyu-subduing virtue should be used for sprink- ling purposes and oil duly cooked and prepared with the decoction of their roots and with the drugs of the Sarvagandha, group and ¡with Kaitaryya* and Sura- manda as Kalka should be used in anointing the body of the child laid up with an attack of Skanda-graha. Draughts of clarified butter duly cooked with Deva-dáru, Rásná, the drugs of the Madhura group and with milk, should be internally administered. 2-3. Fumigation :- Moreover the body of the child should be fumigated with the fumes of the mustard secds, the cast-off skin of a snake, Vachá, Kákádani, clarified butter and the hairs of a camel, a goat, a sheep or of a cow mixed together and burnt. 4. The twigs of Soma-balli (Guduchi), Indra-balli (As- mantaka) and S'ami as well as the thorns of Vilva and the roots of Mrigadani, should be strung together (in the shape of a garland) and tied (round its neck). 5. The physician (or any other person acting on his bchalf) should bathe in the night and worship the god Skanda for three successive nights in the inner quadrangle of the house of the child or at the crossing of roads with various offerings, vis., garlands of red flowers, red flags, red perfumes such as Kumkuma, edibles of various

• Kaitaryya, according to Dallana, means Nimba or Guduchi. 19

146 THE SUSIIRUTA SAMHITA. [ Chap. XXVIII.

kinds and newly harvested barley grains, Sáli rice. A cock should be sacrificed on the occasion (to appease his wrath) and bells should be rung (for his propitiation). The water to be uscd for bath (in course of worship), should be consecrated by reciting the Gáyatri Mantra and the sacrificial fire should be duly lit with (three, seven or ten) libations (of clarified butter). 6. Mantras :- The body of the child should be guarded by a careful physician against the influence of the malignant Grahas by reciting every day a Mantra which runs as follows :- "May Skanda, the eternal and changeless deity who is the receptacle of all sorts of energies produced by austerities, fame, valour, or organic combination (vital energy), be propitious to thee. May the almighty Guha protect thee from all evils-Guha who is the commander-in-chief both of the army of the gods and of the Grahas and is the destroyer of the enemies of the army of the gods (in which rank he has been installed, lit. wedded, with the suffrage of all the gods). May he who is the begotten son of the supreme deity-the god of the gods and who acknowledges severally the exalted motherhood of Gangá, Umá and the Krittikas, give thee health and comfort. May the beautiful god who pierced with a single shaft right through the heart of the mountain Krouncha and who is effulgent with the red rays of his own divine person smeared with the paste of red sandal-wood and decked with the garland of red flowers, protect thee from all perils." 7.

Thus ends the twenty-eighth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the Therapeutics of Skanda-Graha.

CHAPTER XXIX.

Now we shall discourse on the chapter which deals with the Therapeutics of an attack by Skandápasmára (Skandapasmara-Pratishedha). I. A decoction of Vilva, S'irisha, Golomi (Durálabhá), and the drugs of the Surasadi group should be employed in sprinkling the body of the possessed child in a case of the present disease. Medicated oil duly cooked with the drugs of the Sarvagandha group should be used in anointing its body. Clarified butter duly cooked with milk and the decoction of the barks of the Kshiri trees together with the drugs of the Kakolyadi group as Kalka* should be prescribed for internal usc. 2A. The body of the affected child should be rubbed (Utsadana) with the paste of Vacha and Hingu taken together. The dungs of an owl and a vulture, human hairs, the nails of an elephant, clarificd butter, and the hairs of a bull should be mixed together and used for fumigating the child's body. Ananta, Vimbi, Markati, and Kukkuti should be strung together and fastened (as a charm) to the body of the child. 2B. The physician (or the votary officiating for him) should worship the presiding deity of the disease in a ditch (dug out for the purpose) with the offerings of both cooked and uncooked meat, fresh blood (of a goat), milk, and edibles prepared with the Måsha pulse for the ghosts, and the possessed child should be bathed at the crossing of roads by physician observing the

• Although Dallana prescribes the druge of the Kákolyádi group to be uscd as Kalka, we are inclined to take the sentence to mean that the decoction of those drugs should be used.

148 THE SUSHRUTA SAMHITA. [ Chap. XXIX.

necessary fast, etc. with the rccital of the following Mantra :- "O thou, the trusted and beloved friend of the god Skanda, O Skandápasmára, O thou ugly-faced one whom the world knows by the epithet of Visakha, may good befall this child in distress." 2.

Thus ends the twenty-ninth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the Therapeutics of an attack by Skandápasmára.

CHAPTER XXX.

Now we shall discourse on the chapter which deals with the medical treatment of an attack by Sakuni (Śakuni-Pratishedha). I. A wise physician should sprinkle the body of the child possessed by Sakuni with the decoction (duly prepared) of Vetasa, Amra and Kapittha. Oils duly cooked with the drugs of the sweet and astringent groups should be used in anointing its body. Pradehas (plasters) composed of Madhuka, Us'ira, Hrivera, Sárivá, Utpala, Padmaka, Rodhra, Priyangu, Manjishthá and Gairika, should be applied. 2A. Various kinds of medicinal powders and diet and remedial measures in general described in connection with the mcdical treatment of Ulcers * as well as the fumigations (Dhupana) mentioned in the chapter on the treatment of Skanda-graha (vide ch. XXVIII.) should be prescribed for the disease under discussion. Drugs such as S'atávari, Mrigádani, Erváru, Nágadanti, Nidigdhiká, Lakshmana, Sahadevá and Vrihati should be fastened (as a charm) to the body of the child (in the preceding manner). 2B. The presiding deity of the discase (Sakuni Graha) should be worshipped by a physician of self-control inside a Karanja bower and be propitiated with offerings of huskless sesamum, garlands of flowers, Haritala (yellow orpiment) and Manahs'ila (realgar) and the child should be bathed duly inside the bower (according to the rules laid down in the treatment of Skanda Graha) The medicated Ghrita prescribed for

• See Chapter I, Chikitshita Sthána.

THE SUSHRUTA SAMHITA. [Chap. XXX.

the treatment of Skanda Graha may also be ad- vantageously given in the present instance. 2C. Various sorts of worship should be made with the offerings of various species of auspicious flowers. The Mantra to be recited on the occasion runs as folllows :- "May the ever down-looking sharp-beaked goddess, Sakuni, who (with her keen and far-seeing eyes) is decked with all sorts of ornaments and who traverses the ethereal sky in her flight, be propitious to thee. May the brown-eyed, fierce-looking, huge-bodied, large- bellied, and spike-eared Sakuni, who strikes terror into the heart of man with her terrible voice, be pleased with thee." 2.

Thus ends the thirtieth chapter of the Uttara Tantra in the Sus'ruta Samhita which deals with the treatment of (an attack) by S'akuni.

CHAPTER XXXI.

Now we shall discourse on the chapter which treats of the Therapeutics of an an attack by Revati (Revati- Pratishedha). I. The duly prepared decoction of As'vagandhá, Sárivá, Ajas'ringi, Punarnavå, the two kinds of Sahá and Vidari should be employed in sprinkling (Sechana) the body of the affected child (in a case of an attack by Revati). Medicated oil duly cooked with Kushtha and Sarjarasa (resin) * should be used in anointing the child's body. Medicated Ghrita duly cooked with the decoction of Dhava, As'va-karna, Kakubha, Dhataki and Tinduka and with the drugs of the Kakolyadi group (as Kalka) should be employed internally as a draught. 2A. Kulattha, (burnt and) powdered S'amkha (conch-shell) and the drugs of the Sarvagandha group should be used as Pradehas (plasters), and the body of the child should be fumigated (Dhupana) morning and cvening with the smokes of barley, Yava-phala (bamboo), and the dungs of vultures and owls mixed with clarified butter. Neck- ornament should be made with (the wood or pith of) Varuna, Arishta (Nimba), Ruchaka, Sinduka (Nirgundi), and Putranjivaka and should be always worn on the neck (as a charm) by the child. 2-3. The presiding deity of the disease known as Revati should be worshipped in a cow-shed by a self-controlling physician with the offerings of white flowers, milk, parched

• There is an additional text in the Bhívaprakás'a which says that Guggulu (Palamkashá), Nalada (Khus-khus) and Giri-kadamba should also be used in the preparation of the medicated oil.

152 THE SUSHRUTA SAMHITA. [Chap, XXXI.

paddy and boiled S'áli rice and the nurse as well as the child should be bathed in a junction of rivers. The Mantra (to be recited in course of worship) runs as follows :- "May the goddess, Revati, of dark com- plexion who is clad in parti-coloured garments and garlands of flowers of various colours and painted with anointments of various kinds and with oscillating ear- rings, be pleassd with thee. May the goddess, Revati, who is tall, drooping and terrible-looking, and who is the mother of many sons be always propitious to thee." 2.

Thus ends the thirty-first chapter of the Uttara-Tantra in the Susruta Samhita which deals with the Therapeutics of an attack by Revati.

CHAPTER XXXII.

Now we shall discourse on the chapter which treats of the medical treatment of an attack by Putaná (Putana-Pratishedha). I. A decoction of the barks of Kapota-banka, Araluka,. Varuna, Páribhadraka and A'sphota should be used in washing, and medicated oil duly cooked and prepared with (the Kalka and decoction of) Vacha, Vayasthá, (Bráhmi), Golomi, Haritála, Manah-s'ilá, Kushtha and Sarja-rasa (resin) should be used in anointing the body of a child possessed by Putaná. 2-3. Clarified butter duly cookcd with the Tuga-kshiri, Kushtha, Talis'a, Khadira and Chandana, and the drugs of the Madhura group would be found bencficial. 4. Deva-dáru, Vachâ, Kushtha, Hingu, Giri-kadamba, Ela and Harenu should be used in fumigating the body of the child. Fumigation of Gandhanakuli, Kumbhika, marrow of Vadara-fruits, shells of crabs, and mustard-sceds pounded together and mixed with clarificd butter may also be uscd. Kákádani, Chitra- phalá, Vimbi and Gunja should be worn on the body (as a charm) by the child. 5-6. Putana, the presiding deity of the diseasc, should be worshipped in the interior of a lonely chamber with oblations and with the offerings of boiled rice prepared with the admixture of fish as well as those of Kris'ard, and Palala (meat or puddings of sesamum) placed in a saucer and covered with another, and the child should be bathed with the water left behind after worship. 7A. The worshipping Mantra is as follows :- "May the slovenly shag-haired goddess, Putana, .who is dressed in dirty clothes, and who loves to haunt lonely 20

I54 THE SUSHRUTA SAMHITA. [Chap. XXXII.

dwellings, preserve the child. May the fierce-looking, frightful goddess who is as black as a dark rain-cloud, who loves to haunt lonely and dilapidated human dwellings and whose body gives off filthy odours protect the child from all cvils." 7.

Thus ends the thirty-second chapter of the Uttara-Tantra in the Sus'ruta Samhitá which deals with the medical treatment (of an attack) by Putaná.

CHAPTER XXXIII.

Now we shall discourse on the chapter which deals with the medical treatment of (an attack by) Andha-pu- taná (Andha-putana-Pratishedha). I. The decoction of the leaves of the trees of the Tiktaka gana (trecs of bitter taste) should be used in sprinkling (the body of the posscssed child). Surd (wine). Souviraka (a kind of acid gruel), Kushtha, Harrtála, Manah-s'ila and Sarjarasa (resin) should be used in due proportion in medicating the oil (for the child) and mcdicated Ghrita sbould be duly cooked with the Kalka and decoction of Pippali, Pippali-mula, the drugs of the Madhura group, S'alaparni and the two kinds of Vrihati with the addition of honey (as an after-throw). 2A. Plasters of the drugs of the Sarva-gandhá (Eládi) group should be applied to the body of the child and its cyes should be soothed with cold applications. The feces of the the cock, its feather and skin*, the cast-off skin of a snake and the ragged garment of a (Buddhist) monkt should be used for fumigating the child's body. The child should be made to wear (the roots of) Kukkuti, Markati, S'imbi and Ananta as a charm. 2B. Offerings of meat, cooked or uncooked, and of blood should be made (to Andhaputaná) at the crossing of roads or inside a house for the preservation of the

• Some explain "ar" (hair) and (zkin) as those of man and not of a cock. | Bhavaprakas'a reads "नोशंञ्ञाभीत्णशी वासु:" z. e., very old cloth. This reading does not suggest that the cloth to be used should have been worn by a Buddhist monk.

156 THE SUSHRUTA SAMIIITÁ [Chap. XXXIİt

child, which (with its nurse) should also be bathed with the decoction of the holy drugs of the Sarva-gandha group. The Mantra runs as follows :- "May the dread- ful, brown-coloured, bald-headed, goddess Andha-putaná, wearing a red-coloured garment be pleascd to save this child." 2.

Thus ends the thirty-third chapter in the Uttara Tantra of the Sus'ruta Samhita which deals with the medical treatment of (an attack) by Andha-putaná.

CHAPTER XXXIV.

Now we shall discourse on the medical treatment of (an attack by) Sita-putana (Sita-putana-Prati- shedha). I. The decoction of Kapittha, Suvahá (Rásná), Vimbi, Vilva, Prachivala (?), Nandi (Vata) and Bhallátaki should be used in sprinkling (the child's body). The urine of a cow and of a she-goat, as well as Musta, Deva-dáru, Kushtha and the drugs cf the Sarva-gandha (Eládi) group should be used in duly preparing a medicated oil (for the purpose) and medicated Ghrita should be duly cooked with (threc parts of) the decoction of Rohini, Sarjarasa (resin), Khadira, Palásá and barks of Arjuna and (one part of) milk. 2A. Dungs of an owl and a vulture, the cast-off skin of a snake as well as Ajagandhá and Nimba leaves and Yashthi-madhu should be used for fumigating purposes, and Lambá (Tiktálávu), Gunjá and Kákádani should be be worn (as a charm) by the child. 2B. The goddess Sitaputana should be worshipped with the offcrings of the preparation of rice and Mudga pulse (cooked together) as well as with Váruni wine and blood, and the child should be bathed near a river or a tank. The Mantra is as follows :- "May the goddess Sita-putaná, who is fond of the preparation of rice and Mudga pulse, who delights in drinking wine and blood and who resides by the side of a river or a tank, preserve thee." 2.

Thus ends the thirty-fourth chapter in the Uttara-Tantra of the Sus'ruta Samhita which deals with the medical treatment of (an attack by) S'itaputaná.

CHAPTER XXXV.

Now we shall discourse on the chapter which deals with the medical treatment of (an attack by) Mukha- mandiká (Mukha-mandika-Pratishedha). I The decoction of Kapittha, Vilva, Tarkari (Jayanti), Vams'a-lochana (D.R. Vásá), Gandharva-hastaká (Eranda) and Kuverakshi (Patalá) should be used in sprinkling (the body of the possessed child). Oil and fat (in equal parts) should be duly cooked' with the expressed juice of the Bhringarája, Ajagandhá and Harigandhâ (Aśwa- gandha) and be used in anointing the child's body. Medicated Ghrita should be duly cooked with Madhulika (Murva), Tuga-kshiri and the drugs of the Madhura and the minor Pancha-mula groups and with milk. 2. A. Fumigation with Vacha, Sarjarasa and Kushtha mixed with clarificd butter would be found beneficial and the child should be made to wear the tongue of a Chása bird, a Chiralli bird or a snake (as a charm). 2. B. Offerings of Varnaka (Kampillaka), Churnaka, gar- lands of flowers, Rasanjana, Párada (mercury), Manah- S'ila, Payasa (rice boiled in milk) and puddings should be made (to the deity) inside a cow-shed and the child should also be bathed therein with water consecrated with Mantra. The Mantra runs as follows :- "May the beautiful and blessed goddess, Mukhamandiká, who is decked with ornaments, who can assume different forms at will and who resides in cow-sheds, preserve thee".

Thus ends the thirty-fifth Chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the medical treatment of (an attack by) Mukhamandiká.

CHAPTER XXXVI.

Now we shall discourse on the chapter which deals with the medical treatment of (an attack by) Naigamc- sha (Naigamesha-Pratishedha). I. The decoction of Vilva, Agnimantha and Putika should be used in sprinkling (the body of the possessed child) and sprinkling with Sur, Sauvira and Dhány- ámla (Kánjika) is also advisable in such cascs. A medicated oii should be duly cookcd with Priyangu, Saralá, Anantá, S'ata-pushpá and Kutannata and with cow's urine, the liquid of the milk-curd (Dadhi-mastu) and Kanjika Medicated Ghritas should be duly pre- pared with the drugs of the Madhura group as Kalka, with the decoction of the Dasamula and with milk or with the head of a date-palm tree 2. .1. The child should be made to wcar Vachá, Vayasthá, Golomi and Jatilá as a charm and the utsadana measures recommended in the treatment of Skandápasmára should be used in this case also. Siddharthaka (white mustard), Vacha, Hingu, Kushtha, parched rice, Bhallá- taka and Ajamoda should be used in fumigating the body of the child. In cases of attacks by Navagraha the dungs of a monkey, an owl and a vulture should also bc used by persons wishing the good of the child for a fumigating purpose and that at the dead of the night when all persons are aslecp. 2. B. Offerings of huskless sesamum, garlands of fowers and various dishes should be made to the deity Naigamcsha (the preserver of the child) at the foot of a Vata tree on the sixth day of the fortnight and the child should be bathed there at the foot of the tree.

160 THE SUSIIRUTA SAMIIITA. [Chap. XXXVI.

The Mantra runs as follows :- "May the far-famed god, Naigamesha, the prescrver of children, who has a goat's face with moving brow and rolling eyes and who can assume different forms at will, preserve the child." 2.

Thus ends the thirty-sixth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the medical treatment of (an attack by) Naigamesha.

CHAPTER XXXVII.

Now we shall discourse on the chapter which deals with the origin of the (nine) Grahas (Grahotpatti- Adhyaya). I. The nine presiding deities-vis., Skanda and others- of the nine diseases of infant life are all possessed of cthereal frames, divine effulgence and specific sex- distinction of their own. They were created by the gods Agni, Mahadeva and the goddesses Krittika and Umá for guarding the person of the new-born Guha though protecting himself with his own divine prowess amidst the stems of S'ara grass. Of thesc Grahas the females who are possessed of various shapes as described before are considered as originally made of the Rájasa essence of the goddesses Gangá, Umá and Krittiká. 2A. The Naigamesha Graha who is possessed of a sheep's face was created by the goddess Parvati as the friend and protector of the young god Guha and who was as dcar to him as his own self. Skandápasmára, the presiding deity of the disease named after him, was created by Agni, the fire-god (Vulcan). Ile is as bright as fire itself and is a constant companion of the god Skanda and is also known by the name of Visakha. The god Skanda, the tutclar divinity of the disease of that denomination, was begotten by His Holiness, the Almighty Destroyer of Tripura and is otherwise known by the name of Kumára (lit. a child, vis., of Mahá- deva). 2B. It is impossible that the god springing from Rudra and Agni, with his exalted parentage would find pleasure in such a dangerous discase even out of childish frolic- 21

162 TIE SUSHRUTA SAMHITA. [Chap, XXXVII.

someness and it has also been asserted by eminent authorities on the physical science that some unintelli- gent persons have been misled into holding, through a mistake due to the identity of the names, that the author of the discase under discussion (Skanda) is no other than the invincible Skanda. 2. On the effulgent god Skanda's being clevated to the leadership of the armies of Heaven, the presiding deities of those diseases waited upon him and with folded palms asked him about the means of their subsis- tence. The god Skanda in his turn, referred them to His Holiness the god Siva for the answer, whereupon they went to the latter in a body and made the samc query. Mahadeva, the Destroyer of Bhaga's eyes, replicd "Gods, men and other animals, O, ye Grahas, exist on the principle of reciprocal bencfit *. The gods minis- ter to the wants of men and beasts, etc., by marshalling different scasons of the year and by setting the air in motion and sending down the rain, and men, in their turn, propitiate the gods by duly and reverentially per- forming the sacrificial rites, by saying their prayers with blended palms, by bowing down in reverencc, and by repctition of prayers, religious vows and other religious observances. All services and their emoluments in consequence have been filled up and settled and therc remains nothing for you to fill. Your proper means of subsistence will, therefore, be in the life of an infant (though the emoluments you shall receive shall bc staincd with the tears of many an anxious, watchful and night-worn parent). 3A.

• Exchange or reciprocity of services underlies the foundation of all distinet and cognitive existences, whether beasts, men or gods. The worlds are linked to one another by bonds of service. Give-and-take is the law of the universe, Duty implies obligation.

Chap. XXXVII. ] UTTARA-TANTRA. 163

Children of the families in which the gods, the Pitris (departed fathers), the Brahmans, the pious, the precep- tors and the seniors and the guests arc not properly worshipped and attended upon and wherein the rule» of cleanliness and virtues are not observed and the mem- bers of which do not make daily offerings to the gods and give alms to beggars and live on food prepared by others and cat from broken bowls and plates of Indian bell-metal would be the proper persons whom you might strike with impunity, and by your malign influence lay them up with discases peculiar to infant life. (It shall be your duty to sec that iniquities of the parents are visited on their children. Attack them without least compunction of heart and ample mcans of subsistence will be thereby secured to you). There the parents of thore children will worship you in thcir calamities and you shall get plenty to live upon." 3B. Thus the Grahas came into being and began to attack the children (of iniquitious parents), and it is therefore that a child attacked by a malignant Graha becomes very hard to be cured. Death or permanent disfigurement of any limb or organ is sure to ensue from an attack of Skanda Graha, since he is the most dreadful of all the Grahas. A case of full-developed attack by any other Graha should be likewise held as incurable. 3

Thus ends the thirty-seventh chapter of the Uttara Tantra in the Sus'ruta Samhita which deals with the origin of the Grahas.

CHAPTER XXXVIII.

Now we shall discourse on the chapter which deals with (the symptoms and) the therapeutics of the discases of the female* organ of gencration (Yoni-vyapat- Pratishedha). I. Causes :- The bodily (as well as the local) Váyu of a girl of tender years, weakly constitution or build and dry organic temperament, is deranged and aggravated in consequence of her excessive indulgence with a man of abnormally developed reproductive organ, and on getting into her organ of generation (yoni) gives rise to different local vaginal discases which become manifest through the presence of the symptoms of the aggravation of the three specific Doshas. 2. In the chapter on the enumeration of diseases, the diseases which affcct the female organ of generation (yoni) have been classified into twenty different kindst. The injudicious conduct of life which is usually found in females, menstrual disorders, the discased or defective nature of the secd (of the parents of the girl), or any accidental cause may be fairly set down as causcs of these female diseases. Now hear. them discussed separately. 3. Enumeration and Classification :- Udávartá (dysmenorrhœa), Bandhyá (sterility), Viplutá (introversion of the uterus), Pariplutá (retroversion or retroflexion of the uterus) and Vatala are the five kinds

• The term "yoni" is here used in a very comp.chensive sense and means the whole female organ of generation, i. e., Uterus, Vagina, etc. + These three lines correspond verbatim with three lines in the Charaka Sambita (vide Charaka Samhita, Chapter XXX, Chikitsita- sthána).

Chap. XXXVIII.] UTTARA-TANTRA. 165

of Vataja vaginal diseases. Rudhirakshará (menorrhœa), Vâmini, Sramsini, Puttraghni and Pittalá are the Pittaja ones. Atyánandá (nymphomania), Karnini, thc two kinds of Charana and Slaishmiki find their origin in Kapha, and Shandi, Phalini, Mahati, Suchivaktrá and Sarvajá are said to be due to the aggravation of the three Doshas. 4. Symptoms of the Vataja types :- An Udávarta yoni discharges painful and frothy menses and a Bandhya yoni is marked by the absence or suppression of the catamenial flow. A local pain is always complained of in a Vipluta yoni and in a Paripluta yoni an cxcessive local pain is experienced at the time of sexual congress. A Vatala yoni is marked by an aching and piercing pain in the organ which seems rough and numbed. The peculiar pain duc to the derangement of the Váyu is also felt in the first four types of the serics. 5. Symptoms of the Pittaja types :- Discharge of the menses with a burning sensation in the passage is the characteristic symptom of Lohita- kshara or Rudhira-kashra yoni. The yoni from which the semen charged with the menstrual blood, is cjected with Vayu (sound) is called Vamini ; the coming out (prolapsus) of the organ (uterus) when disturbed and a difficult or painful parturition arc the symptoms of a Prasramsini yoni. The yoni in the case of repeated abortions due to the excessive discharge of catamenial blood during the period 'of gestation is called Puttraghni. An extremcly burning sensation and suppuration in the organ attended with fever are the symptoms which mark a Pittala yoni. The four previous vaginal diseases are also marked by the specific symptoms of the aggravated Pitta. 6.

166 THE SUSHRUTA SAMIIITA. [Chap. XXXVIII.]

Symptoms of the Kaphaja types :- An Atyananda yoni knows no satisfaction in matters of sexual pleasures. Hæmorrhoid growths or polypii duc to the aggravation of Kapha and vitiated blood appear on the living membrane of the organ in a Karnini yoni. In an Acharana yoni a greater quantity of ovum is secreted before the completion of sexual act, and in the other i.r., in an Aticharana yoni the semen is not retained in consequence of over-indulgence. A Sleshmala yoni is very cold and slimy and has a local itching sensation. The first four kinds of this series of vaginal discase (lit. diseased vagina) arc also characterised by the actions of the derangcd and aggravated Kapha in the locality. 7. Symptoms of the Tri-doshaja types : -The yoni of a woman marked by the non- appearance of the menses, non-development of her breasts and the roughness of the vagina (vaginal canal) which is felt at the time of coition is called a Shandhi. A woman of tender years, who has just passed her girlhood, when ravished by a man with an abnor- mally developed genital organ, offers the illustration of a Phalini yoni. An cxtremcly dilated vagina is called Mahayoni, while an extremely constricted one is called a Suchivaktra (lit. a vagina with a needle-cycd vulva). The yoni marked with the symptoms of the aggravation of all the three Doshas is said to be a Sarvaja yoni. The four preceding kinds of vaginal malformations or diseases arc also due to the concert- ed action of the three deranged Doshas in the locality and these last (five) kinds of Tridoshaja vaginal diseases are incurable. 8. Medical Treatment :- The medical treat- ment of the curable types of vaginal diseases should

Chap. XXXVIII.] UTTARA-TANTRA. 167

begin with the administration of a Sneha according to the Dosha involved in each case and applications of properly charged vaginal enemas (Uttara-vasti) should be particularly resorted to. In cases where the yoni (vagina) would feel cold, rough, numbed and be marked by diminished sensibility of its mucous membrane during sexual action it should be fomented, in the manner of Kumbhi-sveda, with the flesh of aquatic and A'nupa animals; and drugs of the Madhura group mixed with Vesavára (all described before) should be applied (in the form of poultice) to the part, and plugs of oil-soaked cotton should be constantly retained in the yoni (vagina). Proper vaginal lotions and washes as well as the measures of Purana i e. medical injection (prepared with the Vayu-subduing drugs) should also be employed ; cooling measures should be adopted in the cases marked by dryncss and sucking pain (Osha and Chosa) in the affected locality. The vagina should be filled up with the powders of the five officinal kinds of drug (Pancha-kasháya) in a case, marked by fetour and slimy mucous secretion, and the decoction of the drugs of Rájavrikshádi group should be used in wash- ing. Pindas (balls) of disinfectant (Sodhona, lit. purify- ing) drugs pasted with cow's urine and saturated with salt, should be inserted into the vagina marked by the discharge of pus. 9-12. A yoni (vagina) markcd by an itch and impaired sensibility should be fumigated with the vapour of Vrihati and the two kinds of Haridra taken together, which should be as well inserted and retained in the vagina (in the shape of a plug). A plug or stick com- posed of a paste of disinfectant (or Sodhana) drugs should be inserted into and retained in a Karnini yoni ; and a prolapsing (Prasramsini) yoni should be fomented with

168 THE SUSHRUTA SAMHITA. [Chap. XXXVIÍI.]

hot milk and rubbed with clarified butter. It should then be restored to its proper place and, being pasted with Vesavara, should be duly bandaged. 13-14. Diet .- Sura, Asava, Arishta, (wines of medicinal drugs) should be prescribed according to the Dosha involved in each case and the patient should be made to take the expressed juice of garlic (Lashuna) every morning and her diet should consist mainly of milk, meat-soup, etc. 15. We have already described the nature of the medical treatment and the remedial agents to be respectively pursued in and prescribed for diseascs of the semen, menstrual complaints, affections of the mammac, impotency, cases of false presentation of child and diseases during the period of pregnancy and motherhood, and all those may be employed with equal benefit in thesc diseases peculiar to the female sex. Other diseases (such as fever etc.) which may arise from immature delivery should be treated in the manner described in the respective treatment of those diseases in the Uttara Tantra. 16,

Thus ends the thirty-eighth chapter of the Uttara Tantra in the Sus'ruta Samhita which deals with the therapeutics of the female organ o generation.

Here ends the Kaumarabhritya Tantra,

CHAPTER XXXIX.

Now we shall discourse on the (symptoms and) medical treatment of Fever (Jwara-Pratishe- dha). I. The Divine Dhanvantari, who in his first incarna- tion arose out of the primordial Ocean with a pitcher of ambrosia on his head, (when it was churned by the gods and the demons) and who conferred immortality on Indra and his brother celestials, was thus interro- gated by his disciples, Susruta and others "You have instructed us, O, you, the foremost of physicians, the subject on all the concomitant distressing symptoms (Upadrava) of Uleer (Vrana). Now let us have a general outline and detailed description of the concomitant dis- tressing symptoms, physiological and pathological condi- tions e. g. fever, dysentery, cough, etc. showing in an ulcer- patient. An ulcer attended with many a concomitant symptom Upadrava) may be cured only with the greatest difficulty and such concomitant symptoms appearing in an emaciated and weak ulcer-patient, take time to be subdued bccause of the loss of his Doshas and Dhátus. Hence illumine us fully, O sir, on those diseases affecting the whole body (and not localised in any particular limb or organ) observed by the holy sages of yore, and instruct us the nature and application of the therapeutic agents to be employed in their cure". 2. t.

Descriptlon of Jwara :- To the query of the disciples, the divine physician, Dhanvantari replied as follows :- "First I shall discourse on the nature and origin of fever for it is the king of all bodily, distempers 22

170 THE SUSHRUTA SAMHITA. (Chap. XXXIX.

in as much as it affects the whole orgainsm at a time. It was begotten by the fire of wrath of Rudra, and afflict- ed the whole animal world or organic kingdom. The different names by which it is designated amongst the different kinds of animals are well known. Its presence is perhaps an indispensable condition under which a creature can come into being or can depart from this . life, and hence it is called the lord of ailments and none but a god or man can bear the heat of fever. Men may become gods by virtue of their good deeds (Karma) in life and would again revert to humanity (mortality) at the close of their blissful effects, and it is this divine or godly element in man that enables him to bear this abnormal heat of fever whereas the lower animals are simply lost under its influence. 3. Definition and Classification of Fever : -The disease which is marked by the arrest of the flow of perspiration, by increased heat (of the skin), by pain all over the body and by a sensc of numbness in the limbs, is called Jwara (fever). Cases of fever of which the causes are numerous, are divided into eight types according as they are brought on through the derangement of the three bodily Doshas separately, or through that of any two of them in combi- nation or through their cencerted action, or by any ex- traneous causes .* 4-5. When the Doshas of the body are deranged by their respective aggravating causes and in the hours of their specific dominancet they bring on an attack of fever by * There can be three cases of fever due to the derangement of the three Doshas separately, three cases from the derangement of two of them at a time and one case only from the concerted action of the three Doshas These are the seven cases while that due to an extraneous cause is the eighth. + Kapha is aggravated in the morning, Pitta, at noon and Váyu, in the evening. Fever follows a distinct periodicity determined by the

Chap. XXXIX. ] UTTARA-TANTRA. 171

spreading through the whole organism. The deranged bodily Doshas augmented or enraged by their specific aggravating causes, enter into the Amasaya and soon find lodgment in the Rasa (lymph-chyle) by virtue of their inherent heat ( Ushman ). The Doshas thus deranged and mixed with Rasa obstruct the Rasa- carrying and sweat-carrying ducts, impair the digestive fire and expelthe inherent heat (Ushman) out of its seat in the Pakvasaya, and spreading all over the body during the period of their specific dominance, bring on fever and causes its rise and exhibit their specific colour on the skin, etc. (of the patient). 6-7. Pathology :- The improper and excessive application of Sneha, etc., any kind of blow, the pre- sence of any other affection in the organism, sup- puration (of an existing boil or ulcer in the body), over-fatigue, any process of physical waste, indigestion, introduction of any extrancous poison or poisonous matter into the system, infringement of any habitual rule of diet and conduct, the sudden change or contrarie- ty of seasons, the smelling of any kind of poisonous herb or flower, grief, the malignant influences of inaus picious stars or planets (at the time of birth), dynamics

time of aggravation of the deranged bodily Doshas ushering in the attack An attack of fever due to the deranged Kapha comes on in the morning or after dusk ; one due to the deranged Pitta comes on at noon or mid- night, one due to the deranged Vayu comes on in the afternoon or during the small hours of the night. In a case of Dvi-doshaja fever (due to the combined action of the two deranged bodily Doshas) the heat is aggra- vated during the specific hours of domination of the stronger Dosha and continues through those peculiar to each of them. All night attacks should be regarded as connected with the action of the deranged Pitta. In a Tri-doshaja case, the heat comes on with the specific hour of the strongest one and is abated on the approach of the time peculiar to the weakest. Vayu is aggravated in the Varsha (rainy) season, Pitta, in the S'arat (autumn) and Kapha, in the Vasanta (spring)

172 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

of deadly incantations or charms, curses (from Bráh- manas and superiors), any fancied dread or anxiety, effects of miscarriage or untimely parturition, injudi- cious conduct of life on the part of a woman after delivery, and the first accumulation of the milk in the breast (after delivery) are the causes which lead to an attack of fever, the derangement and aggravation of the fundamental vital principles, (Doshas) of the body being the existing origins of the disease. The stomachic heat is propelled by the extremely deranged and aggravated Doshas of the body, and, coursing through the wrong channels in the orgainsm, tends to escape through the surface (the skin of the body) and, by incarcerating the vitiated Rasa Dhátu generally causes a rise in the bodily temperature and puts a stop to perspiration. 8-9. Premonitory Symptoms :- A sense of fatigue or physical languor, aversion to all sorts of work, paleness of complexion, bad taste in the mouth, tearfulness of the eyes, alternate liking and dislike for heat, cold and air, constant yawning, aching of the limbs, a sense of heaviness of the body, horripilation, disrelish for food, darkness of vision, depression and a feeling of creeping cold in the body are the general premonitory symptoms which usher in an attack of fever Constant yawning, burning of the eyes and aversion to food are the special pre- monitory symptoms of the derangement of Váyu, Pitta and Kapha respectively. The derangement of all the three Doshas is marked by the presence of all the symptoms, while, in the derangement of any two of these, the special symptoms of those two Doshas appear. IO. Symptoms of Vataja fever :- Shivering,

Chap. XXXIX.] UTTARA-TANTRA. 173

irregular fits of fever, dryness of the throat, lips and of the mouth, loss of sleep, stoppage of sneezing, par- chedness of the skin, pain in the head, chest and limbs, distaste in the mouth, suppression (D. R .- hardness) of stool and aching pain (in the abdomen) are the characteristics of a case of fever due to the action of the deranged Vayu of the body. II. Symptoms of Pittaja fever :- High fever (hyperpyrexia), diarrhœa, scanty but disturbed sleep, vomiting, inflamation in the throat, lips, mouth and nostrils, perspiration, delirious talks, swoon or fainting fits, burning sensation in the body, loss of consciousness, pungent taste in the mouth, ycllowness of the stool, urine and of the eyes and vertigo are the symptoms which mark the Pittaja type of fever. 12. Symptoms of the Kaphaja fever :- Heaviness of the limbs, shivering, nausea, appearance of goose-flesh, excessive sleep, obstruction of the internal passages of the body, slight pain (in the limbs), water-brash, swcet taste in the mouth, slight heat in the body, vomiting, lassitude, mal-assimilation (Avi- pákatá), whiteness (glossinss) of the eyes are the indica- tions which point to the Kaphaja origin of the disease. 13. Symptoms of the Tri-doshaja fever :- Insomnia, vertigo, laboured or difficult breathing, drowsiness (somnolence), a sense of innertness in the limbs, aversion to food, thirst, swoon, delirium, numbness, burning sensation and shivering of the body, pain about the region of the heart, delayed assimilation of the deranged bodily Doshas, (temporary) insanity, blackish yellow coat on the teeth, blackness and roughness of the tongue, pain in the head, in' the joints

174 THE SUSHRUTA SAMHITA. [Chap- XXXIX.

and in the bone, dilation of the pupil and cloudiness of the eyes, pain and ringing in the ears, delirious talks, inflamation of the living membranes of the channels (of the nose and of the mouth), indistinct sound in the mouth, coma (loss of consciousness) as well as perspiration, scanty emission of urine and fæcal matter at long intervals, are the symptoms which are exhibited in a case of fever duc to the concerted action of all the three deranged Doshas of the body (Tri-do- shaja or Sannipataja) 14. Abhinyasa fever :- Now hear from me about the peculiar forms of this type of fever the symptoms whereof are as follows :- Where a slight or imperceptible rise of the bodily heat, or a slightly subnormal tempera- ture attended with a subcomatose state, erroneous vision, loss of voice, injured or cracked condition of the tongue, dryness of the throat, suppression of stool, perspiration and urine, tearful eyes, hardness of the thorax *, aversion to food, dulness of complexion, difficult breathing and delirious talks and other con- comitant symptoms are the specific indications in a patient always confined to his bed, it is known by the name of Abhinyasa, while others call it a case of Hataujasa fever. 15. An attack of Sannipátaja fever can be cured only with the greatest difficulty, while others hold it to be almost incurable. A case of Sannipátaja fever atten- ded with somnolence is called Abhinyasa, it is called Hataujasa when the vitality of the patient is greatly diminished and it is called Sannyasa when there is an innertness of the limbs. 16 "सामुनिर्मुद्रणयनः" is a different reading in place of 'साखी निर्भु- wrea:"I The term firify is more appropriately applicable to wuw than to wr both grammatically and in sense.

Chap, XXXIX.] UTTARA-TANTRA. 175

When (in a case of Sannipátaja fever), the Ojo-dhátu (one of the fundamental principles) of the organism being disturbed or agitated by the deranged and aggra- vated Pitta and Váyu, gives rise to shivering and numbness of limbs and makes the patient drop into fits of unconsciousness whether asleep or awake, and when there are somnolence delirious talks, hor- ripilation, looseness. of the limbs and slight pain (in the body)-this kind of fever is called Ojo-nirodhaja fever (due to an obstruction or an overwhelmed condi- tion of the Ojo-dhatu) by the experts. 17. The disease, (in such cases) finds aggravation on the seventh, the tenth or on the twelfth day * when the case takes either a favourable turn or ends in death. 18. Symptoms of Dwandvaja fever :- A case of fever which involves, and is due to the combined action of any two deranged Doshas of the body, is called Dwaudvaja fever and such cases are classified into threc different types (e. g. Vâta-pitta-fever, Vata-s'leshma-fever and Pitta-sleshma-fever). Yawning, distension of the abdomen, loss of consciousness, shiver- ing pain in the joints, emaciation of the body, thirst, delirium and heat or increased temperature of the skin, are the characteristic symptoms of Vata-pitta fever (due to the action of the deranged Pitta and Vayu). Aching pain (Sula), cough, the vomiting of Kapha, shivering, coryza, cold, sense of heaviness of the limbs, aversion to food, and a feeling of general numbness, are the

• The fever in which Váyu predominates gets aggravated on the 7th, that in which Pitta predominates becomes aggravated on the 1oth and that in which Kapha predominates comes to be aggravated on the 12th day. According to some authority, however, Abhinyása, Hataujasa, and Sannyasa types of fever are pacified on the 7th, 1oth and 12th. day respectively .- Dallana,

176. THE SUSHRUTA SAMHITA. [Chap. XXXIX,

symptoms of a case of Vata-sleshma-fever (due to the action of the deranged Vayu and Kapha). Sensation of cold and heat, aversion to food, numbness, perspi- ration, epileptic fits, unconsciousness, vertigo, cough, lassitude and nausea are the symptoms which charac- terise a case of Pitta-sleshma-fever (due to the action of the deranged Pitta and Kapha) *. 19-21. Even a small residue of the deranged bodily Doshas in a patient just cured of an attack of fever but still sufferring from weakness and indulging in injudicious regimen of diet and rule of conduct, is apt to be augment- ed and aggravated by the deranged Vayu of the body, and thus begets five different types of fever lodged in any of the five specific locations of Kapha +. These five types are known as the Satata, Anyedyushka, Tritiyaka, Chaturthaka and the Pralepaka t. The (residue of the) dcranged Dosha of the body, shifting from one location of Kapha to the next in the course of the entire day

• Dallana in his commentary has quoted in eight lines with different wordings the symptoms of these kinds of Dwandvaja fever and these lines have been adopted by Madhava in his Nidana The lines when transtated would be thus :- Thirst, unconsciousness, vertigo, burning sensa- tion, somnolence, pain in the head, dryness of the mouth and of the throat, vomiting, horripilation, disrelish for food, giddiness, pain in tbe joints, and yawning are the symptoms of Vata-pitta-fever. Sensation of moisture ( fefa ) all over the body, pain in the joints, excessive sleep, heaviness of the limbs, pain in the head, catarrh, cough, scanty perspiration, slight sensation of heat, and pulsation not too quick nor too slow, are the symptoms of Vata-sleshma-fever. A bitter taste, a coating on the mouth, somnolence, unconsciousness, cough, disrelish for food, thirst, alternate and varying sensation of heat and cold are the symptoms of Sleshma-pitta-fever. + The five locations of Karha are the Amas'aya, chest, throat, head and the joints. $ There is another kind of Vishama Jwara named Santata (cf. S'loka 31 of this Chapter) and Dallana remarks that it is begotten when the residue of the deranged Dosha is lodged in all the five seats of Kapha.

Chap. XXXIX.] UTTARA-TANTRA. 177

and night, ultimately finds lodgment in the Ámásaya. (stomach) and thus brings on the virulent attack of (those) fevers. Of these the typc known as the Prale- paka appears in cases of Sosha (consumption) and though its attak is a mild one, it puts almost insurmountable difficulties in the way of its cure, brings about a loss or waste of Dhátus (the seven fundamental principles of the organism) and thus ultimately ends in death. There are cases of Vishama-jwara known as the Viparyyaya type (reverse of the above type) which are the result of the deranged bodily Doshas being simultancously located in two or four specific seats of the deranged bodily Kapha and arc hard to cure. 22-23. Several authorities hold Vishama Jvara to be sui- generis in its origin. But whether spontancously idio- pathic or not, an cxtrancous fact (cither a passing psychic condition such as fear, gricf, ctc. or the presence of any foreign poisonous matter in the system) is always involved in and intimately connected with a case of Vishama fever. The pre-dominance of the deranged and aggravated Váyu is marked in cases of Tritiyaka (tertian) and Chaturthaka (quartan coming on every fourth day) fevers. A case of fever duc to the abuse of any wine or ardent spirits as well as the one occuring in a low land at the foot of a mountain, should be supposed to involve a predominant action of the deranged and aggravated Pitta. A case of Pralepaka fever is due to the concerted action of the deranged and aggravated Váyu and Kapha, of which the action of the latter should be regarded as morc dominant. Cases of Vishama fever ushered in by cpileptic fits should be regarded as the result of the concerted action of any two deranged Doshas of the body. 24-25. The deranged Kapha and Váyu of the body, if lo- 23

THE SUSHRUTA SAMHITA. [Chap. XXXIX.

cated under the surface of the skin, produce cold (shiver- ing) during the first istage of fever, while the deranged Pitta brings on the characterstic burning sensation at its latter stage after the subsidence of the deranged Kapha and Váyu. In certain cases the burning sensatlon is engendered by the deranged Pitta at the outset, cold (shivering) being brought on by the deranged Kapha and Váyu at the latter stage after the subsidence of the deranged Pitta. Both thesc two types of fever are brought on through the combined action of two deranged Doshas of the body and of these two, the type which is ushered in by a burning sensation in the body is extremc- ly hard to cure. A case of continued fever resulting from an abnormal psychic condition (such as anger, grief, desire, etc.) or due to any blow or hurt is likewise hard to cure. 26-28. Fever of the Vishama type attacks a man in various ways and follows a distinct periodicity, it being aggra- vated during the six specific times of dominance of the deranged bodily principles (Doshas) as mentioned before * in the course of day and night. This Vishama fever never finds complete remission, (but lurks in the deeper organic principles of the body) and produces a sense of physical langour and heaviness of the limbs as well as the characteristic cmaciation. It is called Vishama-jwara becausc its abatement is always con- founded with its cure and remission, and this confound- ing is due to the fact that the disease (fever) lies dormant in a very small degree in the deeper principles of the vital organism to be patent only at the slightest exciting cause, just as a feeble fire fed with an insufficient supply of fuel, becomes patent at the slightest exciting. cause. 29. . See chapter XXI, -Sutra-sthana.

Chap. XXXIX. ] UTTARA-TANTRA. $79

Seat of Vishama Jwara :- Even a small residue of the deranged bodily Dosha, lurking in the system after the apparent cure of fever, is aggravated by a course of injudicious conduct and indifference to strict regimen of diet, and thus invites a fresh attack * which is known as the Vishama Jwara. A case of Santata (remittent or continuous) fever has its seat in the vitiated Rasa (serum) and blood + of the organism; while a case of Anyedyuh finds location in the contaminated flesh of the body. The type known as the Tri-tiyaka (tertian-fever coming on every third day) affects the principle of Meda (fat), whilc the onc called Chaturthaka (quartan-fever coming on evcry fourth day) affects and is infiltrated into bones and marrow. The last named type is very dangerous. It brings on a simultaneous attack of several other diseases and often terminates fatally. Several authorities include cases of fever duc to the malignant influence of evil spirits within the category of Vishama Jwara. 30. Duration of Vishama Jwara :- The type of fever which continues for seven, ten or twelve days without any break or remission, is called Santata. A case of Satataka fever is characterised by two distinct aggravations in the course of day and night. Fever of the Anyedyushka type comes on only once a day and one of the Tri-tiyaka typc comes on every third i. e. on every alternate day, while a case of Chaturthaka fever sets in every fourth day. 31.

• A case of fever may lapse into a Vishama type even from the very conimencement of the attack. + Vijaya Rakshita, the commentator on Mádhava Nidána, says, on the authority of Charak, that by the term Santata are meant here both Santata and Satataka and that they have their origin in the vitiated Rasa and blood respectively.

180 THE SUSHRUTA SAMHITA. [Chap. XXXÍx.

Influence of Vayu on Vishama Jwara :- Just as the ocean is overflown when its water is swollen up by the gusts of wind (Váyu), so the bodily Doshas are aggravated by the bodily Váyu, and give rise to different kinds of fever. Just as the water of the occean floods the shore at flow- tide and rolls back to its former place during cbb-tide, so fever being augmented by the deranged Doshas of the body, rushes out of its lurking place in the organism and manifests itself (or comes to the surface of the skin) during the hours of the specific aggravation of the Doshas, only to be driven back into the decper tissues and vital principles of the body during the period of their specific abatement, or to be expelled from the organisim at the completion of their perfect assimilation in or elimination from the system. 32. Ágantuka Jwara :- A case of fever due to any extraneous blow or injury should be treated in the light of its periodicity and aggravation or in other words the nature of the deranged bodily Doshas under- lying, or involved in such a case should be ascertained from the periodicity of its aggravation. A case of fever due to the effects of poison is marked by such symptoms, as blackness of the face, burning sensation, diarrhœa, catching pain in the region of the heart, aversion to food, thirst, piercing pain in the limbs, epileptic fits and extreme weakness. A case of fever caused by smelling the pollens of any kind of ( strong smelling ) herbs ( as Hay fever ) is marked by fainting fits, pain in the head and sneezing. A case of fever incidental to an un- gratified amorous longing of the heart, or due to any such ardent passion is characterised by aberration or a distracted state of the mind, drowsiness, languidness,

Chap. XXXIX.] UTTARA-TANTRA. 181

aversion to food, pain at the cardiac region and a speedy emaciation of the body. Delirium marks a case of fever due to grief or terror and shivering charac- terises one due to a fit of anger. Thirst and fainting fits are the concomitants of a case of fever due to any curse, or ushured in through the dynamics of deadly incantations. Anxiety, laughter, shivering and weeping mark a case duc to the malignant influence of evil genii. 33-34. The bodily Váyu derangcd and aggravated by fatigue, physical waste or by a blow spreads through the entire organism and begets (traumatic) fever. Therc is another kind of fever which is due to any extrancous cause or which results from the acute stage of any other discase attendant on the body. It exhibits all the symptoms characteristic of each of the derangcd bodily Doshas involved therein * 35-36. Gambhira fever and its prognosis :- A case of Gambhira fever is characterised by a feeling of internal burning sensation in the body (which is not complained of in the surface), thirst, suppression of the stool, laboured or painful breathing and cough. Paleness of the complexion, dulness of the sense-organs, emacia- tion cf the body, depression of the mind + and presence of supervening symptoms (e.g. hard breathing, cough, etc.) in cases of both Gambhira (inward or latent) and

• "Abhichar,' means incantations or Atharvan rites by which disease, death and any other injuries are brought about. "Abhis'apa" means the curse pronounced by Bráhmins, preceptors, seniors and alters possesed of puissance. + Dallana says in his commentary that some read a few additional lines after this. He, however, does not comment on those lines and further adds that Jejjata does not read them. So we, too, refrain from translating those lines.

I82 THE SUSHRUTA SAMHITA [Chap. XXXIX

Tikshna (high) fever are the indications which point to the hopeless nature of the case. 37-38. A slightly, middling or excessively aggravated condi- tion of the deranged Doshas of the body forebodes the continuace of fever for three, seven and twelve days respectively, each succeeding one being more difficult to cure than the one immediately preceding it in order of enumeration. Thus we have done with the description of (the nature, causes and symptoms of) the different types of fever. We shall now deal with the remedial measures or therapeutic agents to be employed in these cases. 39. Treatment :- Draughts of filtered (matured but non-medicated) clarified butter should bc given as soon as the premonitory symptoms would make their appearance and the patient would get relief thercby. This is applicable only in a case of the Vataja type of fever while purgatives should be administered in a case of the Pittaja and mild emetics, in a case of the Kap- haja type under similar conditions. In cases of Dwi- doshaja and Tri-doshaja fevers, the foregoing measures should be adopted according to the Doshas involved in cach case. In the cases in which emulsive mcasures (Sneha-Karma) and exhibition of purgatives and emetics are forbidden, such mcasures should be employcd as would tend to lighten the system such as fasting, (Langhana) etc. 40. Fasting :- The premonitory and the actual stages of fever are of various forms like those of fire and its fume. Fasting is pre-eminently the best remedy as soon as the characteristic symptoms of the disease make their appearance distinctly and vomit- ing is most efficacious in a case marked by the presence of the deranged bodily Dosha in the Amásaya (stomach) and attended with nausea, thirst, water-brash.

Chap. XXXIX.] UTTARA-TANTRA. 183

Fasting should be continued as long as the least quantity of the deranged Dosha or Doshas would remain intact in the organism, and light food should then be given with discretion after the Doshas have been fully assimi- lated in (to) the sysmtem. 41. Prohibition of Fasting :- Fasting is pro- hibited in a case of fever duc to a wasting process in the body or incidental to the action of the deranged bodily Váyu or appearing in consequence of any serious state of the mind (c. g. lust, anger, grief, etc,) as well as in cases in which fasting has becn forbidden as in the chapter on Divi-vrana (Chapter I, 25-Chikitsá- sthána). 42. Effect of Fasting :- Fasting in the casc of a patient in whom the bodily Doshas have been deranged and of whom the digestive fire bas become dull, lead to an assimilation of the deranged Doshas and kindles the digestive fire, produces remission of fever, lightness of the body and relish for food. 43. Satisfactory and excessive fast- ing :- Easy and natural passing of Vayu and stool and urine, intolerable keenness of thirst and appetite, lightness of the body, sprightly, action of the mind and the sensc-organs and a weakness of the body are the results which spring from Satifactory fasting ; while such symptoms as loss of strength, thirst, dry- ness (of the mouth), insomnia, vertigo, doziness, fatigue and such other supervening symptoms (as diffi- cult breathing, cough, fever, hic-cup) mark an excessive fasting. 44-45. Tepid water :- Tepid (boiled) water is appetis- ing and it tends to disintegrate the accumulation of Kapha and restores the deranged bodily Pitta and

184 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

Váyu to their normal condition. The use of tepid water which allays thirst is highly efficacious in cases of fever due to the actions of the deranged bodily Kapha and Váyu, as it tends to cleanse the internal passages of the body and helps in the casy movement of the deranged bodily Doshas in the organism. The effect of cold water is just the reversc and its inherent cold tends to aggravate fever. 46 Peya :- A potion consisting of water boiled with the admixture of the following bitter drugs viz. Gángeya (Musta), Nágara, Us'ira, Párpata, Udichya (Bálaka) and red sandal-wood should be given, when cooled, for drinking in a case of Pittaja fever, as well as in one due to the effect of any liquor or poison *. A Peya prepared with digestive drugs should be given to the patient when hungry in as much as it is digestive, appetising, light and febrifugal. Tasteful decoctions of digestive drugs, which alleviate thirst, remove bad taste in the mouth, bring about a fresh relish for food and prove remedial for fever, should be given after the seventh day in a case of fever which, in consequence of a plethora of deranged Dosha in the system, would not abate even after the observance of fasting and the subsequent use of Yavagu and wherc the digestive power of the patient has been impaired. 47-49. A decoction of Pancha-mula assimilates the bodily Dosha in a case of Vátaja fever, while a decoction of Musta, Katuka and Indra-yava mixed with honey (when cold) proves curative in a case of Pittaja fever, and a decoction of the component drugs of the Pippalyâdi group helps the assimilation of the deranged bodily Dosha in a case of Kaphaja fever. Decoctions remc-

• According to different anthori ies purely boiled water, when cooled, may also be given in such cases.

Chap. XXXIX.] UTTARA-TANTRA. 185

dial to each of the deranged bodily Doshas should be administered in combination in a case of fever due to the concerted action of any two deranged Doshas of the body. A decoction should not be given to a patient immediately after cating, drinking or fasting, nor to a patient afflicted with thirst, extreme weak- ness, emaciation and indigestion. 50. Symptoms of Pakva-Jwara :- Abate- ment of the bodily heat, lightness of the body and an easy passing of stool and urine are the indications from which the assimilation of the deranged bodily Doshas should be presumed, and it is then that febri- fuges should be administered according to the nature of the deranged bodily Doshas underlying the case under treatment *. Some, however, believe that the assimilation of the deranged Doshas should be presumed from the changes in the symptoms characteristic of the Doshas. 51. Symptoms of Ama-Jwara :- A crushing sensation in the region of the heart, drowsiness, sali- vation, aversion to food, non-assimilation of the derang- ed bodily Doshas, suppression of stool (and wind), copious discharge of urine, laziness, sense of heaviness in the abdomen, stoppage of perspiration, undigested stool, dissatisfaction, somnolence, heaviness and numb- ness of the limbs, dulness of appetite, bad taste in the mouth, a sense of physical languor and increased virulence and continuity of the attack of fever (abnor- mal rise in the bodily temperature) are the symptoms by which a learned physician should ascertain the

• Some read these two lines in a different way. They would mean that the non-assimilation (A'ma) of the deranged Doshas would be presumed by the presence of high fever, heaviness of the body and stoppage of the excreta (Mala), and the reverse is the sign of their assimilation (Páka). 24

186 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

undigested state of the deranged bodily Doshas ushering. in an attack of fever. 52. Time for administering Febrifuge :- According to several authorities, medicines (febrifuges) should be given in a case of fever after the seventh, or according to others after the tenth day of the attack. Febrifuges may be administered earlier in the cases of Pittaja fever, or in the event of the deranged bodily Doshas being digested earlier. An administration of (febrifugal) medicine in an undigested stage of the fever is sure to producc a recrudescence of the disease. Corrective, purifying and soothing (Samaniya) remedics (in a case of fever with undigested Dosha) helps the lapse of the disease (fever) into a Vishama type. 53-54. The spontaneous motions of the bowels (Mala) of a patient suffering from fever should not be stopped unless they are excessive, when the case should be medically treated as one of Atisára (Diarrhea). 55. Preliminary Treatment :- A suitable purgative should be administered even in a case of acute fever if the digested Malas (fæcal matter etc.) are accumulated in the internal passages of the Koshtha (abdomen), in as much as their presence in the organism in that undigested state may usher in an attack of Vishama Jwara attended by distressing symptoms, or may produce loss of strength. Hence they should be eliminated from the system with the helf of emetics, etc. Emetics, Asthápana-enemas, purgatives, Siro-virechana and errhines should be successfully em- ployed for the purpose. Emetics should be at the outset exhibited in a case of Kaphaja fever where the patient would be found to be a person of considerable physical strength, and pargatives should be given in a case of

Chap. XXXIX.] UTTARA-TANTRA. 187

fever marked by the predominant action of the derang- ed Pitta in the event of there being laxity of the bowels (intestines). Nirudha-vasti should be applied in a case of Vátaja fever attended with aching pain in the limbs and with Udávarta (obstinate constipation of the bowels), whereas Anuvasana-vasti should be pres- cribed for a patient with a strong appetite, if there be pain in the regions of the back and the waist. Siro- virechana (head-purgative) should be adiministered in cases marked by the accumulation of the deranged Kapha in the head, as the pain in and heaviness of the head would be relieved, and the sense-organs roused up thereby to their normal functions. 56-A. A plaster composed of Deva-dáru, Vacha, Kushtha, S'atahva, Hingu and Saindhava pasted together with Kanjika should be applied lukewarm to the abdomen in a case of fever attended with painful tympanites if the patient be weak, whercas a medicated plug (Varti) prepared with the above drugs should be applied into the anus in a case marked by the upward coursing of the bodily Váyu attended with suppression of stool and urinc, and Yavagu prepared with Pippali, roots of Pippali, Yamani and Chavya should be given to the patient as a potion, it being remedial for the deranged bodily Váyu. 56. Administration of Ghrita :- The residue of the deranged bodily Dosha having lurked in the system (of a patient) even after the exhibition of proper emetics and purgatives, the fever should be remedied by draughts of medicated clarified butter, if the system of the patient be sufficiently dry (Ruksha). 57. A weak patient with only a small quantity of the deranged bodily Dosha should be treated with the help of soothing (Samaniya) remedies. Fasting should be

188 THE SUSHRUTA SAMHITÁ. [Chap. XXXIX

the principal cure for all types of fever due to (Santar- pana) over-eating etc., provided the patient be found to possess sufficient strength. 58. Diet :- Diluted barley gruel (Yavagu) should be given to a patient constantly feeling thirsty and with impaired digestion. Powdered parched corn (paddy) mixed with honey and water should be given in copious quantity to a patient suffering from the after-effect of liquor, and afflicted with vomiting, thirst, burning or perspiration and it should be followed, when duly digested, by meals of rice-soup and meat-soup. A diet consisting of boiled rice mixed with meat-soup should be given to a patient suffering from an attack of fever marked by the prepondcrancc of the bodily Váyu, as well as in a mild type * of fever due to fasting or over-fatiguing physical labour. The diet in a case of Kaphaja fever should consist of boiled rice and of Mudga pulse. In a case of Pittaja fever it should consist of boiled rice and a soup of Mudga pulse and be taken, when cold, with the admixture of sugar. In a case marked by the concerted action of the deranged Váyu and Pitta, the dict should consist of Mudga soup mixed with (the expressed juice of) Áma- laka or Dádima. In a case of Váta-sleshmá fever the dict should be prescribed to be taken with the soup of tender radish, while in one of Kapha-pitta type it should consist of the soup of the leaves of Nimba and Patola. 59-60. Laja-tarpana-powdered parched corn (paddy) mixed with a copious quantity of water and with honey (and sugar)-should be given, instead of any other diet (e.g

• This passage is quoted by S'reekantha Datta in his commentary on Chakra-datta wherein he does not read efo (mild type), and his read- . ing appears to be the better one, it being supported by Charaka as well.

Chap. XXXIX.] UTTARA-TANTRA. 189

boiled rice) to a patient suffering from fever marked by burning sensation, vomiting, thirst and weakness. Yavágu is not beneficial in summer as a diet in a case of Kapha-pittaja fever or in a case of Rakta-pitta (Hemoptysis ?) or in the case of a habitual drunkard. Such a case should be treated with the soup of any pulse or of the meat of Jangala animal with or without any acid juice. 61-62. Prepared barley mixed with any old wine would prove beneficial in cases of (fever accompained by) a dullness of appetite. Takra (butter-milk or whey) mixed with the powdered Tri-katu should be given in case of disrelish for food due to the action of the derang- ed Kapha. 63-A. Milk as a diet :- Milk may be given with advantage in a case of chronic or lingering fever mark- ed by the scanty presence of the deranged bodily Dosha in the system, by emaciation of the frame and by mental depression as well as in a case of Váta-pittaja fever accompained by dryness of the organism and non- emission or otherwise of the deranged bodily Doshas as well as in a case of fever marked by thirst or burning sensation. But milk taken in a case of fever in its acute stage is highly injurious. 63 A spare and light diet for a weak person should be observed in all cases of fever, when its intensity abates, as, otherwise by a heavy diet, it is aggravated. A proper and wholesome diet should be given in a case of fever even if the patient would show a positive aversion to it since the want of food at the proper time or when the system craves for it, is sure to be followed by the waste of the body, and may bring about dcath in the end. A food which is heavy of digestion (Guru), or secreting ( Kapha-producing) in its effect should by no means

igo THE SUSHRUTA SAMHITA. [Chap. XXxÍx.

be taken nor should food be taken at an improper time, since such a food which is not beneficial, is neither conducive to longevity nor to happiness (in a case of fever). 64-66. A light diet (such as milk or essence of meat) may be given in copious quantity and with advantage to a patient emaciated through a long and protracted attack of Satataka or Vishama fever. The soup of such pulses as Mudga, Masura, Chanaka (gram), Kulattha and Makushtaka, etc. may be given with benefit as diet to the hungry patient suffering from fever. 67. A Meat-dlet :- The meat of Láva, Kapinjala, Ena, Prishata, S'arabha, Kála-puchchha, Kuranga, Mriga-mátriká (different kinds of decr) or S'as'a (hare) may be prescribed as diet for a fever-patient accustomed to the use of animal food *.. Several authorities, however, + do not recommend the use of the meat of Sárasa, Krouncha, Mayura (peacock), Kukkuta (cock) and of Tittira in cases of fever, owing to its heaviness (as regards digestion), as well as to its heat-making potency. (We, too, subscribe to this opinion with a certain limitation) The use of the flesh of these animals may, however, be recommended in a case of fever in moderate quantitiy. and at proper time provided the fever is marked by a preponderance of the deranged bodily Vayu. 67. "Prohibitions in fever :- A fever-patient should forego baths, washing (Parisheka), plunge-bath (Avagáha. D. R. Pradeha-plaster), anointments, emul- sive potions, day-sleep, physical exercise, sexual inter- course and any cold articles or any emetic or purgative

• According to Charaka, the meat-soup, in cases of fever, may be given with or without the addition of an acid juice (e.g. Dádima, A'mlaki, etc ) Charaka also holds the same opinion as Sus'ruta.

Chap. XXXIX ] UTTARA-TANTRA. 191

medicine (for a time even after his recovery) till he is restored to his wonted strength and vigour. * 68. Any of the preceding prejudicial acts done in a weak state of health, closely following a recovery from fever may bring on a relapse which invariably con- sumes the body just as fire does a dried and sapless tree. These rules, therefore, should be strictly followed after recovery from fever till the fundamental Principles of the body have returned to their normal condition and the health and strength is fully regained. 69. A very small amount of physical exertion, in cases of fever, is likely to usher in an attack of fainting fit and hence the patient in such cases should be support- ed when he sits taking his food or passing urine or stool. An emetic or purgative (Sodhana) remedy should be resorted to even after the subsidence of fever in the case where the continuance of a resi- due of the deranged Doshas in the organism would be apprehended from such symptoms as aversion to food, weariness of the limbs, discoloration of the body, its evacuations, etc. A fever-patient emaciated through prolonged suffering should not be largely fed at a time (D. R. should not have a bath) and in haste i.e. until the patient recruits his strength in as much as it might lead to a fresh attack of the disease. 70-72. All cases of fever should be remedied with thera- peutic agents antidotal to the exciting factors. The principal pathogenic cause or causes should be first removed and remedied in a case of fever"due to bodily

• Additional text :- A patient suffering from acute fever should forego also the use of astringent, heavy and dry food as well as fatty and secreting food. In short he should also discourage mental emotions of anger, grief, etc. as well as the use of newly collected corns, This is evidently Dallana's reading.

192 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

exhaustion, waste or hurt. An attack of (peurperal) fever incidental to miscarriage or to the spontaneous accumulation of, milk in the breast of the mother after delivery, should be medically treated by an experienced physician with Dosha-subduing (Samsamana) remedies according to the deranged bodily Dosha involved therein. Now we shall deal with the recipes of Dosha-subduing (Samsamana) decoctions which may be advantageously employed in all types of fever. 73-74. Sams'amana decoctions for Vata- J'wara :- A decoction duly prepared of Pippali, Sárivá, Drákshá, Satapushpá and Harenu should be given with the admixture of treacle in a case of Vátaja fever or a cold infusion t of Guduchi should be taken by the patient. Similarly a decoction of Valá, Darbha and S'wa-danshtra boiled down to a quarter part of the original quantity of water and mixed with sugar and cla- rified butter ; or a decoction of S atapushpá, Vachá, Kush- tha, Devadáru, Harenuká, Kustumburu Nalada and Musta mixed with sugar and honey should be given to a patient in a case of Vátaja fever. A decoction of Drák- shá, Guduchi, Kás'marya, Tráyamáná and Sárivá mixed with treacle should be prescribed in a case of Vátaja fever. A potion of the expressed juice of Guduchi mixed with an equal quantity of that of S'atavari and with treacle proves almost instantaneously efficacious in a case of fever of the same type. Rubbing of the

According to Dallana the cold infusion of Guduchi should be given in a case of Vátaja fever involving the action of vitiated Pitta also ; whereas the decoction duly prepared of Guduchi should be prescribed if, in a case of Vátaja-fever, the vitiated Kapha is also involved. Cold infusion is prepared by keeping over-night a quantity of the drugs immer- sed in hot water. The infusion thus prepared is used in the morning.

Chap, XXXIX.] UTTARA-TANTRA. 193

body with clarified butter as well as fomentation. (Sveda) and plaster should also be prescribed under certain conditions in the present disease. 75-SI. Samśamana decoctions for Pittaja Jwara :- A decoction of S'riparni, red sandal wood, Us'ira, Parushaka and Madhuka (Moul) flowers duly boiled and mixed with a proportionate quantity of sugar (when cold), or a decoction of the drugs of the Sarivadi group duly mixed with sugar, or a decoction of the drugs of the Utpaladi group and Yashti-madhu, * or a cold infusion of the drugs of the same group mixed with sugar would cure a case of Pittaja fever. A similar preparation of Guduchi, Padmaka, Rodhra, Sárivá and Utpala taken, when cold, with sugar would prove beneficial in cases of Pittaja fever. 82-84. A decoction of Draksha and Aragvadha, or - of Kas'marya, or of the drugs of sweet, bitter or astringent groups mixed with sugar and used, when cold, would alleviate thirst and the severe burning. sensation of the body (in a case of Pittaja fever). The contents of the stomach should be vomited out by large draughts of cold water saturated with honey whereby thirst (in a case of Pittaja fcver) would be alleviated. Milk duly cooked with the decoction (of barks or twigs) of the Kshiri-Vriksha (milk-exuding trees), or with Chandana or with any other cool- ing drugs should be used cold (both internally and externally) as a relief for an internal sensation of burning in a case of Pittaja fever. 85-87. Draughts of water with Padmaka, Yashti-madhu,

• Yashti-madhu is comprised in the drugs of the Urpalddi group. Hence in preparation of this deeoction, two parts of Yashti-madhu should be taken. 25

194 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

Drakshá, Paundarika (white lily), Utpala, parched barley, Us'ira, Samang and Kas'mari fruit steeped there- in and stirred and kept overnight and then mixed and taken with honey (in the morning) would give relief from fever and burning sensation and a plaster of the same drugs should be applied over the scalp in a case of fever accompained by dryness of the tongue, the palate, the throat and of the Kloma. Pastes of the polens or filaments (Kes'ara) of Mátulunga mixed with honey and Saindhava salt, or of Dadima mixed with sugar, Drákshá and Kharjura (date) as well as gargles prepared from these drugs should be retained in the mouth with a view to removing its bad taste. 88-89. Sams'amana decoctions for Kapha- Ja Jwara :- A decoction of Saptachchhada, Gudu- chi, Nimba and Sphurjaka mixed with honey, or of Tri- katu, Nága-Kes'ara, Haridrá, Katurohini and Indra- yava, or of Chitraka, Haridrá, Nimba, Us'ira, Ativishá, Vacha, Kushtha, Indra-yava, Murvá and Patola mixed with honey and pulverised Maricha (black pepper) should be given in a case of Kaphaja fever. A decoction of Sárivá, Ativishá, Kushtha, Puru (Guggulu), Durálabhá and Musta, or of Musta, Vrikshaka-seeds (Indra-yava), Tri-phala, Katurohini and Parushaka will be found to be equally efficacious in the case of Kaphaja fever. 90-94. Treatment of Kapha-Vataja Jwara :- A decoction of the component members of the Raja. vrikshådi group mixed with honey and taken in due course, would readily prove curative in a case of fever due to the concerted action of Vata and Kapha. The éxhibition of the decoction of Nágara, Dhanyáka, Bhárgi, Abhayá, Devadáru Vachá, Parpataka, Musta, Bhuțika,

Chap. XXXIX.] UTTARA-TANTRA. 195

and Katphala mixed with honey and Hingu (asafœtida) would be attended by almost instantaneous benefit in the present type of fever accompanied with bronchitis, cough, asthma, constriction of the throat, hic-cough, swelling in the throat and aching pain at the chest and at the sides. 95-96. Pitta-S'leshmaja Jwara :- A decoction duly prepared with Elá, Patola, Tri-phalá, Yashtyáhva, and Vrisha (Vasaka) and mixed with honey, or one of Katuka, Vijayá, (Haritaki), Drákshá, Musta and Par- bataka, or of Bhárgi, Vacha, Parpataka, Dhanyáka, Hingu, Abhayá, Ghana, Nágara and Kás'marya mixed with honey would prove efficacious in a case of fever due to the combined action of the deranged Pitta and Sleshma. Similarly two Tola-measure of powdered Katuka and sugar dissolved in warm water proves curative equally in a case of the present type. 97-100. A decoction of Bhu-nimba, Guduchi, Dráksha, Áma- laki and S'athi mixed with treacle, or of Rásna, Vrisha (Vásaka), Tri-phalá and fruits of Rája-vriksha proves curative in a case of fever due to the combined action of the deranged Vayu and Pitta 101-102. Drugs and therapeutic agents remedial to each of the specific deranged Doshas involved in a case of the Tri-doshaja type should be employed in combination for cure according to the predominance of each Dosha. A potion of milk duly boiled with Vris'chika (white Punarnavá), Varshábhu (red Punarnavá), Vilva and water, but frøm which the water has entirely evapor- ated would prove curative in Tri-doshaja fever. The pith and marrow of a S'irisha tree duly mixed with milk (weighing eight times that of the drug) and with water wcighing three times that of the milk, should be boiled down to the quantity of the milk which, if administered

195 TIE SUSHRUTA SAMHITA. [Chap. XXXIX.

as a drink would prove curative in Tri-doshaja fever. A potion of the decoction* duly prepared with the roots of Nala and of Vetasa (cane) and Murvá and Devadaru would prove remedial to this form of fever. + Clari- fied butter mixed with the decoction of Tri-phala should be given to a patient suffering from an attack of Tri- doshaja fever. $ 103-106. Two-Tolá-measure of powdered Ananta (Durálabhá), Válaka, Musta, S'unthi and Katuka should be given with (one Pala of) tepid water with benefit to a patient before sun-rise in Tridoshaja fever. Moreover, it acts as a good appetiser. Any one or two of the (groups of the) drugs of the purgative or appetising properties can be employed with bencfit in a case of (chronic) fever. A lambative composed of Abhajá pasted together with honey and mixed with oil and clarified butter should be licked by the patient in a case of Tri-doshaja fever. Trivrit with honey would pacify a case of high fever. 107-109. Medical treatment of Vishama- Jwara :- Purgatives and emetics should be exhibited in a case of Vishama Jwara and the medicated clarified butter described under the treatment of Plihodara (chapter XIV Chikitsa-sthána), or pulverised Tri-phald § with the addition of treacle may be advantagcously used in the type under discussion. A decoction of

• The decoction should be prepared with water only or with milk and water according to the rules of Kshira-paka, if the exigencies of the case so require .- Dallana. .. t Additional text :- A potion' of the decoction of Haridra, Bhadra-musta, Tri-phala, Katuka, Nimba, Patola, Devada'ru and Kanta- ka'ri wonld cure a case of Tri-doshaja fever with indigestion, water-brash, dropsy, cough and disrelish for food. # Dallana includes this line also in the additional text. .§. According to Dallnaa the decoction of Trisphala' should be used.

Chap. XXXIX. ] UTTARA-TANTRA. 197

Guduchi, Nimba* and Dhatri duly mixed with honey, may be likewise prescribed (in a case of Cháturthaka fever). The patient should be likewise made to take Las'una (garlic) with clarified butter. The three decoc- tions duly prepared with three, four or all of the following drugs, viz :- Madhuka, Patola, Katuka, Mus- taka (D. R .- Batsaka) and Haritaki + should be like- wise administered. 1IO-III. A potion consisting of milk, clarified butter, sugar, honey and Pippali should be administered according to the strength of the patient. Similarly Pippali should be taken with the decoction of Das'a-mula. Pippali- Bardhamana (sec chapter V, Chikitsita-sthána) should bc likewise used by a patient who should then be made to take only milk or meat-soup. The use of good wine with the meat of fowl is also recommended. 112 Use of medicated Ghrita in cases of Vishama Jwara :- Clarificd butter duly cooked with the decoction of Kola, t Agnimantha and Tri- phald, with milk-curd (Dadhi), with Tilvaka as Kalka would be found to be highly cfficacious in a case of Vishama Jwara A potion of clarified butter duly cooked with the Kalka (and decoction-Dallana) of Pippali, Ativishá, Drákshá, Sárivá, Vilva, Chandana (red), Katuka, Indra-yava, Us'ira, Simhi, Tâmalaki, Musta, Tráyamáná, Sthirá (Sála-parni), A'mlaki, S'unthi and Chitraka would be found highly beneficial to irregular (Vishama) appetite and would cure cases of chronic

• Chakradatta reads "Musta" in place of "Nimbah: + Dallana says that some commentators are inclined to use the decoction of the 16 different combinations of the five drugs taken three, four or five at a time. (25) Kola is here used for Pancha-kola, viz :- Pippali, Pippalt-roots, Chavya, Chitraka and Na'gara.

i98 THE SUSHRUTA SAMHITÁ. [Chap. XXXIX

fever, headache, Gulma, Udara (ascites), Halimaka, consumption, cough, burning sensation in the body and pain at the sides. 113-114 Guduchyadi Ghrita :- The use of a medi- cated clarified butter duly cooked with the decoction of Guduchi, Tri-phala, Vasâ (D. R. Rsna), Tráyamáná and Durálabha together with the Kalka of Dráksha, Mágadhiká, (Pippali), Ambhoda (Musta), Nágura, Utpala and Chandana would be attended by good results in cases of consumption, asthma, cough and Jirna-Jwara (chronic fever). 115. Kalasyadi Ghrita :- Cases of chronic fever, headache, pain at the sides, cough, and of consumption (lit .- any wasting disease of the body attended with fever) would rcadily yield to the curative efficacy of a medicated clarified butter duly cooked and prepared with the decoction of Kalas'i (Prisni-parni), Vrihati, Drákshå, Tryánti, Nimba, Gokshura, Va!á, Parpataka, Musta, S'ála-parni and Yavasaka and with the Kalka of S'athi, Támalaki, Bhárgi, Medá, Kataka (D. R .- Amalaka) and Pushkara-roots and with milk twice as much as the clarified butter. 116. Patoladi Ghrita :- Clarified butter duly cooked with the Kalka of Patola, Parpata, Arishta (Nimba), Guduchi, Tri-phala, Brisha, Katuka, Ambuda (Musta), Bhu-nimba, Yavåsa, Yashti-madhu, Chandana, Dárvi, Indra-yava, Us'ira, Tráyamáná, Kaná and Utpala and with the expressed juice of Dhátri, Bhringa-rája, Abhiru (Satávari) and Kâka-máchi readily proves curative in cases of Apachi (scrofula), Kushtha, fever, Sukra and Arjuna (two optical diseases), ulcer and in diseases of the mouth, ears, nose and the eyes. 117. Kalyanaka Ghrita :- Clarified butter duly cocked with the Kalka of Vidanga, Trithala, Musta,

Chap. XXXIX ] UTTARA-TANTRA. 199

Manjishtk4, Dádima, Utpala, Priyangu, Elá, Elaváluka, Chandana, Devadáru, Varhistha (Válaka), Kushtha, Haridra, the two kinds of Parnni and of Sariva, Hare- nuka, Trivrit, Danti, Vacha, Talis'a, Kes'ara aud Malati flowers with milk twice as much as clarified butter, is called the Kalyanaka Ghrita. The range of its thera- peutic application inc'udes such discases as Vishama Jwara, asthma, Gulma, insanity and diseases due to the effect of any poison. It is auspicious and it removes affections due to the evil influences of malignant spirits and demons, ctc., dulness of appetite, epileptic fits, senilc decay, sterility and diseases of the seminal cord. It invigorates the cye-sight and imparts memory and longevity to the person who uses it. 118. Maha-Kalyanaka Ghrita :- A Prastha measure of clarified butter made from the milk of a cow of Kapila species and duly cooked with the Kalka of the preceding drugs and the drugs known as Sarva- gandha (Eladi-gana) and with (dead) gold and gems should again be duly cooked with the Kalka of Sumanah, Champaka, As'oka and S'irisha flowers and with Nalada and Padma (red lotus) and the polens of Dadima flowers with the milk of a cow of the same species. It should be prepared under the auspicious of favourable astral combinations and lunar planes of both the physician and of the patient and then be duly con- secrated by Bramhanas. It is called Maha-Kalya- naka Ghrita aud may be prescribedifor a king. It proves curative in all forms of fever. Its very touch and sight confers bliss and destroys disease. Its use enables a man to live to three hundred years free from disease and decay and to remain invincible against the attacks of all created beings. 119.

200 THE SUSHRUTA SAMHITA. [Chap- XXXIX.

Pancha-Gavya-Ghrita :- Fqual parts of milk, curd, clarified butter and urine of a cow and the expressed fluid of cow-dung duly cooked with the Kalka of Tri-phala, Chitraka, Musta, the two kinds of Haridra, Ativisha, Vacha, Vidanga, Tri-katu, Chavya and Sura- dáru prove curative in Vishama Jwara. It is called Pan- cha-Gavya-Ghrita. The same five substances obtained from a cow (e.g., milk, curd, clarlfied butter, urine and the expressed liquid of cow-dung) may be duly cooked without the addition of any Kalka as also with the above Kalkas and the expressed juice of Våsaka or of Valá, or of Guduchi. * All of these medicated Ghritas are efficacious in cases of Jirna Jwara (chronic fever), chlorosis and edema. The same five substances (c. g. milk, curd, clarified butter, urine and the expressed fluid of dung) of a she-sheep, a she-goat or a shc- buffalo and the four substances ( c. g. milk curd, clari- fied butter and urine) of a she-camel may be prepared (and used) in the samc manner. 120-122. Tri-phaladi Ghrita :- Clarified butter duly cooked with the Kalkas + of Tri-phala, Us'ira, Sam- páka, Katuka, Ativishá, S'atávari, Sapta-parna, Guduchi, the two kinds of Rajani, Chitraka, Trivrita', Murva, Patola, Árishta, Válaka, Kiráta-tikta, Vachá, Visálá, Padmaka, Utpala, the two Kinds of Sárivá, Yashti- madhu, Chaviká, Rakta-chandana, Durálabhâ, Parpataka, Tráyamáná, Atarushaka (Vásaka), Rásná, Kumkumi (saffron), Manjishthá, Mágadhi and Nagara with the

• Dallana says that the expressed juice of Vásak, Bald or Guduchi, should be separately used along with the ordinary Kalkas (Tri-phala, etc.) of the Pancha-gavya Ghrita. But we are inclined to take the lines to mean that Vasaks, Valu' and Guduchi should be separately used as Kalkas in place of the ordinary Kalkas. + Some here add Ghana (Musta) with the other Kalkas.

Chap. XXXIX.] UTTARA-TANTRA. 201

expressed juice of Dhátri weighing twice as much as clarified butter proves curative in Parisarpa (erysipelas), fever, Asthma, Gulma, Kushtha, Chlorosis, enlargement of the spleen and dulness of appetite. 123. One Pala weight cach of Patola, Katuka, Dárvi, Nimba, Vásá, Tri-phalá, Durálabhá, Parpataka and Tráyamaná and a Prastha measure of Amalaka should be boiled in one Drona measure of water down to its quarter measure. A Prastha measure of Ghrita should then be cookcd with the above decoctions. * The Ghrita thus prepared proves curative in cases of Rakta- pitta, discases due to Kapha, perspiration, muco-purulent discharges, atrophy of the limbs, fever, chlorosis, erysi- pelas and Ganda-málá (scrofula). 124. Pancha-s'ara :- Boiled milk, sugar, Pippali, honey and clarified butter should be taken by stirring them together with hands. The compound is called Pancha-sara and may bc employed with advantage in cases of Vishama-Jwara, Kshata-Kshina, consumption, asthma and affections of the heart. 125. Medicated Tailas :- A medicated oil duly prepared by cooking it with Lákshá, Vis'va, Nis'á, Murvá, Manjishthá, Sarjiká and Amaya (Kushtha) as Kalka and with Takra weighing six times as much as oil acts as a febrifuge. A medicated oil duly cooked and prepared with Kshiri-Vriksha, Asana, Arishta, Jambu, Sapta-chchhada, Arjuna, S'irisha, Khadira, Asphotá, Amrita-valli, Atarushaka, Katuka, Parpata, Us'ira, Vacha, Tejovati and Ghana as Kalka may be employed

*Additional text :- Some recommend the use of Kutaja, Bhu- nimba, Ghana (Musta), Yashti.madhu, Chandana and Pippali as Kalka in the preparation of this Ghrita and that it proves efficacious in the diseases of the eye, nose, ear, mouth and of the white part of the eye and of the eye-lid and in ulcer. 26

202 THE SUSHRUTA SAMHITA. (Chap, XXXIX.1

in anointing the body of the patient in a case of Jirna- Jwara with benefit. 126-127. The patient should be frightened with a non-veno- mous snake, trained elephants and bogus thieves (or rebuked with a thievish act falsely supposed to have been committed by him before) at the appointed date and hour of the paroxysm and be kept in empty stomach for the day. In the alternative, he should be fed with heavy and extremely secreting articles (milk, milk- curd, etc.) and be made to continually vomit out the con- tents of his stomach afterwards, or he should be made to drink any strong liquor, or febrifugal medicated clarified butter or simply matured clarified butter in copious quantity or be treated with drastic purgatives, or with!fomentations followed by Nirudha-Vasti applica- tion on the date of the expected attack. 128. Fumigation and Anjana :- The body of the patient should be fumigated with the fumes of the skin and hairs of a goat and a sheep mixed with Vachá, Kushtha, Palankashá (Guggulu), Nimba leaves, and honey and burnt together. The excreta cf a cat should be similarly used in fumigating the body of the patient in a case of fever marked by shivering. Pippali, Saindhava and Naipali (Manah-silá) should be pasted together and mixed with oil and be applied along the eye-lids as an Anjana. 129-130. The medicated Ghritas mentioned in conection with the treatment of Udara (ascites), as well as the Ajita Ghrita mentioned in the Kalpa-sthána (Chapter II.) may be likewise employed with benefit in fever. 131. A case of fever due to the malignant influence of the spirits, etc. should be remedied with the help of magical incantations (Avesana), binding and beating (D. R .- adoration) mentioned in the treatment of Bhuta-vidyá

Chap. XXXIX.] UTTARA-TANTRA. 203

(demonology-Chapters LX-LXII). A case of fever due to any mental condition should be cured with psychic (hypnotic) measures ; while the one due to over- fatigue or exhaustion should be treated with diets of Rasaudana * after anointing the body of the patient with clarified butter. Fever due to any curse or to deadly incantations (exorcism) may be cured by per- forming Homa (offering oblations to the gods) and such other ceremonies ; while the cases due to the malignant influence of any hostile planet, or of any unearthly sound may be cured by practising charity, hospitality and peace-giving rites (Svastyayana). All heat-engendering (Ushna) measures are prohibited in a case of traumatic fever and sweet and astringent drugs charged with oil or clarified butter should be prescribed. Other therapeutic agents should also be employed according to the nature of the specific derangement of Dosha involved in the case. In a case of fever caused by the smell of any herb or cereals or in one due to the effect of any sort of poison, the treatment should consist in such measures as would alleviate the poison and the aggravated Pitta in the system. + Decoction of Sarva-gandha (the drugs of the Eládi-gana) is also beneficial in these cases. A decoction of Nimba and Deva-dáru or of Jati flowers may be prescribed as well. Clarified butter, wine and preparations of barley grains are wholesome in a case of Vishama-Jwara which may be got rid of as well

• Rasaudana is a kind of food prepared by boiling rice in meat soup (instead of in water). The term may, however, mean rice simply mixed with meat-soup. + In place of "विषरपित्तप्रसादमै." some read "विषपीतप्रसादजे:" and that would mean that the measures and remedies prescribed in cases of poisoning (sec Kalpa-sthana) should be applied. This variant seems to bo the better one.

204 THE SUSHRUTA SAMHITA [Chap. XXXIX.

by worshipping Brahmans, cows, the god Isana, and Ambika. 132-133. The body of the patient overwhelmed with coldness (shivering) in cases of fever duc to the action of the aggravated Kapha or Vayu, should be plastered with a paste of the drugs of the heat-making group * and heating measures should then be resorted to. In the alternative, a compound of Aranála, S'ukta, cow's urine and Mastu (curd-cream) made lukewarm should be sprinkled over the body. Plasters of the leaves of Surasa, Arjaka and S'igru pasted together with water would prove beneficial. The body may be rubbed with Kshara-taila (oil cooked with alkali) mixed with S'ukta. A decoction of the drugs of the Aragva- dhådi group proves highly efficacious particularly in the present case, and decoction of Váyu-subduing drugs should be used tepid as a bath. The shivering having been thus relieved with the foregoing measures and by the sprinkling of tepid water over the body, the languid body of the patient should be smeared with pasted Káláguru and wrapped up in a silk, woolen or linnen cover and then the patient should be made to lie in a bed. 134 .- A. Damsels young, beautiful and skilled in the sport of love, with faces glowing like the full moon of autumn and darting forth beams of love from their languid blue-lotus-like eyes, with eyc-brows moving in the ardour of desire and with dreary foreheads throbbing with the gentle pulsations of love, with girdles sliding down from their slender waists, with their splendid buttocks naturally making them lazy in their steps, with their lips vying with the ripe Vimba fruit in their luscious

• Dallana explains the Ushna-varga (hcat-making group) to mean the Bhadra-dárvádi, Surasádi and the Eládi groups.

Chap. XXXIX. ] UTTARA-TANTRA. 205

redness, with their elevated thickest breasts, and smeared with saffron and Aguru pastes and clad in thin trans- parent garment, fumigated and scented with the vapours of burnt Aguru, should be asked to take the patient into a firm embrace like a forest-creeper entwining itself around a sylvan trec, and the girls should be told to keep off as soon as the patient would fcel himself hcated. The patient thus cured of the discase (cold-fever) by the fond embrace of these beautiful damsels should be treated to such a wholesomc repast as would be welcome to him. 134. Measures which alleviate the burning sensation should be employed in a case of fever marked by sever burning sensation of the body. Vomiting should be induced in such cases with honey and treacle mixed with the (cold) infusion of Nimba leaves. The body of the patient should be anointed with Sata-dhauta * Ghrita and then plastered with a paste formed by mixing powders of barley, Kola and Amalaka with the fermented boilings of S'uka paddy, or with the cold paste of tender leaves of Phenilá (soap-berry) mixed with Kola and A'malaka and pasted with Amla (Kánjika), or with the cold paste of the lcaves of Palás'a pasted with Amla (Kanjika', or with the froth (produced by stirring in Kánjiká the paste) of the leaves of Vadara or Arishta, + whereby thirst, swoon and burning sensation would be relieved and removed. 135. A Prastha mcasure of oil duly prepared by cook-

• Clarified butter w ashed hundred times in water is known as Sata- dhauta Ghrita. t Arishta according to Dallana and S'rikantha (the commentator of Vrinda) may mean either Nimba or Phenila' (soap-b rry). But S'ivadása, the commentator of Chakradatta, explains Arishta to mean (leaves of) Nimba. The practice, however, is, to use the leaves of Nimba.

206 THE SUSHRUTA SAMHITA. [Chap, XXXIX.

ing it with half a Kudava measure of Yava (barley), half a Pala weight of Manjishtha and a hundred Prastha measure of Amla (Kánjika). The oil is called Prah- ladana (refreshing) Taila and it relieves the burning sensation of the body due to an attack of fever. 136. In the alternative, the body of the patient should be plastered with the pasted drugs of the Nyágrodhadi, Kákolyádi or Utpaládi groups, or anointed with a Sneha duly cooked with the decoction of the drugs of the preceding groups and with Amla, or the patient should be given a bath (Avagáha) in the Sita-kasáya * of these drugs. On the alleviation of the burning sensation, the patient should be raised out of the tub and then washed with the spray of cold water and smeared with soothing sandal pastes, etc. Young, gay, beautiful and lotus-faced damsels with their youthful cooling breasts profusely smeared with sandal pastes, wearing garlands of beauti- ful lotus flowers as well as necklace of pearls, etc., and clad in fine silken clothes should be asked to hold the depressed patient in their firm embrace and to kiss him. These damsels should be removed as soon as the patient would exhibit symptoms of exhilaration. He should be given wholesomc (Pitta-subduing) food which would give him much relief. Purgative and pacifying (soothing) medicines described in connection with the Pittaja fever are likewise beneficial in the present case. 137. General treatment of the Compli- catlons :- The deranged Pitta should be crushed and remedied first of all in a case of fever, involving therewith the co-operation of any of the deranged Doshas of the body, in as much as it is extremely hard

. "sita-kasaya" may here mean cither the cold infusion of the drugs or only the cold decoction.

Chap, XXXIX.] UTTARA-TANTRA. 207

to subdue the deranged Pitta especially in a case of fever. Such distressing symptoms as vomiting, epilep- tic fits, thirst, etc. should be remedied with such thera- peutic agents as are not hostile or aggravating to the · principal disease (fever) but are antidotal to the exciting factors. 138. Specific treatment of the complica- tions :- Now hear me tell you other specific remedies for the complications. A plaster composed of Yashti- madhu, Rajani, Musta, Dádima, Amla-vetasa, Rasánjana, Tintidika (tamarind), Nalada (Mánsi), Patra, Utpala, Tvak (cinnamon), Vyághra-nakha, the expressed juice of Matulunga, honey and Madhu-s'ukta, * if applied to the head, would alleviate heat in the head, delirium, vomiting, hic-cough, and shivering-concomitants in cases of fever. Vomiting would yicld to the use of a com- pound consisting of Madhuka flower, Hrivera, Utpala and Madhulika mixed with honcy and clarified butter and used to be licked up with the tongue as a lambative. It is equally efficacious in water-brash, hic-cough, Rakta- pitta (hemoptisis) and asthma. Fits of cough and asthma in cases of fever readily yield to the use of the clectuary prepared with Tri-phala, Pippali and Mák- shika + and mixed with honey and clarified butter. 139-141. A plaster of Vidári, Dádima, Lodhra, Dadhittha and

• Madhu-s'ukta is prepared by preserving the expressed juice of Jambira-lemon, Pippali and honey in an earthen pot formerly used in keeping honey. It should be laid for a month under the heap of paddy before use. (Dallana) For an alternative mode of preparation see et, Chapter X-मध्य खण्ड. + Dallana takes "Måkshika" in the sense of honey and comments largely on the seperate use of honey (wy) in the compound. But we are inclined to take "Makshika" as the mineral of the same name.

208 THE SUSHRUTA SAMHITA. [Chap, XXXIX.

Vijapuraka pasted together may be applied with advantage to the scalf of a fever-patient afflicted with thirst and burning sensation. Pastes of Dádima and sugar, and of Draksha and Amalaka, if kept in the mouth, or a gargle (Gandusha) of milk, expressed juice . of sugar-cane, Madhvika, * clarified butter, oil and warm water, according to the exigency of the case, would remove the bad taste in the mouth in fever. An empty feeling in the head in fever would bc relieved by using as an errhine (Nasya) the medicated clari- fied butter prepared with the drugs of the Jivaniya group. 142-144. A pulverised compound consisting of Tri-phala', S'ya'ma', Trivrit and Pippali mixed with honey and sugar, can be given for purgative purposes with benefit after the digestion of the derangsd Dosha in a case of chronic Pittaja fever, in an up-coursing Raktapitta and in shivering. The system of the patient should be cleansed with similar purgativcs and lardaceous lubrications in cases of Kaphaja and Vátaja fever. Lambative of honey, sugar and Abhaya' should be given in a case marked ·by vertigo (Bhrama) even after the subsidence of the aggravated Dosha. 145. Application of Vastis :- Nirudha-vastis charged with the decoctions of sweet (Kákolyádi) or Váyu-subduing (Bhadra-dárvadi) drugs, should be applied in fever due to the derangement of the bodily Váyu, according to the nature and intensity of the specific deranged Dosha in the case and to the strength of the patient; in the alternative, Anuvasana Vasti should also be similarly applied. The decoction of the drugs

• Dallana seems to read "Ma'kshika," and explains it as honey. "Madhvika" which generally means the wine made of honey, may however, also mean honey.

Chap. XXXIX.1 UTTARA-TANTRA. 209

. of the Utpaladi group mixed with Chandana and Us'ira and sweetened with the addition of sugar should be similarly applied cold (as a Nirudha Vasti) in cases of Pittaja fever. A Vasti (in the manner of Nirudha) charged with a compound consisting of Amra-barks, etc., S'amkha (conch), Chandana, Utpala, Gairika, Rasánjana, Manjishthá, Mrina'l: and Padma-káshtha pasted together and dissolved in milk saturated with sugar and honey should be passed through a. piece of linen and then applied cold in a case of (Pittaja) fever marked by intolerable pain. The characteristic burning sensation due to fever may be relieved by applying Vasti charged with a dccoction of the preceding drugs in the manner of an Anuvásana-vasti. A Nirudha Vasti charged with the decoction of the drugs of the Aragvadhadi group mixed with (the pow- ders of) the drugs of the Pippaladi group and with honey should be applied in cases of Kaphaja fever and the decoction of the Kapha-subduing (Aragvadhádi) drugs should also be injected into the rectum in the manner of an Anuvásana Vasti. In cases of fever due to the aggravation of two or three Doshas, the Vastis (Nirudha and Anuvásana) to be applied should be charged with the decoction of the drugs respectively antidotal to the deranged Doshas involved in each case. 146-150. All the medicated lardacious substances with the exception of oil, which have bcen prescribed as being efficacious (in the use of Vastis) in diseases of the de- ranged Váyu, are equally applicable (in Anuvásana Vastis) in a case of fever due to the same cause. But all of them (including also oil) are equally applicable to anointing, etc. Lubrication of the body with oil at the close of the acute stage i.e., on the thirteenth or fourteenth day of the attack would be attended with 27 *

210 THE SUSHRUTA SAMHITK. [Chap, XXXIX.

beneficial results in a case of Váta-dleshma fever, where fomentations have utterly failed to relieve the distress- ing symptoms of the deranged Váyu. Clarified butter duly cooked with sweet and bitter drugs should be used (for the purpose of annointing) in Pittaja fever; while in Kaphaja fever, the Ghrita should be cooked with bitter and pungent drugs. In the cases of fever due to the concerted action of two or three Doshas, the Ghrita should be cooked with the drugs of two or more of the above groups according to the nature of the Doshas involved in each case. 151-152. The presence of even a small residue of the deranged Pitta in the organism maintains the heat of the skin up to the fever-point, so the remedy consists in taking the expressed juice of sugar-cane, or sweet cordials or Sarvats (sugar dissolved in water), and the diet in such a case should consist of cooked Sáli and Shashti rice and milk. Fomentations and anointments should be employed in cases of Kaphaja and Vátaja fevers. Draughts of clarified butter should be given in all forms of fever at the close of twelve days, for by that time the aggravated Doshas return to their respective Ásayas (places in the system). The Dosha involved (in a case of fever) becomes aggravated by affecting, at the time of the remission of the fever, the other fundamental vital principles (Dhátus) of the body and thereby makes the patient weak and dejected at this time. 153-155. Symptoms of remission :- The features or indications which mark a complete remission of fever, are lightness of the head, flow of perspiration, pale and yellowish colour of the face, sneezing and desire for food. 156. Fever originating from the wrath-fire of the god Sambhu, is a dangerous disease. It affects appetite and

Chap. XXXIX.] UTTARA-TANTRA. 21İ

the strength as well as the complexion of the body and is virtually the sum-total of all the. other diseases. It is, therefore, called the lord of all bodily diseases. It is common to all created beings (men and animals), affects the whole of the organism (including also the mind), is extremely hard to cure and is present in all cases at the time of the death of all creatures. Hence it is rightly called the destroyer of created beings. 157.

Thus ends the thirty-ninth chapter of the Uttara Tantra in the Sus'rutra Samhita which deals with the (symptoms and) medical treatment of fever.

CHAPTER XL.

Now we shall discourse on the (causes, symptoms and) medical treatment of diarrhœa, etc. (Atisara- pratisheda). I. Causes of Atisara :- The excessive use of extremely heavy (hard to digest), oleaginous, dry, hot, cold, fluid, thick, and incompatible articles of food, eating irregularly and at improper time (or unaccus- tomed articles of fare), indigestion, eating before the digestion of the previous meal, excessive use or misuse of any lardacious substances, etc., (Sneha, Sveda, etc.), use of any poison, fright, grief, drinking impure water, the excessive drinking cf liquor, change of season or physical contrarieties, indulgence in aquatic sports, voluntary repression of any natural urging (of the body) or germination of parasites in the intestines are the causes which bring on an attack of diarrhœa (Atisara) the symptoms whereof will be dealt with presently. 2. Pathology :- The liquid part (Ap-dhátu) of the body, if aggravated and carried downward by the bodily Váyu, impairs the fire in the stomach (fire of digestion) and mixing with the fecal matter, is painfully and cons- tantly emitted through the anus. This dangerous disease is named Atisara from the constant oozing out (Ati and Sarana) of the liquid fecal matter from the anus. It is usually classified into six different types, vis., those due to the predominance of the deranged bodily Doshas severally involved therein, that due to the concerted action of the three Doshas, one due to grief and that due to the indigested mucous accumulations (Áma)

Chap. XL.] UTTARA-TANTRA. 2İ3

in the intestines. Some authorities hold that Atisára is of many kinds but the holy Dhanvantari, on the contrary, holds that it is not so but that the physical conditions of a diarrhœic patient undergo changes and become manifold. 3. Premonitory Symptoms :- Piercing pain in the regions of the heart, umbilicus, rectum, abdomen and in the Kukshi (sides of the abdomen), a sense of numbness in the limbs, stoppage or suppression of flatus and of stool, distension of the abdomen, and indiges- tion are the premonitory symptoms of the disease. 4. Symptoms of Vataja, PittaJa, Ka- phaja and Tri-doshaja Types :- The Vayu-origined type of the disease is marked by Sula (colic), suppression of urine, rumbling sound in the intestines, looseness (constant movement in the intes- tines) of the abdominal (Apána) wind, a gone feeling in the waist, in the thighs and in the legs, and frequent emissions with flatus of a scanty, frothy, dry (Ruksha) brown-coloured (yellowish black) stool. The specific fcatures of the Pitta-origined type are that the stool is fetid, hot, yellow, blue or slightly red-coloured, or resembles the washings of meat, and is emitted with sharp or acute force and is accom- pained by thirst, epileptic fits (fainting), burning sensa- tion, perspiration, suppuration and inflamation (Páka) of the affected organs, and fever. In the Kapha- origined type of the disease the stool becomes loose and constant, gets mixed with the lump. of mucus and looks white. The stool comes out without any sound. A sense of constant urging is complained of and cach motion only creates the apprehension of a fresh one in the mind. The patient becomes drowsy or sleepy, and feels a sense of heaviness in the limbs, nausea, disrelish for

214 THE SUSHRUTA SAMHITK. [Chap, XL.

food, horripalation and lassitude. The symptoms which mark a case of Tri-doshaja type (due to the concerted action of the three simultaneously deranged bodily Doshas) are drowsiness, swoon, lassitude, dryness of the mouth, thirst and a varied colour of the stools. A case of Tri-doshaja type, if attended with all the symptoms, is very hard to cure and. if occurring in an infant, or an old person, is scarcely amenable to medical treatment. 5-8. Symptoms of Sokaja and Ámaja Atisara :- The suppressed tears of a bereaved person of sparing diet, on quenching the digestive fire, reach down into the Koshtha (intestines) and there freely mix with, and vitiate the local blood which becomes dark-red like Kakananti (Gunjá). It then passes through the rectum, charged with a peculiar fetour impart- ed to it by the fecal matter in case of its combi- nation with the latter or without any fetid smell, when passing out unmixed. Such an attack ushered in by the grief of bereavement of a person is according- ly considered very hard to cure. The local bodily Doshas in the Koshtha (abdomen) are aggravated and deranged when they come in contact with the Ama (unassimilated chyle), and are brought down into the Koshtha (bowels), where they are more agitated and emitted in combination with the undigested fecal matter in various ways, and are attended with pain and characterised by a variety of colour. This is the sixth type of Atisára. 9-10 Symptoms of Áma and Pakva Atl- sara :- A case of Atisára (diarrhœa) would be said to be in the Ama (acute) state, if the stool of the patient suffering from any of the foregoing Doshas would be found to sink in water and to emit a very fetid smell

Chap. XL.] UTTARA-TANTRA. 215

and to pass in broken jets (D. R .- to be slimy). A contrariety of the preceding symptoms and a sense of lightness of the body and in the affected cavity would indicate that the disease has passed the acute stage and it is then called Pakva (chronic) Atisara. II. Prognosis :- If the colour of the stool (in a case of Atisára) resembles that of clarified butter, fat, the washings of Vesavára, oil, goat's milk, honey, Manjishtha, brain-matter, or Rasanjana, or if the stool is cold or hot to the touch, or if it is charged with a fleshy or fetid smell, or marked with lines or specks of variegated colours, or if it looks like pus or clay, or if just the opposite or reverse symptoms or other distressing symp- toms would be exhibited, the case is likely to end fatally in case the patient be weak. A patient suffering from an attack of Atisára would be given up (as incurable) if he be weak, if the orifice of his anus become suppurated and cannot be closed, if there be distension of the abdomen (D. R .- if the patient be not self-restrained), if there be distressing symptoms and if the patient be found destitute of thermal heat. 12-13. An attack of Atisára ushered in by whatsoever cause, is sure to be marked by the specific symptoms of the deranged bodily Dosha or Doshas complicated with it. All cases of Atisára whether due to the indiges- tion of any oleaginous food or drink (Ghrita, oil, etc.), whether with (or without) the symptoms of Praváhiká and the accompanying colic, as well as those due to Visuchiká or any 'other kind of indigestion as also those due to the effect of any poison (affecting the digestive system), hœmorrhoids (Arsas), or worms in the intestines,-all of them are marked by the symp- toms of the specific Dosha involved therein. The treat- ment of Atisára varies according to its acute or matured

216 THE SUSHRUTA SAMHITA. [Chap. XT ..

stage, the characteristic symptoms of those therefore are to be carefully observed. and noted in each case under treatment. 14-15. The patient should be kept without food as soon as the premonitory symptoms of Atisára would appear, and then the dietic gruels (Yavagu) prepared with the admixture of digestive drugs should be given in their proper order. In a case marked by colic and flatulent distension of the abdomen, fasting should be first advised. And then vomiting should be induced with draughts of water mixed with powdered Pippali and Saindhava salt. A light diet in the shape of a Khada-yusha, Yavagu, etc., prepared with the admix- ture of the drugs of the Pippalyadi group, should then be prescribed after the cessation of vomiting. A decoc- tion of the drugs of the Haridradi, or Vachadi group, should be be taken in the morning where the preceding remedies would fail to relieve mucous accumulations in the intestines (Amatisara). No astringent or costive medicine in the acute or immature (Ama) stage of the disease should be administered in as much as by obstructing the passage of the Doshas it might bring on an attack of enlarged spleen, chlorosis, disten- sion of the abdomen with suppression of stool and urine, Meha (urinary complaints), Kushtha (cutaneous affections), ascites, fever, œdematous swellings of the limbs, Gulma (abdominal gland, etc.,) diarrhœa, piles, colic, Alasaka and catching pain at the heart. 16-17. Purging should be induced with Haritaki in a case marked by constant and scanty motions (of mucus and) attended with griping and pain (Sula) or by an incar- ceration of the deranged bodily Doshas (in the intestines). Emetics should be first exhibited and followed by fastings and digestive or assimilative (Páchana) remedies

Chap. XL ] UTTARA-TANTRA. 217

in a case marked by watery and copious motions. l'ow- dered Haritaki and Pippali with tepid water should be administered for purgative purposes in a case marked by scanty emissions of stool at times attended with pain and colic (Sula). Fasting is the first remedy to be prescribed in cases of Ama (acute) Atisára, or in the alternative, digestive remedies should be prescribed. The recipes of digestive medicinal compounds which are curative in the discase under discussion (Ámátisára) arc described below. 18-19. Twenty different Recipes for Ámati- sara :- (I) Deva-dáru, Vacha, Musta, Nágara, Ativishá and Abhayá ; or of (2) Kalinga (Indra-yava), Ativishá, Hingu, Sauvarchala-salt, Vacha and Abhayá, or of (3) Abhayá (D. R .- Nagara), Dhanyáka, Musta, Válaka and Vilva ; or of (4) Musta, Parpataka, S'unthi, Vacha, Ativishá and Abhayá ; or of (5) Abhayá, Ativishá, Hingu, Vachá, and Sauvarchala-salt ; or of (6) Chitraka, Pippali- mula, Vacha, Katuka-rohini, or of (7) Páthá, Vatsaka- seeds (Indra-yava), Haritaki and Mahaushadha (Sunthi), or of (8) Murvá, Nirdahani, (Chitraka), Páthá, Tryushana (Tri-katu) and Gaja-pippali ; or of (9) Siddhárthaka, Bhadra-dáru, S'atáhvá and Katu-rohini; or of (10) Elá, Sávaraka (Lodhra), Kushtha, the two sorts of Haridra, Kutaja-seeds (Indra-yava); or of (11) Mesha-s'ringi, Tvak, Elá, Krimighna (Vidanga) and Vrikshaka (Indra-yava); or of (12) Brikshdani, Virataru, the two kinds of Vrihati and the two kinds of Sahá (Mudga-parni and. Másha-parni) ; or of (13) barks of Eranda, Tinduka, Dádima, Kutaja and of S'ami; or of (14) Pátha, Tejcvati, Musta, Pippali and Indra-yava ; or of (15) Patola, Dipyaka (Yamani), Vilva, the two kinds of Haridra and Deva-dáru ; or of (16) Vidanga, Abhayá, Páthá, S'ringavera, Ghana (Musta) and Vacha ; or of (17) Vacha, 28

218 THE SUSHRUTA SAMHITA. [Chap. XL.

Vatsaka-seeds (Indra-yava), Saindhava and Katu-rohini; or of (18) Hingu, Vatsaka-seeds (Indra-yava), Vacha and dried green Vilva; or of (19) Nagara, Ativishá, Mustá, the two kinds of Pippali and Vatsaka-seeds (Indra-yava); or of (20) Mahaushadha, Prati-visha and Musta,-these are the Twenty different recipes of the remedies which are digestive (of the mucous accumulations) in cases of Áma-Atisára and should be administered (in the shape of powder) with Dhányámla (Kánjika), tepid water or wine, or their decoctions in luke-warm state should be used. This is a detailed list of the best remedies in cases of Ama-Atisara. 20. A compound of Haritaki, Ativishá, Hingu, Sau- varchala and Vacha should be taken with tepid water in cases of Áma-Atisáras. Similarly a compound of Patola, Yamáni, Vis'va, Vachá,Pippali, Nágara, Musta, Vidanga, and Kushtha, or that of S'unthi and Guduchi should be taken with tepid water. 21-23. The five following compounds separately composed (t) of all kinds of officinal salt, Pippali, Vidanga and Haritaki ; or of (2) Chitraka, S'ims'apá, Páthá, S'árn- gashta, and all kinds of officinal salt; or of (3) Hingu, Vrikshaka-seeds (Indra-yava) and all kinds of officinal salt taken in equal parts; or (4) of Nága-danti and Pippali, weighing two Tolás; or (5) of Vachá and Guduchi-stems, would be found beneficial, if taken with tepid water. Twenty Musta, should be boiled in a quantity of milk and thrice as much water. The milk which is left back after all the water is evaporated by boiling, should be used for the relief of the griping (Sula) due to the accumulation of mucus (Ama) in the intestines. 24-25. Clarified butter mixed with Saindhava-salt and Yava-kshara should be given to a patient of weak

Chap. Xt.] UTTARA-TANTRÁ. 2t9

digestive pcwer in a case in which the Váyu Has not been restored to its normal condition in 'spite of the subsidence of the intestinal Sula (griping) and which is marked by scanty (but repeated) motions passed with pain. The Ghrita duly cooked with Nágara, Chângeri and Kola (Vadara) and with milk*, curd (Dadhi) and Amla (Kánjika), or simply the transparent part of clari- fied butter should be taken as a relief for Atisára attended with Sula (pain). In the alternative, clarified butter mixed with (an equal quantity of) oil and duly cooked with curd, together with a paste of Tri-katu, Jati (flower) and Chitraka, or with that of Pippali-mula, Vilva, Dadima-bark and Kushtha should be given. All these are the remedies to be cmployed in a type of Atisára due to the action of Váta or of Sleshmá; and all the foregoing remedies with the exception of thosc of keen and heat-making potency, may be used in the Pittaja type of the disease. 26-27. Fasting as already advised should be first observed and it should be broken with gruels (Yavágu) duly cooked with the two kinds Vald, or with Ams's-mati, or S'vadamshtra and Vrihati, or S'atávari made cold and mixed with honcy. The soup (Yusha) of Mudga duly cooked with the drugs of appetising virtue, or with mild and bitter drugs of appetising property would cure (the Dosha in) the acute stage (Amá-dosha) of the stool. Decoctions of Haridrá, Ativishá, Páthá, Vatsa-seeds (Indra-yava) and Rasanjana ; or of Rasánjana, the two kinds of Haridra and Kutaja-sceds (Indra-yava ; or of Patha, Guduchi, Bhu-nimba and Katu-rohini would

• We have tha recipe of this Ghrita in Charaka Samhita also. But there we find Ksbara in place of Kshira and that appears to be the better reading. See Chapter XIX,-under Changeri Ghrita, Charaka Samhitd.

220 THE SUSHRUTA SAMHITA. [Chap. XL.

prove extremly useful in correcting (Páchana) the deranged Pitta. 28-29. Six Yogas for Pittaja-Atisara :- Any one of the six decoctions respectively prepared with Musta, Kutaja-seeds (Indra-yava.), Bhu-nimba and Rasánjana ; or with Dárvi, Durálabha, Vilva and red Chandana ; or with Chandana, Válaka, Musta, Bhu- nimba, Duralavá ; or with Mrinala, Chandana, Rodhra, Nágara and Nilotpala ; or with Patha, Musta, the two kinds of Haridra, Pippali and Kutaja-seeds ; or with the seeds and barks of Vatsaka, S'ringavera and Vacha mixed with clarified butter should be regarded as good remedies for the Pittaja type of Atisara. 30. A case of Pittaja-Atisára in its acute (Ama) stage would yield to the use of a decoction of (unripe) Vilva, Indra-yava, Ambhoda (Mustá), Válaka and Ativishá. A decoction of Yashti-madhu, Utpala, Vilva, Amra, Hrivera, Us'ira and Nágara mixed with honey proves curative in the case under discussion. 31-32. Astringent or constipating (Samstambhana) reme- dies should be employed in a case of the chronic (Pakva) Atisára marked by dullness of the Grahani, vis, the digestive fire and by constant motions. Any of the four following medicinal compounds, vis., Samangâ, Dhataki-flower, Manjisthá, Lodhra and Musta ; or 'of S'almali-veshtaka, Rodhra and the bark of Vrikshaka (Kutaja) and of Dádima; or of the stone of Amra, Lodhra, the inner pulp of (unripe) Vilva and Priyangu ; or of Yashti-madhu, S'ringavera and the bark of Dirgha-vrinta (Syonáka) should be taken with honey and the washings of rice in cases of chronic (Pakva) Atisára. 33-34. The decoction of Musta alone should be taken with honey in the case under discussion, or a decoction of

Chap. XL.] UTTARA-TANTRA. 221

. any of the nine Ganas, vis., the Lodhradi, Amboshthadi, or Priyangvadi groups, etc. (see Chapter XXXVIII, Sutra-Sthana) should be employed. Similarly, the decoction of Padmá, Samangá, Yashti-madhu and dried Vilva and Jambu fruits should be taken with the washings of rice mixed with honey. A paste of the root of Kachchhura weighing an Udumvara (two Tolas) should be similarly taken with the same vehicles). A casc of Pakvátisára marked by bloody stool or by emission of blood (from the intestines) would yield to the usc of the decoction of Payasyá, Chandana, Padmá (Bhárgi), Sita (sugar), Musta and the polens of lotus. 35-38. Application of Ghrita :- Clarified butter with Yava-kshara should be given to a patient with due regard to the. state of his digestive power if, after being treated with fasting, etc., he be still found to be affected with Sula and dryness and if the stool would be found to be free from mucus i.e., in a case of Pakvátisára. The colic (in a case of Atisára) is relieved by taking (a potion of clarified butter duly cooked with) Vald, Vrihati, Ams'u-mati and Kachchhurd-roots mixed with a little honey and Yashti-madhu (as an after-throw). Clarified butter duly cooked with Dárvi, Vilva, Kaná (Pippali), Drákshá, Katuka and Indra-yava would prove curative in a case of Atisará due to the action of the Váta, Pittá and Kaphá (jointly or separ -* ately). A draught of milk, honey and clarified butter (in equal parts) mixed with sugar, Ajamoda, Katvanga , and Yashti-madhu (as an after-throw), would relieve the griping (Sula) in the intestines (in a case of Atisára). 39-42. Putapaka Preparations :- A case of long-standing (chronic) Atisára marked by stools of various colours and a keen digestion but unattended

22 THE SUSHRUTA SAMHITK. [Chap, XL.

with any sort of pain or complication should be reme. died with medicines prepared in the maner of Puta- paka preparation (described below). The barks of Dirgha-vrinta (S'yondka), and polens of lotus should be pasted together and wrapped up in leaves of Kas'mari or of Padma (lotus) with their ends tied with string or thread (D. R .- Kusa). The cover should be then coated with a plaster of clay and duly scorched in the fire of (smokeless) charcoal (of Khadira). When well cooked, it should be taken out and the juice, squeez- ed out of its contents. This juice should be cooled and administered in combinaticn with honey in a case 'of Atisára. Similar preparations of the drugs known as Jivanti and Mesha-s'ringi, etc., may also be used in the same way. The skin of a Tittira bird should be peeled off and a paste of the drugs of the Nyagrodhádi group should be stuffed into its belly after it has been previously drawn. After this it should be duly stitched up and cooked (scorched) in the fire in the above manner. The juice should then be squeezed out therefrom and administered, when cool, with the admixture of honey and sugar in a case of Atisára. The drugs known as Lodhra, Chandana, Yashti-madhu, Dárvi, Páthá, Sitá (sugar), Utpala and the barks of Dirgha-vrinta pasted together with the , washings of rice should be duly scorched in the fire in the above manner (of a Puta-páka). The juice pressed out of its contents and taken with honey, when cold, proves curative in cases of Atisára due to the action of the deranged Pitta and Kapha. Similar preparations may be made of the aerial roots of Vata, etc., and may be advantagcously prescribed with the soup of the flesh of any Jángala bird (such as Tittira, Kapinjala, etc,). 43-47.

„Chap. XL.] 'UTTARA-TANTRA. . 223

The Kutaja-bark taken with treacle would cure per- force the long-standing cases of Atisára attended with blood and marked by the diminished action of the bodily Váyu but a predominant action of the deranged Kapha. The drugs of the Ambashtadi group as well as those of the Pippalyadi group taken with honey would be similarly beneficial. 48-49 A Peya duly prepared with the admixture of Pris'ni- parni, Balá, Vilva (D. R. Viśva), Bálaka, Utpala, Dhanyáka and Nâgara, should be taken by a patient suffering from Atisára. A case of Pakvátisára would yield to the curative efficacy of a light medicinal gruel (Yavágu) duly prepared with the admixture of the paste of S'yonaka-bark, Priyangu, Yashti-madhu, and tender sprouts of Dádima pasted together with curd. A case of Atisára attended with blood and colic (Sula) would be readily cured by the use of Rasánjana, Ativishd, Dhátaki, Nágara and the bark and seeds of Kutaja taken with honey and the washings of rice. 50-52. Yashti-madhu, (dried) green Vilva-fruit mixed with honey and sugar, or particles of S'ali and Shashtika rice (administered with the same drugs) would prove curative in a case of Atisára. Badari-roots pasted with honey should be given to be licked with the same result. Barks of Badari, Arjuna, Jambu, Ámra, S'allaki and Vetasa taken with honey and sugar would cure a case of Atisára. Gruels (Yavágu), Mandas (thick gruel squeezed through a piece of linen) and Yusha (soup) may also be duly prepared with the admixture of tthese drugs, and in a case marked by excessive thirst, the water for drinking should be prepared by duly boiling these drugs. The cold infusion of * S'dlmali-stems kept in the open

• Powders of S'álmali stem should be kept immersed for whole

224 THE SUSHRUTA SAMIIITA. [Chap. XL.

space for a whole night, may be given good with good results as a drink in combination with Yasthi-madhu and honey. 53-54. Use of Milk in Atisara :- Milk should be given in a case of Atisára marked by the suppression of stool and Váyu and attended with griping (Sula), constant scanty motions, symptoms of Rakta-pitta and thirst. Milk is ambrosia itself in such a case of Atisára (Dysentery), and in long-standing cases the milk to be taken should be duly boiled with thrice as much water. This would remove the remnant, if any, of the Dosha involved and is, therefore, considered as the best remedy in such cases. Oily purgatives and application of Pich- chila-Vasti (slimy intestinal injections) as well as the medicated Ghrita duly prepared with the expressed juice of the barks of slimy trees, c. g., S'yond, S'almali, etc., are beneficial under the circumstances (in chronic or longstanding cases). 56. Draughts of clarificd butter duly prepared with the tender sprouts of the Kshiri trees and mixed with honey and sugar (as an after-throw) should be taken in a casc of Atisára marked with a discharge of blood before or after the passing of the stool and with a cutting pain (in the region of the anus). Draughts of medi- cated clarified butter duly prepared with the barks of Deva.dáru, and with Pippali, S'unthi, I.ákshá, Indra- rava, and Bhadra-rohini (Katuká) administered through the medium of any kind of Peyd, would prove highly efficacious in a case of Tri-doshaja Atisára of severe type. 57-58.

night in an equal quantity of water. In the morning the water should be passed through a piece of linen. Four-Pala-weight of this water mixed with a Karsha weight of Yashti-madhu and honey should be taken.

Chap. XL.] UTTARA-TANTRA. 225

Exhibition of emetics or vomiting is an excellent remedy in a case of Atisára marked by heaviness, (in the abdomen) and the predominance of the déranged bodily Kapha. A case attended with fever, burning sensation and suppression of stool and marked by an aggravation of Váyu should be treated as a case of Rakta-pitta. Intestinal injections with urine-purifying (Mutra-Sodhana) drugs should be speedily administered in the manner of an Asthapana or Anuvasana Vasti, as the occasion might arise, in a case marked by an exces; sive accumulation of the deranged bodily Doshas in the affected locality as well as by the suppression (of stool) during the mature stage of the disease. 59-60. Intestinal injections consisting of oil or clarified butter duly cooked and prepared with the drugs of sweet and acid tastes should be applied in the manner of an Anuvasana Vasti in a case marked by the protrusion of the bowel through violent and excessive straining and by painful obstruction of urine (Mutrágháta) and pain in the waist. Pitta-subduing washes, and injec- tions prepared with the Pitta-subduing drugs and appli- ed in the manner of Anuvásana Vasti, are the remedies in a case marked by the suppuration of the anus due to the aggravation of Pitta in an injudicious or intem- perate patient. Anuvasana Vasti charged with oil duly cooked with wine, Vilva and Dadhi-manda should be applied in a case of Atisára marked by the aggra- vation of the deranged bodily Vayu, and milk duly boiled and cooked with the admixture of Kachchurd, roots should be given to drink. 61-63. Pichchha-Vasti should be applied (into the rectum) in a case of Atisára marked by painful and frequent emission of blood, though in scanty quantities at a time, and by an entire suppression of Váyu (flatus). An 29

226 THE SUSHRUTA SAMHITA. [Chap. XL.

atonic condition of the anus results from a long- standing attack of Atisára which should, therefore, be remedied by rubbing the part with oil. 64-65. Diet :- The diet of the patient suffering from Atisára should be prepared with the admixture of Kapittha, S'álmali, Phanji (a kind of Páthá), Vana- Kárpåsi (D. R. Vata and Kárpási), Dádima, Yuthiká, Kachchhura, S'elu, S'ana, Chuchchu, Dadhi (curd), S'ála- parni, Pris'niparni, Vrihati, Kanta-káriká, Valá, S'vad- amstrá, Vilva, Páthá, Nágara and Dhanyáka and may also consists of the pastes of sesamum and Mudga pulse or of Mudga soup. 66. Causes and Symptoms of Raktati- sara :- The bodily Pitta of a person already suffering from an attack of Pittaja-Atisára is further deranged and aggravated, if Pitta-generating eatables are taken, and ushers in the discharge of blood with stool accom- panied by fever, burning sensation, thirst, gripings (Sula) and excessive suppuration (inflamation) of the anus (Guda). The above are the characteristies of the Raktati-sara. 67. Treatment :- Draughts of milk duly boiled and cooked with the leaves of Vata, etc. (those includ- ed within the Nyagrodhadi group) should be given with clarified butter, or with sugar and honey in a case marked by a discharge of blood before or after motions ; or the butter prepared by stirring the preceding prepara- tion of milk should be taken ; and draught of the Takra (thus prepared) should be taken as an after-potion. The discharge of blood (in a case of Atisára) may be stopped by a potion consisting of the barks of Piyála, S'almali, Plaksha, S'allaki, and of Tinis'a pasted to- gether with milk and mixed with honey. The same result is obtained by administering the milk of a she-

Chap. XL ] UTTARA-TANTRA. 227

goat with a paste of Yashti-madhu, sugar, Lodhra, Payasyá (Arkapushpi) and Darvi and mixed with honey, or with a paste (or powder) of Manjishtha, S'arivá, Lodhra, Padmaka, Kumuda, Utpala and Padmá (Bhárgi. 68-71. Sugar, Utpala, Lodhra, Samangá, Yashti-madhu and Tila; or Tila, Mocha-rasa and Lodhra; or Yashti-madhu and Utpala; or Kachchurd and Tila are the ingre- dients of four recipes which, if taken with the she-goat's milk and honey, would remove the blood in the stool. Pastes of unripe Vilva fruits, treacle and honey taken before the meal would be a remedy in a case marked by watery motions mixed with blood. A case of blood- dysentry due to the deranged blood, and Pitta and attended with Sula yields to the use of a compound con- sisting of Kos'akára (a kind of sugar-cane) pulverised parched paddy fried in clarified butter and mixed with sugar and honey. A case of blood-dysentery due to the action of the deranged blood, and Pitta may be cured with a compound of the kernel of a (unripe) Vilva-fruit mixed with Yashti-madhu and taken with the washings of rice, honey and sugar. The remedies mentioned in connection with a case of Guda-páka (suppuration of anus) should also be employed in these cases. Application of Pichchha-Vasti is recommended in the type where the pain begins to subside. A purga- tive consisting of the decoction of Vidanga, Triphala and Pippali should be given to a patient with good appetite as soon as the stool would assume* the colour of blood. In the alternative, a purgative con- sisting only of milk cooked with Eranda-roots (castor plant) should be employed and the patient should be

. D. R .- When the stool would harden "amfaz" I

228 THE SUSHRUTA SAMHITA. [Chap. XL.

given Yavågu prepared with appetising and Váyu- subduing drugs. 72-78. Treacle (Phanita) mixed with powdered S'unthi, curd, oil, milk and clarified butter should be given in a case marked by good appetite but by frothy motions devoid of all fœcal matter. Badara-fruits boiled with oil and treacle, or cakes prepared from them and dried unripe Vilva-fruits should be prescribed. Cakes prepared with boiled Másha-pulse should be prescribed to be taken with curd followed by a draught of S'vetd (cake- made) wine in the case marked by the absence of fecal matter in the stool. The blood-stained flesh of a harc cooked with S amanga, curd and clarified butter should be taken with well boiled rice. 79. A decoction of Másha-pulse, Kola and barley duly cooked in equal parts of the oil and clarified butter and mixed with curd and the expressed juice of Dádima should be prescribed as diet in the case. The absence of any fecal matter in the stool (Furisha-Kshaya) would yield to the use of Bit (black salt), dried unripe Vilva fruit and S'unthi pasted with any acid juice and mixed with curd-cream and cooked in equal parts of oil and clarified butter. Clarified butter duly cooked with as- tringent and appetising drugs should be given in a case of Atisára attended with Sula where the patient feels a good appetite after the loss of fecal matter. 80-81. Symptoms of Pravahika :- The Váyu in the organism of a person addicted to the use of unwholesome food, is deranged and aggravated. It carries down the accumulations of Valása (mucus) into the lower part of the body, whence, mixed with stools, they are constantly passed off with tenesmus. The disease is called Pravahika (mucous diarrhœa). The

Chap. XL.] UTTARA-TANTRA. 229

motions are attended with Sula (pain) in the Vataja type of the disease, with burning sensation in the Pittaja one, with mucus in the Kaphaja one and with blood (blood-streaked mucus) in the Raktaja (blood- origined type). Excessive use of dry (Ruksha) or of fatty articles of food may be regarded as the exciting factor of these cases. The specific indications of Praváhiká as well as its Ama or acute and Pakva or mature stage are respectively identical with those of the several types of Atisára. 82-83. Treatment :- In the event of fasting and other digestive (Páchana) compounds (cf Praváhiká) producing no beneficial effect in serious cases they are found to readily yield to the use of boiled milk, oil, Tila (sesamum) or Pichchhila Vasti. The green stems of S'almali well covered with green Kus'a-blades, should be scorched in the fire in the manner of Puta-páka. The juice should be squeezed out thereof and mixed with boiled milk, oil, clarified butter and powdered Yashti-madhu, and should be carefully injected into the rectum in the manner of Vasti application in cases of Praváhiká marked with the retention of stool and urine. Similar injections of a dccoction of Das'a-mula duly cooked in milk and mixed with honey and applied in the manner of an Asthapana-Vasti as well as the application of oil in the manner of an Anuvasana Vasti would prove highly efficacious in cases marked with painful tenesmus. 84-86. Diet :- Oil duly cooked with the drugs of the Váyu-subduing (Vidári-gandhádi) group and with (the five officinal kinds of) salt should be used in (the preparation of) food and drink. A compound consist- ing of Lodhra, Bit-salt and dried unripe Vilva-fruit pasted with oil and mixed with Tri-katu should be

230 THE SUSHRUTA SAMHITA. [Chap. XL.

given to be licked *. The food (boiled rice) of a diar- rhœtic patient should be taken with honey and curd from which the cream has not been removed ; or with milk warmed by a piece of red-hot metal + (other than gold and silver) and mixed when cold with a profuse quantity of honey. The use of milk duly boiled and cooked with the admixture of Tri-katu and Vidari- gandka, with the food would prove curative in a case attended with Sula. He should also be given soups (Rasa) prepared with the drugs of appetising, astringent (Gráhi) and Vyu-subduing virtues. Fish he may take and his soup should be prepared with oil and clarified butter with the admixture of Vayu-subduing drugs. The diet in this disease should consist of venison, mutton or goat's flesh cooked with the tender sprouts of a Vata tree or of blood of a fatty goat duly cooked with curd (Dadhi), oil and clarified butter. He may take his food with an unsalted soup (Yusha) of a peacock or of a Láva bird, or with well prepared curd. He may take (with benefit) well cooked Másha-pulse mixed with the transparent upper part of clarified butter (Ghrita-manda) and with curd, while chewing at inter- vals (with his teeth) the unpowdered Maricha (black pepper). 87-89. A compound of milk, honey and clarified butter mixed with the decoction of Yashti-madhu and Utpala should be applied in the manner of Vasti-application in (a case of Praváhiká, marked by) excessive pain and painful micturation (Mutra-Krichchhra). The applica- tion of this Vasti would alleviate the burning sensation,

• According to some variants this compound should be taken thrice .daily. + In place of "a"-Kupya (any metal other than gold and silver) some read "id"-Kurpa which is explained to mean a kind of stone.

Chap. XL.] UTTARA-TANTRA. 231

allay the the accompanying fever and remove the blood (in the stool). Injections of the decoction (of the drugs) of Madhura group (such as Kákoli, etc.) in the manner of an Anuvásana Vasti, should also be applied every day-at daytime or in the night, if the patient be feeling any pain. 90. A Vasti applied with the admixture of oil would pacify the aggravated bodily Váyu and Praváhiká, would be removed with the pacification of the deranged bodily Váyu. The main treatment, therefore, in a case of Praváhiká is to restore the deranged local Váyu to its normal condition, (which is identical with a cure). 91. Medical Treatment :- The drugs known as Páthá, Ajamodá, Kutaja-seeds, S'unthi and Mága- dhiká taken in equal parts, pasted together and dissolved in tepid water or milk duly boiled with the testicles of a goat and mixed with clarified butter would prove efficacious in a case of Praváhiká. Clarified butter mixed with oil and duly cooked with S'unthi and Kshavaka would give instantaneous relief, if lickcd. Yavágu duly prepared with the admixture of Vilva and the expressed juice of Gajas'ana (Sallaki), Kum- bhika and Dadima and with curd, oil and clarified butter would prove highly beneficial. The use of milk just drawn. would similarly prove beneficial in the case. 92. A wise and experienced physician should employ the foregoing medicinal compounds and decotions in the complaints of the bowels and of the 'stomach (Udará- maya) as well as light, appetising and emulsive (Snigdha) articles of fare and other articles of food prescribed before as diet in the cases. 93. Yavagu :- Yavágu (gruel) is always efficacious in cases of fever and Atisára in as much as it allays

232 THE SUSHRUTA SAMHITA. [Chap. XL.

thirst, is light in digestion and appetising, and acts as a cleanser of the bladder (diuretic). 94. General Principle of Treatment :- Drying (Ruksha) measures should be employed in a case due to the excessive use of any oily or emulsive food and emulsive (Snigdha) measures should be adopted in a case brought on through an excessive use of any dry (Ruksha) article. The cause of terror should be first removed in a case due to fright, while the mind should be calmed or consoled in the case due to any grief or bereavement. The treatment in cases (of Atisára) due to piles or worms (in the intestines) as well as in those due to the effect of poison (intro- duced into the system) consits in employing therapeutic agents which are simultaneously remedial both to the disease and to its exciting factors. Complications or distressing concomitants such as vomiting, thirst, faint- ing fits, etc., should be removed with drugs which are not incompatible with the main treatment of the disease, and which do not aggravate the exciting factors. In a case of fever or Atisára marked by the simultaneous aggravation of the deranged bodily Doshas, the deranged Pitta should be first remedied, while in all other affections, it is the deranged bodily Vayu which should be first curbed down or corrected. 95-96 .. Indications of cure :- Non-emission of stool at the time of urination and the free emission of flatus (Váyu), as well as the rousing of the appetite, and the lightness of the abdominal cavity (Koshtha) are the indications of cure in a case of Udarámaya (Diarrhœa, etc.) .* 97.

• The printed edition of Dallana's commentary says that these are the symptoms of cases of aggravated Atisira.

Chap. XL. J UTTARA-TANTRA. 233

Static or Dynamic causes of Dis- eases and Treatment :- Some diseases are due to the dynamics of Karmas (deeds done by a man in the present or any prior existence), and some are due to the effects of deranged bodily Doshas, while there may be others which have their origin both in the dynamics of Karma and the necessary physiological (Doshaja) causes. Of these a Karma-origined disease may come on without any apparent exciting factor and it dis- appears with the extinction of its (Karma's) result effected by means of any remedial measure (e.g. penance, etc.) other than medical treatment, whereas as a Dosha-origined disease is conquered as soon as the involved deranged Doshas of the body are restored to their normal condition. Cases due to a slight derange- ment of the bodily Doshas but attended with a good deal of troubles as well as those duc to the excessive aggravation of the Doshas but attended with only slight troubles should be attributed both to the physiological causes and to the dynamics of Karma, and these are cured only when both of these causes vis., Karma and aggravated Doshas are removed. 98. Grahani :- The Grahani (lit. the uppermost extremity or the receiving ducts of the intestines) is affected by the causes which produce dulness of appetite. The digestive fire of a patient is again de- ranged, even after * the subsidence of an attack of Atisára, if, with the dulness of appetite, he be still in- temperate and injudicious in matters of food and drink. Hence the regimen of diet and conduct in a case of Atisára should be as laid down in connection with the

• The use of "fq" in the text shows, say the commentators, that Grahani is possibie even without a previous attack of Atisára. 30

234 THE SUSHRUTA SAMHITA. [Chap. XL.

sequel of any purgative course (Virechana), until the deranged Doshas of the body would be completely res- tored to their normal condition, bringing in the natural health and strength in their train. The sixth Kalá which has been described as the Pitta-dhará Kalá (Pitta- containing sheath) is situated between Pakvásaya and Amásaya (duodenum ?) is called Grahani. The strength of the organ of Grahani is dependent on the digestive fire (Agni) and the latter is situate in the former. Hence anything that impairs the digestive fire (Agni) necessarily affects the Grahani. 99-102. The aggravation of one or all the bodily Doshas leads to the derangement of the Grahani into which the food taken is passed off in the shape of undigested fecal matter, or if it is digested, it sometimes produces constipation of the bowels and sometimes liquid motions accompained (in both cases) by pain and fetid smell. The disease is called Grahani (chronic diarrhœa ?) by experienced Physicians. 103. Premonitory Symptoms :- Incomplete digestion, lassitude or a sense of physical langour, laziness, thirst, a sense of exhaustion, weakness, aversion to food, cough, ringing in the ears (Karna-Kheda) and rumbling sound in the intestines are the symptoms which mark the premonitory stage of the disease. 104. Symptoms :- Swelling or œdema of the hands and of the feet, emaciation, pain at the joints, greediness, thirst, vomiting, fever, aversion to food, burning sensa- tion, eructations of bitter, acid or fermented taste, or of those smelling of blood or smoke, water-brash, bad taste in the mouth and non-relish for food, as well an attack of Tamaka-Svása (variety of asthma) are the indications of the developed stage of the disease (Grahani) 105,

Chap. XL.] UTTARA-TANTRÁ. 235

Specific Symptoms of Grahani :- A case of the Vataja type is accompained by a severe aching pain at the anus, thorax (Hridaya), sides, abdomen and the head. A case of the Pittaja type is marked by a burning sensation in the body, while the one of Kaphaja origin is characterised by a sense of heaviness in the limbs. A case of Tri-Doshaja Grahani exhibits symptoms belonging to all the symptoms of the three cases (Vátaja, Pittaja and Kaphaja types). The deranged bodily Dosha involved in a case imparts its characteristic colour to the finger-nails, eyes, face and excreta (stool and urine) of the patient. Thus it furnishes a satisfactory clue to the diagnosis of the disease, which, if neglected or unchecked at the outset, may usher in an attack of Hrid-roga (disease of the heart), Pándu (chlorosis), Udara (ascites, etc.), Gulma, piles and enlargement of spleen. 106. Treatment and Diet :- Appropriate emetics and purgatives should be exhibted (for cleansing the upper and lower parts of the body) in accordance with the aggravation of the Dosha or Doshas involved, and Peyás (gruels) and other articles of diet duly pre- pared with appetising drugs should then he prescribed in their due order. Therapeutic agents possessed of digestive, astringent and appetising virtuc should then be employed through the vehicles of Surá, Arishta (wine), Sneha (oil or clarified butter), cow's urine, tepid water, or Takra. The use of Takra in the morning is in itself an excellent cure for the disease (Grahani). Remedies mentioned in connection with the treatment of worms in the intestines, Gulma, ascites or piles may also be adopted with benefit in the disease uuder discussion. The compound known as the Hingvádi- churita, or the medicated clarified butter described as

236 THE SUSHRUTA SAMHITA. [Chap. XL.

remedial in a case of enlarged spleen, or the one duly cooked with the expressed juice of Changeri and with the drugs of the Mágadhádi (Pippalyadi) group as Kalka may be likewise prescribed with beneficial results. Clarified butter duly cooked with four times as much curd (Dadhi) may also be used with benefit. Whatever is appetising (medicines, drugs and diet, etc.) would be beneficial in cases of Grahani. Complications (Upadrava) such as fever, etc. should be subdued with drugs not incomptible with the main treatment of nor in any way aggravative of the main disease. 107

Thus ends the fortieth chapter of the Uttara-Tantra in the Sus'ruta Samhitá which deals with the (symptoms) and medical treatment of Atisára.

CHAPTER XLI.

Now we shall discourse on the (symptoms and) medical treatment of Phthisis (Sosha-Pratishedha). I. Nomenclature :- Wasting or a general ema- ciation of the frame marks the sequel of and comes in as a premonitory symptom of an organic disease. Any cachectic condition of the body accompanied by a low lingering fever is called Kshaya. A correct diagnosis and a radical cure of the disease under dis- cussion has baffled many a skilful physician. The disease is nameds Sosha from the fact of its consuming or drying up (Sosha-withering) the vital principles of the body such as Rasa-serum, etc. It is called Kshaya (wasting) since a wasting process is found to accompany all the functional activities of the body during its attack. Since the Moon-god, the king of the Brahmanas, was the first to fall a victim to its attack, it is also called Raja-yakshma (king's disease) + by some authorities. 2. Some say that the disease is produced by the separate action of the three fundamental Doshas of the body. It being usually found to be attended with all

• The mythological origin of Sosha (Phthisis) is :- The Moon-god married 27 daughters of Daksha of whom he was attached to Rohini in the extreme. Thereupon the personated wrath of his father-in-law, Daksha entered the Moon-god in the shape of Phthisis, whereby the body of the Moon-god began to emaciate. The Moon-god became penitent and the wrath of his father-in-law having been subdued at the intervention of the other gods, he managed to send down the personated Phthisis to earth to take possession of men indulging in any kind of excess and more particularly-sexual excess. The moon-god was then medically treated and radically cured by the celestial physicians, the twin As'wins. 4 Cf. Scrofula which is now known as the "King's disease."

238 THE SUSHRUTA SAMHITA [Chap. XLI.

the eleven distressing symptoms which are manifested simultaneously with the ushering in of the disease, and being the only instance in the science of therapeutics in which the treatment does not vary according to the variation of symptoms. This disease, Sosha, is more properly said to originate in the simultaneous aggravation of all the three Doshas, and it is the symptoms of the most predominant Dosha only that are manifested. 3. Ætiology and general symptoms :- The process of any wasting disease in the system, re- pression of any physical urging or propulsion, over-fatigu- ing physical exercise and irregular diet are the causes which, by aggravating the bodily Doshas and propelling them all over the organism, give rise to the disease. The aggravated Doshas with Kapha as the most predo- minant factor having obstructed the lymphatic channels, or the semen of a person having been exhausted by sexual excesses consequently produce a loss of the other Doshas or the principal elements of the organism, thereby producing a cachectic condition of the body, and the following symptoms, vis, aversion to food, fever,* asthma, cough, emission of blood, loss of voice, number- ing six in all are found in cases of Råja-yakshmá. 4-6. Specific Symptoms :- The symptoms which mark the action of the deranged bodily Vayu in the disease are loss of voice (hoarseness), aching pain (in the chest), contraction of the sides and stoop at the shoulders (Amsa), while those which are exhibited through the action of the deranged Pitta are fever, burning sensation, Atisára and expectoration of blood, and the features which indicate the action of the deranged Kapha in the disease are a sense of fullness in the head, aversion to food, cough and a sense of the

Chap. XLI.] UTTARA-TANTRA. 239

presence of a lump or plug in the throat (as if something is rising up). 7. Prognosis :- A physician having an eye to his professional reputation or good name should not take in hand the treatment of a case of Sosha (Phthisis) whether marked by all the preceding eleven kinds of symptoms or attended with six of them vis. cough, Atisára, pain at the sides, loss of voice, aversion to food and fever, or accompanied by only three symp- toms, vis. fever, cough and blood-spitting. 8. Other causes of Sosha and their symptoms :- Sexual excess, grief, old age, over- fatiguing physical exercise, toils of journey, fasting, ulcers and ulceration of the Urah (lungs) are included by certain authorities within the exciting factors of this diseasc, Sosha. A case of Sosha due to sexual excess is attended with all the symptoms due to loss of semen and is marked by palour or yellowness of the complexion, the vital organic principles beginning with semen being wasted up in succession in their inverse order of enumeration. Constant brooding over the departed person, looseness of the limbs and all the symptoms of sexual excess other than the actual dis- charge of semen mark a case due to grief. A general cachectic condition of the body accompanied by imbeci- lity of the mind, diminution of bodily strength, impaired functions of the sense-organs, laboured or difficult breath- ing (D. R. shivering of the limbs), aversion to food, a gong-like voice, expectorations marked by the absence of mucus (A. R. hcaviness of the limbs), a general apathy to the concerns of life and (constant mucus) secretions from the ears, nose, eyes and mouth are the symptoms which indicate the origin of the disease iin the natural and spontaneous waste of an extreme old age. 9-12.

240 THE SUSHRUTA SAMHITA. [Chap. XLI.

A case due to the toils of journey or travel develops such symptoms as looseness of the limbs, flabbiness of the muscles, scorched or burntness of complexion, a haggard and cadaverous look, a gone-feeling in the limbs, the absence of natural gloss of the body and dryness of the mouth, throat and of the Kloma. These symptoms in addition to those of the ulcerated lungs (Urah-Kshata) without actual ulceration, characterise the type due to over-fatiguing physical exercise. 13-14 If a case of ulcer is attended by loss of blood, pain and difficulty in eating, it is turned to a case of Sosha and is pre-cminently the most uncurable type of the desease. Rupture or ulceration in the lungs (Urah- kshata) is caused by physical exercises, lifting up heavy loads, excessive and loud reading, a hurt or a blow, or excessive sexual congress and such other acts as require the active co-operation and entail cxcessive straining of the chest (Urah). They ultimately dis- charge blood and pusy secretions. Yellowish, black or purple coloured blood is expectorated or hawked out by coughing. A burning sensation is felt inside the region of the chest. A fetid smell is felt in the mouth and in the breath. The complexion of the body and the tone of the voice is changed and the patient becomes senseless from the excessive pain he suffers from. In certain cases the symptoms vary according to the varied natures of their exciting factors, and all the specific symptoms are not fully exhibited. Never- theless these diseases also go under the denomination of Kshaya (consumption) owing to the fundamental vital principles of the body being equally consumed or withered up in them, and the specific mode of their treatment has already been explained before (Chapter XV, Sutra-Sthána). 15-17.

Chap. XLI.] UTTARA-TANTRA. 241

Premonitory Symptoms :- Laboured or difficult breathing, a gone-feeling in the limbs and a sense of physical lassitude, secretion of mucus, dryness of the palate, vomiting, dulness of appetite, vertigo or fainting fits, nasal catarrh, cough, somnolence, whiteness of the eyes, desire for meat, and increased sexual propen- sities are the symptoms which mark the advent of the dreadful disease-Sosha. The patient dreams that he has been borne on the wings of a crow or a parrot or a vulture or a pea-cock or has been riding a porcupine or a lizard or a monkey or sees in dreams river-beds dried up and trees dried up or fanned by gales of wind or surrounded by flames or fumes of fire. 18. Prognosis :- A gradual wasting of the body inspite of sufficient food, presence of Atisára (diarrhœa) and swelling of the abdomen and scrotum are the symp- toms of a comsumptive patient who should be given up. The treatment, however, of a patient temperate in his habits and strictly conforming to the instructions of the physician and possessed of a good digestive fire and not much reduced in body may be taken in hand provided the disease be an acute one. I9-20. Treatment :- The patient should be made first to use the medicated clarified butter prepared from the milk of a ewc or a she-goat and duly cooked with the drugs of the Sthiradi (Vidari-gandhadi) group and then mild emetics and purgativcs. Intestinal injections after the manner of an Asthápana Vasti should follow the preceding medicinal measures and head-purgative (Siro-vireka) should be applied. The diet should then be given consisting of (cookcd) wheat, barley S'ali-rice together with meat-essence. Construc- tive tonics or tissue-builders (Vrimhana) should be given to a patient with a good digestion and relieved of .31

242 THE SUSHRUTA SAMHITA. [Chap, XLI.

all distressing symptoms or concomitants. Complica- tions peculiar to the action of the deranged bodily Váyu generally mark a case due to sexual excess, wherein constructive tonics and remedial agents of Váyu-subduing virtue would be found to be extremely efficacious. 21-22. Diet-meat, etc. :- The flesh of a crow or an owl or a mungoose or a cat or a Gandupada (carth- worm) or a cormorant or a beast of prey (Vyála) or of any animal of the Vilesaya or Jangala class mixed with Saindhava salt and fricd in mustard oil, should be prescribed in various ways for a patient laid up with Phthisis. The diet may also consist of Mudga-soup or of Adhaki-soup or of the flesh of an ass, camel, clephant, mule or horse variously prepared and well cooked. Meat in combination with any Arishta as well as wine mixed with Madhvika may also be given. 23. Various articles of food made of barley-grains previously soaked in the alkaline water duly prepared with Arka and Amrita may likewise be prescribed. Clarified butter skimmed off from the milk of a ewe or a she-goat, may be given with gruel at the meal-time to an extremely emaciated patient. A compound con- sisting of Tri-katu, Chavya and Vidanga made into a paste with honey and clarified butter should be given to be licked up by a patient suffering from Phthisis. The use of a medicated clarified butter duly cooked with the essence of the flesh of any carnivorous animal and mixed with Pippali and honey as an after-throw proves remedial in a case of Phthisis. A lambative consisting of Drâkshá, sugar and Mágadhiká pasted together with honey and oil proves efficacious as a cure for Phthisis. A case of Phthisis would yield to the use of a lambative consisting of Tila, Masha-pulse and As'vgandha ground

Chap. XLI.] UTTARA-TANTRA. 243

to a fine paste with the addition of honey and clarified butter skimmed out of the milk of a she-goat, or of sugar, As'vagandha and Pippali pounded together and made into a fine paste with the addition of honey and ' clarified butter. Milk duly cooked with the admixture of As'vagandhá may be prescribed as a constructive tonic. Butter skimmed out of the preceding preparation of milk and mixed with copious quantity of sugar should be taken, as an alternative, every morning and this should be then followed by a draught of milk. 24. As'vagandhá, Punarnavá and Yava should be used in rubbing (Utsádana) the body of the patient. Clari- fied butter duly cooked with (the decoction of) the whole of a Vásaka tree (vis., its roots, leaves, branches and barks) and with its flower (as Kalka) and mixed with an adequate quantity of honey* should be taken by a consumptive patient strictly conforming to the regimen of diet. Thus a virulent attack of Phthisis accompanied with cough, asthma and chlorosis would be speedily conquered. 25-26. A wise physician should take equal parts of clarified butter, milk, decoctions of Murvá, Haridrá and of Khadira and the expressed liquid of the dungs of a cow, a horse, an elephant, a she-goat and a cwe. Ten equal parts of the above ten articles should be duly boiled and cooked together with the Kalka of powdered Tri-katu, Tri-phala, Devadaru and the drugs of the sweet (Kákolyádi) group. · This medicated clarified butter would be found highly beneficial in the cure of Phthisis (Yakshmá). 27. Six Pátra measures of the duly prepared decoction of Das'a-mula, Varuna, Karanja, Bhallataka, Vilva, the two

• This preparation is also found in the Charaka Samhita though in different language under the treatment of Rakta-pitta.

≥44 THE SUSHRUTA SAMHITK. [Chap. XLİ.

kinds of Punarnava, Yava, Kulattha, Badara, Bhárgi, Pátha, Chitraka and Mahi-Kadamba should be cooked with a Patra measure of clarified butter and with (the Kalka of) Vyosha (Tri-katu), the milk of Maha-vriksha (Snuhi), Abhaya, Chavya, Devadáru and Saindhava salt (D. R. Pippali). The medicated clarified butter thus pre- pared proves efficacious in cases of Phthisis, Ascites and Vátaja-Prameha. Clarified butter duly cooked with the milk, blood, meat-essence and the expressed liquid of the dungs of a cow, a mare, a ewe, a she-goat, a cow- elephant, a hind, a she-ass and a she-camel and with the Kalka of Drákshá, As'vagandhá, Magadhá and sugar proves extremely beneficial in cases of Phthisis. 28-29. Eladi-mantha :- A Prastha measure of clari- fied butter should be duly cooked with the decoction of Elá, Ajamodá, Ámalaka, Abhayá, Aksha, Gáyatri, Arishta, Asana, S'álasára, Vidanga, Bhallátaka, Chitraka, Ugrá*, Tri-katu, Ambhoda and Surashtraja-earth. When duly cooked it should be taken down from the oven and thirty Pala weight of candied sugar, six-Pala-weight of Tuga-kshira (Vamsa-lochana) and two-Prastha- measure of honey should be added to it and stirred with a laddle. A Pala weight of this preparation followed by a draught of milk should be given to be licked every morning to a Phthisical patient. The present elixir is possessed of ambrosial sanctity. The extent of its therapeutic application embraces such diseases of the body as Phthisis, chlorosis, fistula-in- ano, asthma, loss of voice, cough, troubles of the heart, enlarged spleen, Gulma and chronic diarrhea or indigestion. It imparts longevity to a person using it, leads to the expansion of his intellectual faculties and

*Chakradatta does not read Ugrá in the list.

Chap. XLİ.] UTTARA-TANTRA. 245

tends to invigorate his eye-sight. It is the best of all rejuvenating preparations cf our pharmacopea and no strict regimen of diet and conduct is required to be followed while it is used. 30. The medicated clarified butter mentioned under the treatment of Plihodara (dropsy of the abdomen owing to the enlargement of spleen-Chapter XIII, Chikitsita- sthana) as well as the three others mentioned in that connection may be also used with advantage in the disease under discussion. The accompanying symptoms or complications such as hoarseness of voice, etc. should be remedied with appropriate medicines presented for those diseases in the Sastras. The patient should be made to use regularly the milk, butter, urine, blood, meat and the (expressed liquid of the) dung of a goat as his bath or in any other way possible (e.g., in drinking) and to live in a goat-shed (in the company of goats) whereby he would be cured of his Phthisis in a month. A Phthisical patient should likewise be made to take Rasona (garlic) or Nága-valá or Mágadhiká or S'ilájatu with milk, in the prescribed manner (laid down in connection with the medical treatment of Mahá-váta- Vyádhi). 31-34. Rules of conduct :- He should not allow any grief, anger or jealousy to disturb the equilibrium of his mind, should lead a life of strict continence, deal in the discussion of sublime subjects and conform to the injunctions of his medical advisers or physicians. He should pay respects to the gods, superiors and Bráhmanas and listen to the discussions of the spiritual truths from the lips of Brahmans. 35.

Thus ends the forty-first chapter of the Uttara Tantra in the Sus'ruta Sambita which deals with the (symptoms and) treatment of Phthisis.

CHAPTER XLII.

Now we shall discourse on the chapter which deals with the symptoms and) medical treatment of Gulma (Gulma-Pratisheda). I. Definition and number of Gulmas :- The fundamental principles of the body, deranged and aggravated by their respective or specific exciting causes and factors tend to accumulate in the cavity of the abdomen (Koshtha) and help the formations of ball- like tumours or Gulmas (internal tumours inculsive of those known as the phantom tumours) somewhere inside the body lying between the extreme confine of the regions of the heart and of the bladder (Vasti). The Gulma is of five kinds and found to be round or spheroid in shape and may be either fixed or mobile (lit. shifting) in their character and subject to variations in their mass and size. 2. Localisation and nomenclature :- They have five locations inside the abdominal cavity, vis. the two sides, the region of the heart, the bladder (Vasti) and the 'region of the umbilicus). The Gulmas are so named because their root or base cannot be exactly localised as well as their cause cannot be exactly ascertained owing to the fact of their having their origin in the aggravated condition of the local bodily Váyu, or because of their being but a agglomeration of the deranged bodily Doshas in the affected locality and the shrub-like large converse outline of the surface (Gulma-shrub). Since a Gulma, like a bubble of water, is a self-contained agglomeration of the deranged bodily Doshas and freely moves about in the cavity of its growth, it is not marked by the advent of

Chap. XLII.] UTTARA-TANTRA. 247

any suppurative process in its mass or body. The Gulmas are the products of either the several or con- certed actions of the three Doshas, while in females a separate class of tumours (such as the ovarian or uterine tumours) intimately connected with the deranged or vitiated condition of the blood (catamenial fluid, etc) is also recognised. 3-5. Primonitory Symptoms :- A sense of lassitude, dulness of appetite, pain and rumbling in the intestines, suppression of stool, urine and flatus, in- capacity to take food to the full, aversion to food, and an upward coursing of the internal Vayu are the indications which may be set down as the premonitory symptoms of Gulma. 6. Specific Symptoms :- Pain (Sula) in the region of the heart and the belly (Kukshi), dryness of the throat and of the mouth, suppression of Váyu (flatus), irregularity of digestion and all other symptoms which specifically indicate the deranged condition of the bodily Vayu are the characteristics of the Vataja-Gulma. Fever, perspiration, defective digestion, burning sensa- tion, thirst, redness of the body (Anga-rága), bitter taste in the mouth and all other specific symptoms of the deranged Pitta mark the Pittaja type of the disease. A sensation of wetness all over the body, an aversion to food, lassitude, vomiting, water-brash, sweet taste in the mouth and all other specific indications of the deranged Kapha are exhibited in the Kaphaja type of the disease. The Tri-doshaja type exhibits the symptoms specifically belonging to each of the preceding ones and should be regarded as incurable. 7-9. Symptoms of Raktaja-Gulma :- The symptoms of Raktaja-Gulma are mentioned below. The bodily Váyu of a woman newly delivered of a child as

248 THE SUSHRUTA SAMHITA. {Chap. XLII.

well as that of a woman who has recently miscarried, or of a woman in her courses is deranged by the use of unwholesome or injudicious food (and regimen of con- duct), and by supressing the discharge of the blood (lochia) it gives rise to Gulma attended with pain and burning sensation. A Gulma of this type is easily mistaken for a case of conception, which exhibits all the symptoms of pregnancy as well as those which are peculiar to the state of the Pittaja type, with the exception that the abdomen does not enlarge and there is no movement (in the womb). The medical treatment of a Gulma of the present type should be taken in hand after the lapse of the natural term of gestation and this is known as the Raktaja-Gulma * by the experienced physician. I0. General Treatment :- A person suffering from an attack of Vataja Gulma should be duly treated with a Sneha, purged with any fatty purgative and then treated in the proper time with Nirudha and Anuvásana Vastis. In a case of Pittaja type of the disease, the patient should be treated (rubbed) with clarified butter duly prepared and cooked with the drugs of the Kákolyadi group and then being properly purged with the compounds of sweet drugs (of the Aragvadhadi group) he should be treated with Nirudha Vastis. In a case of the Kaphaja type, the patient should be first anointed with a medicated Ghrita duly cooked and prepared with the drugs of the Pippalyadi group, then purged with a strong (Tikshna) purgative and then treated with Nirudha Vastis of the same

• This Raktaja Gulma is peculiar to the females only. But some authorities are of opinion that a kind of Raktaja (blood-origined) Gulma due to the vitiated blood of the organism may be possible both in the males and females.

Chap. XLII.] UTTARA-TANTRA. 249

character. In a Tri-doshaja type, measures held to be remedial for each of the Doshas should be adopted or employed. Measures laid down in connection with the Pittaja type of the disease should be as well cmployed in cases of Raktaja (blood-origined) Gulma in female patients. Now hear me describe the recipes of the medi- cines which would particularly lead to the disintegration of the blood (in cases of Raktaja Gulma). Clarified butter duly cooked and prepared with the alkaline preparation of Palás'a wood (water charged with the burnt ashas of Palása) should be internally adminis- tered, and the medicated clarified butter known as the Pippalyadi Ghrita should be employed after the manner of an Uttara-vasti. In the alternative, the discharge (of blood) should be induced with the help of the drugs of heat-making (Ushna) potency (e.g, Pippalyádi group) and measures laid down in connection with menorr- hagia (Asrigdara) should be adopted after the flow has fairly set in. II. Anuvasana :- The use of curd, clarified butter, oil, lard (Vasa) and marrow of Anupa (such as boar buffalo, etc.) and Audaka (aquatic) animals, boiled together and applied after the manner of an Anuvasana- vasti, proves beneficial in a case of Vataja-Gulma. The application of similar Vastis charged with a solu- tion of clarified butter and the lard of animals of the Jangala and Eka-sapha groups proves efficacious in the Pittaja type of the disease, while the application of these containing solutions of oil and the marrow of any Jángala animal will prove beneficial in a case of the Kpahaja type *. 12-15.

• Dallana recommends the use of Váyu subduing, Pitta-subduing and Kapha-subduing drugs as Kalka in the preparation of these three Vastis respectively.

250 THE SUSHRUTA SAMHITA. [Chap, XLII,

In a case of the Vataja type of Gulma, the patient should be made to use the medicated Ghrita duly cooked with the cxpressed juice of Amalaka and with the Kalka of the six drugs * and with the admixture of sugar and Saindhava (as an after-throw). 15. Chitraka Ghrita :- Clarified butter duly cooked with curd, fermented rice-boilings (Kánjika) as well as with the decoction of Vadara and the ex- pressed juice of Mulaka and with the Kalka of Chitraka, Tri-katu, Saindhava, Prithviká, Chavya, Dâdima, Dipyaka, Granthika, Ajáji, Habushá and Dhanyáka taken in equal parts, proves curative in cases of Vataja Gulma, Sula (colic), distention of the abdomen and dulness of appetite. 16. Hingvadi Ghrita :- Ciarified butter duly cook- ed with Hingu, Sauvarchala-salt, Ajáji, Vit-salt, Dádima, Dipyaka, Pushkara, Vyosha, Dhanyáka, Amla-vetasa, Yava-kshára, Chitraka, S'athi, Vachá, Ájagandhá, Elá and Surasa as Kalka and with the admixture of curd (Dadhi) as liquid, proves efficacious in a case of Vátaja Gulma, colic-pain and suppression of stool and urine. 17. Dadhika Ghrita :- Clarified butter duly cooked with Vit-salt, Dadima, Saindhava, Chitraka, V yosha, Jiraka, Hingu, Sauvarchala-salt, Yava-Kshára, Kushtha, S'unthi, Vrikshamla (turmerie) and Amla- vetasa as Kalka and with the expressed juice of Vija-pura and with curd weighing four times as much as of Ghrita, proves curative in cases of Gulma, enlarge- ment of spleen and Sula. The clarified butter thus prepared is called Dadhika-Ghrita. 18. Rasona Ghrita :- Clarified butter duly cooked with the admixture of the expressed juice of Rasona

• The six drugs to be used as Kalka are Pippali, Pippali-mula, Chavya, Chitraka, Nâgara and Yava-kshâra taken one Pala of each.

Chap. XLII.] UTTARA-TANTRA. 251

and with the decoction of (major) Pancha-mula as well as with wine (Sura), Aranala (fermented rice-boilings), curd, and the expressed juice of Mulaka, with the Kalka of Vyosha, Dádima, Vrikshámla, Yamáni, Chavya, Sain- dhava, Hingu, Amla-vetasa, Ajaji and Dipyaka (Aja- modá) taken in equal parts, includes within the rangc of its curative efficacy such diseases of the body as Gulma, Grahani (chronic diarrhœa), piles, asthma, in- sanity, consumption, fever, cough, epilepsy (Apasmára', dulness of appetitc, enlargement of spleen, colic, and the derangements of the bodily Váyu. 19. An Adhaka measure each of curd, Sauviraka (a kind of Kánjika), clarificd butter and the decoctions of Mudga and Kulattha pulse should be cooked with the admixture of two Pala weight of cach of the following drugs, viz., Sauvarchala, Sarjiká, Devadáru and Sain- dhava. The medicated Ghrita thus prepared proves curative in cases of Vátaja Gulma and acts as a good appetiser. 20. Ghritas in Pittaja and Raktaja Gulmas :- Clarified butter duly cooked with the Kalka of the drugs or the Jivanija (Kákolyádi) group and with the decoction of the component members of the Trina-pancha-mula, or of the Nyagrodhadi or of the Utpaládi group, would undoubtedly prove curative in cases of Pittaja and Raktaja Gulma. 21. Ghritas in Kaphaja Gulma :- A Gulma of the Kaphaja type would surely yield to the use of medicated Ghritas duly cocked with the drugs of the Dipaniya (Pippalyadi) group as Kalka with the admix. ture (as liquid) of the decoction of the component mem- bers of either the Áragvadhádi group, the alkaline (Mushkakadi) group or the Aragvadhadi Gana, or with the officinal group of (animal) urines. 22.

252 THE SUSHRUTA SAMHITÁ. [Chap. XLIİ.

A Gulma of the Sannipatika type (due to the concerted action of all the three fundamental Doshas of the body) should be treated according to the pre- dominance of any specific deranged bodily Dosha involved thercin. The patient should be made to take at the proper time (ic, as soon as the disease sets in) the pulverised compound known as the Hingvadi-churna or the medicated Ghrita known as Tilvaka-Sarpih or the one (vis. Shatpalaka Ghrita) which has been describcd as curative of the enlargement of the spleen, as these would prove curative in a case of Gulma. 23-24. Internal use of Kshara :- Alkaline prc- paration should be duly made with the following drugs, vis., the ashes of (dricd stems of) Tila, Ikshuraka, Sarshapa and Yava and of (the barks of ) Palás'a and of Mulaka with the urines (weighing four times as much) of a cow, she-goat, ewc, she-ass and she-buffalo. This alkaline preparation should then be cooked in an iron vessel and on a slow fire with one Pala weight of each of the following pulveriscd drugs, vis, Kushtha, Sain- dhava, Yashti-madhu, Nágara, Vidanga and Ajamodá and with ten Pala weight of Sámudra-salt thereto added and, should be taken in the form of a lambative with one or the other of clarified butter, curd, winc, ferment- ed rice-boilings (Dhanyámla), warm water or the soup of Kulattha. The alkaline compound, thus preparcd, undoubtedly proves curative in cases of Gulma and in the derangements of the bodily Vayu. Compounds consisting of Sarjika-Kshara, Kushtha and the ashes of Ketaki taken with oil*, or of Sarjika-Kshara, Kushtha

• According to Dallana, Sarjika-Kshara, Kushtha and Yava-Kshára with nil would form the ist compound and the Ketaka-Kshara with oil would form a separate compound.

Chap. XLII ] UTTARA-TANTRA. 253

and Saidhava taken with tepid water, would subdue an attack of the deranged bodily Vayu. 25-26. Vrischirarishta :- The drugs known as Vris'chira, Uruvuka, Varshábhu, the two kinds of Vrihati and Chitraka should be duly boiled together with a Drona-mcasure of water and taken down from the oven after three-fourths of the water are evaporated by boiling. It should then be poured into an earthen pitcher of which the interior has been previously coated with pastes of Magadhi, Chitraka and honey. One Seer of powdered Pathya and four Seers of honcy shonld be subsequently added to its contents and the pitcher should be then kept buricd in a heap of husks for ten days, after which it should be taken out and its contents should be given to the patient aftei the digestion of his daily food. The Arishta (fermented wine) thus pre- pared proves curative in cases of Gulma, indigestion and aversion to food. 27. Powders of Páthá, Nikumbha, Rajani, Tri-katu, Tri- phalá, Agnika (Chitraka), Saindhava-salt and Vriksha- vija (Indra-yava) in cqual parts should be taken with matured treacle of their combin d wcight; or the powders of the above drugs with pulverised Pathya (weighing a fourth part only of the other powders taken together) should be cookcd with cow's urine (weighing four times) to a thick consistency and made into pills which should be taken in an empty stomach (by the patient). These medicines would radically cure the cases of Gulma, enlarged splcen, indigestion, heart-disease, chronic diarrhæa and violent forms of chlorosis. 28. Blood-letting :- Blood-letting by the applica- tion of leeches or by venesection should be effected in a case of elevated and immobile (unshifting) Gulma

254 THE SUSHRUTA SAMHITA. [Chap, XLIt.

characterised by Sula, burning sensation, inflamation and piercing pain. 29. Diet and Sveda :- Drinks composed of the meat-essence of an animal of the Jángala group, pro- fusely salted with Saindhava and mixed with clarified butter and Tri-katu and taken lukewarm are good for Gulma-patients. Peyas prepared with the Váyu- subduing drugs and the soup of Kulattha-pulse cooked with a Sneha as well as the Khada-yusha prepared with Pancha-mula also are likewise efficacious as Diet. Draughts of milk with Ardraka should be prescribed in a case of Gulma attended with the suppression of stool and flatus. Fomentation (Sveda) after the manner of Kumbhika, Pinda and Ishtaka (see Chapter XXXII) Chikitsita Sthána) are also efficacious. 30-32. Purgatives preceded by the application of fomenta- tion should be exhibited to a Gulma-patient, since it is extremely difficult to purge him. Vilepana (massage of the Gulma), application of unguents and poultices, Samdahana (cauterisation) as well as tepid fomentation after the manner of Salvana-Sveda and the like arc likewise applicable. Medicated Ghritas, powders and Vartis mentioned in connection with the treatment of Udara as well as medicated salts mentioned under the head Udarámaya* are likewise applicable in the present discase. 33-34. Medicated Plugs or Vartis made of Sámudra t,

• Udarámaya may mean either indigestion or ascites. Anilámaya (Váta-vyádhi) is a variant addopted by Dallana and is undoubtedly pre- ferable since there are several medicated salts e. g., Patra-Lavana, Kánda-Lavana, in the treatment of Váta-Vyádhi. Sce Chap. IV, Chikit- sita Sthána. + According to some 'Samudra' means Samudra-salt and others, it means Samudra-Phena.

Chap. XLII.] UTTARA-TANTRA. 255

Årdraka, Sarshapa (mustard) and a profuse quantity of Maricha pasted together should be inserted into the rectum in suppression of stool and flatus in a case of Gulma. Arishtas made with Danti -roots, Chitraka-roots, or with the Vayu-subduing drugs according to the manner laid down in the Sutra-sthána should be pres- cribed, or the patient should be made to use the duly fried tender sprouts of Putika and Nripa-Vriksha. A Gulma patient with the upward coursing of his bodily Vayu should not be treated with Nirudha-Vasti. 35-37. Compounds of Trivit and S'unthi or of treacle and powdered Haritaki* as well as of Guggulu, Trivit, Danti, Dravanti, Saindhava and Vacha should be adminis- tered through milk, winc or the expressed juice of grapes, according to the strength (of the disease and of the patient). Pilu made into a paste and salted with the addition of Saindhava should also be similarly taken. Wine surcharged with Pippali, Pippali-roots, Chavya, Chitraka and Saindhava and taken at an oppor- tune moment (i. e., when attended with tympanities, etc.) would prove readily curative in a case of Gulma. A Gulma-patient afflicted with a suppression of stool and of flatus should take barlcy with milk or Kulmásha (Másha-cakes) profusely saturated with salt and clarificd butter. 38-39. Supervening Symptoms :- If Sula which is its supervening symptom anyhow appears whereupon the patient suffers a kind of digging and piercing pain resembling that arising from the piercing of a dart, there will also appear the following distressing con- comitants according to the Dosha or Doshas involved,

• According to some commentators the first two compounds should be taken with water.

256 THE SUSHRUTA SAMHITA. [Chap. XLH.

vix,, supression of stool and urine, difficult respiration, and numbness or stiffness of the limbs (in cases cf aggravated Vayu), thirst, burning sensation, vertigo, ill- digestion of food, and excess of the colic pain (in cases of aggravated Pitta), and goose-flesh, aversion to food, vomiting, increase of pain after the taking of food and a sense of lassitude in the limbs (in cases of aggravated- Kapha). The course of medical treatment in such cases should be determined by the nature and number of the deranged bodily Doshas specifically lying at the root and should be as follows. 40. The following three compounds, vis., (1) Pathyâ, the threc kinds of salt (Saindhava, Sauvarchala and Vit) Yava-Kshára, Hingu, Tumburu, Pushkara, Yamáni, Harid á, Vidanga and Amla-vetasa; (2) Vidári, Triphalá, Satávari, S'ringáta, Guda-s'arkará (Gángeri-phala), Kásmari-phala, Yashthi-madhu, Parushaka, Hima (san- dal wood) and (3) Shad-granthá (Vacha), Ativishá, Deva- dáru, Pathyá, Maricha, Vrikshaka, Pippali-mula, Chavya, Nágara, Kshára (Yava-kshára) and Chitraka should be respectively given in the Vataja, Pittaja and Kaphaja types of the diseasc. The medium through which these compounds should be given would be tepid Amla- Kanjika, luke-warm milk and tepid water respectively. The preceding three compounds should be jointly administered in sets of two or three when two or three Doshas are involved in any casc. 41. Sprinkling (of water), baths, plaster (Pradcha) un- guents and dietetic treatment should be similarly applied in Vátaja cases. Contacts with vessels filled with cold water should be applied in Pittaja cases, while the use of emetics, rubbing, fomentation (Sveda), fasting and other Kapha-subduing remedics should be recommended in Kaphaja types. Applications of Sneha and such-like

Chap. XLII ] UTTARA-TANTRA. 257

remedial measures are specifically recommended 'in the discase, according to the Dosha or Doshas involved in each case. 42. Prohibited articles :- A person suffering from Gulma, should refrain from taking Vallura (dried meat), Mulaka (radish), fish, dried pot-herbs, any prepara- tion of pease, Aluka, (potato of any kind) and any kind of sweet fruit. 43. Causes and symptoms of Sula :- Now I shall deal with the causes, the characteristic symptoms and the treatment of Sula occurring in any specific locality of a Gulma even without its actual presence or formation therein. A voluntary retention of flatus (Váta), stool or urine, over-eating, indigestion, eating before the digestion of previous food, over-exertion, use of articles of food which are incompatible in their com- bination, drinking water when hungry, use of germinated grains, dry food or cakes of dry meat, as well as the usc of other such-like articles of fare, derange and aggravate the bodily Váyu, which produces a violent cutting and spasmodic pain (Sula) in the main cavity of the trunk (Koshtha). The patient complains of as if being pierced with a Samku (spear) in the inside and of a feeling of suffocation under the influence of that excruciating pain, which fact has determincd the nomenclature of Sula (lit .- a spear). 44-45. Vataja Sula :- The patient experiences a violent colic whenever in an empty stomach and he feels a difficulty of respiration. The limbs seem to be numbed or stuffed and the flatus, stool and urine are evacuated with the greatest difficulty-these are the symptoms which mark the Vataja typc of the disease. 46. Pittaja Sula :- Thirst and a burning sensation in the body attended with an excruciating pain, giddi- 33

258 TIE SUSIIRUTA SAMIIITA. [Chap. XLII.

néss, loss of consciousness, desire for cold things and amelioration on application of cooling measures, are the specific features of the Pittaja type. 47. Kaphaja and Sannipatika Sulas :- An agonising pain attended with nausea, excessive full- ness of the stomach and a sense of heaviness in the limbs are the indications which distinguish the Kaphaja type of the diseasc. The type due to the concerted action of the three simultancously deranged Doshas of the body (Sannipatika Sula) exhibits all the series of symptoms which respectively mark the preceding types, and hence it is said to be incurable. 48-49. General treatment :- The symptoms have been described. Now hcar me describe the mode of medi- cal treatment (to be gencrally pursucd in curing a case of Sula). Since the deranged bodily Váyu (which is the principal and immediately exciting factor, is very active in its operation, hence it should be specdily subducd. Fomcntations with Páyasa, Kris'ará or cooked meat saturated with any Sneha (clarified butter, etc.) should be resorted to. Fomentation naturally gives relief to a patient suffering from Sula. The patient should take cooked Trivrit-leaves (as pot-herbs) with his meals cooked with a Sneha (clarified butter) and served hot ; or he should eat the tender sprouts of Chiravilva fried with oil, or drink the meat-essence of the flesh of any birds of the Jangala group charged with a Sneha, or take the meat of any animal of the Vilesaya group. 50. Treatment of Vataja Śula :- Surd, Sauvi- raka (fermented rice boilings), S'ukta, the cream of curd and Udas'vit (half-diluted Takra) saturated with Kála- salt *, should be taken in a case of Vataja Sula. The

• Kála Lavana generally means 'Vit-salt', but here, according to Dallana, it means 'Sauvarchala-salt'.

Chap. XLII. ] UTTARA-TANŤRA. 259

soup of Kuluttha with an adequate quantity of the acid articles (e. g. pomegranate, etc.) and cooked with the soup of Lara bird salted with Saindhava and seasoned with pepper, exercise a curative efficacy in a case of the Váyu-origined type. The compound of Vidanga, S'igru, Kampilla, Pathyá, S'yama, Amla-vetasa, Surasá, As'va-karna and Sauvarchala should be taken with wine in an attack of the Vayu-origined type of Sula. 51-52. A pulverised compound consisting of Prithviká, Ajáji, Chaviká, Yaváni, Vyosha, Chitraka, Pippali, Pippala-mula and Saindhava pounded together should be taken with milk or Kámbalika or Madhvásava (wine of honey) or Chukra or Sura (wine) or with Sauviraka (fermented rice-boilings) as alternatives. The above pulverised compound should be soaked in the ex- pressed juice of Mátulunga and with the decoction of Badara several times after the manner of Bhávaná saturation, and the compound should be taken with a profuse quantity of Hingu, and with sugar. A Varti made of the same powders and pulverised (pith of) Dádima wood mixed together should be lieked with trcacle or honey or taken with wine in cases of Vátaja Sula as giving an instantancous relief. 53 In a case of Sula due to hunger, light and sparing dict should be given with lukewarm milk, Yavágu or meat-soup charged with clarified butter. Emulsive diet should be given in a case of Vátaja Sula to a patient of dry or parched organism, use of well scasoned Ghrita-puras being specially recommended. The patient should also take Váruni wine wherefrom he will get relief. 54-55. Treatment of Pittaja Śula :- The treat- ment of Vátaja Sula has been described above. Now I shall narrate the therapeutic agents and remedies in

260 THE SUSHRUTA SAMHITA. [Chap, XLIİ.

respect of Pittaja-Sula. A person afflicted with an attack of the present type of the disease, should be made to vomit without any violent effort by drinking (a stomachful of) cold water. He should have recourse to cooling measures and avoid all heat-making ones. Vessels of copper, silver, or precious stones and cooling gems and filled up to the brim with water, should be placed upon the seat of affection (Sula) in his body. Treacle, barley, S'a'li rice, milk, (draughts of, clarified butter, purgatives, the flesh of any Jangala animals- these should be prescribed in cases of Pittaja Sula. All Pitta-generating articles should be avoided and those which soothe the Pitta should be used. The soup of the meat of Jangala animals may be taken with sugar as an alternative. Parushaka, grapes, dates and aquatic fruits such as S'ringa'taka, etc., should also be taken with sugar as they tend to relieve Pittaja Sula. 56. Treatment of Kaphaja Sula :- A fit of Sula due to the action of the deranged Kapha is aggra- vated just after eating. Vomiting should be induced in such a case with draughts of the decoction of Pippali *. Dry fomentations and other heating measures . should be likewise resorted to and the patient should be made to take Pippali and S'unthi (in any shape) in cases of Kaphaja Sula. Páthá, Vachá, Tri-katu, and Katuka-rohini should be used with the decoction of Chitraka, or the soup (of any Sula-subduing article) should be taken with an equal part of Arjaka. 57-58. Seeds and roots of Eranda, Gokshura-roots, S'ála- parni, Pri'ni-parni, Brihati, Kantakari, S'rigála-vinna (a kintd of Prisni-parni), Sahadeva, Mahdsahá (Máshaparni),

• Some cemmentators, according to Dallana, take [Pippali to mean sceds of Madana-phala.

Chap. XLİL.] UTTARA-TANTRÅ. 261

Kshudra-saha (Mudga-parni) and Ikshuraka-roots should be duly boiled with a Drona measure (sixty-four seers) of water and should be boiled till reduced to a quarter part. This decoction should be used with the admix- ture of Yava-kshara *. By this compound attacks of Vataja, Pittaja, Kaphaja and Tri-doshaja types of Sula would be thrown off just as the floating clouds are shattered and driven by the wind. Pippali, Yava, Chitraka, Us'ira and Sarjiká-kshára should be burnt together and reduced to ashes. Taken with tepid water, this compound proves curative in an attack of Kaphaja Sula. 59-60. Symptoms of Pars'va-Sula :- The de- ranged Kapha in the regions of the Pársva (sides) arrests the course of local Vayu which thus irritated causes an immediate distention of the abdomen and a rumbling in the intestines. A pricking pain is felt in the affected part, which seems as if being pierced with needles, and the patient complains of insomnia and has nc relish for food and his respiration becomes painful and difficult. The disease is named Parsva-Sula (side- colic) and is brought on by the action of the deranged Váyu and Kapha. 61. Treatment of Pars'va-Sula :- A pul- verised compound of Pushkara-roots, Hingu, Sauvar- chala, Vit-salt, Saindhava, Tumburu and Pathya should be taken with a decoction of barley in a case of (colic) pain at the sides, at the region of the heart and at the region of the bladder. The medicated Ghrita mentioned in connection with abdominal dropsy due to the en-

• The total weight of the drugs should be 8 seers, according to Dallana. According to others, however, it should be 12 seers. The preparation should be used in any shape both internally and externally e. g. a bath, washings, etc.

262 THE SUSHRUTA SAMHITA. [Chap. XLİİ.

larged spleen, or clarified butter mixed with Hingu should be as well administered in such cases. Vija- puraka-Sára* duly cooked in milk as well as draughts of castor oil mixed with wine, Mastu, milk or meat-soup (whichever of these may be conducive to the health of the patient) should be taken and the diet should be taken with milk or with the meat-soup of Jángala animals. 62. Symptoms of Kukshi-Sula :- The de- ranged and aggravated bodily Váyu, affecting the fire of digestion and incarcerated in the region of the Kukshi (loins) interferes with the digestion of the food previously taken which remains stiff and undigested in consequence. The patient breathes heavily owing to the accumulation of undigested (fecal) matter and tosses about in agony of pain, finding no relief in any posture whatever, whether sitting or lying. The disease is called Kukshi-Sula, and is due to indigestion incidental to the action of the deranged bodily Vayu. 63. Treatment of Kukshi-Sula :- Vomiting should be induced and fasting should be prescribed in the case according to the strength of the patient. Acid and appetising drugs should be employed for the alleviation of the Doshas (Vayu and Ama). A decoc- tion of Någara, Dipyaka, Chavya, Hingu, Sauvarchala, Vit, + and the seeds of Mátulunga, S'yáma, Uruvuka, Brihati and of Kantakári, should be taken for the relief of the pain (Sula). Vacha, Sauvarchala, Hingu, Kushtha Ativishá, Abhayá and Kutaja-seeds taken together would instantaneously relieve Sula. Purgatives should be administered, and Sneha-Vastis and Nirudha-Vastis should be applied for the amelioration of the deranged

• Vijapuraka-sára, according to Dallana, means the fruit of Vija- puraka. Vijaka-sara (the pith of Vijaka) is, however, a variant. + Uingu, Souvarchala and Vit-salt should be used as an after-throw.

Chap. XLII.] UTTARA-TANTRA. 263

Doshas according to their nature and intensity. Sneha- Sveda and poultices should be applied and Dhányámla (fermented paddy-boilings) should be employed as washes. 64-66. Symptoms and treatment of Hrich- chhula :- The deranged bodily Vayu aggravated by the vitiated Rasa (chyle) and incarcerated in the region of the hcart through the action of the deranged Pitta and Kapha, produces Sula (pain) in the heart and give; rise to difficulty of respiration. This disease which is called Hrich-chhula (cardiac colic) is ushered in through the action of the deranged Vayu and Rasa of the body. Remedial measures mentioned in connection with the trcatment of the diseases of the heart should be as well employed in the present malady. 67-68. Symptoms of Vasti-Sula and Mutra- Sula :- The local Váyu aggravated by the suppres- sion of stool and urine is incarcerated in the region of the Vasti (bladder) and gives risc to a pain in the bladder, in the groins and about the umbilicus causing a further suppression of the stool, urine and flatus. The diseasc is called Vasti-Sula (bladder colic) and is due to the action of the deranged bodily Vayu. A cutting pain cxperienced in the genital, the intestines and the loins as well as at the sides and in the inguinal regions and about the umbilicus and causing a complete suppression of urine, is called Mutra-Sula. The diseasc should be likewise attributed to the action of the deranged bodily Váyu 69-70. Symptoms of Vit-Sula :- Thc bodily Vayu deranged and aggravated by the usc of dry food, ctc., affects or impairs the digestive fire and obstructs the evacuation of feces accumulated in the bowels and gives rise to an excruciating pain in the locality by

264 TIIE SUSHRUTA SAMHITÁ. [Chap. XLII.

stuffing or choking the channels of the intestines. The pain is first experienced in the region of the right or left Kukshi (loin), but it soon extends over the whole abdomen with rumbling sounds therein. Thirst becomes unquenchable and vertigo and epileptic fits follow in its train, and the patient finds no relief even after the evacuation of the bladder and of the bowels. This disease is called Vit-Sula and is a very violent one. 71. Treatment :- An experienced physician should instantly employ (in such cases) the medicinal remedies which have the virtue of eliminating the deranged Doshas from the system. Fomentations, emetics as well as Sneha-Vastis and Nirudha-Vastis should be applied, and the bowel-cleansing compounds dealt with before should be administered. Medicinal measures mentioned in connection with the treatment of Udávarta should be likewise employed with advantage. 72. Symptoms of Annaja Sula :- A vora- cious eating in an impaired state of digestive fire, aggravate the local Vayu which makes the food taken remain stiffed in the Koshtha. The food thus undigested in the Koshtha causes an intolerable colic, which brings on a distension of the abdomen, epileptic fits, eructation, nausea and an attack of Vilambiká. The patient shivers, vomits, or passes stool, and even loses consciousness. Anti-colic (pain-killing) pills, powders and medicinal Ksháras are recommended in the casc. All the medical remedies applicable in cases of Gulma should likewise be applied in cases of Sula. 73-74.

Thus ends the forty-second chapter of the Uttara-Tantra in the Sus'ruta Sanhita which deals with the medical treatment of Gulma.

CHAPTER XLIII.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of the disease of the heart (Hridroga-Pratishe- dha). I. Etlology and Nomenclature :- The de- ranged Doshas of the body, aggravated by such causes as voluntary repression of any natural urging (of stool, urine, etc.), external blow or hurt, use of extremely dry (Ruksha) and heat-making articles of fare in inordinate quantities or of such articles as are indigestable or are incompatible in combination or are uncongenial to the system as well as taking food before digestion, con- taminate the bodily Rasa (lymph chyle) and find lodgement in the heart, producing the characteristic pain in the organ, which is known as Hridroga (the diseasc of the heart). The disease may be divided into five distinct types, of which four are Dosha-origined, (vis .- Vátaja, Pittaja, Kaphaja, Sánnipátika) and the fifth is due to the presence of worms (Krimi). The different symptoms should be first described and then the medical treatment thereof. 2-3. Specific symptoms :- In the Vataja type, a pain is felt in the region of the heart which seems as if being drawn and crushed, pierced and cracked, pricked and split. Thirst with a burning sensation, a gone-fecl- ing and a sucking pain in the heart, epileptic fit, pers- piration, fumy cructation and dryness of the mouth, are the symptoms which characterise the Pittaja type. A sense of heaviness in the chest, secretion of mucus (from the nose and the mouth), an aversion to food, feeling of numness (in the body), dulness of appetite and 34

266 THE SUSHRUTA SAMHITA. [Chap. XLIII.

a sweet taste in the mouth are the features which mark the Kaphaja type of the heart-disease. 4-6. Krimija Hridroga :- Nausea, salivation (spitting), piercing and cutting pain (in the heart), dark vision, an aversion to food, a dull yellow hue of the eyes, as well as emaciation of the body (D. R. swelling) are the indications which point to the presence of worms (Krimija Hridroga) as the exciting factor of the disease 7. Supervening symptoms :- Vertigo and a sense of exhaustion attended with a feeling of physical lassitude and emaciation of the body exhibit themselves as the distressing concomitants in all the cases, while the supervening symptoms of Kaphaja worms exhibit themselves in case of Krimija Hridroga also. 8. Medical treatment of the Vataja type :- In a case of the Vataja typc, the patient should be first treated with a Sneha and then made to vomit (out the contents of his stomach) with a draught of the decoction of Dasa-mula mixed with salt and a Sneha. After being purged he shouid be made to take a pulverised compound consisting of Pippali, Ela, Vachá, Hingu, Yava-kshára, Saindhava-salt, Sauvarchala, S'uthin and Ajamoda through the medium of the juice of (acid) fruits, fermented rice-boilings, decoction of Kulattha, curd, wine, Asava or with any kind of Sneha. The patient should be made to have his meal of matured S'ali rice, with the soup of any Jangala meat cooked with clarified butter. Oil duly cooked with the Váyu- subduing drugs should be applied as a Vasti in an adequate,quantity in the casc. 9. Treatment of Pittaja type :- In a case of Pittaja-Hridroga, vomiting should be induced with the

Chap. XLİII. 1 UTTARA-TANTRA. 267

decoction of S'ri-pari-fruit, Yashti-madhu and Utpala (D. R .- treacle) mixed with honey and sugar. Clarified butter duly cooked with the drugs of the Madhura group, as well as the decoction efficacious in Pittaja- fever, should be internally administered. The food of the patient should be prescribed with the soup of the flesh of the principal animals of the Jangala group cooked with clarified butter, and he should then be treated with a Vasti, charged with honey and oil duly cooked with Yashti-madhu. IO. Treatment of Kaphaja type :- In the Kaphaja type of the disease, vomiting should be induced with the decoction of Vachd or of Nimba and the pulverised medicinal compound prescribed for the Vátaja type, should be adminstered. The patient should also be advised to take clarified butter with his food. A decoction of Tri-phala or of the drugs of the Phaládi (Madana-phaládi-Sutra, Ch. XXXIX) or the Mustádi (Sutra, Ch. XXXVIII) group, should be pres- cribed for internal usc, or the patient should be purged with clarified butter mixed with powdered S'yámá (Vriddha-dáraka) and Trivrit. A physician skilled in the art of applying Vasti should prescribe a Vasti charged with Vala-oil under the circumstances. It. Treatment of Krimija type :- In the type (Krimija) characteriscd by the persence of worms, the patient should be first treated with a Sneha. A meat-diet with curd or (fried and) powdercd sesamun should then be given to the patient for three days in succession after which he should be purged with the compound of Ajáji and sugar mixed with the salt- predominating* purgative preparation (see-Sutra, * Some read "Su-pala-lair-jogaih" in place of 'Salava-nair-jogaih'. It would mean that the compound should be mixed with fried and powdered sesamum.

268 THE SUSHRUTA SAMHITA. [Chap. XLİIÍ.

XLIV.) and mixed with the scented drugs (mentioned in the Sutra-sthána, Ch. XLIV). . An adequate quantity of fermented-rice boilings (Dhányámla) with a profuse quantity of Vidanga should then be internally adminis- tered, whereby the worms would be dislodged from the hearts (and expelled through the lower orfices of the body). A diet consisting of cooked barley grains saturated with powdered Vidanga should then be given to-the patient. 12.

Thus ends the forty-third chapter of the Uttara Tantra in the Sus'ruta Samhita which treats of the (symptoms and) treatment of Hridroga.

CHAPTER XLIV.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Jaundice, ctc. (Pandu-roga Pratishedha). I. . Etiology and Nomenclature :- The deranged bodily Doshas of a person addicted to sexual cxcesses* or to eating clay or salts or articles of keen potency and of acid or saline taste or to strong liquors in excessive quantlties or to sleeping in the day, con- taminate the blood and produce a yellowish (Pándu) colour of the skin. This is known as Pándu-roga and is divided into four distinct types + according as they are severally originated through the action of the deranged Váta, Pitta, or Kapha, the fourth being the one incidental to their concerted action. The discase has got the name of Pandu-roga from the fact that a deep ycllow (Pándu) colour is imparted to the skin of the patient suffering therefrom. 2 Premonitory symptoms :- Cracking of the skin, salivation (spitting) a sense of lassitude in the limbs, (desire for) eating clay, swelling of the cyc- lids, yellow colour of stool and urinc, and indigestion arc the premonitory symptoms which usher in an attack of Pándu-roga. The discases known as Kámalá-Pálaki- Pándu (popularly called Kámalá), Kumbha-Kámalá,

• Mádhava in his Nidána reads "Vyáyáma" (physical exercise) in the place of "Vyavaya" "sexual enjoyment." Charaka, however, includes both "Vyaváyá" and Vyáyama" in the long list of the causes of Pándu-roga. + A variant reads that Pandu-roga is of eight kinds. In that case the four different varieties of Pándu, separately mentioned below should be added to the four kinds mentioned here. Charaka says that Pandu-roga is of five different tvpes :- by separating and adding the one duc to the eating of clay to the four kinds enumerated here.

270 THE SUSHRUTA SAMHITA. [Chap. XLİV.

Lágharaka and Alasa (otherwise known as Halimaka) are all included within Jaundice (Pámdu-roga), the characteristic symptoms of which are fully enumerated in succession below. 3-4. Specific Symptoms :- A black colour of the cyes and of the skin marked by the prominent appearance of black-coloured vein (on the surface), black colour of the stool and of the urine, blackness of the face and of the finger-nails as well as other symptoms characteristic of the deranged bodily Váyu are mani- fested in the Vataja type of Pandu. Yellowness of the eyes and of the skin marked by the appearance of veins (Sirá) of the same colour (on its surface), yellowness of the stool and of the urine, ycllowness of the face and finger- nails and other specific symptoms of the deranged Pitta, mark the Pittaja type of the disease. Whiteness of the eyes and of the skin, marked by the appearance of veins of the same colour (on its surface), whiteness of the stool and urine, whiteness of the face and of the finger-nails and other specific symptoms of the deranged Kapha mark a case of the Kaphaja type of the diseasc. All the preceding symptoms are exhibited in a casc of the Sannipata type. Now I shall describe the symptoms which mark the disease known as Kamala. 5 -8. The Pitta of a paticnt suffering from any disease not radically cured gets deranged by the use of any. acid, or unwholesome food or drink, and imparts a (deep) yellow tint to his complexion and produces physical weakness as well as all the specific symptoms (of Pándu-roga) described above. This disease is known as Kamala. When it is accompanied by a general swelling (edema) of the body and a crushing pain in the joints, is called Kumbha-Kamala, which, when it developes in its course such symptoms as fever,

Chap, XLIV.] UTTARA-TANTRA. 271

aching, pain in the limbs, vertigo, physical langour, drowsiness and emaciation comes to be known ąs Lagharaka. This, in its turn, when marked by an excessive preponderance of the deranged Váyu and Pitta is called Alasa, otherwise known as Halimaka, by those who are conversant with its nature. 9-12. Supervening Symptoms :- Aversion to food, thirst, vomiting, fever, hcadache, dulness of appetite, swelling about the neck, weakness, epileptic fits, exhaus- tion and a pain in the region of the heart are included their distressing concomitants. 13. General Treatment :-- Having ascertained the curable nature of an attack of Pandu-roga, the patient should be treated with clarificd butter *. He should then be purged and vomited with the compounds containing powdered Haritaki mixed with a copious quantity of honcy and clarified butter. Clarificd butter duly cooked with turmeric or the one known as Trai- phala-Ghriita + as well as the one known as Tailvaka- Ghrita + may also be used for the purpose. Drugs possessed of purgative propertics should also be taken in combination with clarified butter (or clarificd butter duly cooked with purgative drugs should be prescribed). Half a Pala (four Tolás) of Nikumbha duly cooked in an adequate quantity (eight Palas) of the urine of a she-buffalo should be daily used. Similarly half a Kudava measure of treacle mixed (D. R. duly cooked)

• Some say that the Sneha used should be the Kalyánaka-Ghrita (Ch. LXII.). Others says that simply matured clarified butter should be used. t Traiphala-Ghrita may mean either the Ghrita duly cooked with Tri-phala or the one known as Traiphala-Ghrita mentioned in. * $ Similarly Tailvaka-Ghrita may mean the Ghrita of that name men. tioned in Chap. V. Chikitsita-sthana or the one duly cooked with Tilvaka.

272 THE SUSHRUTA SAMHITA. [Chap. XLIV.

with pulverised Haritaki should be taken by the patient. A decoction of the drugs of the Áragvadhadi group, may be likewise prescribed for internal use. Powdered (dead) iron mixed with pulverised Vyosha and Vidanga, or powdered Haridrá* and Tri-phald should be licked up with honey and clarified butter.+ Any other medicinal compound mentioned anywhere as remedial to Gulma should also be administered. 14. The aggravated Doshas should be gradually elimi- nated from the system in as much as an quick and ex- cessive elimination of the Doshas under the circum- stances might produce swelling in the patient. Either the expresed juice of Dhátri or of sugar-cane, or a Mantha t should be taken with honey by a patient and he should take wholesome diet. 15-16. Clarified butter duly cooked with the Kalka and decoction of the two kinds of Vrihati, Rajani, S'ukákhyá (S'uka-s'imbi), Kákádani, Kákamáchi, Ádári-vimbi and Kadamba-pushpi (Bhumi-Kadamba) should be taken as a remedy for Pandu-roga. Pippali-powder dissolved in milk should also be taken according to the condition of the appetite. The use of a decoction of Yashti- madhu, or of powdered Yashti-madhu mixed with honey would likewise prove efficacious. Powdered * Here we have followed Dallana in the text. Some take Haridrá to mean Dáru-Haridrá. t According to Charaka's recipe, however, we find that the two compounds here have been combined into one and there we find the definite mention of Dárvi (Dáru-haridrá). In our practice also we follow Charaka in this case. # Mantha is prepared by mixing powdered grains of barley with clari- fied butter and a copious quantity of water. Some commentators, however, on the authority of other medical works, are of opinion that in cases of Pándu (jaundice) the word "Mantha" is technically used for the prepara- tion of the powdered grains of barley mixed with the expressed juice of A'malaki and of sugar-cane and with honey.

Chap. XLIV.1 UTTARA-TANTRA. 273

leaves of Tri-phald and powdered (dead) iron should be frequently taken as an electuary in combination with cow's urine. A compound composed of powdered coral, pearl, antimony and conch-shell, or powdered Giri- mrittik (ferrugnious earth) should be similarly used by the patient. 17-18. A compound consisting of half a scer of powdered goat's dung together with a Pala weight of each of the drugs known as Vit-salt, Haridra and Saindhava-salt, should be lickcd with honey by a patient living on wholesome diet. A compound of Mandure (iron-rust), Agni (Chitraka), Vidanga, Pathyá, Tri-katu all taken in equal parts with Tapya (Svarna-makshika) equal to their combincd weight should bc duly soaked in cow's urine and formed into a lambative with the addition of honey, the same being prescribed for an immediate cure of a serious type of Pándu-roga. 19-20. Vibhitaka, Mandura (iron-rust), Nagara and Tila should be pounded together and made into a paste with the addition of a profuse quantity of treacle. Pills prepaicd from this compound should be administered through the medium of Takra whereby a violent attack of jaundice would be defcated. Pills of the Kaláya weight of each of Sauvarchala, Hingu and Kiráta-tikta pasted together, should bc taken wlth tepid water. As an alternative, a lambative compound of Murvá, IIaridrá and Amalaka pounded together and alternately dried and soaked in cow's urine for a week, should be given to be licked by the patient. 21 -. 22. A patient suffering from Pandu-roga should observe a proper regimen of diet and take two-Tolá-weight of the compound of the powders of Vald and Chitraka (with cow's urine or tepid water). The compound of Saindhava salt and powdered S'igru-seeds taken in equal 35

274 THE SUSHRUTA SAMIIITA. [Chap. XLIV.

parts should be taken with tepid water, followed by a meal of cooked rice with milk. The decoction of the drugs of the Nyagrodhadi group should be taken, when cold, with honey and sugar followed by a proper regimen of diet. Powders of the drugs included within the S'ála- sárádi group or of Amalaka should be formed into a lambative with the addition of honey and given to be licked by the patient. 23-26. The pulverised compound of Vidanga, Musta, Tri- phalá, Ajamodá, Parushaka, Vyosha and Chitraka as well as clarified butter, honcy, sugar and treacle should be dtly cooked in the decoction of the drugs of the S'ála-sárádi group till reduced to the consistency of a lambative. It should then be taken down and preserved inside a covered vessel prepared of Mokshaka (Mush- kaka). This lambative proves curative in cases of Pándu attendcd lwith a general edema as well as in cases of the violent types of Kamala. 27. Treatment of Kamala, etc :- Tribhandi (Trivrit) taken with sugar as well as Gavákshi or S'unthi taken with treacle, is beneficial to a patient suffering from an attack of Kámalá. Clarified butter duly cooked with Káleya-wood and mixcd with turmeric as an after-throw is also efficacious. In the alternative the patient should take Srotanjana and S'ilajatu with cow's urine in a case of Kumbha-Kamala. Mandura (rust of iron) kept immerged in cow's urine should be likewise taken with Saindhava-salt continually for a month. Mandura should be burnt in the fire of Vibhitaka- wood and cooled with cow's urine. The process should be repeated eight times in succession. The iron-rust thus tempered should be subsequently reduced to powders. Licked with honey it would act as a speedy cure in cases of Kumbha-Kámalá. 28-30.

Chap. XLIV.] UTTARA-TANTRA. 275

Saindhava-salt once made red-hot by heating (in the fire of Vibhitaka-wood) should be cooled in cow's urine. Iron-rust (Mandura) should be successively heated in fire and cooled with cow's urine as directed above, the process being repeated many times. The two substances (Saindhava and iron-rust) thus prepared, (taken in equal parts) and made into a paste with (five times of) cow's urine, should be cooked on an oven, care being taken to guard against their ignition. When dried, the com- pound should be reduced to powder and taken with Udas'vit (a kind of Takra) The medicine acts as a good appetiser and proves curative in cases of Pándu. The patient using it should take his diet with Takra after the assimilation of the medicine. Clarified butter duly cooked with the expressed juice of Drákshá, Guduchi and Amalaki proves curative in cases of Lagharaka. 31. Articles of Diet :- Arishtas and Asavas prepared with treacle or with honey or with sugar or with cow's urine or with Kshara (alkali) as well as the essence of meat of any Jangala animal saturated with clarified butter and mixed with the expressed juice of Ámalaka or of Kola should be prescribed and meals of cooked barley grains or of S'ali rice and the prepara- tions prescribed in cases of swelling (Sopha) should bc daily taken by a patient suffering from an attack of Pándu-roga. 32. Treatment of supervening Symp- toms :- The supervening symptoms such as difficulty of breathing, diarrhœa, aversion to food, cough, epileptic fits, thirst, vomiting, colic pain, fever, swelling (Sopha), burning sensation in the body, indigestion, hoarseness, lassitude, etc. should be remedied on the principles laid down in the Sastras with due regard to the nature and

276 TIIE SUSHRUTA SAMHITA. [Chap. XLIV.

intensity of the deranged bodily Doshas, severally lying at their roots. 33. Prognosis :- If a patient afflicted with Pandu have an cdematious swelling of the extremities with an emaciation of the abdominal region and vice versa or if he have a swelling of the scrotum or of the genitals or about the anus or if he be suffering from fever or diarrhæa or be lying in a sub-comatose state, he should be given up and should not be attended by a physician caring anything for his fame. 34.

Thus ends the forty-fourth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) medical treatment of Pándu-roga. .

CHAPTER XLV.

Now we shall discourse on the Chapter which deals with the symptoms and) medical treatment of Hemorrh- age (Rakta-Pitta-Pratishedha). I. Cause and Pathology :- Excessive indul- gence in grief, fright or anger, excessive physical labour, exposure to the sun and fire, constant use of pungent, acid, saline and alkaline food, or, of articles of fare which are keen or heat-making in pctency, or incompatible in their combination, or are followed by deficient gastric or intestinal digestion arc the factors which tend to aggravate the Rasa (chyle), which, in its turn, aggravates the l'itta. The aggravated Pitta thus imperfectly assimi- lated affects or invades in virtue of its own cssence the blood (lit. leads to its imperfect digestion) which finds an outlet through the upper or the lower channels of the body or through the both. The deranged blood accumu. lated in the Amasaya (stomach) finds out an upward outlet, while it flows out through the lower orifices in the event of its continuing in a similar state in the Pakvásaya (intestines). and it escapes through both the upward and downward orifices in the event of its being deranged and accumulated in both the Amasaya and the Pakvásaya. According to several authorities, the ejected blood in the diseasc comes from the spleen and the liver. 2. Prognosis : - A case of Rakta-pitta in which the blood finds outlet through an upward channel of the body is amenable, while palliation is all that is possible in a case in which it flowes out through a downward orifice of the body. A case marked by the emission of

THE SUSHRUTA SAMHITA. [Chap. XLV.

blood through both these outlets, upward and downward, should be regarded as incurable. 3. Premonitory Symptoms :- A sense of lassitude in the limbs, desire for cooling things, a sense as if fumes are rising in the throat, vomiting and fetor of blood in the breath are the symtoms which usher in an attack of Rakta-pitta. The number of the cases of Rakta-pitta as well as the aggravation of the different Doshas involved in each case should be ascertained from the colour and nature of the cjected blood (as described before in Chap. XIV-Sutra-sthána). 4-5. Supervening Symptoms :- Weakness, laboured breathing, cough, fever, vomiting, mental aberration (lit : a state like intoxication), yellowness of complexion, burning sersation in the body, cpileptic fits, acidity of the stomach,restlessness, extreme pain in the region of the heart, thirst, loss of voice (D. R. loose stool), hcat in the head, fetid expectoration, aver- sion to food, indigestion and absence of sexual desire (D. R. bending of the body after sexual act) are the usual complications in a case of Rakta-pitta. 6. Symptoms of Incurable Types :- In a casc of Rakta-pitta the emitted matter resembling the washings of meat or drug-decoction, or turbid water or fat or pus, or being liver-coloured or dark-black or blood-red in colour or looking like a ripe Jambu-fruit or blackish blue or variously coloured like a rain-bow or having a very fetid smell as well as the presence of the above mentioned supervening symptoms-these are the indications which show that the case should be given up as incurable. 7. General Principles of Treatment :- It is improper to arrest the emission of blood imme- diately at the outset of the disease if the patient be a

Chap. XLV.] UTTARA-TANTRA. 279

sufficiently strong man, in as much as such a procedure may bring on an attack of * Pándu-roga, Grahani, Kushtha (cutaneous diseases), Gulma, or fever or enlarge- ment of the spleen. An attack in which the blood makes a downward course should be arrested with emetic medicines, while purgatives should be exhibited in a case in which the blood finds an upward course. But weak patient, under the circumstances, should be treated in both cases with soothing remedies. Fasting should be first enjoined in the case of an excessive emis- sion + of blood in respect of a strong patient with an unimpaired digestion and an unemaciated frame. A Peyá prepared with a small quantity of rice should be given to the patient after fasting t. Tarpana measures, decoctions of digestive drugs, as well as a varicty of medicinal lambatives and Ghritas should be the proper applications in the disease under discussion. Purgation should be induced with the compound of Dráksha, Yashti-madhu, Kás'marya and sugar, while vomiting should be induced with an emetic compound consisting of Yashti-madhu mixed with honey. 8-II. Articles of Fare :- The use of milk, the drugs of cold-producing potency (e g. the drugs of the Utpaládi group), essence of the meat of an animal of the Jangala group, soup of Satina (cerials), S'ali-rice, Shash- tika-grains, leaves of Patola, S'elu, Sunishanna, Yuthika

• Both Chakrapani and Vrinda read "urw etc." i.e., they say that it may bring on an attack of heart-disease also. * + Both Chakrapani!and Vrinda read " na" i.e. in cases of upward emission. There is also another variant "or wureg" i.e. in cases of excessive upward emission or in cases where a good deal of the vitiated Doshas takes an upward course. $ Additional Text :- Meat-essence (Rasa) and soup (Yusha) seasoned with clarified butter prepared from cow's milk.

280 THE SUSHRUTA SAMHITA. [Chap, XLV.

and Sindhuvara (Nirgundi) as well as the tender sprouts of Vata and Atimuktá (Tinduka) as pot-herbs and cooked with clarified butter are recommended as diets. Soup of the meat of pigeons, S'amkha (conch) and tortoise as well as the gruels mentioned before mixed with the expressed juice of Dhátri and pomegranate and with a profuse quantity of clarified butter should be given to the patient as diet. Milk should be duly cooked in combination with the drugs of the Utpaladi group, and the cream therefrom should be likewise prescribed with a copious quantity of honey and sugar. Cold Pradehas, honey, sugar, and clarified butter are said to be beneficial in cases of Rakta-pitta. 12-13. An experienced physician should prescribe any onc of the four lambatives composed of the powders of the flowers of Madhuka, S'obhánjana, Kovidára or of Priyangu, mixed with honey to be licked up by a patient suffering from Rakta-pitta. Similarly lambatives of Durba, or the tender leaves of Vata, or of white Karnika pasted together with the honcy should be given to be licked up by the patient *. Dates and other friuts of the same therapeutic virtuc, taken with honey, would prove efficacious in the disease. 14-15. Medicinal compounds mentioned in connection with the treatment of Raktátisára (blood-dysentery) may be as well employed with advantage in the present instance. A picce of sugar-cane devoid of its skin and crushed should be kept immersed in cold water contained in a new earthen pitcher. The picther with its lid off should be kept in an open place for a night. Its contents duly strained in the morning should be given with pow- dered Utpala and honcy to a patient suffering from

• Dallana takes only Durbá and Vata under one recipe. Some com- mentators would prescribe all these together under one recipe.

Chap. XLV.] UTTARA-TANTRA. 281

Rakta-pitta. A cold infusion of Jambu, Amra and Arjuna should be taken with honey. As an alterna- tive, the expressed juice of Udumbara fruit should be taken (with honey). 16-A. The best six Yogas :- A paste (Kalka) of Trapusi-roots in combination with honey and washings of rice or two Tolas of the pasted Vashti-madhu should be taken (with the samc vehicles). A compound con- sisting of Chandana, Yashti-madhu, and Rodhra taken in equal parts or Karanja-seeds made into a paste with sugar and honey should be similarly used In a similar way, the pith of Ingudi together with Yashti-madhu should be taken. As an alternative, salt (Saindhava) and Karanja-seeds turned into a paste with curd-cream should be taken lukeworm for threc days in succession by a person suffering from an attack of Rakta-pitta. The six preceding medicinal compounds act as excellent cures for the disease under discussicn. 16. Pathyd should be employed as an errhine after the manner of Avapida-Nasya in the event of the blood passing through the nostrils. In case of excessive hæmorrhage (in the disease) the patient should drink blood in combination with honey, or eat a goat's raw liver with the bile. 17. Clarified butter duly cooked with the admixture of an adequate quantity of the expressed juice of (the bark of) Palás'a trees should be taken, when cool, in combination with honcy, or clarified butter prepared by churning the milk duly cooked with the expressed juice of (the bark of) the Vanaspati-trees (Vata, ctc.) should be used with sugar. A Pala weight of each of Dråkshå, Us'ira, Padmaka and sugar should be kept immersed in cold water during the (whole) night. This cold infusion would cure a case of Rakta-pitta. A 36

282 THE SUSHRUTA SAMHITA. [Chap. XLV.

draught of milk with an equal quantity of water is also recommended for a patient comforming to a proper regimen of diet and conduct. 18. The watery secretion of the dung of a horse or a bull should be taken with honey and sugar. In the alter- native, powders of the seeds of Vástuka or (of the roots, of Tanduliyaka-plants should be licked with honey. A lambative formed of Lája (parched paddy) and Anjana * mixed with honey, or powdered Tuga-kshiri mixed with honey and sugar should be licked. A patient suffering from an attack of Rakta-pitta should take a compound of Drákshá, Tikta-rohini, Yashti-madhu and sugar with cold water, or lick a compound of pulverised Pathya, Ahinsra and Rajani with clarificd butter. I9. The compound of (bluc), Utpala Souráshtra mrithika (red earth), Priyangu, Lodhara, polens of lotus and sugar mixed together and taken with honcy and a decoction of Vásaka would speedily stop the emission in a virulant type of Rakta-pitta. Similarly a compound consisting of flowers of Khadira, Jambu, Arjuna, (red) Kovidára, S'irisha, Lodhra, Asana, S'álmali and S'igru, pounded togcther and mixed with honey should be licked by the patient in a case of Rakta-pitta. 20-21. The alkaline water prepared with the ashes of Indivara and taken with honcy, powdered Karanja-seeds taken with honey and clarified butter and the decoction of Jambu, Arjuna and Amra-these three compounds prove curative in cases of Rakta-pitta. A paste made of the roots and flowers of Matulunga should also be taken with the washings of rice. 22-23.

• Kálánjana is a variant, in place of Lája and Anjana. For Kálánjana Dallana reads Souviranjana. This should be the proper reading because there is a word in the receipe which shows that there will be only one thing and not two.

Chap, XLV.] UTTARA-TANTRA. 283

A solution of milk or water saturated with sugar should be applied into the nostrils in the event of bleeding from the nose. The expressed juice of grapes, clarified butter prepared by churning milk or the express- ed juice of sugar-cane should be taken cold (through the nostrils) in combination with sugar *. All cooling measures and sweet-drugs should be employed in the present disease 24-25. Ásthapana and Anuvasna :- The ap- plication of an Asthapana-Vasti charged with milk duly cooked with the drugs of the Vidári-gandhádi group and mixed with honey, clarified butter, sugar and Drákshá, proves extremely efficacious in the disease under discussion. The application of an Anuvásna- Vasti charged with clarified butter * would be attend- ded with equal benefit. The drugs known as Pri- yangu, Lodhra, Souviránjana, Gairika, Utpala, Suvarna- gairika, Káliyaka, conch-shell, Chandana, sugar, As'va- gandhá, Ambuda, Yashti-madhu, Mrinála and Sougan- dhika, taken in equal parts, should be pounded together and mixed with copious quantities of milk, honey and clarified butter. This solution should be injected into the rectum after the manner of Nirudha-Vasti. The patient should be sprinkled with cold water and given his diet with milk after which clarified butter duly cooked with Yashti-madhu should be injected into the rectum of the patient after the manner of Anuvasana-Vasti. This measure proves extremely beneficial in cases of down-coursing Rakta-pitta and violent types of blood- dysentery. In the case of an excessive discharge of

• S'rikantha Datta, the commentator of Vrinda, would mix sugar with the juice of sugar-cane only and not with the other two. All these should be applied into the nostrils.

284 THE SUSHRUTA SAMHITA [Chap, XLV.

blood, if the patient be strong enough, vomiting should be induced after the cessation of the blood-discharge. 26-27. Urethral-injections composed of the aforesaid drugs should be applied (after the manner of Uttara-vasti) in the event of bleeding from the bladder. Measures laid down in connection with the treatment of Rakta-pitta should be resorted to in cases of bleeding-piles. In cases of menorrhagia as well as in cases of excessive bleeding incidental to any surgical operation, the above measures (of the medical treatment) should be adopted by an ex- perienced physician. The subsequent treatment of the cases should be determined by the nature and intensity of the deranged bodily Doshas as well as of the blood involved therein. 28- 29.

Thus ends the forty-fifth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with (the symptoms and) the medical treatment of Rakta-pitta.

CHAPTER XLVI.

Now we shall discourse on the chapter which deals with (the symptoms and) the medical treatment of faint- ing fits (Murchchha-Pratishedha). I. Defination :- The deranged and aggravated Doshas of the body of a person who is emaciated or accustomed to the use of incompatible articles of food or who has become very weak on account of a sudden suppression of his natural urgings or of any external blows or injury give rise to fainting fits. The deranged bodily Váyu. etc. choking up the sense-carrying nerves of the body, produces that giddy state in a patient in which the world seems to vanish from the eyes of the afflicted person and the perception of the pleasure or pain is suspended for the time being. The patient, in consequence of this suspension of the sense-perception drops down insensible as a log of wood and this disease is called Murchchha or Moha (fainting). It admits of being divided into six kinds or types according as an attack is duc to the action of the deranged Doshas scparately or to that of blood, wine or poison, but a predominance of the deranged Pitta may be detected in all form's of the discases due to any cause whatever. 2. Premonitory Symptoms :- Pain or op- pression of the heart, yawning, lassitude, loss of cons- ciousness and of strength arc the symptoms which usher in an attack of the disease (Murchchha) according to the nature of the deranged bodily Dosha lying at its root. 3. The natural elements, water (Ap) and earth (Kshiti) abound with the attribute of Tamas (insensibility). A smell of blood also contains the same attribute, Tamas.

286 THE SUSHRUTA SAMHITA. [Chap. XLVI.

It is therefore that persons generally lose their conscious- ness at the smell of blood. Several authorities hold that the loss of consciousness in these instances happens in virtue of the natural properties of the thing itself, viz., blood, wine and poison which also possess these pro- perties in a greater degree and it is therefore that an use of cither of these substances suspends animation and produces Moha (fainting). 4-5 Symptoms :- A case of Murchchhá (fit of uncon- sciousness) due to the effects of (deranged) blood is charac- terised by stiffened condition of the limbs and by the fixedness of the cyes (Drishti) and by deep breathing. Delirious talks, mental aberration and the state of the patient convulsively lying flat on the carth until the wine is perfectly assimilated into the system are the symptoms of a case of Murchchha duc to the effects of wine ; while shivering, drowsiness, thirst and numbness of the body) attended with the specific symptoms of poisoning form the general characterstics of the type due to the effect of poison. 6. General Treatment :- Constant sprinkling of water over the body (water-spray) plunge-bath in cold water, contact of cold gems and garlands of flowers, cold plasters and compresses, (cold) brecże and fanning, cold and perfumed drinks and cooling measures in general are efficacious in all cases of the desease under discussion. Cordials prepared with the expressed juice of Ikshu, Piyala and Drákshá and with sugar or with the expressed juice of Drákshá and Madhuka ( Maula ) or those prepared by boiling Kás'marya and Kharjura or clarified butter duly cooked with the drugs of the Jivaniya group with the d"ugs of the Madhura group, or the essence of Jangala meat in combination with the expressed juice of pomegranate should be taken in a

Chap. XLVI ] UTTARA-TANTRA. 287

casc of Murchchha. The diet should consist of cooked red S'ali-rice or barley grains or Satiua-pulsc .* 7-8. Specific Treatment :- A compound con- sisting of Nágu-kes'ara, Maricha, Us'ira, the kernal of Kola as well as Visa (lotus stock) and Mrinala (lotus- stem) taken in cqual parts should be taken with the decoction of Satina (D. R .- with cold water). Pippali with honcy or Pathya with sugar should also be taken. The mouth and the nostrils should be pressed close during a fit and the breast-milk should be given to the patient to bc drunk. 9. Strong medicinal errhine should be administered and strong emetics should be as well employed in cases of repcated attacks of the fit. Clarified butter duly cooked and prepared with the decoction of Haritaki or with expressed juice of Amalaki should be prescribed. The decoction remedial to Pittaja-fever should be given in a cold state, mixed with Dråkshá, sugar, parched paddy, Nilotpala and Padma and well perfumcd with any good-smelling scent. I0. Sannyasa :- The case of a patient lying in a comatous state and incapable of being roused up or brought to under the circumstances owing to the aggrava- ted nature of the delusion (unconsciousness) due to an extensive preponderance of the deranged bodily Dosha (involved therein) should be looked upon by an intelli- gent physicion as extremely hard to cure. This is said to be a case of Sannyasa (Epilepsy ?). Just as a lump of clay, when thrown into water, should be instantaneously taken up before it is being finally desolved thercin, so a patient lying unconscious under an attack of suspended

• Chakrapáni and Vrinda both-read Mudga also in the list of the diet.

288 THE SUSHRUTA SAMHITA. [Chap, XLVI.

animation ( Sannyása ) should be speedily restored to consciousness with the help of medecinal remedies before the process of final dissolution ( lit .- death ) sets in his body. 1I-12. Treatment :- The patient should be tried to be roused up with the applic-tion of strong eye-salves (Anjana), unguents and inhalation of smoke (Dhuma) or by pricking needles into his finger-nails or by discoursing sweet words and music in his hearing or by shaking his limbs roughly or by rubbing his skin with the fruits of Atma-gupta crcepers. An attack of the present disease not amenable to the above remedies but attended with, salivation, laboured breathing, retention of stool and urine and distension of the abdomen should be given up as irremadiable. Strong emetics and purgatives should be exhibited after the return of consciousness and diet should consist of light articles of fare. S'ilajatu* mixed with Tri-phala, Chitraka, S'unthi, etc. should be employed in combination with sugar and continued for a month. Matured clarified butter should be used in particular. Medicinal compounds remedial to any case of fever originated by the Dosha in the case may be as well prescribed in any case of Murchchhá ; and a case dùe to the action of poisom should be remedied with the antitoxine remedies (mentioned in the Kalpa Sthána). 13-14.

Thus ends the forty-sixth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) treatment of Murchchhá.

• According to Dallana S'ilájatu should be prepared with the said drugs after the manner of Bhávana saturation and then be applied with sugar.

CHAPTER XLVII.

Now shall discourse on the (symptoms and) medical treatment of alcoholism and its kindred maladies (Panatyaya-Pratishedha). I. Properties and actions of Wine :- Wine is heat-making in its potency, keen or sharp in its properties, subtile in its essence, acts as a soaker or cleanser of moisture and albuminous matter (Visada), is dry, and instantaneous in its action (Asukara), stimula- ting or exhilarating in its effect (Vyaváyi) and is diffu- sive (Vikási). It destroy cold and shivering by virtue of its heat-making potency. It suspends all cognitive process (lit .- intellectual motions) on account of its keen- ness or sharpness, enters into every limb and member of the body by reason of its subtlety ( Sukshmatva ), destroys Kapha ( phlegm ) and semen in virtuc of its Vaisadya, enrages or aggravates the bodily Váyu on account of its dryncss ( Rukshmtva ), and is instantaneous in its action by reason of its As'ukáritva. It is exhila- rating on account of its Vyaváyitva and diffusive (coursing swiftly all through the body) for its Vikásitva. Wine is acid in its taste, is light and appetising, and produces fresh relish for food. Others assume the pre- sence of all the tastes except the saline one in it. 3-4. Wine taken in combination with cooked meat and boiled rice, or any other articles of food profusely saturated with a Sneha (clarified butter, etc.) adds to the longevity, muscular strength and corpulency of a person (using it in moderate quantities) and to the exhi- larated state of mind accompanied with beauty, fortitude, vigour and valour and these benefits one may derive from the proper use of winc. This fiery liquid in com- 37

290 THE SUSHRUTA SAMHITA. [Chap. XLVII.

bination with the aggravated bodily fire ( Káya-Agni ) produces the symptoms of intoxication and unconcious- ness, etc. ( Mada ) in a foolish person taking it without food or in an empty stomach and in an inordinate quantity. 5. Evil effects of Drinking :- Excessive drinking produces incidental nescience which gradually creeps into and clouds the sense-perceptions, destroying all power of self control (control over the sense-organs) and giving publicity to the innermost thoughts (in the mind) of the intoxicated person. 6. Three stages of Alcoholic Intoxica- tion :- There are thrce stages of intoxication-vis., the first, the second or intermidate and the third or last. The first or preliminary stage ( of intoxication ) is marked by an exhilarated state of mind with increased valour, and conviviality as well as satisfaction and talkativeness, ctc. The second or intermediate stage is indicated by incoherent speech, exhilaration and the performance of proper and improper acts. In the third or last stage the man lics down unconscious, bereft of all powers of action, of memory and of judging the ethic effects of his acts. 7. A man who is in the habit of taking fatty food or in whom Sleshmá predominates, or in whosc constitution, therc is only a little of Pitta, is not so easily affected by the action of wine, which, however, proves distressing in a person of contrary nature. Wine, if taken daily without food by a man in an empty stomach, gives rise to many distressing and dangerous diseases in his organism and leads to the ultimate dissolution of his body. 8-9. Cases where wine is prohiblted :- Wine should not be taken by a person under the in- fluence of anger, grief, fright, thirst or hunger. The use

Chap. XLVII.] UTTARA-TANTRA. 291

of wine is prohibited immediately after -a fatiguing journey, physical exercise or an act of load-carrying, or after the repressing of any physical urging, or after the use of excessively acid food, (D. R. excessive water and food) to the full, or before the proper digestion of food or by a weak person, or by one suffering from the effects of heat. In the above cases, wine undoubtedly proves a source of a host of bodily derangements such as Pánátyaya, Paramada, Pánájirna and the violent Pána- vibhrama the characterstic symptoms of which I shall presently describe. I0. Specific symptoms of Panatyaya :- The Vataja type of Panatyaya is marked by such symptoms as numbness and aching pain in the limbs, palpitation, a catching and pricking pain in the region of the heart and headache. Perspiration, delirium, dryness of the mouth, burning sensation and fainting fits (loss of consciousness) and yellowness of the face and eyes are the features which distinguish the Pittaja type (of Pánátyaya). Vomiting, shivering and water- brash are the indications which mark the Kaphaja type. The symptoms of all the threc preceeding types being exhibited in the one duc to the concerted action of the threc deranged bodily Doshas-Tri-Doshaja type of Pánátyaya. 11. Symptoms of Para-mada :- Heat and a s:nse of heaviness in the body, bad taste in the mouth, excessive accumulation of Sleshmá in the body, an aversion to food, supression of stool and urine, thirst, headache and a crushing pain in the joints are the symptoms which the learned physicion sets down to Para-mada (reactionary effects of the abuse of wine). 12. Panajirna and Pana-Vibhrama :- Distension of the abdomen (tympanites), acid or sour

292 THE SUSHRUTA SAMHITA. [Chap, XLVII.

taste (in the mouth), vomiting, deficient gastric diges- tion are the symptoms which are exhibited in a Pana- jirna type (alcoholic indigestion). Aggravation of the deranged Pitta should be regarded by a physicion as the exciting factor of the disease. The malady which exhibits such symptoms as piercing pain in the heart and limbs, vomiting, fever, a sensation of the rising of fumes into the throat, salivation, epileptic fits, headache, a burning sensation in the throat and an aversion to all sorts of food and wine (in connection with an abusc of wine) is called Pana-Vibhrama. 13-14. Prognosis :- A patient suffering from the effects of excessive drinking and exhibiting such symptoms as protuded upper lip, excessive shivering or burning sensation and clamminess of the face, black or blue colour of the tongue, lips or teeth and yellowness or blood-colour of the eyes should be givin up as incurable. Hiccough, fever, vomiting, shivering, tremor, cramp of the sides, cough and vertigo are the supervening symp- toms ( Upadrava ) which are found in all forms of Pánátyaya (alcoholism). 15. Treatment of Vataja type :- Now hear me describe the medicinal remedies, for all the above said maladies. Wine saturated with the mixture of pulverised Chukra, Maricha, Adraka, Dipya (Yamáni), Kushtha and Souvarchala should be given for the relief of the Vataja type of Pánátyaya, or one mixed with Prithviká, Dipyaka, Mahoushadhi and Hingu, or with Souvarchala should be taken for comfort. Shádavas or cordials made of Amrataka, Amra-fruits; Dádima and Matulunga should be given for relief. In the alternative, the cooked flesh of an animal of Anupa group ii. tor- toise, etc. should be seasoned with the expressed juice of above fruits and be taken. 16.

Chap. XLVII.] UTTARA-TANTRA. 293

Treatment of Pittaja type :- In the Pittaja-type of Pánátyaya, wine mixed with the decoc- tion of the drugs of the Madhura group and saturated and flavoured with the admixture of sugar and scented drugs should be taken, or wine profusely mixed with the expressed juice of sugar-cane should be taken and fully vomited out, a short while thereafter. Meat-juice (Rasa) of Láva, Ena and Tittira unmixed with any acid, or Mudga soup should be taken with sugar and clarificd butter. 17. Treatment of Kaphaja and Tri- Doshaja type, etc. :- In the Kaphaja type of Pánátyaya, the mucus should be climinated by taking a potion of wine mixed with the expressed juice or decoction of Vimibi and Vidula (Vetasa). Meat-juice of any fatty Jángala animal mixed with bitter and and pungent articles as also the Mudga-soup made bitter and pungent should be taken as bencficial to the patient. The diet should consist of preparations of barley, flesh of Jángala animals and also the Kapha-subduing articles, as well as those calculated as remedial to the present type of Pánátyaya. The above kinds of medicines and diet should be combinedly applied in the one due to the concerted action of the three Doshas of the body (Tri-Doshaja type), while in the Dvi-Doshaja types, the treatment should be according to the nature of the predominant Doshas. 18-19. Now I shall describe the medicinal compounds which tend to relieve the delirious state of mind and may be employed for the relief of all forms of Pánátyaya in general. The fine powder of Nága-pushpa, Magadhika, Ela, Madhuka, Dhanya, Ajaji and Maricha taken in equal parts mixed copiously with the expressed juice of Kapittha, water and Rarushaka should be duly taken

294 THE SUSHRUTA SAMHITÁ. [Chap. XLVIÌ.

in all forms of Pánátyaya after the mixture is strain- ed through a piece of cloth. The body of the patient should be anointed with a paste of Haridra, Padma, Paripelava, Karavira, Padmaka, drugs of the Sárivádi group and acquatic flower pasted togather, and clear and cold water should be sprinkled over the body of the patient in a case of Madátyaya. 20-21. Panaks :- A Panak prepared with Tvak, Patra, Chocha, Maricha, Elá, Nága-pushpa and flowers of S'leshmátaka ground together into a paste and mixed with treacle and Drákshá, should be filtered and per- fumed and given to a person suffering from an attack of Pánátyaya. The patient would find relief by the frequent use of a Panaka (draughts) composed of Yashti-madhu, Katurohini, Drákshá and Trapusha-roots, or of Kárpása- roots, Nága-valá and Suvarchalá (Surjávarta) all taken in equal parts. 22-23. Treatment of Para-mada :- A Panaka ( cordial ) made of the fruits of Káshmarya, Dáru, Dádima, Vit, Pippali, Drákshå pasted together and disolved in water and takcn in combination with the expressed juice of Vijapuraka, instantly gives relief in discomforts due to an abuse of wine (Para-mada). Pánakas made of sugar, Drákshá, Madhuka, Jiraka, Dhánya, Krishna (Pippali) and Trivrit, or of Souvarchala, the meat-soup (Rasa) of any fatty Jaugala animal and Phaldmla should be taken. Cold infusion of Bhargi would be found beneficial in sprinkling. :4-25. Treatment of Panajirna :- Vomiting should be induced with an Anjali measure of milk duly cooked with the admixture of Ikshváku, Dhámá- rgava, Brikshaka and two kinds of Udumvarikd after: which the patient should be advised to take wine in the evening in a case of indigestion due to an abuse

Chap. XLVII.] UTTARA-TANTRA. 295

of wine (Panajirna). Phalámla in combination with Tvak, Pippali, Naga-pushpa, Vid, Hingu, Maricha and Elá, or a compouud consisting of Saindhava, vid, Tvak, Chabya, Elá, Hingu, Pippali, Pippali-roots and S'unthi pounded and desolved in warm water should be taken. The food of the patient should be made palatable with the admixture of Khada-jusha * in the present ins- tance. 27. Treatment of Pana-vibhrama :- A Pánaka composed of Drakshá, Kapittha, Phala ( Mátu- lunga, etc.) and Dádima sweetened with profuse quantity of sugar and honey, as well as the one made with the expressed juice of Kola and Amrataka swectened in the same manner would prove curative in a case of Pana- vibhrama. A compound consisting of Kharjura, Vetra, Karira, Parushaka, Drákshá and Trivrit pounded together and disolved in cold water should be taken, swectened with sugar, or the same should be taken in combination with S'ri-parni. In the alternative, the tender sprouts of Kshiri-trees, Visa (Mrinála), Jiraka, Nágapushpa, Patra, Elaválu, Sita-sárivá, Padmaka, Ám- rátaka, Bhavya, Karamarda, Kapittha, Kola, Vrikshámla, Vetra-fruits, Jiraka, Dádima, Yashti-madhu and Utpala, all pounded together and mixed with the cold infusion of such drugs as Maricha, Jiraka, Naga-pushpa, Tvak, Patra, Vis'va, Chaviká and Elá filtered through a piece of thin linen duly perfumed with the addition of scented drugs would be found curative in the seven types of dis- tempers which have their origin in drinking excesses. 28. Objects which are pleasing to the five sense-organs of man and gratifying to the mind and heart, as well as

• Dallana in his commentatory says that some read "a;" in place of "a;" and others read "e:" in place of "m:".

296 THE SUSHRUTA SAMIIITÁ. [Chap. XLVII.

light wine should be always prescribed in a case of Panatayaya and the patient should be enlivened with the embrace of handsome and youthful damsels exceedingly attached to the gratification of the senses with splendid hips and thighs with their slender waists drooping under the weight of the exuberance of their breasts. 29. Potions prepared with powders of Nága-pushpa, Ajaji, Krishna and Maricha taken in equal parts mixed with sugar, Madhuka and Tri-sugandhi and then disolved in the expressed juice of Kushmánda fruits, should be taken. The drugs known as Varshábhu, Yashtyáhva, Madhuka, Lákshá, Tvak, tender sprouts of Karvudara, Jiraka, Drákshá, Krishná and Kes'ara should be given mixed with tepid milk. 30-31. A person afflicted with diseases duc to the excess of Surá, Asava, etc. should be treated with the same wines (Surá, Ásava, etc.) duly administered otherwise he will be ruined, in the same manner as a person who has incurred the king's displeasurc, should be saved by courting the royal favour. An inveterate drunkard giving up his habit of drinking is afflicted with the symptoms of Pánátyaya if he suddenly revert to his former pernicious habit. 32-33. The Agneya and Váyaviya virtues of wine tend to produce a dryness in the water carrying channels of the body, hence thirst is experienced by a drunkard person. A cold infusion of Patola, flowers and bulbs of Utpala, and Mudga-parni mixed with Magadhika' should be taken under the circumstances (reactionary thirst), or oil, clarifiied butter, Vasá (lard) and marrow (D. R .- milk) should be duly cooked with curd (four times), ex- pressed juice of Bhringa-ra'ja (four times), and the decoc- tion of Vilva and Yava (four times) with the Kalkas of the drugs known as the Sarva-gandhá should bę

Chap. XLVII.] UTTARA-TANTRA. 297

applied as an Abhyanga. The body should be sprinkled (Seka) with the cold decoction *. Palatable foods and cold, pleasing and scented cordials should be pres- cribed according to the nature and intensity of the deranged bodily Doshas underlying the disease. 34 -35. The heat generated by drinking being aggravated by bodily Pitta and blood of an intoxicated person, escapes through the surface of the skin and causes a feeling of intense burning (Daha) which should be remedied with measures and therapcutic agents pres- cribed in connection with the aggravation of Pitta. 36. Remedies for Daha :- Now I shall describe the cooling measures which should be employed for alleviating the burning sensation (Daha) in the case of a rich patient. The body of such a patient under the circumstances should be smeared at the outest with Chandana white sandal wood) pastes made cooler by the contact of cold bcams of the moon, pearl-necklaces and the water produced from melted ice. He should be laid down in a bed of full-blown lotus flowers sparkling with dew drops or of lotus-leaves sprinkled with spray of translucent water, and youthful damsels decked with necklace and bangles of lotus-stems cooler even than cold water, should be asked to touch him. He should try to alleviate the burning feeling by strolling on the banks of a tank in a garden in the soft, cool and sweet breeze bearing on its wings the soft perfume of Kalhára (red) lotus and water-moss dancing in the adjoining tank. Water cooled and charged with Us'ira, Valaka and (white) sandal paste should be sprinkled over his body, or he should be made to sport in a cleansed tank filled with freshly collected water em-

• Decoction of the drugs of Madhura-gana and of the drugs of cold virtues. 38

THE SUSHRUTA SAMHITA. [Chap. XLVII.

balmed with full-blown red and blue lotus-flowers and scents (e. g. sandal pastes) after being smeared with sandal paste and with the hairs of his body standing on their roots with the magnetic touch of beloved female hands. Here he should take his bath with young, gay and beautiful damsels skilful in aquatic sports refreshing him with the lotus-like touch of their cold hands, thighs and mouth and hard (i.e., full-grown) breasts and with their sweet words. 37-A. He should lie down, when tired, in a cool chamber cooled with watery breeze, fitted with fountains and made dusky with the misty jets (vapours, of water. The floor of the chamber should be sprinkled over with scented water and flowers and the walls thickly coated with pastes of sandal wood, Teja-patra and Válaka. The chamber should be scented and decorated with Mánsi, Tamála, Musta, Kumkuma, Padma-leaves, Játi- flower, Utpala (blue-lotus), Priyangu, Kes'ara (Bakula), and Pundarika (red-lotus), Punnága, Nága-Kes'ara, and Karavira and there in the room with garlands of flowers gently swinging in the sweet and lazy wind, the patient should lie down and listen to the sweet discourses about the Hemanta, the Vindhya, the Malaya or the Himálaya mountains as well as about cold water, leaves of Kadali or of any other evergreen tree or plant and about the receptacles of full-blown blue or red lotus, as well as about topics of moon-rise, or any other subject which may be calculated to be agreeable to his mind under the circumstances. Young and beautiful damsels with their full and thick-set breasts and thighs anointed with sandal pastes, being clad in wet clothes (adhering to and advantageously showing the splendid contours of their limbs, ctc.,) and with their necklaces and girdles loosely sliding down their bosoms. and

Chap. XLVII.] UTTARA-TANTRA. 299

slender waists should lie there with him in their firm embrace. These damsels should refresh him with their secret charms in that lonely chamber and by means of their bodily coolness would be able to alleviate the burning sensation of aggravated Pitta due to over- drinking. 37. These are the measures in general which should be employed also in the cases of burning sensation due to the aggravated condition of blood, Pitta and thirst. Now hear me discourse on the measures which are to be specifically employed in the case of a burning sensation in the body under different circumstances. 38 A. Symptoms of Raktaja Daha :- The blood coursing through the whole body when aggravated by any cause whatsoever becomes heated and imparts a copper colour to the skin, complexion and the eye- balls of the patient. It produces a bloody smell in the mouth and the body, and the patient feels a burning and contracting sensation as if he is surrounded by fire. 38. Treatment :- Fasting should be prescribed at the outset in such a case and then the diet should be regulated conformably to the nature and intensity of the deranged bodily Dosha involved therein. If such burning sensation (in the body) be still unrelieved, the patient should be treated with a diet largely composed of the soup of Jangala flesh and venesection in the ex- tremeties should then be resorted to duly in conformity with the rules (prescribed in Chapter VIII-Sárira Sthána). Cases of burning sensation due to the aggrava- tion of Pitta would produce the symptoms of Pittaja fever and remedies for Pittaja fever should in such cases be resorted to. 39. Symptoms and treatment of Daha due to thirst :- The watery part is dried up in

300 THE SUSHRUTA SAMIIITA. [Chap. XLVtt.

the event of an unslaked thirst, thus generating a heat in the organism. This produces an extreme dryness of the lip, throat and palate and a burning sensation (Daha) both in the skin and inside the organism of the patient followed by the coming out of the tonguc and the trembling of the whole body. The medical treat- ment under such circumstances consists in alleviating the hcat and adding to the watcry component of the body. A large draught of cold water or cooled milk saturated with a copious quantity of sugar, or of the expressed juice of sugar-cane or of Mantha should be given to the patient to his satiety under the circumstances. 40-41. An intense burning sensation in the body is caused by the presence of accumulated blood in the abdomen (Koshtha), the symptoms and therapeutics of which are those mentioned in the chapter on Sadyo-vrana (Chap. II-Chikitsita-Sthána) A burning sensation of the body incidental to the waste (Kshaya) of any of its funda- mental organic principles (Dhátus) brings on thirst, fainting fits, feebleness of voice, suspension of physical and mental faculties or functions, weakness and lassitude in its train which should be remedied with measures laid down under Rakta-pitta. Emulsive and Váyu-subduing remedies are likewise applicable therein. 42-43. A severe internal burning sensation in the body may also be produced by (the aggravation of) blood due to (the breach of the rules of) diet and to grief of any kind. The symptoms in such cases are thirst, fainting fits and delirium. The remedy should consist in giving the patient the wished-for objects, and the diet under the circumstances should largely consist of milk and meat- essence to be partaken of in company with friends in the manner described beforc. A burning sensation in the body incidental to a hurt or to a blow on any of

Chap. XLVII.] UTTARA-TANTRA. 3ot

its vulnerable or tender parts (Marma) is the seventh of its kind and should be deemed as incurable. All kinds of burning sensation in the body with a coolness of its surface are incurable. Emetics and purgatives should be exhibited according to the Dosha involved even after the subsidence of the supervening symptoms of excess in wine. 44-46. Wine mixed with half its quantity of water and scented with Jiraka, Sauvarchala, Ardraka and S'unthi becomes palatable and immediately allays thirst. Wine, taken with meal and with cooked meat by a person besmcared with sandal paste and wearing wet ciothes and garlands of flowers, does not produce any of its bad after-effects nor brings on intoxication which in its turn would throw the mind and mental faculties off their balance. 47-48.

Thus ends the forty-seventh chapter of the Uttara-Tantra in the Sus'ruta Samhitá which deals with the (symptoms and) medical treatment of alcoholism.

CHAPTER XLVIII ..

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of thirst (Trishna-Pratishedha Adhyaya). I. He who is not satisfied even with the constant drinking of water but craves for more and more water should be regarded as afflicted with the disease known as thirst (morbid desire for water). 2. Etiology :- The Pitta and Váyu of the body become extremely aggravated by such factors as (excessive) exercise, grief (or any violent mental agita- tion), fatigue, drinking, use of any extremely dry, acid, hot or pungent fares, or of those which cause a parched condition in the organism, or waste of any vital organic principle (Dhátu) of the body, fasting or exposure to the sun, and combinedly affect the water- carrying channels of the body (diminish the liquid portion of the bodily lymph-chyle). The water-carrying channels thus affected give rise' to violent thirst. The disease is divided into seven types. . 3. Classification :- The first three are due to the action of the deranged Doshas (Vayu, Pitta and Kapha). The fourth and fifth!are respectively incidental to any ulcer and to the waste of any of its fundamental organic principles. The sixth is due to the presence of undigested fecal matter in the intestines (lit. mucus) and the seventh is due to errors in diet. Now hear me describe their specific symptoms and the therapeutic agents to be employed in curing them. 4. Premonitory Symptoms :- An extreme dryness of and a, burning sensation in the palate,

Chap. XLVIII.] UTTARA-TANTRA. 303

throat, lips and mouth, external heat, vertigo, loss of consciousness, and delirium are the general premoni- tory symtoms which usher in an attack of the disease. The specific symptoms are given below. 5 Symptoms of Vataja, Pittaja and Kaphaja Thirst :- Dryness of the mouth with a tingling sensation in the regions of the temples, and the head (D. R .- throat), obstruction of the (water-carrying) channels of the body and a bad taste in the mouth, are the symptoms which specifically mark a case of the Vataja type in which the drinking of cold water leads to a distinct aggravation of the diseasc (thirst). Loss of consciousness (epileptic fits), delirium, an aversion to food, dryness of the mouth, yellowness of the eyes, extreme burning sensation in the whole body, desire for coldness, a bitter taste in the mouth and a fumid sensa- tion (in the throat) are the features which specifically mark the Pittaja type of the disease. The vapours produced by the fire of digestion being enveloped and obstructed in their course by the layer of accumulated Kapha, the heat (pent up in the body tends to dry up the moisture of its water-carrying channels and) produces a kind of thirst which is characterised by somnolence, a sense of heaviness in the limbs, a sweet taste in the mouth, extreme emaciation, cold-fever, vomiting, an aversion to food and suppuration in the skin are the symptoms of Kaphaja type. And where such symptoms are present, the patient has no excessive desire for drinking water. 6-8. Kshataja and Kshayaja Thirsts :- A case of thirst which is engendered in consequence of pain in or discharge of blood from, any cut in the body is the fourth type and is known as. Kshataja thirst. The days of the patient in such a case pass with great un-

304 THE SUSHRUTA SAMHITA. [Chap. XLVIII.

easiness even if he drinks water. In the type due to the waste of the fundamental organic fluid (Rasa) which is known as Kshayaja thirst, the patient constantly drinks water in large quantity both in the day and in the night but still finds no relief. This type is attributed by several authorities to the concerted action of the three deranged Doshas and all the specifice symptoms due to the waste of the vital organic principle (Rasa) described before are expected therc. 9-I0. Ámaja and Annaja Thirst :- The symp- toms of all the three (aggravated) Doshas in addition to pain in the heart, spitting and a sense of lassitude in the limbs are present in the type which is due to indigestion (Amaja). The case of thirst which is produced by using extremely fatty and saline articles of farc, as well as those which are hard to digest is due to errors in diet (and is known as Annaja thirst). 1I-12. Prognosis :- A patient who has become ex- tremely weak and deaf in consequence of thirst and who suffers from a mental stupour and lies with his tongue protruded and hung down should not be taken charge of (by a physician) for treatment. 13. General Treatment :- Vomiting should be induced with a solution of powdered Pippali in a case of thirst in which the stomach of the patient becomes fully loaded (with water). A plaster composed of Dádima, Amrátaka and Mátulunga is also beneficial. Drugs which are cooling in their virtue and potency should be applied in the three cases of thirst (due to the three Doshas). A gargle composed of a solution of powdered Amalaka with any acid drug (Mátulunga, etc.) should be retained in the mouth for removing the bad taste in the mouth under the circumstances. Water made hot by immersing bits of heated gold, silver, etc,

Chap. XLVIII.] UTTARA-TANTRA. 305

as well as pieces of heated stone or baked clay in it and taken in a tepid state, or cold water charged with sugar and honey, is possessed of the efficacy of allaying thirst. 14-16. Specific Treatment :- A patient suffering from Vataja thirst would find relief by taking lukewarm and in a little quantity at a time the water boiled with the drugs of any of * the five Pancha-mula groups or with the drugs of the first group (Vidári-gandhádi- gana). A decoction of the drugs of the Pitta-subduing groups + subsequently cooled and taken with the addition of honey and sugar, or milk duly boiled with the admixture of the drugs of the Jivaniya group (Káko- lyádi Gana) would allay a casc of Pittaja thirst. Water duly boilcd with Vilva, Adhaki, the drugs of the Kantaka-Pancha-mula t and Darbha allays a case of Kaphaja thirst. Vomiting induced with the help of a draught of the infusion of tender Nimba-leaves taken lukewarm would likewise prove curative in such a case. 17-19. The Pitta-subduing remedies and measures should, in the alternative, be applied in all types of thirst which cannot otherwise be allayed. The expressed juice or a decoction of ripe Udumvara should be taken with

• The five Pancha-mula groups are (1) The major pancha-mula, (2) The minor Paucha-mula, (3) The Valli Pancha-mula, (4) The Kantaka-Pancha- mula, (5) The Trina-Pancha-mula. See Chap. XXXVIII, Sutra sthána. + The Pitta-subduing groups are Utpaládi, Sárivádi and Kákolyádi . groups. + In place of "कस्टकपस्मूली, etc.", some read "कस्टक पच्चकील" eic., i.e. Kantaka (Gokshura) and the drugs included in the group known as "yate," viz. Pippali, Pippali-mula, Chavya, Chitraka and Nágara. The commentator Kartika Kundu supports this :- Dallana. For Kantaka- Pancha-mula, see Chap. XXXVIII-Sutra-Sthána. 39

306 THE SUSIRUTA SAMHITA. [Chap. XLVIII.

sugar under the circumstances. A thirst-afflicted patient should likewise drink the water duly boiled with the drugs of the Sarivadi group sufficiently cooled down for the purpose. 20-21. Water duly boiled with Kas'eru, S'ringataka, Padma, Mocha (plantain-flower) and Vis'a is cfficacious in allay- ing thirst incidental to hurt (Kshataja). Water contain- ing Nilotpala, Us'ira and red Chandana should be kept in an open space during the night and a physician should give this well-scented water mixed with sugar and honey and with a large quantity of Dráksha to the thirst- afflicted patients on the following morning for their benefit. Cold infusions of the drugs of any of the Trina- pancha-mula, Utpaladi and Madhura (D. R. the first group i.c., Vidárigandhádi) groups mixed with the drugs of the Sárivádi group as well as that of the drugs of the Madhuka-pushpadi groups should be prepared in the preceding manner and prescribed. The six kinds of cordials (Pánaka) separately prepared (in the preceding manner) with the (four kinds of) Rájádana, Kshiri or Kapitana are also beneficial in such cases. Fruits of Tundikeri (wild Kárpása) and of Kárpása pasted to- gether (and dissolved in water) and taken internally would prove beneficial. A case of thirst incidental to any ulcer (Kshataja) is allaycd with the stoppage or removal of the pain or by taking mcat-soup or the blood (of deer, goat, etc.). 22-26. A case of thirst due to the waste (Kshayaja) of any fundamental organic fluid (Rasa) is removed by taking draughts of clarified butter churned from milk,*

• In places of "नौरपत" "मांसीदक" and "मधुकोदकं" some read "सोरजलं" (milk mixed with water), "माषोदक" (soup of Masha pulse) and Hei (honey mixed with water) respectively.

Chap. XLVIII. J UTTARA-TANTRÁ. 307

as well as those of meat-soup and infusion of Yashti- madhu. Thirst which is incidental to the presence of mucus and undigested fecal matter in the intestines (Amaja) should be remedied with the decoction of Vilva, Vachá and the drugs of the Dipaniya (Pippalyádi) group or with the decoction of the drugs of the Dipaniya group mixed with Amrataka, Bhallataka and Vala. The type which has its origin in the use of heavy and indigestible fares or due to errors in diet as well as all other types of thirst with the exception of the one which is incidental to the waste of any fundamental organic principle should be cured by inducing vomit- ing. 27-28. Solution of common treacle or Mantha or meat- soup is efficacious in allaying thirst which is due to physical fatigue. Warm Yavágus or cold Manthas * would alleviate a thirst caused by the obstruction of the participated meal. A man should drink warm water in cases of thirst due to an excessive taking of any fatty substance (Sncha). The thirst of a habitual drunk- ard which is due to the reactionary effects of wine is allayed by draughts of half-diluted wine. Thirst due to heat, may be allayed with draughts of cold water surcharged with sugar or with the expressed juice of suger-cane. 29-33. General Treatment :- Vomiting should be induced in these cases with the decoction of such drugs as are remedial to the deranged bodily Doshas involved in each case and the digestive (Páchana) remedies as prescribed in cases of fever should also be prescribed in these cases. Use of cooling plasters and of cold

• Warm Yavágu should be prescribed in cases where Váyu pre- ponderates and cold Mantha in cases where Pitta preponderates.

308 THE SUSHRUTA SAMHITA. [Chap. XLVIIt.

baths and spray, residence in cold chambers, exhibition of emetics and purgatives, use of milk, meat-essence, clarified butter and sweet and cooling lambatives would be likewise prescribed in all cases of thirst. 34-35.

Thus ends the forty-eighth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) treatment of thirst.

CHAPTER XLIX.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of vomiting (Chhardi-Pratishedha). Causes and Nomenclature :- The bodi- ly Doshas are deranged and aggravated per force by the use of extremely liquid, emollicnt, unpalatable or oversalted food or of one taken at an improper timc or in an inordinate quantity or which is incongenial to the physical temperament of its user, as well as by over-fatiguing physical cxercise, fear, mental agita- tion, indigestion, presence of worms (in the intestines), or quick cating or owing to pregnancy or any disgus- ting or loathsome causes. Thus deranged, the Doshas rush up to the mouth and after covering the whole of it come out with great force and with an aching pain in the limbs. This is, therefore, called Vomiting (Chhardi). 2. The vital Vayu known as the Udána-Váyu coming in combination with the onc known as the Vyána-Váyu in a man addicted to incompatible food and drink leads to the derangement of the bodily Doshas and rushes up to the upper part of his body (which causes vomit- ing). 3. Premonitory Symptoms :- Nausea, sup- pression of eructations, thin and saline water-brash and an aversion to food and drink are the premonitory symp- toms of vomiting. 4. Specific Symptoms :- Scanty ejections of frothy matter of strong astringent taste accompanied with a loud sound and cramps at the back and the sides

310 THE SUSIIRUTA SAMHITA. [Chap. XLİX.

produce a sense of exhaustion or fatigue and increase after the digestion of a meal and this should be ascribed to the action of the deranged bodily Vayu. Vomiting of yellow, greenish or blood-streaked matter with an excessively acid, pungent or bitter taste in the mouth and attended with such complications as fever, dryness of mouth, fainting fits and burning and sucking (Chosha) sensations in the body, should be ascribed to the action of the deranged Pitta. Excessively cold, white, swcet, thick and mucous vomiting attended with horripilation, an aversion to food, heaviness of the limbs and lassitude should be ascribed to the Kaphaja type of vomiting. The specific features of all the three preceding types are present in the type duc to the concerted action of all the three Doshas. 5 -- 8. Traumatic Cases :- The five cases of vomit- ing duc to any disgusting or loathsome causc or to pregnancy, indigestion, presence of worms (in the bowels) or the taking of uncongenial food and drink, should be duly classified according to the Dosha aggra- vated in each casc. The stomach is irritated in all types of vomiting. Fasting should, therefore, be the first remedy in these cases. Violent cramps and nausea as well as the symptoms of Krimija-IIridroga are the special characteristics of a case of vomiting due to the presence of worms in the bowels. 9-IO. Prognosis :- A skilful physician shall not take in hand the medical treatment of a patient afflict- ed with vomiting, where the patient is emaciated and is. distressed with the supervening symptoms,* and in which the ejected matter is mixed with pus and

• The supervening symptoms are :- Cough, asthma, fever, hic- congh, thirst, mental dejection, heart-disease and Tamaka-S'vasa.

C bap. XLIX.] UTTARA-TANTRA. 3II

blood, and resembles the variegated colour of a peacock's plume and where vomiting is almost constant. II. General Treatment :- In a case of vomit- ing marked by an excessive preponderance of any Dosha (or by the presence of all the three Doshas), emetics or purgatives should be administered with a due regard to the nature and intensity of the Dosha or Doshas involved. In cases due to the concerted action of any two of the deranged bodily Doshas the medical treatment should be determined according to their relative order of preponderance. Diet in these cases should consist of dry and light articles and what the patient is accustomed to. Febrifuge decoctions should be administered according to the nature and intensity of the deranged bodily Doshas involved in each case. 12. Treatment of Vataja Type :- Draught of clarified butter churned from milk, * or the soup of Mudga and Amalaka taken with clarified butter and Saindhava-salt, or gruels (Yavagu) prepared with the drugs of Pancha-mula and taken with honcy, would prove curative in the Vataja type of vomiting. The use of the essence of any bird of the Vishkira group (e. g. chicken, etc.) taken with a little quantity of salt and juice of acid-fruits would likewise prove efficacious. Lukewarm oily purgtives mixed with salt arc also recommended in such cases 13. Pittaja Type :- Cold drinks and decoctions of Pitta-subduing virtue would relicve vomiting due to the derangement of Pitta. Emetics or purgatives com- posed of the drugs of the Madhura-drugs and mixed

• "alrga" has been explained by some commentators as milk mixed with clarified butter. Chakradatta reads "a" milk and water in place of "चौरधृतं",

312 THE SUSHRUTA SAMIIITA. [Chap, XLIX.

with the cxpressed juice of Dráksha may likewise be employed in the present type. In violent' attacks of vomiting the medicated clarified butter known as Tailvaka-ghrita should also be prescribed. 14. Treatment of Kaphaja Type :- A de- coction of the drugs of the Aragvadhad-group or of Das'a-mula should be given with honey in a case of vomiting due to the aggravation of Kapha. A cold infusion (Hima-Kasháya) of Guduchi mixed with honcy would prove an excellent remedy in all the threc preceding types of vomiting. 15-16. Vomiting due to ( the use or sight of ) any disgusting or loathsome thing should be treated with agreeable things, while that peculiar to pregnancy should bc relieved by giving to the enceinte the things she longs for. Traumatic Types :- Vomiting duc to the use of any unaccustomed or incongenial food should be relieved with fasting, vomiting or with the administra- tion of habituated or congenial food. Vomiting due to the presence of worms in the bowels (Krimija) should be treated with remedies applicable in a case of Krimija Hrid-roga (heart-disease of parasitic origin). The measures and remedies prescribed before should be employed with a due regard to the nature and intensity of the derangcd bodily Dosha or Doshas involved in each casc. 17. General Treatment :- Vomiting is relieved by frequently licking a lambative made of Pippali, honey and the expressed juice of Kapittha-fruit. Madhurasa* with the washings of rice and with honey may be likewise taken for the purpose. Tarpana (soothing) measure with the admixture of honey would be bene-

*, "Madhurasá" may mean (1) Drak'shá (2) Gámbhári fruit (3) Murvá or (4) Yashti-madhu. The practice is to prescribe Drákshá.

Chap. XLIX.] UTTARA-TANTRA. 313

ficial in all the threc cases (due to the aggravation of the Doshas) .* A potion composcd of powdered Atma-gupta'- seeds and Yashti-madhu mixed with a copious quantity of rice-washing and with honey as well as gruels prepared with the admixture of Karanja-leaves should be administered. Kustumburu pasted and mixed with salt and acid would also be benificial. Kapittha should also be taken with Tri-k tu and rice-washing. 18-A. The excreta of flies should be licked with sugar, honey and sandal paste. A lizard should be immersed in hot milk and this milk, when cooled, should be given to the patient to drink. Powdered fricd paddy mixed with honcy and clarificd butter should bc given to drink or pulverised Pippali mixed with honcy, sugar and clarified butter should be licked. Sandal-paste * with the expressed juice of Amalaka or the decoction of the leaves of Mudga + as well as a lambative composed of the marrow of Kola and Amalaka spiced with the Tri-sugandhi drugs (vis., Ela, Patra and Tvak) powdercd together should be prescribed. Gruels of fried S'ali paddy mixed with honey should also be prescribed. The use of perfumes which are agrecable both to the mind and to the organ of smell, is also recomended. 18-B. Diet :- The meat of any Jangala animal and palatable cordials and victuals of various plates should be likewise taken with care in all cascs. 18.

Thus ends the forty-ninth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) treatment of Vomiting.

• The practice is to take white Sandal in this case. I Vágbhata'prescribes the decoction alone as a separate remedy.

40

CHAPTER L.

Now we shall discourse on the chapter which dcals . with the (symptoms and) medical treatment of hic- cough (Hicca-Pratishedha). I. Causes :- Hiccough, cough and asthma are the result of using those articles of fare which are heavy, dry, or secreting (Abhishyandi) or which are followed by an acid reaction or which remain long in an undigested state (in the stomach) as well as of cold drinks, residence in cold places, exposure to cold or dust or smoke or fire or wind, over-fatiguing physical exercises, physical exer- tion, load-carrying, toils of journey, voluntary repres- sion of (physical urgings), fasting (Apatarpana), accumu- lation of Ama-dosha (mucus in the intestines), blow or hurt, emaciation (weakness) due to sexual excessc, concomitant distress or agony of any existing or con- tinuing physical ailment, irregular dict, cating before the digestion of a previous mcal or of a wrong applica- tion of Samsamana remedics. 2. : Derivation :- The Vayu (wind) constantly belches out of the mouth with a report shaking, as it were, the spleen, the liver and the intestines. The physicians have bestowed the name Hicca on the discase owing to fact of its speedily extinguishing the vital spark in man (from Sanskrit root-Ilins to kill). 3. Classification :- Hiccá is divided into five kinds which arc styled Annaj, Yamalá, Kshudrá Gambhirá and Mahati, all of which are the effects of the derangement of the bodily Váyu acting in unison with the deranged Kapha. 4. Premonitory Symptoms :- An astrigent

Chap. L,] UTTARA-TANTRA. 315

taste in the mouth, an aversion to all sorts of pursuits, hcaviness about the throat and cardiac region and a rumbling sound in the abdomen (Jathara) are the pre- monitory symptoms which usher in a fit of hic- cough. 5. Symptoms :- The bodily Váyu being suddenly deranged by taking too much food and drink, is pushed upward and belched out in gusts which are known as Annaja Hicca. The hiccough which occurs in double strokes and at long intervals shaking the head and the neck is called Yamala. The hic-cough which rises with a mild force and at long intervals from the root* of the clavicles (Jatru) is called Kshudrika. The violent hiccough which rises from the region of the umbilicus accompained by a deep sound and interfering with frec respiration, causing dryness of the lips, throat, tongue and of the mouth and producing pain at the sides and. complicated with many other distressing symptoms, is called Gambhira The hiccough which produces a fecling of crushing pain as it werc, at the vulnerable parts (Marmans) and stretches out the body in full, shak- ing all the limbs and which occurs frequently and with a considerable force accompained by a report. and produces a severe thirst is called Maha-Hicca. 6-15. Prognosis :- A hiccough-patient whose body is stretched out in full during a fit, with his cyes turned upward and fixed in a gaze as well as the one suffering from weakness, frequent sneezing (D. R .- cough) or an aversion to food as well as those suffering from the last two cases of Hicca vis., Gambhira and Mahati should be given up as incurable. 1I

• By the word "Mula" (i. e, root) of the Jatru (clavicles) Gayadas'a understands the regions of the heart, Kloma, throat, etc .- Dallana.

316 THE SUSHRUTA SAMHITK. [Chap. L.

Treatment :- Practice of Pránáyáma (control of breath-wind), tickling, frightening and producing con- fusion by pricking with needles may be effectively re- sorted to in a casc of (simple) hiccough. Yashti-madhu mixcd with honey, or Pippali mixed with sugar, or a Inkewarm compound of milk, clarified butter and the expressed juice of sugar-canc* should be employed after the manner of an Avapida-Nasya. Vomiting and purging may bc induced in a patient not extremely weak. Red sandal-wood madc into a paste with the breast-milk, or lukewarm clarified butter mixed with Saindhava salt, or powdered Saindhava dissolved in water is beneficial, if administered as a medicinal snuff. 12. Gummy exudation of S'ála trees, Manah-s'ilá, or cow's horn, or cow's hairs and skin, charged with clarified butter, should be used in fumigation (Dhupana). As an alternative, the seats of hiccough (viz., umbilical region, etc.) should be duly fomented. The patient should be advised to use a lambative composed of Svarna-Gairika or the ashes of the bones of any domes- tic animal pasted with honey. Hairs of Svavidh t, a sheep, a cow or of Sallaki should be burnt in a covered pot and given to be licked with honcy. Plumes of a peacock or the fruit of Udumvara or (the bark of) Lodhra should be similarly burnt and the ashes thus prepared should be licked by the patient in combination with honey and clarified butter. Sarjiká-kshara licked with the expressed juice of Vijapura and with honey

Tepid milk, tepid clarified butter and expressed juice of sugar-cane are also separately used as snuff. + S'vávidh and S'allaki are the two different kinds of porcupine.

Chap. L.] UTTARA-TANTRA. 317

would also give instataneous relief in a paraxysm of hic- cough. 13. Lukewarm gruels (Yavágu) saturated with clarified butter as well as lukewarm Páyasa prove curative in a case of hiccough. The milk of a she-goat duly cooked with S'unthi and water * (in the manner of Kshira-páka) and mixed with sugar could be as well taken with benefit. The urine of a she-goat and of a cwe taken to satiety would readily cure a fit of hiccough. Similarly the smell of Puti-keeta + duly soaked in the infusion of radish, Vachá and Hingu + after the manner of Bhavana saturation would have the same result. 14. Nága kes'ara mixed with sugar and honey should be taken with a copious quantity of) the cxpressed juice of sugar-cane and of Madhuka flowers. A Pala weight of Saindhava salt should be used with two-Pala weight of clarified butter. Haritaki should be first taken and then a draught of tepid water. Clarified butter should be taken with milk and honey. A Pichu (two Tolás) weight of the cxpressed juice of Kapittha should be taken with honey and powdered Pippali for the relicf (of hiccough). A lambative prepared with Pippali, A'malaka, S'unthi, sugar and honey, or one prepared with Anjana (Souviranjana), powdered fried paddy, and the kernel (of the stone of) Vadara-fruit should be licked as a remedy for an attack of Hicca. 15. The four different liquid compounds !l prepared

• Some render शुगहौतीय as the decoction of S'unthi. t Puti-keeta is a kind of bad-smelling worm appearing generally during the rainy season. Some read 'fesrer' (IIingu and lotus) in place of 'fee', In both cases, however, 'urfea' means simply 'mixed'. I| According to Vrinda and Chakrapáni lambatives should be pre- pared with thesc drugs. According to some, the decoction should be used.

318 THE SUSHRUTA SAMHITA. [Chap. L.

with the drugs mentioned in the four quarts of the present verse, vis., (1) The fruit and flower of Pátalá, (2) Gairika and Katu-rohini (3) the kernel (inner pulp) of Kharjura and Pippali and (4) Kasisa (sulphate of iron) and Kapittha (D. R .- Dadhi), should be mixed with honey and administered by an experienced physician in cases of Hicca. 16. Meat as diet :- The soup prepared with the meat of S'allaka (porcupine), S'vadamshtrá, Godha, Vrisha-dams'a (wild cat), Rishya (D. R. Riksha-a bear) and Mriga (different kinds of deer. as well as of Kapota and Párávata (different kinds of pigeon), Láva and other birds should be taken lukewarm with the ex- pressed juicc of acid fruits and with Saindhava and a Sneha (clarified butter, ctc.). 17. Purgatives as well as potions of tepid clarified butter mixed with Saindhara-salt and sugar should be regarded as highly beneficial in an up-coursing of the bodily Vayu in cases of Hiccá. Some authorities are of opinion that the application of an Anuvásana-vasti would be also beneficial in such cascs. 18.

Thus ends the fiftieth chapter in the Uttara-Tantra of the Sus'ruta Samhita which deals with the (symptoms and) treatment of hiccough.

CHAPTER LI.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Asthma (Śvasa-Pratishedha). I. Ætiology :- To the samc group of exciting factors which bring in an attack of hiccough should be attributed the origin of that voilent disease which is known as Svása (asthma). The vital Váyu known as the Piána-Vayu foregoing its normal function rises upward in unison with the deranged Kapha of the body and produces that gasping and laboured breathing which is called Svasa (asthma). This dreadful disease though virtually one in its nature and origin is divided into five spicific types, vis., Kshudra-Svása, Tamaka-Svása, Chhinna-Sva a, Maha-Svasa and Urddhva-Svasa. 2 4. Premonitory Symptoms :- Pain in the region of the heari and at the sides, aversion to food as well as to all other pursuits, suppression of stool and urine and a bad taste in the mouth, may be regarded as the premonitory symptoms of the diseasc. 5. Specific Symptoms :- The type in which the least movement or exertion brings on an aggrava- tion of the discase, and a distinct amelioration or relief is restored in a sitting posture, is called Kshudra-Svasa The type which is accompained by such symptoms as thirst, perspiration, vomiting and a rattling sound in the throat and finds aggravation specially in foul wcather is called Tamaka-Svasa. In a case of Tamaka- Svása the patient is wcak and has a loud (wheezing) sound in the throat, as also cough, the symptoms of (bronchial) catarrh and an aversion to food. He is oppressed with difficult breathing even in sleep which

320 THE SUSHRUTA SAMHITA. [Chap. LI.

abates only when the cough subsides and is aggravated when the patient sleeps. If a case of Tamaka-Svása be attended with fever and fainting fits, it is then called Pratamaka. 6-9. The case wherein the patient pants for breath and has tympanites and a burning sensation in the bladder, and wherein the breaths are painful, detached and intermittent, is known as Chhinna-Svasa. The case wherein the patient breathes heavily lying unconscious and with a loud rattling sound in his throat and with cramps at his sides, the lips and the throat being parched and the eyes riveted in a fixed gaze or stare, is known as Maha-Svasa. The case wherein a patient breathes hurriedly, lies unconscious with choked voice and upturn- ed eyes and with his Marmans stretching out fully with cach stroke of breath is called Urddhva-Svasa. 10-12. Prognosis :- Of these (five) types the one known a Kshudra-Svasa is casily curable, while the one known as Tamaka-Svasa is hard to cure, and the thrce remaining ones, as well as Tamaka, ocurring in a weak or enfeebled patient are regarded as incurable. 13. General Treatment :- Several authorities aver that mild emetics and purgatives (lit. upward and downward clcansing -Sodhana-of the system) with the exception of the application of Sneha-vasti would be the chicf remedies in cases of asthma, if the patient possesses sufficient vitality. Old and matured clarified butter duly cooked with Abhaya, Vit-salt and Hingu or with Souvarchala, Abhaya and Vilva would be bene- ficial in cases of cough, asthma, hiccough and heart- disease. Similarly old and matured clarified butter duly cooked with the pulverised drugs of the Pippalyádi group as Kalka and with (the decoction of) the drugs of the first i.e. the Vidárigandhadi group and with the

Chap. LI.] UTTARA TANTRA. 323

five officinal kinds of salt added to it by way of an after-throw, relieves both cough and asthma. 14-15. Himsradi Ghrita :- Clarificd butter should be duly cooked with a Kola (D. R. Karsha) weight each of * Himsrá, Vidanga, Putika, Tri-phalá, Vyosha and Chitraka, and with milk twice as much and water four times as much as clarified butter. A draught of this mediated Ghrita relieves both cough and asthma and proves curative in cases of piles, aversion to food, Gulma, diarrhœa and consumption (Kshaya). 16. A quantity of clarificd butter, duly cooked with four times as much of the decoction of all the parts (viz .- leaves, branches, barks, flowers and roots) of Vásaka and with its roots and flowers as Kalka, should be used with honey when cold (in cases of asthma). 17. Śringyadi-Ghrita,-A Prastha mcasure of clarified butter duly cooked with S'ringi, Madhuriká, Bhárgi, S'unthi, Rasanjana, sugar, Ambuda, Haridrá and Yashti-madhu all taken in cqual parts and as Kalka and with four times of water, would cure cases of cough, asthma and hiccough 18. Suvahadi Ghrita :- A Prastha measure of clarified butter should be duly cooked with twice as much of water and with a Kola (one Tolá. D. R .- Karsha) weight cach of Suvahá, Kalika, Bhárgi, S'ukanásá, fruits of Nichula, Kákádani, S'ringavera, Varshábhu and the two kinds of Vrihati. Taken hot after being made pungent (by the addition of some pungent drug e. g., Pippali), it would cure all forms of asthma. 19. Calrified butter duly cooked with the admixture of Souvarchala, Yava-kshára, Katuka, Vyosha, Çhitraka, Vachá, Abhayá, and Vidanga, proves curative in a casc

• Some prescribe the Kalkas to be taken in the ordinary way and say that the dose would be one Kola weight. 41

322 THE SUSHRUTA SAMHITA. [Chap. LI.

of asthma. Similarly clarified butter duly cooked with the decoction of Gopa-valli (Sárivá) weighing twice as much as the clarified butter is also prescribed. Physicians prescribe these five medicated Ghritas in cases of asthma and cough .* 20-21 Tallsadl-Ghrita :- Clarified butter mixed with Hingu weighing a quarter part of its own weight and duly cooked in combination with four times as much of water and with Tális'a, Támalaki and Ugra, Jivanti, Kushtha, Saindhava, Bilva, Pushkara, Putika, Souvar- chala, Kaná (Pippali), Agni (Chitraka), Pathyá, (Hari- taki) and Tejovati as Kalka proves curative in all forms of asthma. The medicated Ghrita known as Vasa- Ghrita + and Shatpala-Ghrita + would likewise prove bencficial. 22. The proper use of oil duly cooked in combination with the expressed juice of Bhringa-rája weighing ten times as much, would relieve cough and asthma. 23. Meat as Diet :- Essence of any bird of the Vishkira species (e.g. chicken, Láva, etc.) charged with the juice of any acid fruit (eg. pomegranate, Vijapura, etc.) and with clarified butter and salted with a profuse quantity of Saindhava, or the soup of Kulattha cereals, properly cooked with the heads of Ena deer, etc., as well as milk duly cooked with (Anti-asthmatic and Váyu- subduing) drugs (c.g. Pancha-mula) would destroy cough and asthma. 24. The five Lambatives :- A lambative com-

• Some editors add this sentence after the next (Tálisádi) Ghrita. t Vasd-Ghrita is mentioned in the treatment 'of Rakta-pitta (Ch. XLV, 20, Uttara-Tantra). It should be prescribed in cases of asthma when Pitta predominates. $ Shatpala-Ghrita is mentioned in the treatment of Váta-Vyádhi. #it should be prescribed if Vayu prevail.

Chap. Lİ.] UTTÁRA-TANTRA. 323

posed of any of the following five groups of drugs men- tioned in a hemistich each, vis, Tinis'a-seeds, Karkata- S'ringi and S'uvarchiká (Jatuka-creeper), or Durá-labhá, Pippali, Katuka and Haritaki,; or porcupine's hair, peo- cock's feather, Kola' (Chavya) Mágadhika, and Kana',* or Bhargi, Tvak, (cardamom), S'ringavera, S'arkara' (sugar) and S'allaka-bark, or the well-pounded seeds of Tri-kantaka alone, should be licked with honey and clarified butter by a patient suffering from cough and asthma. 25. Powders of sapta-chchhada-flowers and Pippali should be taken with curd-cream (Mastu) or powders of fried barley grains (?) previously soaked for several times in the expressed juice of tender Arka-twigs together with honey should be taken. As an alternative, a patient suffering from asthma wou'd drink the Tarpana (cordial) prepared with the above-mentioned barley- powder (by mixing it with a copious quantity of water and) with honey. 26. A potion prepared with the flowers of S'irisha, Kadali and of Kunda and with Magadhika and dissolved in the washings of rice would completely cure all forms of asthma. The pith or inner pulp of Kola-stone, roots of Tála (palm) trec (D. R .- Tála-muli) and the burnt skin + of a deer of the Rishya species, should be taken with honey ; or Bhargi with honey and clarified butter, or Kadamba-seeds and Nimba in combination with honey and the washings of rice. 27-28. Drákshá, Haritaki, Krishná, Karkata-sringi and

• Maghadhika and Kana are synonyms and mean Pippali. Some, therefore, prescribe two parts of Pippali in the compound. Others prescribe one part of Pippali, and one of Gaja-pippali. t The skin of the deer should be burnt in a covered earthen pitcher and the black contents should be used.

324 THE SUSHRUTA SAMIITA. [Chap. LI.

Durálabhd in combination with honey and clarified butter, should be licked by a patient whereby he would get rid even of a violent attack of asthma. A lambative composed of the equal parts of Haridra Maricha, Drákshá, treacle, Rásná, Kaná and S'athi, should be given to be licked with oil by an asthma-patient, con- forming to the regimen of wholesome diet. 29-30. The expressed liquid of cow-dung and horse-dung should be licked by the patient with honey and powdered Pippali in cases of cough and asthma. The medicinal remedics or compounds mentioned in connection with Pándu-roga, and edema (Sotha) or cough, may be employ- ed with efficacy both in cough and asthma. A compound made of Bhárgi, Tvak, Tryushana, oil, Haridrá, Katu- rohini, Pippali, Maricha, Chanda and the cxpressed liquid of cow-dung should be given (to be licked). Utkarika should be prepared with Tala-keeta-vija *. Taken internally, it instantaneously subdues even a violent attack of asthma. 31-34. Articles recommended :- Matured clari- fied butter, Pippali, soups of Kulattha, or of the flesh of any Jángala animal, Surá, Souviraka (fermented rice- boilings), Hingu, the expressed juice of Matulunga, honey, Dráksha, Amalaki and Bilva are recommended (as diet) in cases of asthma and hiccough. 35. Application of Sveda :- Oily fomentation (Snigdha-Sveda) with the help of oil and salt should be applied to the patient suffering from asthma and hic- cough, whereby the hardened Kapha (accumulated in the channels) would be liquefied and the deranged bodily Vayu pacified. If the Vayu and Kapha be not thereby

• We do not know what 'Tala-kecta' is. Some printed editions read "Talpa-keeta" which would evidently mean a "bug". Dallana is silent on the point.

Chap. LI.] UTTARA-TANTRA. 325

pacified, the patient should be first treated with Sneha and then with a diet consisting of boiled rice cooked with meat-soup. Application of Dhuma-inhalation should then be resorted to. 36A. Application of Dhuma :- The stick (Varti) to be used in the process should be duly made of Manah- s'ilá, Deva-dáru, Haridrá, Patra, Guggulu, Lákshá and Eranda-roots made into a paste. Compounds made of clarified butter, fresh wax and resin ; or of cow's horn, hairs, hoof, tendon and skin ; or of Turashka (Silá-rasa), S'allaki (Mocha-rasa), Guggulu and Padmaka, should be pounded together (and made into sticks) with the addi- tion of clarified butter. An intelligent physician should use these (sticks) for the purpose of smoke-inhalation in the disease. 36. Purging and vomiting should be induced in a patient overwhelmed with the action of the deranged Kapha, while Tarpana measures with the administration of a potion of the well-cooked soup of mutton or of the flesh of any Jangala or Anupa animal, should bc prescribed in the case of a weak or enfeebled patient, or in respect of one suffering from an internal parched condition of the body. 37. A lambative should be prepared with Nidigdhika paste of the weight of an Amalaka, mixed with half as much of powdered Hingu and with a copious quantity of honey. Duly taken, it would per force conquer a paroxysm of asthma within three days. 38. Irresistible is an attack of asthma like that of a fire fed with heaps of fuel (D. R. fauned by the wind) or like that of the thunderbolt hurled by the wrathful Indra, the king of the gods. 39.

Thus ends the fifty-first chapter in the Uttara-Tantra of the Sus'ruta- Samhita which deals with the (symptoms and) treatment of asthma.

CHAPTER LII.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of cough. (Kasa-Pratishedha). I. Cause and Etlology :- Cough has its origin in the same sets of causes, which excite or usher in an attack of hiccough or asthma. The vital Váyu of the body known as the Prana-Vayu combined with other Doshas (Pitta and Kapha) is deranged by such causes as the entrance of smcke or of particles of dust (into the larynx and nostrils), over-fatiguing physical exercise, inordinate use of any dry or parched (Ruksha) food, any food going wrong way, voluntary repression of sneezing or of any natural propulsion of the body. Thus deranged, it is suddenly pressed upward and emitted through the mouth in unison with the deranged Udána-Váyu (situated in the trachea) producing a peculiar sound resembling that of broken Indian bell-metal. This is called Kasa (cough) by the learned. 2-3. Classification :- This disease is divided into flve types according as it is originated through the action of the deranged Vayu, or Pitta or Kapha of the body, or is due to the presence of any ulcer (Kshata) or to any wasting process (Kshayaja) in the organism. These five types of cough are recognised by the physi- cians (in practice), which, when fully developed, (i.e., if neglected) would tend to produce phthisis (Yakshmá). 4. Premonitory Symptoms :- Itching in the throat, a sense of obstruction in eating (difficulty of deglutition), a sticky feeling in the throat and in

Chap. LII.] UTTARA-TANTRA. 327

the palate, changed voice, aversion to food, and dulness of the digestive fire are the symptoms which usher in an attack of cough. 5. Specific Symptoms :- A person affected with a cough of the Vataja type, complains of an aching pain in the region of his heart, in his temples, head, stomach and the sides and has dry and frequent coughs (unattended with mucous expectorations), with a pale face, a weak and hoarse voice and diminished strength and vigour (Ojas). A burning feeling in the region of the heart, fever, sense of dryness, and a bitter taste in the mouth, thirst, yellow and pungent expectoration, paleness of complexion and a burning sensation in the body, are the indications of the Pittaja type of Kása. A sticky sense in the mouth, a sense of physical lassitude, head- ache, aversion to food, a sense of heaviness in the body, itching, frequent fits of cough and thick mucous expectorations are the features which distinguish the Kaphaja type. 6-8. Symptoms of Kshataja Kasa :- Ulcer- ation in the Vakshas (chest ?) caused by loud reading, over-fatiguing physical exercise or carrying loads of excessive weight, or incidental to any blow or hurt dealt thereon, affects the locality and gives rise constant fits of cough accompained by blood-spitting. The disease is called Kshatja Kasa or cough of ulcerated chest. 9. Sexual excess, carrying heavy loads, excessive toils of journey, over-exertion in battle, forçible controlling of horses and elephants and such other fatiguing feats tend to produce parchedness of the system and ulcers in the Uras (chest) whereby the bodily Vayu is deranged and cough is produced. The patient is afflicted only with a sort of dry cough at the outset but begins to

328 TIIE SUSIIRUTA SAMHITA. [Chap. LII.

spit blood with the progress of the disease. The patient feels an excessive pain in the throat and his Uras (chest) seems to be broken and pricked into with sharp needles, and cannot bear the least touch on account of the pressure of an intolerable aching pain (Sula) in the locality. Breaking pain in the joints, fever, asthma, thirst, and loss of voice are the symptoms which mark the Kshataja type of the disease and the patient lies moaning like a pigeon. IO. Kshayaya-Kasa .- The fire of digestion in a person who is addicted to the habit of taking unwhole- some and incongenial food or of taking it at improper time and quantity or who is given to sexual excesses or who indulges in grief or disgust or abhorrence (of food) in his mind, or who voluntarily represses any natural urging of his body, becomes affccted and diminished. It (thereby) aggravates all the three Doshas of the body, which, in their turn, give rise to a type of cough attended with a gradual emaciation of the body. The disease is called Kshayaja Kasa. Cramps in the limbs, fever, burning sensation in the body, fainting fits (Moha), loss of strength (Prana) and of flesh, emaciation of the body, spitting blood streaked with pus, and weakncss are the symptoms of this type of Kása known as Kshayaja Kása. It is said by medical experts to be due to the concerted action of all the three Doshas and to be included within the category of diseases which are very hard to be cured. A case of cough (in an old man) due to his declining years is only susceptible of pallia- tion. 1I-12. General Treatment :- A compound con- sisting of Sringi, Vacha, Kat-phala, Ka-trina, Musta, Phanyaka, Abhayá, Bhárgi, Deva-dáru, Viswa and

Chap. LII.] UTTARA-TANTRA. 329

Hingu taken in hot water would rapidly cure a case of long-stand ing cough. A lambative composed of the equal quantity of Triphala, Vyosha, Vidanga, S'ringi, Ra'sna', Vacha, Padmaka and Deva-dáru pounded together and mixed with a copious quantity of honey, sugar and clarified butter, would speedily conquer a serious attack of cough. 13 -14. A patient afflicted with cough should use a lamba- tive composed of Pathya, sugar, Amalaka, fricd paddy, Mágadhi, and S'unthi pounded together and mixed with honey and clarified butter, or take Krishnd and Saindhava salt with warm water. He should usc Nagara and Pippali in combination with treacle, or use a lambative of the paste of Dráksha mixed with honey and clarificd butter. A compound composed of the equal parts of Drákshá, sugar and Mágadhiká, or of S'ringa- vera, Vashti-madhu, and Tuga (Vamsa-lochana) should be licked with honey and clarified butter ; or a com- pound consisting of S'itopala (sugar) and an equal quanti- ty of Maricha should be licked with honcy and clarificd butter. A compound consisting of Dhátri, Kana, Vis'va and S'itopala (sugar) should be taken with curd-cream (Dadhi-manda). A person suffering from an attack of cough should use Harenuká and Mágadhikå taken in equal parts and pounded together through the medium of curd. The two kinds of Haridrá, Deva-dáru, S'unthi and the pith of a Gayatri-tree pounded and mixed in equal parts, should be taken with the urine of a goat, or a pulverised compound consisting of Danti, Dravanti and Tilvaka 'should be taken. Leaves of Vadara pasted with Saindhava salt and fried in clarified butter should be taken; or a Kola (two tolas) weight of Hingu should be taken with fermented rice-boilings (Souviraka) or with the juice of acid fruit. 42

330 THE SUSHRUTA SAMHITA. [Chap. LII.

Powdered Maricha should be likewise licked with honey. 15. Inhalation of Dhuma :- The patient should be made to inhale the smoke of a burning Varti (medicinal stick) composed of Bhárgi, Vachá and Hingu, pounded together and mixed with clarified but- ter, or of the scrapings of (green) bamboo,* Elá and Lavana mixed with clarified butter. Similarly, a patient suffering from an attack of cough due to Vata and Kapha should inhale the smoke of a Varti prepared with Musta, bark of Ingudi, Yashti-madhu, Mansi, Manah-s'ila and Haritala pasted together with goat's urine and then take a draught of milk. 16. In the alternative, Sidhu (a kind of wine) should be taken in combination with Maricha, whereby a fit of cough would be instantaneously subdued. Milk duly boiled and cooked with the admixture of Draksha, Ambu (Valaka), Manjishtha and Purat should be taken with honey. Well-boiled Mudga pulse should be taken with powdered Kanta-Káriká, Nágara and pippali mixed with honey !. Utkáráká (a kind of confection) prepared with clarified butter, Mula §, Truti (Elá), leaves of Vadara and a copious quantity of powdered Nágara should be used. A thin Peya prepared with the preced- ing drugs may be taken cold in combination with honey. 17-19. Treatment of Vataja Kasa :- The medi- cated clarified butter mentioncd in connection with the

• Dallana explains वेखुत्वक् as वंभदलं (leaves of bamboo). t Pura means S'allaki (gum) or Guggulu. -Dallana. t Dallana reads oa1q as a variant and explains that the powders of Tri-katu should be added in a large quantity in place of honey. §By the term "" some mean aua (raddish), while others take it 'to mean the drugs of the Pancha-mula-group.

Chap, LIf.] UTTARA-TANTRA. 331

medical treatment of Plihodara (enlargement of spleen) and known as Shadanga-Ghrita * proves equally cura- tive in cases of Vataja-Kasa. Clarified butter duly cooked with the drugs of the Vidari-gandhadi group, or with the expressed juice of Vásaka, would also prove beneficial. Applications of purgatives with any Sneha, as well as those of Asthapana or Anuvasana-Vasti are recommended. Inhalation of Snaihika (oleaginous) Dhuma as well as potions of lukewarm clarified butter, gruels duly cooked with meat-essence, milk and lamba- tives saturated with clarified butter, may be taken with advantage in such a case. 20. Treatment of Kaphaja Kasa :- Cases of Kaphaja Kasa readily yield to the use of emetics, purga- tives, medicinal head-purgatives, medicinal gargles, hot and pungent lambatives as well as the inhalation of smoke (Dhuma). Any articles of food which are emaciating (i.e., light, percifying and small in quantity and even fasting) should more particularly be bencficial. A case of cough due to the action of the deranged bodily Kapha is relieved by the use of Tri-katu, + or of clarified butter duly cooked with the expressed juicc of Krimighna ; (Vidanga) or with the cxpressed juice of the leaves of Nirgundi. 21. A clarified butter duly cooked in combination with twice as much juice of Nidigdhiká (Kantikári) and with the Kalka of Pátha, Vit-salt, Vyosha, Vidanga, Sain-

• For Shadánga-ghrita, see chapter XIV, Para 18. It is better known as Shatpalaka-Ghrita. t According to Vágbhata the clarified butter should be duly couked with the Kalka of Tri-katu and with the decoction (Rasa) of Vidanga. ț Some take 'Krimighna' to mean Vidanga, others take it to mean any antiparasitic drug, vis., the drugs of the Surasadi-gana .- Dallana. The infusion or decoction of Vidanga shJuld be used if its expressed juice be not available .- Ibid.

332 THE SUSHRUTA SAMHITA. [Chap, LiI.

dhava, Tri-kantaka (Gokshura), Rásná, Chitraka, Valá, S'ringi, Vachá, Mustá, Deva-dáru, Durálabhá, Bhárgi, Abhaya and S'athi, proves curative in asthma, dulness of digestion, hoarseness, as well as the violent attacks of the five different types of cough. 22. Pittaja and Kshayaja Kasa :- A case of cough of the Pittaja-type, as well as the one due to the wasting (Kshaya) brought about by sexual excess, yields to the use every morning of the clarified butter, duly cooked with the decoction of the drugs of the Vidári-gaadhádi, Utpaládi, Sárivâdi and the Madhura (i.c. Kákolyádi) groups and with the expressed juice of sugar-cane, water, milk and with the drugs of the Kákolyádi group as Kalka and with the addition of sugar as an afterthrow. The three cases vis., Pittaja, Kshataja (ulcer-orignicd) and Kshayaja (due to any wasting process in the system) of Kása are relieved by the use of the compound prepared with Kharjura, Bhárgi, Pippali, Piyála, Madhuliká. Elá and Ámalaka mixed in equal parts, and taken with a copious quantity of clarificd butter, honey and sugar. 23-24. Cases of the Kshataja (ulcerated) or Kshayaja (con- sumptive) Kása, would become amenable to the use of a compound consisting of the equal parts of Rakta (Manjishthá), Haridrá, Anjana (antimony). Chitraka, Páthá, Murvá and Pippali pounded together and taken with honey, or of clarified butter duly cooked with the expressed juice of sugar-cane. Amalaka powder duly cooked with milk and taken in combination with clari- fied butter would prove efficacious. Persons afflicted with the three types of cough may take with |benefit the fine powders of wheat, barley as well as of the drugs of the Kakolyadi group, with milk and clarified butter. Treacle boiled with water should be taken,

Chap. LİI.] UTTARA-TANTRA. 333

when cold, with honey and with Maricha taken at intervals by biting it. 25-28 Kalayana-Guda :- Thrcc Prastha measures of the expressed juice of Amalaka and half a Tula measure (six seers and a half) of treacle should be duly cooked with eight-Pala-wcight of powdered Trivrit (lightly fried) with eight-l'ala measures of oil. Powdercd Granthika (Pippali-roots), Chavya, Jiraka, Vyosha, Gaja- pippali, Havashá, Ajamodá, Vidanga, Saindhava, Tri- phalá, Yamáni, Páthá, Chitraka and Dhánya, cach weighing a Pichu weight (two Tolas) should then be added to it as an after-throw and the whole compound should be scented with the three scented drugs (Tvak, Ela and l'atra). The patient should take an Aksha (two Tolá) weight of this preparation. The medicinc thus prepared is called Kalyanaka Guda and it proves cura- tive in cases of Grahani, cough, asthma, hoarseness of voice and phthisis. It serves to improve appetite, increase the semen of males and remove sterility in females. There is no special restriction about the regimen of dict and conduct when it is uscd. 29. Agastya-Leha :- Two Palas cach of the drugs known as Das'a-mula, Gaja-pippali, Atma-guptá, Bhárgi, S'athi, Pushkara-roots, S'unthi, Páthá, Gulancha, Gran- thika (Pippali-roots), S'amkha-pushpi, Rásná, Chitraka, Apámárga, Valá and Durálabhá, and onc Ádhaka (half a seer) of Yava together with one hundred large-sized Haritaki should be boiled with one Drona measure of water and taken down from the oven with its three- quarter part evaporated in the process. ft should then be filtered through a piece of linen. A Tul weight of treacle should be dissolved in the above decoction and duly cooked with the addition of a Kudava measure each of oil and clarified butter. When the cooking is

334 THE SUSHRUTA SAMHITA. [Chap. Lİt.

finished, powdered Pippali should be added as an after- throw and honey should be mixed with it, when cooled. One Karsha weight of this elixir Leha should be licked every day in combination with two Abhayás. It conquers cases of phthisis, Grahani edema, dulness of appetite, hoarsencss of voice, cough, Pándu, asthma, head-ache (Siroroga), Hrid-roga (diseases of the heart)., hiccough and Vishama Jwara. A regular use of this elixir improves strength and memory, imparts vigour of mind and energy of action and removes disinclination to work. It was first concocted by the holy sage, Agastya. 30. Clarified butter duly cooked with the decoction madc by boiling the drugs of the Madhura or any other suit- able group with the cssence of Kulira (crab), Sukti, Chataka, Ena-deer and Láva proves curative in the case of cough due to the presence of any ulcer (in the lungs) or to any wasting process in the system. The use of clarified butter duly cooked with S'atávari, Nága-vala and Valá proves beneficial to a person afflicted with cough. 31-32.

Thus ends the fifty-second chapter of the Uttara Tantra in the Sus'ruta Samhita which deals with the (symptoms and) treatment of cough

CHAPTER LIII.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of hoarseness of voice (Svara-bheda-Pratishedha). I. Etlology :- The Vayu and the other Doshas are deranged and aggravated by such causcs as ex- tremely loud speaking, taking poison, reading at the top of the voice, external hurt or injury and exposure to cold, etc., * and finding lodgment in the sound carry .- ing channels, they affect the voice. The disease is called Svara-bheda (hoarseness of voice) and is classified into six different typcs. 2. Specific Symptoms :- The Vataja type im- parts a black colour to the face, eyes, urinc and stool and the voice acquires the sound of the rough and hoarse braying of an ass +. The face, eyes and the stool and urine of the patient are tinged yellow in a case of the Pittaja type and the voice sounds sunken as if proceeding from the throat with an internal burn- ing sensation. In the Kaphaja type the patient cons- tantly feels a sense of constriction in his throat with mucus and is only enabled to speak slowly and softly and that specially in the day. Symptoms specifically belonging to the three preceding Dosha-originated types, are simultaneously present in the type due to the concerted action of the threc Doshas (Tri-Dhoshaja) together with indistinctness of speech and incapability

• Here Pitta aggravating and Vayu-aggravating causes also are intended by the word 'भादि' i.e., etc. in 'जौतादिभिः'। + Dallana's reading evidently is गद्ग दवत् (indistinct).

336 THE SUSHRUTA SAMIIITÁ. [Chap. LIII.

of articulation. This type should be deemed as in- curable. 3-6. Symptoms of Kshayaja and Me- doja types :- In the Kshayaja typc the voice emits vapour and, becoming lower and lower, it ulti- mately disappears. This stage of Svara-bheda (loss of voice) should be given up as incurable. In an attack of the Medoja type the paticnt speaks very indistinctly, the voice remaining, as it werc, inside his throat. And his throat, lips and palate become sticky. 7-8. Prognosis :- Svara-bheda in cases of weak, old, emaciated, or fatty patient, as well as a long-standing, congenital or Tri-Doshaja one should be regarded as incurable. 9. General Treatment :- The body of the patient should be first rubbed wiih a Sneha (clarificd butter, lit .- treated with emulsive measures) and the deranged bodily Dosha underlying the root of the attack should be curbed with the help of emetics, pur- gatives, Vasti, errhines, Avapida-Nasya, lambatives, smokc-inhalations or gargles. Measures and remedics previously mentioned in connection with the treatment of cough and asthma should be as well employed in their entirety in the present discase. Now hear mc describe the medicinal remedies which are specifically beneficial to a patient afflicted with an attack of Svara- bheda. I0. Treatment of Vataja Type :- In the Vataja type of the discase, the patient should take, after a full meal, clarified butter mixed with the cx- pressed jujce of Kása-marda, Vártáku and Márkava with Artagala (Arjua). In the alternative, Ghrita prepared from goat's milk and duly cooked with Yava-Kshara and Aiamoda or with Chitraka and Amalaka, or with

Chap. LIII.J UTTARA-TANTRA. 337

Deva-dáru and Agni (Chitraka) should be taken with honey. The diet of the patient in such a case should consist of boiled rice taken with treacle and clarified butter, followed by draughts of tepid water. II. Pittaja and Kaphaja types :- Clarified butter should be constantly used with milk in the Pittaja type of the disease. Páyasa * duly prepared with the admixture of Yashti-madhu and clarified butter, should also be taken. Lambatives composed of the powdered drugs of the Madhura (Kakolyádi) group saturated with honey and clarified butter, or of powders of S'atávari or of Vald should be similarly taken. Pow- ders of pungent drugs should be taken with a copious quantity of cow's urine or licked with oil and honey in a case of the Kaphaja type of Svara-bheda. 12-13. Medoja, KshayaJa, etc., Types :- The medical treatment in the case of the Medoja type of Svarabheda should be the same as in the Kaphaja type. The medical treatment of the Tri-Doshaja and Kshayaja types of the disease should be taken in hand without holding out any hope of recovery. Milk + duly cooked with the drugs of the Madhura group should be taken in combination with sugar and honey in a case due to the effects of loud speaking. 14-15.

Thus ends the fifty-third chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) treatment of hoarseness.

• Payasa is a special preparation of rice boiled with milk and sugar. t Milk of a cow or of a she-buffalo, etc., may be used here .- Dallans.

43

CHAPTER LIV.

Now we shall discourse on the chapter which deals with the (symtoms and) medical treatment of worms (Krimi-Roga-Pratishedha). I. Causes :- The Pitta and Kapha of the body are aggravated by such causes as eating before the digestion of a previous meal, excessive use of any indigestible, uncongenial, incompatible or filthy articles of fare, seden- tary habits, partaking of cold, heavy or fatty meals, slceping in the day-timc, excessive use of Másha, cakes, Vidala (cereals), Visa (lotus stems), S'áluka (bulbous root of the lotus), Kas'eruka, pot-herbs, Surá (wine) S'ukta (a kind of fermented rice-gruel), curd, milk, trcacle, sugar-canc, Palala (dried plants of corn), flesh of Ánupa animals, Pinyáka (oil cakes), Prithuka (Chipi- taka), and such other articles of fare as well as by the usc of sweet, acid and liquid articles. They help the germin- ation of parasites of various shapes in the different parts of the body, Ámásaya (stomach) and Pakvásaya (intes- tines) being their principal seats or location. 2. Classification :- The worms or parasites (which are found to germinate and grow in a living human organism) are divided into twenty different species, and have their origin either in feces, Kapha or blood *. Now I shall enumerate their names and characteristic features. 2-3. Names and Symptoms of Purishaja Worms :- The seven kinds of worms which are

• Charaka speaks of another kind viz. Malaja (produced from the external filth of the body), over and above that kind of worms which are present in every organism from the very birth (Sahaja).

Chap. LIV.] UTTARA-TANTRA. 339

known as Ajava, Vijava, Kipya, Tripya, Gandu-pada, Churu and Dvi-mukha, originate from feces (Purishaja). They are white and extremely attenuated in their size. They frequent the passage of the rectum and produce a pricking pain (therein). Several of them are thicker and have tails. Cramps (Sula), dulness of appetite, yellowness of complexion, distension of the abdomen, loss of strength, water-brash, aversion to food, heart-disease (Hrid-roga) and looseness of stool, are the symptoms which mark the presence of worms (in the intestines), which originate in the feces. Of these Gandu-pada worms are red and long in their shape producing such symptoms as cutting pain (Sula), rumbling sound in the intestines, looseness of stool, and indigestion and they come out of the anus with an itching sensation. 4-5. Names and Symptoms of Kaphaja Krimi :- Those known as Darbha-pushpa, Mahá- pushpa, Praluna, Chipita, Pipiliká and Dáruna, have their origin in the deranged Kapha. They are either hairy or have hairs only on their heads, or are marked with brown spots on their sides or are provided with tails. They are white and small-sized like fresh paddy-sprouts. They eat away the marrow and bore into the eye-balls, the palate and the ears and produce head-ache, cardiac troubles (Hrid-roga), vomiting and catarrh. 6-7. Names and Symptoms of Raktaja Krimi :- The names of the worms originating from the vitiated blood are Kesáda, Romáda, Nakháda, Dantáda, Kikkisa, Kushthaja and Parisarpa *. They are either black or blood-coloured, glossy and thick and

• The names of these worms have been derived from the nature of their actions on the different parts of the organism.

340 THE SUSHRUTA SAMHITA. [Chap. LIV.

generally produce diseases which are peculiar to the vitiated state of the blood * in the body. 8. Specific Causes :- Worms which have their origin in the feces (accumulated in the bowels) are the results of the (excessive) use of such articles of fare as Másha-pulse, cakes, salt, treacle and pot-herbs. The Kaphaja worms germinate in the system in consequence of eating flesh, Másha-pulse (D. R. fish), treacle, milk, curd and Sukta (a kind of fermented rice-gruel). Worms which originate from the contaminated blood of the body, are intimately connected with the use of pot-herbs and other indigestible and incompatible articles of fare. 9. General Symptoms :- Fever, paleness of complexion, Sula, cardiac troubles (Hrid-roga), lassitude, vertigo, aversion to food and diarrhoea (Atisára) are the complaints which mark the presence of worms in the system. 10. Prognosis :- Of these the first thirteen kinds of worms may be seen with the naked eyes, while those beginning with Kesáda (vis., the Raktaja worms) are not so visible and (of these latter ) the first two (viz., Kesáda and Romáda) kinds should be given up (as incurable). II. A physician should first ascertain the nature of the worms and, with a view to destroy their colony in the body, should treat the patient with a Sneha (clari- fied butter or oil) and then administer an emetic with clarified butter duly cooked with the drugs of the Surasádi group. He should then purge the patient with any strong purgative and treat him with an Ásthapana-vasti prepared with the decoction of Yava, Kola, Kulattha-pulse, and the drugs of the Surasádı * See Chapter xxiv.,-Sutra Sthána.

Chap. LIV. ] UTTARA-TANTRA. 341

group, charged with salt and with a Sneha (clarified butter or oil) duly cooked with Vidanga. Just after the flowing out of the injected solution (through his anus) the patient should be bathed with lukewarm water and a meal prepared with vermifugal articles should be given to him. Anuvásana-vasti should then be applied with the preceding Sneha (prepared with Vidanga). He should take a potion composed of the expressed juice of S'irisha and Kinihi (Apámárga) mixed together aud sweetened with honey. The ex- pressed juice of Kevuka may be similarly (mixed with and) administered with a meal prepared with the articles of strong (Tikshna) property. 12. A paste (or powder) of Palás'a-seeds or the expres- sed juice thereof should be taken with the washings of rice. The expressed juice of Páribhadra-leaves should be taken with honey. The juice extracted from Pattura * or the drugs of the Surasadi group should (similarly) be taken, or the powders of dried horse- dung or of Vidanga should be licked with honey. Pupuliká-cakes prepared with (pasted Yava and) the pasted leaves of Mushika-parni (a kind of Danti) should be taken by the patient followed by draughts of Dhányá- mla (fermented paddy-gruels). 13-14. Oil duly cooked with (the paste and decoction of) the drugs of the Surasádi group should be given to be drunk. Different kinds of cakes should be prepared for him with (Yava mixed with) powdered Vidanga. Sesamum-seeds should be duly soaked in the decoction of Vidanga (after the manner of Bhavana saturation) and oil should be then pressed out thereform (for his use). 15 A.

• Dallana explains "Pattura" as S'epháliká, but S'ivadás'a takes it to be S'álincha.

342 THE SUSHRUTA SAMHITK. [Chap. LÍV.

Powdered excreta of a Svávidh (porcupine) similar- ly soaked seven times in ( each of ) the decoctions of Tri-phala and of Vidanga should be licked with honey, followed by draughts of the expressed juice of Åmalaka, Haritaki, and Aksha (Vibhitaka). Powders of any (dead) metal (Ayas) * may also be prepared and taken in the preceding manner. In the alternative, the expressed juice of Putika should be taken with honey, or Pippali-roots should be administered through the vehicle of the urine of a she-goat. Trapu (killed lead) should be rubbed in the upper liquid part of curd (Mastu) and should be taken for a week. Worms which have their origin in the accumulated feces or aggravated Kapha in the body should be destroyed with the help of the aforesaid medicinal remedies. 15. Medicinal Anjanas, Nasyas and Avapidas should be particularly employed in destroying the different classes of vermins which infest the regions of head, heart and mouth and the nostrils. The liquid expressed out of horse-dung should be dried and then successive- ly soaked several times in the decoction of Vidanga. The preperation should be blown into the nostrils (Pradhamana). Powders of killed metal (Ayas, etc.+) may also be applied in the same manner. Oil duly cooked with the drugs of the Surasádi Gana should be used in snuffing with the blue part t of Indian bell- metal. 17 A. Measures and remedies mentioned in connection

• Ayas-lit. iron, is also used for all the metals generally. t Ayas-as in para 15 may mean any metal. ¢ Oil duly cooked with the drugs of the Surasádi Gana should be placed in a pot of Indian bell-metal. When the inner surface of the pot would become blue by being oxidised, the oil should be well stirred and mixed with that blue part and used as an errhine.

Chap. LIV.J UTTARA-TANTRA. 343

with the treatment of alopecia (Indra-lupta)should be em- ployed in cases of Romada worms (vis. where the worms would be found to have invaded the hairs of the body). Medicines enumerated in connection with the treatment of the diseases of the mouth should be prescribed in cases of Dantada worms (vis. where the vermins would be found to have taken lodgment in the teeth). Cases where the worms would be found to have their origin in the vitiated condition of the blood should be treated as cases of Kushtha to all intents and purposes. The drugs of the Surasádi Gana, however, may be used in any shape * in any case (of Krimi). 17. Diet :- Meals composed of the articles of bitter and pungent tastes as well as draughts of milk mixed with the soup of Kulattha-pulse are recommended. A person suffering from any complaint due to the presence of worms (Krimi of whatever kind) and secking their destruction, should refrain from using milk, cooked meat, clarified butter, curd, pot-herb (edible lcaves), things of acid or swect tastes as well as cold things in general. 18.

Thus ends the fifty-fourth chapter in the Uttara-Tantra of the Sus'ruta Samhita which deals with the (symptoms and) treatment of Krimi-Roga.

• Both internally and externally e. g. as a drink or bath.

CHAPTER LV.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of the disease due to the retention of any natural physical urging (Udavarta-Pratishedha). I. Causes :- A wise man valuing his life shall never repress any natural urging of his body, whether upward or downward, e. g. that of Váyu, etc. Udávarta is so called from its origin from the repression of any natural urging such as Váta (flatus), evacuation of bowels, micturition, yawning, lacrimation, sneezing, eructation, vomiting and discharge of semen when it makes its appearance (Udita) and urges a person to answer its call. Udávarta is also brought on by the repression of hunger, thirst, respiration and sleep. I shall now fully describe its symptoms and the mode of medical treatment to be pursued therein. It is of thirteen different types and are brought about through the aforesaid causes, over and above the one incidental to the habitual use of unwholesome food and drink (Apathyaja). 2-4. Symptoms of Vataja Udávarta :- The vital Apana-Vayu (at the anus) anyhow obstructed in its passage gives rise to distension and cramps in the abdomen, oppression and a constricted feeling at the heart, headache, laboured breathing, hiccough, cough, catarrh, catching pain at the throat which makes speaking and Deglutition difficult (Gala-graha), violent movement of deranged Pitta and Kapha all through the body and suppression of stools or emission of fecal matter through the mouth. 5.

Chap. LV.] UTTARA-TANTRA. 345

Purishaja Udavarta :- A repressed urging for stool is followed by the exhibition of such symptoms, as rumbling in the intestines, severe pain (in the abdo- men), cutting pain in the anus, upward coursing of the flatus, suppression of stool or even emission of feces through the mouth. 6. Mutraja Udávarta :- A repression of the desire of making water is followed by scanty emission of urine which is often given out by painful drops produc- ing distension of the bladder and an excruciating pain in the urethra, anus, scrotum and the inguinal regions and about the umbilicus, and sometimes even in the head, ac- companied with distortion of fcatures in consequence. 7. A repression of yawning leads to wry-ncck (numb- ness of the Manya and of the neck) as well as troubles of the head due to the incarcerated local Váyu and violent diseases affecting the eyes, nose, ears and the mouth. Tears born of any mental condition of grief or joy and voluntarily repressed without being given frec vent to, give rise to scvere distempers of the eyes, heaviness of the head and catarrh (Pinasa). 8-9. A repression of sneezing is followcd by acute diseases of the head, eyes, nose and ears. A sense of fulness in the throat as well as the suppression and croaking of the incarcerated Váyu (wind) are also exhi- bited in this case .* The voluntary repression of any natural urging towards eructation gives rise to diseases peculiar to the derangement of the bodily Váyu. 10-11. A repression of vomiting is followed by cutaneous

• The symptoms mentioned in this sentence (which comprises a line in the verse) is taken by Madhava with the following line which enu- merates the symptoms of Udávarta due to the voluntary repression of eructation. 44

34 > THE SUSHRUTA SAMIIITA. [Chap. LV.

affections (Kushtha) due to the bodily Doshas which, being vitiated, had interfered with the gastric digestion with reactionary acidity and produced the vomiting .. Painful swelling of the bladder and of the scrotum, and about the anus as well as suppression of urine, formation of gravels in the bladder and involuntary emission of semen are the symptoms which manifest themselves in a case of repressed seminal discharge. 12-13. Ungratified hunger brings on drowsiness, aching pain in the limbs, disrelish for food, sense of exhaustion, and weakness of eye-sight. An ungratified thirst brings on dryness of the throat and mouth, dulness of hearing and pain at the heart. A suppression of breath in an exhausted person brings on cardiac troubles, fainting fits and an attack of Gulma. An unindulged sleep produces yawning, aching pain in the limbs, and a sense of heavi- ness in the limbs as well as in the hcad and the eyes. It may also bring on drowsiness. 14-17. Prognosis : - An Udávarta-patient afflicted with thirst and cramps (Sula), vomiting fecal matter and suffcring from weakness and a distressing cxhaustion should be given up by a wise physician. 18. General Treatment :- In all forms of Udá- varta the preliminary treatment generally consists in restoring the deranged and incarcerated bodily Vayu to its normal course and direction. Now hear me again describe the specific medicinal remedies to be separately employed in each case. 19. Specific Treatment :- In a case of Vataja Udávarta the patient should be first treated with a Sneha and Sveda (fomentation) after which medicinal injections should be made into the rectum after the manner of an Ásthápana-vasti. In a case due to the incarceration of feces in the intestines ( Purishaja ), the remedial

Chap. Lv.j UTTARA-TANTRA. 347

measures and medicines laid down in connection with the treatment of Anaha should be employed. 20-21. Wine charged with a large quantity of Souvarchala- salt should be administered in a case due to the reten- tion of urine. Milk or Ela should also be taken in combination with wine. The expressed juice of Dhátri diluted with water should be taken for three successive days; or the expressed liquid of the dung of a horse or of an ass should be taken ; or wine made from treacle (Goudika) should be taken with honey and cooked meat should beltaken by biting at intervals. One Tol weight of the compound consisting of Bhadra-dáru, Musta, Murvá, Haridrá and Yashti-madhu shonld be dissolved in an adequate quantity of rain-water and then be taken. The expressed juice of Duspars'á (Durá-labhá) or an infusion of Kum-kuma (D. R .- decoction of Kakubha i e. Arjuna' should be taken, or Erváruka-secds mixed with a little salt should also be taken with water. Milk duly cooked with Pancha-mula,* or the expressed juicc of Drákshá should be prescribed. The medicinal reme- dies previously described as possessed of the efficacy of disintegrating gravels, (Asmari)+ should bc adminis- tered. Similarly, all the measures to be mentioned hereafter in connection wlth the medical treatment of Mutra-krichchhra t (strangury) and of Mutrágháta § (obstruction of urine) which I shall have occasion to deal with later on should also be adopted in this case. 22. A case of Udávarta due to the suppression of

• Both Dallana and S'ivadasa recommend the use of minor Pancha- mula, but S'rikantha recommeds the Trina-Pancha-mula. t For As'mari-See Chiktisita-sthana, Chapter VII. $ For Mutra-Krichchhra-See ch. LIX., Uttara-Tantra. § For Mutrághatá-See ch. LVIII., Uttara-Tantra

348 THE SUSHRUTA SAMHITA [Chap. LV.

yawning should be conquered with the applications of Sneha and of Sveda (fomentation). The patient should be treated with Sneha and then fomented and lachrymation should then be induced (with appro- priate remedies)* in a case where the flow of tears has been suddenly checked. Sneezing should be induced with the help of strong Anjanas and Avapidas, or by the application of Vartis, or by holding any strong smell at his nose or by blowing any strong medicinal powder into the nose (Pradhamna) or by making the patient look towards the sun (or such like luminous body) in a case of Udávarta due to the suppression of sneezing. 23-24. In a case of Udávarta duc to suppressed eructation, the patient should be made to inhale the fumes of oily or lardaceous articles in due ordert or to take draught of wine surcharged with Souvarchala-salt and the ex- pressed juice of Vija-pura. A case of Udávarta duc to suppressed vomiting should be duly conquered with emulsive measures (trcating with a Sneha), etc., according to the nature of the deranged bodily Dosha involved in each case. In the alternative unguents with (Saindhava) salt and (Yava-) Kshara should be applied. 25-26. Milk should be duly cooked with the admixture of four times as much water and with the drugs of bladder-cleansing virtues + and boiled until all the water is evaporated. Draughts of this medicated milk should be prescribed in copious quantities in a case of Udávarta due to the retention of seminal fluid and the patient

• These are the applications of strong Anjanas and Avapida-Nasyas. . t The order is (1) Dhuma-inhalation, (2) Nasya (errhine) and (3) Kavala (gargle) $ These are the drugs of the Trina-pancha-mula as well as of the Viratarvádi groups (Chapter XXXVIII, Sutra Sthána).

Chap. LV.] UTTARA-TANTRA. 349

should be advised to havc sexual intercourse with lovely women. 27. Fatty (Snigdha) things should be taken lukewarm and in small quantities in a case of Udávarta duc to ungratified hunger. Cold Manthas or Yavagus should be given to the patient in a case of Udávarta duc to the suppression of thirst. Food with meat-soup should be given to the patient after sufficient rest in a case of Udávarta originated from the suppression of breath in a tired state of the body. Milk* should be given in a case of Udávarta due to the suppression of sleep and the patient should be made to sleep with the help of sweet discourses. 28. Cases of Adhmana (distension of the abodomen) etc., which are the supervening symptoms of Udávarta) should be remedicd with appropriate medicines and other measures with an cye to the nature and intensity of the deranged Dosha or Doshas involved in each case under- lying at the root. 29. Udavarta due to errors in diet :- The abdominal (Koshthaja) Váyu deranged and aggravated by such factors as eating dry, astringent, pungent or bitter articles of fare (in inordinate quantities) causes an immediate attack of Udávarta in which the Vàyu (follows an upward course and) obstructs its own channels as well as those of feces, urine, Kapha, fat and blood. It dries up the fecal matter (in the body) causing pain in the heart and bladder, a sense of heaviness in the limbs (D. R -nausca), aversion to food (D. R. unwilling- ness to do anything) and difficult and scanty emission of stool, urine and flatus. Laboured breathing, cough,

• S'ivadasa advises the use of buffalo's milk in this case as being more efficacious in bringing on sleep. But Dallana refutes this and re- commends the use of cow's milk.

350 THE SUSHRUTA SAMHITÁ. [Chap. LV.

catarrh, burning sensation in the body, fits of uncons- ciousness, vomiting, fever, thirst, hiccough troubles in the head, defective functional activity of the Manas (mind) and of the ear and such like symptoms, in conse- quence, pre-eminently mark the deranged action of the bodily Váyu. 30. Treatment :- The patient's body should be made emulsive (Snigdha) by the application of unguents composed of salt and oil. Fomentation should then be applied under the circumstances, and intestinal injections should be applied after the manner of a Nirudha Vasti. Intestinal enemas (Vasti) of the Anuvásana kind should also be applied after meal, if the case be attended with loose motions in virtue of the specific nature of the deranged bodily Doshas involved therein. Fatty purgtives should be exhibited after having fully foment- ed the body of the patient, when the foregoing re- medies would fail to give any relief from attacks of Udávarta and he should be made to drink a potion of any acid cordial together with the compound of Pilu, Trivrit and Yavani or with the compound consist- ing of Hingu, Kushtha, Vacha, Svarjika-kshára and Vidanga,* each succeeding drug weighing double the one immcdiately preceding it in the order of enumeration. These two medicinal compounds may bc employed with advantage in relieving attacks of Sula aud Udávarta. 31-32. The drugs known as Deva-dáru, Chitraka, Kushtha, Vacha (D. R-Sunthi), Haritaki, Palamkashd (Guggulu) and Pushkara-roots should be duly boiled with half an Ádhaka mcasure (thirty-two Palas) of water and taken down from the oven with a quarter part of the original

• Chakradatta reads 'farws' (and Vit salt) in place of 'firwr'.

Chap. LV.] UTTARA-TANTRA. 35I

solution remaining. Draughts of the this decoction would relieve an attack of Udavarta. 33. A potion of clarified butter duly cooked with the decoction of dried* Mulaka, Ardraka, Varshábhu, Pancha-mula + and Arevata (Áragvadha) fruits would cure any form of Udávarta whatsoever, 34. A compound consisting of Vachá, Ativisha, Kushtha, Yava-Kshara,Haritaki, Pippali and Chitraka should also be taken with tepid water, or a compound consisting of Iksháku-roots, Madana, Vis'alyá, Ativishá, Vacha, Kush- tha, Kinva (sediment of wine) and Agnika taken in equal parts should also be taken in the aforesaid manner. A compound of Deva-dáru, Agni, Tri-phala and Vrihati, should be taken with the urine of a cow. The decoction of Kantakári-fruits and barley weighing a Prastha cooked in an Adhaka measure of water and boiled down to half a Prastha only, should be taken in combination with Hingu. 35-38. A compound consisting of the pulverised seeds of Madana and of Alavu, Pippali and Nidigdhika should be blown into the rectum with a pipc. A Varti made of Nikumbha (Danti), Kampilla, S'yámá (Trivrit), Iksháku, Agnika, (Ajamodá), Krita-Vedhana (Kosátaki), Mágadhi and salt pounded together, made into a paste with the addition of cow's urine, dried and cut into a propor- tionate size, should be inserted into the rectum. The last two ambrosial remedics give instantaneous relief in a case of Udavarta. 39.

Thus ends the fifty-fifth chapter of the Uttara-Tantra in the Sus'ruta Samhitá which deals with the (symptoms and) treatment of Udávarta.

• Dallana takes dried (S'ushka) with both 'Mulaka and Árdraka. + Dallana recommends the major Pancha-mula ; but according to Chakrapáni's commentary, "Bhánumati," it should be the minor Pancha- mula.

CHAPTER LVI.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Vishu- chiká type of cholera, etc. (Visuchika-Pratishedha). I. Causes :- Visuchi, Alasaka and Vilambiká are produced from the effects of the three kinds of indiges- tion spoken of before (in Sutra. chapter XLVI), vis., Ámájirna (indigestion properly so-called), Vidagdhá- jirna (indigestion with acidity) and Vishtabdhájirna (indigestion with undigested food stuffed into the intestines in the form of undigested fecal matter). 2. Definition :- The discasc in which the derang- ed and incarcerated bodily Váyu produces, owing to the presence of indigestion, a pricking pain in the limbs resembling that produced by the pricking of needles is called Visuchika by the physicians. Men well-versed in the (dietetic) principles and temperate in their diet, enjoy an almost absolute immunity from its attack, whercas fools who are greedy and intemperate and eat like gluttons, fall an easy victim to it. 3. Symptoms :- Fainting, diarrhœa (loose mo- tions), vomiting, thirst, pain, cramps, vertigo, yawning, burning sensation in the body, discolouring or paleness of complexion, pain (cramps) at the heart and a breaking pain in the head arc the symptoms of Visuchika. 4. Alasaka :- Excessive pain in and stuffedness of the abdomen, rumbling noise (in the intestines),* and the upward coursing of the Váyu incarcerated in the abdomen making a croaking rumbling sound in its way

• According to S'rikantha the commentator on Madhava's Nidána- the patient himself makes an indistinct sound.

Chap. LVI.] UTTARA-TANTRA. 353

upwards, absolute suppression of stool and flatus, hic- cough * and eructations-a patient suffering from these symptoms is said have an attack of Alasaka. 5. Vilambika :- The person in whom the deranged and undigested food matter does not find any outlet either through the upper or lower channels of the body owing to the fact of its being obstructed in its course by the action of the deranged Váyu and Kapha, is said to be suffering from an attack of Vilambika by old medical experts and should be given up as in- curable. In whatever part of the body the Áma (undigested food matter) is present, it produces its'own characteristic symptoms in that very part and the vitia- tion of a particular Dosha in such cases should be diagnosed by the presence of the characteristic symp- toms (e. g. distension, etc.,) of Ama (indigestion). 6-7. Prognosis :- A patient exhibiting such symp- toms as blackish blue (Syáma) colour of teeth, nails and lips, diminished consciousness, vomiting, eyes sunk in their sockets, feeble voice and looseness of all the joints, should be regarded as not returning from his journey (to the eternal home). 8. General Treatment :- In the curable types, cauterization of the regions of Párshni (heels), dry fomentation, exhibition of strong emetics and such like measures are recommended. Fasting should be observed at (the time of) the digestion of the food. Digestive (Páchana) remedies as well as purgatives should also be prescribed. The patient gets instantaneous relief in cases of fainting, diarrhœa, etc., on the cleansing of his body with the medicinal (emetic or purgative) remedies. Intestinal injections after the manner of an Asthápana Vasti may be likewise applied in all cases * Mádhava reads "thirst" in place of "hic-cough."

45

354. THE SUSHRUTA SAMHITA. [Chap. LVL.

of the present disease. Now hear me describe the recipes of other medicinal compounds which may be employed in the aforesaid diseases in addition to those already mentioned. 9-I0. A pulverised compound of Pathyá, Vachá, Hingu, Kalinga (Indra-yava), Grinja (a variety of garlic), Souvarchala and Ativisha taken with tepid water instantaneously relieves an attack of indigestion, colic, Visuchiká and an aversion to food. The medicine known as Kshara-gada (Kalpa-chapter VII) or Vit-salt, or mustard-seeds and a profuse quantity of treacle, should be taken (with tepid water). Sain- dhava, Hingu, Vija-pura, (D. R. seeds of Sáka), clarified butter and the two Tri-vargas (Tri-phala and Tri-katu) in combination with any fermented gruel (Kánjika), or Tri-katu and Saindhava-salt mixed to- gether with the milky exudation of Snuhi, should be taken (with Kanjika). In the alternative, the medicated salt known as Kalyana-Lavana described before under the treatment of Váta-vyádhi should be taken (with Kanjika). Pippali, Yamani and Apamarga, or Pippali and Danti in equal parts should be similarly taken. Pippali mixed with Danti should also be used with the expressed juice of Koshávati (Ghoshá). Pippali and . S'unthi should also be taken with hot water. II. The drugs known as Vyosha (Tri-katu), Karanja-fruits (seeds), the two kinds of Haridrd* and the root of Máta- lunga taken in equal parts should be pounded together, made into Gutikás (or pills) and dried in the shade. The application of these pills as an eye-salve (Anjana) along the eye-lids proves curative in cases of Visuchika.+ 12.

• Chakrapáni reads Haridrá in the singular number. + Some here read the following two compounds as an additional text :- Kushtha, Aguru, Patra, Rásná, S'igru, Vachá and Tvak should be

Chap. LVI.J UTTARA-TANTRA. 355

Diet :- Digestive and appetising Peya, etc., should be given to the patient when he experiences a good hunger after he had been fully treated with a course of emetic or purgative or kept fasting for a proper period. 13. Causes and Symptoms of Ánaha :- The disease in which Ama (undigested food) or fecal matter, gradually incarcerated (in the stomach) through the action of the deranged and aggravated local Váyu fails to find its natural outlet, or is not spontaneously evacuated is called Anaha (Enteritis ?). A case of Ánáha due to the accumulation of un- digested food (in the stomach) exhibits such symptoms as thirst, cattarrh, burning in the head, a sense of heavi- ness and cramps in the stomach, nausea (D. R .- heavi- ness of the heart) and suppression of eructations. While a case of Anáha in the Pakvásaya (intestines) is marked by a sense of stuffedness in the back and waist, suppression of stool and urine, colic, epileptic or fainting fits, vomiting of feces, laboured and difficult respiration (D. R .- swelling), as well as the symptoms mentioned under the head of Alasaka. 14. Treatment :- In a case of Anáha due to the presense of Ama, the patient should be treated with emetics and then with digestive medicines and diet according to the prescribed order. The Ama (undigest- ed food) in a case not marked by any vomiting of feces should be treated with fomentation and therapeutic

mixed together and pasted with Kanjika. This would be the best remedy, for rubbing over the body of the patient, in a case of Visuchika. Oil should be duly cooked with Chitraka, Yuthi-flower, oil-cakes (of sesamum), Bhallátaka, the two Ksháras, Saindhava and two parts of Kushtha. This shovld be prescribed by an expert to be rubbed, or used as a plaster over the body of the patient.

356 THE SUSHRUTA SAMHITA. [Chap, LVI.

agents of digestive efficacy. Vartis (suppositories) made`by pasting the purgative drugs mentioned in connection with the medical treatment of Visuchiká together with the urine of a she-buffalo, or of a she-goat or of a ewe or of a she-elephant, or of a cow, should be used. The body of the patient should be first fomented and then the powders of the drugs used in preparing the afore-said Vartis should be blown (into his intestines) through a pipe inserted into his rec- tum. Decoction should be duly prepared by boiling the drugs of emetic and purgative virtue in cow's urine. Nirudha Vasti* should soon be applied with the above decoction mixed with half as much of cow's urine+ and with honey and adding also the powders of Trivrit and salt weighing a Prakuncha (Pala). The procedurc laid down in respect of the exhibition of purgatives should be adopted here. Oil duly cooked and boiled with the foregoing drugs should also be injected into the rectum, if necessary, after the manner of an Aunvasana Vasti. 15-16.

Thus ends the fifty-sixth chapter in the Uttara-Tantra of the Sus'ruta Samhita which deals with the (symptoms and) treatment of Visuchiká.

• The application of this Nirudha Vasti should be prescribed only in the "qw" stage of Ánáha and never in its "qr" stage. t. Kartika Kundu does not include "urine" in this list. Ue reads "मानाडयुशोन" (added in half dose) in place of "मूवाडयुकेन".

CHAPTER LVII.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of aversion to food (Arochaka-Pratishedha). I: Ætiology :- The derangement of the Doshas either several or combined or an apathetic state of the mind (through grief, etc.) tends to block the food- carrying channels vis., the esophagus, etc., as well as the region of the heart causing aversion to all sorts of food, which is designated Bhaktopaghata (lit. aversion to food-popularly known as Arochaka) by the physi- cians and it is divided into five distinct types (according to the different nature of its exciting factor). 2. Specific Symptoms :- Pain and cramps at the heart and a vapid taste in the mouth are the symptoms which mark the Vataja type of Arochaka. Excessive burning sensation (in the region) of the heart, sucking pain (in the locality), a bitter taste in the mouth, thirst and fainting fits are the features which mark the Pittaja type of the disease. Itching sensation, heaviness of the body, water-brash, lassitude, drowsiness and a sweet taste in the mouth are the indications which characterise the Kaphaja type. The Tri-doshaja type is characterised by a good many symptoms which severally mark the three Doshas. Indulgence in sensual "pleasure, as well as in fear and grief, or the sight of any repugnant article, or of anything that tends to disturb the mental Manasa) equilibrium, may also usher in an attack of Arochaka. 3-7. Treatment :- In a case of the Vataja type, the patient should be first made to vomit with the help of

358 THE SUSHRUTA SAMHITA. [Chap. LVII.

decoction of Vacha and then be given a pulverised com- pound of Krishna, Vidanga, Yava-Kshára, Harenu, Bhárgi, Rásná, Elá*, Hingu, Saindhava and Nágara through the medium of any Sneha or wine or hot water. Vomiting should be induced with emetics sweetened + with the solution of treacle in the Pittaja type of the disease. The use of a lambative prepared with Sain- dhava, Sitá (sugar), honey and clarified butter would also be efficacious. In the Kaphaja type, vomiting should be induced with the decoction of Nimba and the powders of Yamáni should then (after the taking of the meal) be administered with the decoction of Aragvadha mixed with honey. The pulverised compound mentioned in connection with the treatment of the Vátaja type may also be administered (in this case). All the preceding measures should be employed in the Tri-doshaja type of Arochaka. 8-I1. Four Specific Lambatives :- (1) Drákshá, Patola, Vit-salt, Vetra, Karira (bamboo-sprouts), Nimba, Murvá, Abhayá, Aksha, Vadara, Amalaka, (barks of) Kutaja and seeds of Karanja and of Aragvadha should be (powdered and) duly cooked with the urine of a cow in the form of a lambative. (2) A similar preparation should be made of Mustá, Vacha, Tri-katu, the two kinds of Rajani, Bhárgi, Kushtha and Nirdahani+ and cooked with the urine of a ewe. (3) Similarly

• Elá-Dallana says that some take Elá in the sense of Ela-váluká (a part used for the whole). S'ivadasa, however, refutes this and asserts, on the authority of Vágbhata, tbat "Ela" should mean Elá. t According to some, the emetic used should be Madana fruit ; while, according to others, it should be the drugs of the Madhura (Kákolyádi) group-the word 'Madhura' indicating the same. Some, however, read 'Madhuka' (Yashti-madhu) for 'Madhura'. $ Nirdahani, according to some, means Chitraka, but, according to others, it means Yamani. The former sense is the most general one.

Chap, LVII. ] UTTARA-TANTRA. 359

Páthá, Vamsá-lochana, Ativishá and Rajani should be boiled together with the urine of a she-elephant. (4) Manduki, Arka, Amritá and Lángalá should be similarly boiled by an experienced and practical. physician with the urine of a she-buffalo. Whoever licks up any * of the four preceding lambatives gets rid of Gulma, aversion to food, asthma' and diseases affecting the heart and the larynx. 12. Regimen of Diet :- The patient should par- take of fruits, edible roots, etc. which grow in his country and take cordials, Shádavas + Rágast and other palatable dishes which are congenial to his physical tem- perament and which he is accustomed to. He should also be made to take (articles of) different Rasas § in different ways and his food should be at the same time light, Ruksha and agreeable to his taste. 13. The due applications of Asthápana-Vasti, purgatives and of light head-purgatives (errhines) are efficacious in the discase under discussion. The drugs known as Tryushana, Rajani (D. R .- the two kinds of Rajani) and Tri-phala pounded together and mixed with powdered Yava-kshára and honey, should be used as a tooth- powder in washing the mouth. Any other drugs of bitter and pungent taste may be likewise prescribed for the purpose. 14-15.

• According to Dallana the four lambatives should be used in cases of Vataja, Pittaja, Kaphaja and Tri-doshaja types of Arochaka respectively. t "Shádava"-It is a preparation with a variety of articles of sweet, acid and saline tastes. "Raga"-It is a preparation of a cordial with sugar, Souvarchala- salt, Saindhava, turmeric, Parushaka, black-berry and mustard, etc. § Dallana interprets "Rasa" by meat-soup but we are inclined to take it in the sense of articles of different tastes (Rasa).

360 THE SUSHRUTA SAMHITA. [Chap. LVII.

Use of Decoction, Arishta and Ásava : -Decoctions of the drugs of the Mustadi and Aragva- dhadi or Das'a-mula groups as well as the different lambatives with honey, the different Asavas prepared with any officinal urine and with treacle as well as the different Arishtas and the different Asavas prepared from any Kshara and resembling in scent, the wine prepared from honey, should be used in conquering an attack of Arochaka. The aforesaid measures should also be employed for the purpose of re-kindling the digestive fire (appetite) impaired through the action of deranged Váyu and Kapha. 16. Treatment of Manasa Arochaka :- In a case of impaired digestion due to the cffects of any ungratified desire, fear, grief, etc., the lost longing for food should be restored in the patient by holding out to him the near prospect of its realisation and by consoling him with the prospects of fresh joy and safety. In a case due to the loss of a splendid fortune, the bitter apathy and loathsomcness of the patient towards taking any food should be removed by infusing fresh hopes into his heart and by narrating to him the balmy stories of the Puránas. A case due to dejection or despondency should be conquered by sinceresympathy and cheering up. In short any impairment of appetite due to any disturbed or agitated state of the mind should be remedied with discourses gratifying to the patient under the circumstances. 17

Thus ends the fifty-seventh chapter in the Uttara-Tantra of the Sus'ruta Samhità which deals with the (symptoms and) treatment of Arochaka.

CHAPTER LVIII.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of the suppression of urine (Mutra-ghata Prati- shedha). I. The disease is of twelve* kinds, vis., Váta-kunda. liká, Ashthilá, Váta-vasti Mutrátita, (Mutra-) Jathara, Mutrotsanga, (Mutra-)Kshaya, Mutra-granthi, Mutra- sukra, Ushna-váta and the two forms of (vis. Kaphaja and Pittaja) Mutraukasada. 2. Symptoms of Vata-kundalika :- The bodily Váyu deranged and aggravated through an extremely parched condition or through the voluntary repression of an urging towards micturition affects and retains the urine in the bladder, causing it to revolve in eddies within the cavity of that organ. It allows the urine to pass in small quantity or (even) to dribble out in drops with pain. This disease is known as Vata- kundalika and is of a violent type. 3. Vatashthila :- The deranged and aggravated bodily Vayu incarcerated or lodged in the region lying between the bladder and the anus gives rise to a thick lumpy tumour like a pebble (Ashthilá), which is hard and non-shifting in its character, producing suppression of stool, urine and flatus, distension of the abdomen and pain in the bladder. It is known as Vatashthild 4. Vata-vasti :- The bodily Vayu in the locality, aggravated by a voluntary repression of a propulsion to urination enters into the bladder of the ignorant

• Mádhava reads thirteen different kinds of this disease. He reads only one kind of Mutra-sáda and adds Vid-vighata and Vasti-kundala. 46

362 THE SUSHRUTA SAMHITA. [Chap, LVIII.

person doing the same and also obstructs the orifice of that organ causing retention of.urine with an oppressive pain in the bladder and loins. The disease is known as Vata-vasti and is extremely hard to cure. 5. Mutratita :- The urine of a person voluntarily suppressing it does not flow out at all or only dribbles out in drops or in scanty jets with slight pain, when he strains. The disease is called Mutratita. 6. Mutra-Jathara :- The vital Apana Váyu is deranged and aggravated by the Udávarta produced by a checked desire for urination and completely fills up and distends, with an excruciating pain in the abdomen below the umbilicus. The disease is called Mutra- jathara and the lower orifices* (vis. the anus and the urethra) are obstructed in this diseasc. 7. Mutrotsanga :- The disease in which the stream of urine gliding along the bladder and urethra is gradually emitted in scanty jets or runs down the exterior surfacc of the glan penis with blood, whether with or without pain, is called Mutrotsanga (lit. gliding urination) and is an outcome of the deranged and aggra- vated action of the bodily Váyu. 8. Mutra-kshaya and Mutra-granthi :- The deranged and aggravated Pitta and Váyu in the bladder of an extremely fatigued person already suffer- ing from an extreme parchedness of organism, finds lodgement in the bladder producing, in concert, a sensa- tion of local burning and pain attended with a scanty accumulation of urine in the cavity of the organ (lit. absence of micturition). The disease which can be made to yeild only to the virtue of therapeutic agents

• Some read "rfefraw" the lower part viz., the neck of the bladder is obstructed.

ChapMLVIII.J UTTARA-TANTRA. 363

with the greatest difficulty is called Mutra-kshaya. A small round painful fixed Granthi suddenly occurring on the interior side (of the orifice) of the bladder and exhibiting by its characteristic pain, etc., all the symp- toms of the presence of gravels (urinary calculii) in that organ, and which stands completely obstructing its orifice without letting out a single drop of urine, or admits only of its being dribbled out in scanty jets, is called Mutra-granthi. 9-IO. Mutra-Sukra and Ushna-vata :- A person visiting a woman in the presence of a strong urging towards urination and by voluntarily repressing the same is found to pass urine highly charged with semen which is sometimes seen to precede or follow the discharge of urine. The urine in this case resem- bles the washing or solution of ashes in colour. The disease is called Mutra-sukra (lit. semen-charged urine). The disease in which the Pitta of a person deranged by such factors as over-fatiguing physical exercise, exposure to the sun, or arduous pedestrian journey, gets into his bladder completely wrapped in the deranged Váyu of his body, and produces an intense burning sensation in his bladder, penis and the anus, setting up a painful flow of a dark yellow or blood- streaked urine or of blood alone through the urethra in its stead, is designated as Ushna-vata. 1I-12. Two kinds of Mutraukasada :- A non- slimy and thick flow of yellow-coloured urine attended with a burning sensation, and leaving a sediment like powdered Rochaná when dried, is called (Pittaja) Mutraukasada. The wise ascribe the origin of this disease to the action of the deranged Pitta. The type in which a pale sediment resembling the powders of conch-shell is deposited when the urine is dried and

364 THE SUSHRUTA SAMHITA. [Chap. LVIII.

in which the flow is painful and the urine is slimy, thick and white, should be attributed to the action of the deranged Kapha. It is but another variety of the disease described immediately before. 13. General Treatment :- Medicinal decoctions, Kalkas, (medicated) Ghritas, (various kinds of) foods, lambatives, preparations of milk, alkalis, honey, Asavas, fomentation and Uttara-vasti should be employed according to their indications in coping with an attack of any of the aforesaid ailments. An intelligent physi- cian shall resort, in these cases, to measures which are efficacious in cases of Asmari, or shall employ in their entirely the medicinal compounds which have been described as curative under the treatment of urinary Udávarta. 14 A case of Mutra-krichchhra would be relieved by the use of pasted Erváru-seeds and Saindhava weighing an Aksha and taken with the fermented paddy-boilings. A person afflicted with Mutra-krichchhra should take wine (prepared from Pishta or pasted rice) in combina- tion with Souvarchala-salt, or he should take wine pre- pared from honey by biting meat at intervals, or take any wine made from treacle. In the alternative, a Karsha measure of Kumkuma should be kept saturated with honey and water during the night and this should be taken in the morning, whereby the patient would be relieved of the trouble (of Mutra-krichchhra). By taking the principal wine (vis., that prepared from Pishta or pasted rice) with salt, powdered Elá, Jiraka and Nagara and saturated with the acid juice of pomegranade one would get rid of Mutra-krichchhra. 15-16 Half a Prastha measure of water with four times as much of milk together with the drugs of the Prithak- Parnyádi (Vidári-gandhádi) group and Gokshura-roots

Chap. LVIII.] UTTARA-TANTRA. 365

should be kept boiling till all the water is evaporated. A person suffering from an attack of Mutrá-gháta due to the concerted action of deranged Váyu and Pitta should use this medicated milk, when cooled, with sugar and honey. The dung of an ass or of a horse should he squeezed through a piece of linen and a Kudava measure of this expressed liquid should be taken for the cure of an attack of painful urination. 17-18. An Aksha measure of the compound made by pasting Musta, Abhayá, Deva-dáru, Murvá and Yashti- madhu, should be taken with the decoction of Draksha. Abhayá, Amalaka and Aksha (Vibhitaka) together weighing a Vadara measure should be taken with salt and water for getting relief in cases of painful uri- nation. An Udumbara measure of Drakshd should be kept saturated in water for the whole night and this cold infusion should be taken (in the morning) for getting relief in cases of painful urination. A Kudava measure of the expressed juice of Nidigdhika or the Kalka of the same should be taken with honey as a relief from the urinary complaints. 19. By taking a Kudava measure of the expressed juice of Amalaka, a person suffering from uninary complaints would get rid of his troubles. In the alternative, the patient should drink a potion consisting of powdered small Eld, dissolved in the expressed juice of Amalaka (and mixed with honey), or he should take a paste of the tender roots of Tála (palm) with cold rice- washing. The expressed juice of Trapusha and white Karkataka should also be prescribed to be taken with milk in the morning. In the alternative a person should take a potion consisting of milk duly boiled with the drugs of the Madhura group saturated with clarified butter as the compound is possessed of excellent diuretic

366 THE SUSHRUTA SAMHITA. [Chap LVIII.

properties and tends to remove the seminal troubles (e. g., Mutra-sukra) as well. 20. A compound consisting of Vala, S'vadamshtra, seeds of lotus(Krouncha)*, Tandula (i.e., seeds) of Kokilakshat, roots of S'ata-parvan t, Devadáru, Chitraka and stone of Aksha, pasted together and dissolved in wine should be taken by a person. under the circumstances inasmuch as it removes the defects of urine and eliminates the gravels from the bladder. 21. The ashes of burnt Pátalá wood, which are effica- cious in relieving all sorts of urinary troubles, should be strained seven times in succession (after the manner of Kshára preparation) and taken with a small quantity of oil. In a similar way a paste of Nala, Ikshu, Darbha, As'ma-bheda and the seeds of Trapusha and Ervaruka, should be duly washed in milk and filtered and taken in combination with clarified butter. Powders of Tvak, Eld and Tri-katu should be taken by the intelligent one in combination with the alkaline solution of the ashes of Pátalá, Yava-kshára, Páribhadra and Tila. Lamba- tives made of the powders of the above-mentioned drugs should be separately licked with treacle. 22-24. Now I shall describe the measures which are bene- ficial in Mutra-dosha (urinary 'defects). Purgatives should be administered to a patient after the due application of Sneha and Sveda. Uttara-vastis should be injected after he has been duly purged. 25. Sexual intercourse should be refrained from by a person afflicted with a discharge of blood from the

• Dallana explains Krounchásthi as bones of a Krouncha bird, but we are not inclined to accept this explanation. + Some explain "Kokilákshaka-tandula" as meaning Kokiláksha and Tandula (rice) which meaning may also be accepted. $ "S'ata-parvan" may mean Durbá-grass or bamboo,

Chap. LVIII.] UTTARA-TANTRA. 367

urethra owing to sexual excesses, and he should be treated with remedies which arc constructive tonics (e. g., meat-soup, milk, clarified butter, * etc.). Uttara- vastis should be applied into the urethra, under the circumstances, with cock's lard and with oil, the process of applying which has already been elaborately des- cribed. (See Chikitsa, XXVII). 26-27. Half a Pátra measure of honey, one Pátra measure of clarified butter churned from milk (Kshira-sarpis) + and equal parts of sugar, and powdered Drákshá, Átmaguptá-seed, Ikshuraka and Pippali, together weigh- ing one half part i.c., half of half a Pátra) should be thoroughly mixed by stirring the compound with a laddle. A Páni-tala (two Tolás) measure of this com- pound should be licked, followcd by draughts of milk. By using this Ghrita, a man is relieved of all injurious principles of his body, and gets rid of distressing and dreadful urinary troubles which cannot otherwise be casily cured by any other remedy. It acts as an excellent blood-purifier, and, by using it, even a barren woman may get rid of her sterility and of all other vaginal and uterine complaints which usually obstruct or retard con- ception in females. 28.

• Dallana says that Kârtika does not read this, in as much as this would increase the number originally mentioned, as also because this case has already been mentioned in Prameha. But according to Jejjata, this is mentioned here to make the case more clear. + Dallana's reading here evidently is 'Kshira-sarpishah', but according to a variant the reading would be "Ksbira-sarpish u" i.e., milk and clarified butter (taken together). The latter reading has the support of Chakrapani and Vrinda who, however, read these lines in a different way and prescribe the drugs in somewhat different proportions. The former reading 'Kshira-sarpishah' with the sixth case-ending is, however, more grammatical.

368 THE SUSHRUTA SAMHITA. [Chap. LVIII.

Equal parts of Valá, stones of Kola-fruits, Yashti- madhu, S'vadamshtrd (Gokshura), S'atávari, Mrinála (lotus-stem), Kaseru, seeds of Ikshuraka, Sahasra-viryá (Durbá), Amsumati (Sála-parni), Payasyá (Vidári), Kálá, S'rigalavinnd (Prisniparni), Ati-vala and the drugs of the Vrimhaniya (Kákolyádi) group should be duly boiled with four times of water of their combined weight and a Tulá masure of treacle. When only a Drona measure of water would remain, it should be taken down and strained through a piece of linen. It should then be duly cooked with an Adhaka measure of clarified butter. The medicated Ghrita (thus prepared) with a Prastha measure of honey added to it (when cooled) should be kept in an earthen pitcher. By using this medicated Ghrita, one would be cured of all urinary troubles .* 29.

Thus ends the fifty-eighth chapter in the Uttara-Tantra of the Sus'ruta Samhita which deals with the (symptoms and) treatment of the suppression of urine (Mutraghàta).

• Additional Text :- Powders of Tuga-kshiri and sugar should be mixed together with honey and licked in an auspicious day according to the digesting capacity of the patient and a draught of milk should then be taken. By its use the patient would be able to conquer all seminal troubles if he observes a perfect continence. One whose semen has been wasted by sexual excesses would get instantaneous relief; and a man who is possessed of vigour (Ojas) and strength would be refreshed and cheerful.

CHAPTER LIX.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of the defects of urine (Mutra-dosha-Pratishedha) .* I. Classification :- The discase known as Mutropaghata is divided into eight different types according as an attack is induced by the deranged action of the bodily Váyu, Pitta and Kapha separatcly, or is due to the concerted action of all of them, or to the effects of an external blow or hurt (on the locality), or to the pressure of the feces incarcerated (in the intestine),-i.e. to the constipation of the bowels-or to the presence of any stone (Asmari in the bladder). The cighth is the one duc to the presence of gravels (Sarkará in the bladder). This disease is onc of the most painful and distressing ailments which assail the human body. 2. Specific Symptoms :- A scanty flow of urine coming out in drops and producing an oppressive and bursting pain in the scrotum, penis and bladder, is the specific feature of the Vataja type of the discasc. The Pittaja type is characterised by the cmission of bloody or high-coloured (lit. dark yellow) and (very) warm urine which produces a burning sensation in the scrotum, bladder and penis being burnt by fire, as it were. A

• Dallana's reading evidently is Mutra-krichchhra (Strangury), for he says that the variant here in some Mss. is Mutra dosha. He says further that some do not read this chapter at all on the ground that the matter in this chapter is included in the chapters on As'mari, Mutrágháta and Udàvarta, etc. But, according to him, it must De read here for treat- ment's sake as well as on the ground of its being separately treated in other authoritative works. Madhava, Chakra-páni, Vrinda and other com- pilers have read this as Mutra-krichchhra in a separate chapter as here. 47

370 THE SUSHRUTA SAMHITA. [Chap. LIX.

sense of weight or heaviness in the scrotum, penis and bladder, an appearance of goose-flesh (on the skin) and the emission of cold, white and glossy (oily) urine, arc the features which mark the Kaphaja typc. Burning sensation (in the urethra, etc.), shivering (of the body), frequent emission of urine of varied colours, painful micturition and loss of consciousness are the indications which point to the Sannipatika origin of the disease which is very hard to cure. 3-6. The presence of any ulcer in or an injury to the urethra, by any external object gives rise to an extremely distressing stricture in the case of which the characteristic symptoms of Váta-vasti manifest themselves. The sup- pression of the feces lcads to the aggravation of the local Váyu which, in its turn, produces a distension of the abdomen and a suppression of urine accompanied with cramps (in the bladder). 7-8. Aśmarija and Śarkaraja :- Mutrá-gháta (obstructed urination) due to the presence of Asmari (stone) has been already mentioned (in the Nidána Sthána). Stones and gravels are of similar origin and exhibit similar symptoms. Now hear me describe the symptoms which are the distinguishing traits of a case ot Sarkará (gravel or urinary calculus in the bladder). Flakes or particles of deranged and condensed Kapha when baked (dried ?) by the action of the deranged and aggravated Pitta and severed in pieces by the deranged bodily Váyu, are called Sarkara (gravels) giving rise to such symptoms as cardiac troubles (pain in the heart, etc.), shivering, cramps in the loins, great diminution of the digestive fire, fainting fits and painful and obstructed urination. The pain, however, subsides with the subsi- dence of the desire for micturition (full evacuation of the bladder), the relief from the pain continuing until

Chap. LIX.] UTTARA-TANTRA. 371

the orifice of the organ (urethra) is not again obstructed by the presence of other calculii. These are the symp- toms which characterise a case of Mutrágháta (obstructed urination) due to the presence of gravels in the bladder. 9. General Treatment :- Now I shall describe the mode of medical treatment and active therapeutic agents to be employed in the cight cases of Mutrá- gháta. Medical measures and remedies mentioned in connection with the treatment of Asmari (stone) should also* be employed in the present instance in due succes- sion-commencing with the application of Sneha, etc. -with proper regard te the Dosha or Dhosas involved in each case. 10. Treatment of Vataja Type :- Oil, clari- fied butter and lard mixed together should be duly cooked with S'va-damshtrá, As'mabheda, Kumbhi (a kind of moss), Hapushá, Kantakári, Balá, S'atávari, Rásná, Varuna, Giri-karnika and the drugs of the Vidári- gandhadi group. Oil or clarified butter alone may also be similarly cooked and prepared with the above drugs. The above preparations should be internally administered, or injected into the intestines after the manner of an Anuvásana-vasti, or into the urethra as an Uttara-vasti for giving relief in cases of Vataja Mutra-krichchhra. 1I-12. Pittaja and Kaphaja Types :- The internal use of the clarified butter duly cooked with the drugs of the Trina-pancha-mula, Utpaládi, Kákolyádi and Nyagrodhádi groups, would give an instantaneous relief in a case of Pittaja Mutra-Krichchhra. The use of this Ghrita as an Uttara-vasti would also similarly give

• Dallana says that the presence of the particle "" (meaning also) indicates that the mode of medical treatment prescribed in cases of Mutrágháta should also be applied in this case.

372 THE SUSHRUTA SAMHITA. [Chap. LIX.

relief in a case of the present type. Any Sneha duly cooked with the preceding drugs should be similarly used after the manner of any of the three Vasti-applica- tions. Purging with milk and the expressed juice of Ikshu and of Dráksha is also beneficial. Oils and Yavágus duly cooked with the drugs of the Surasádi, Ushakádi, Mustádi and the Varunadi groups would prove curative in a case of Kaphaja Mutra-krichchhra. 13-14. Tri-doshaja Type :- The foregoing measures and remcdies should be employed in the Tri-doshaja type of Mutra-krichchhra according to the nature and intensity of the predominance of the Doshas involved. Pulverised compound of Phalgu (Kákodumbara), Vris'- chika (white Punarnava), Darbha and As'ma-sára (dead iron) taken with water, potions of Surá (wine), the expressed juice of Ikshu, and the decoction of Darbha would relieve pain in a case of Mutra-krichchhra. 15. Medicines and medicinal measures mentioned in the chapter on the treatment of Sadyo-vrana should be employed in a case of stricture due to any hurt (Abhighata) to the urethra. Váyu-subduing remedies should be constantly used, and baths, fomentations, un- guents, applications of Vasti and powders should be employed in a case of Purishaja Mutra-krichchhra. The treatment of the last two kinds (vis. Asmari-ja and Sarkará-ja) has already been described. 15-17.

Thus ends the fifty-ninth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the (symptoms and) medical treatment of Mutra- dosha.

Here ends the Kaya-Chikitsa.

CHAPTER LX.

Now we shall .discourse on the chapter which deals with the (symptoms and) medical treatment of the disease brought on through super-human* influences (Amanusha-Pratishedha). I. Now we dilate upon the dictum which has been put forward in the first portion of the present work, and which is to the effect that a patient suffering from ulcers should always be protected from the evil in- fluences cast by night-rangers (i. e. ghost, monsters, and malignant spirits, etc.). Whoever produces super- human character in a man by making him exhibit uncommon fortitude and marked irrelevancy in his dealings and the power to know the private and future events is called a. Graha. 2-3. Causes of influence by a Graha :- Innumerable are the Grahas and their tutelary divinities who roam about in the world in quest of offerings or out of their innate tendency for mischief and cruelty and choose their victims from among persons who are impure in body, mind and acts-be they ulcerated or otherwise. These Grahas though possessed of various shapes and figures are mainly classificd under eight groups or families. The Devas (deities) and their enemies (vis. the Asuras), Gandharvas, Yakshas, Pitris (manes), Bhujangas, (Serpent-dieties), Rákshasas (monsters) and Pisáchas (filthy goblins) are the eight classes of Grahas. 4-5. Indications of attack by Grahas : - A person possessed by a Deva (divine) Graha is cleanly,

• Amánusha-lit. non-mánusha, i. c. other than human. It includes the deities, demons, ghosts, monsters and the manes and even the serpent- deities.

374 THE SUSHRUTA SAMHITA. [Chap LX.

contented, vigorous and with little sleep. He speaks in good and pure Sanskrit, betrays a strong and decided liking for flowers and perfumes, grants boons (after the fashion of a divine being) to all and is devoted to Bráhmanas, and stares with a fixed gaze (in his eyes). A person labouring under the malignant influcnce of an Asura Graha (devil) perspires copiously, speaks ill of the gods, Bráhmanas and preceptors, knits his brow with arched eyes, has no fear, becomes satisfied with all kinds of food or drink and exhibits vicious propensities. A person under the influence of a Gandharva Graha moves about happily along lovely river-banks, or in lovely forest. Always cleanly in body and acts, he shows fondness for songs, flowers and sweet scents, laughs merrily and croons sweet songs and dances. Copper-coloured eyes, partiality for wearing thin red garments, vigour and fortitude, repeated offers for granting boons or gifts to persons, taciternity, restiveness (D. R .- fastness in walking) and gravity of the mind are the symptoms which are manifested in a person coming under the influence of a Yaksha Graha. 6-9. A person similarly affected by a Pitri Graha be- comes calm and quiet as well as reverent towards the manes. He offers oblations on Kus'a-grass and libations of water for their satisfaction, with the upper garment worn in a fashion so as to fall under his left arm and exhibits a liking for cooked meat as well as sesamum, treacle and Payasa. A person struck by the malignant influence of a Bhujanga Graha, sometimes moves on his breast along the ground like a serpent, always licks the corners of his lips with the tip of his tongue, becomes drowsy (D. R. irritable) and shows a marked predilection for treacle, honey, milk and Payasa. 10-11.

Chap. LX.] UTTARA-TANTRA. 375

A fondness for flesh, blood and various kinds of ardent spirit, blank shamelessness, extreme cruelty, courageousness, irritability, extraordinary strength, stirring out in the night and an entire disregard of cleanliness are the traits which mark a person attack- ed by a Rakshasa Graha. Haughtiness, emaciation of the Iframe, roughness of behaviour, garrulousness, fetid smell from the body, extreme uncleanliness and restiveness, voracious eating, fondness for cold water and lonely places, stirring abroad in the night (D. R. fondness for walking about the out-skirts of forest) and roaming about weeping and engaged in vicious pursuits (D. R. anxious looks) are the features which show that a person has been possessed by a Pisacha Graha. 12-13. Prognosis : -If a person possesscd by a Graha, has swollen eyes, quick pace, foam at the mouth which he licks himself, drowsiness, staggering gait which sometimes compels him to fall down on the ground or if he is possessed by a Graha after his fall from a hill, an elephant, a tree or such other high place, or if he be old,* he should be regarded as incurable. 14. Times of possession :- A Deva Graha strikes i. e. possesses a man at full moon; an Asura Graha at the meeting of day and night i. e. in the morning and evening twilights ; a Gandharva generally on the eighth and a Yaksha on the first day of the fortnights. A Pitri Graha possesses a man on the new moon day ; and a Sarpa Graha (serpent- devil) enters on the fifth day of the new or full moon. A Rákshasa Graha possesses a man at night and a

• In place of "वा्जसेन जुष्टः" Madhava reads 'त्योदशाब्दे' i. e. (it is al so incurable) when it has continued for thirteen years,

376 THE SUSHRUTA SAMHITA. [Chap. LX.

Pisacha Graha on the fourteenth day of the fortnights. A Graha imperceptibly enters into the body of the patient in the same way as an image imperceptibly enters into (the surface of) a mirror, as heat or cold penetrates into the body of an organic being and as the rays of the sun are collected in the crystal lens known as the Surja-kanta gem and as soul enters the body unseen. 15-16. Austere penances and vows, self-control, truthfulness, charities and religious practices as well as the eight qualities* are either wholly or partially present in the Grahas according to the degree of their respective power. These spiritual bodies never come in contact with, nor do they themselves strike human beings. Those who hold contrary opinion, must be ignorant of the mys- teries of demonology. It is the thousands and hundreds of thousands and hundreds of millions of the followers of the Grahas, who are fierce-looking and fond of flesh and blood, and who stir abroad in the night and possess the men on earth. 17. Of these malignant spirits (Grahas) those who are associated with the gods should be regarded as of celestial essence in virtue of their partaking of a tinge of divine virtues. Those who are known as Deva Grahas and are cleanly should be worshipped and homaged and prayed like the other gods of our Pantheon. The Grahas should be credited with those powers, virtues and characteristics which are the attributes of

• The eight qualities referred to are :- (1) Animan or the superhuman power of becoming as small as an atom at will. (2) Laghiman-power of becoming excessively light at will. (3) Vyápti-expansiveness. (4) Prá- kàmya-irrisestible will. (5) Mahiman-power of increasing the size at will. (6) Is'itva-greatness. (7) Vas'itva-self-control and (8) Kámáva- sàyità-suppression of passion,

Chap. LX.J UTTARA-TANTRA. 377

their respective masters. They are the issues of Nairiti's daughters and their living has been fixed as such by the various Ganas (or groups of gods and demi-gods) as they are always adverse to truthfulness, i. e. the true performance of the dictates of the Sástra. Those that roam about in quest of evil and mischief in spite of the celestial nature of their own divine essence and tem- perament have been termed Bhutas (spirits). Hence that branch of medical science which treats of the therapeutics of diseases which originate from the influ- ences of Bhutas (or Grahas) is called the Bhuta- Vidya. 18-20. General Religious Treatment :- Japas (mental repetition of a Mantra sacred to any deity), Homas (offering of oblations to the gods) and other religious rites in accordance with the proper rules should be undertaken by a careful physician for their propitia- tion. Offerings of garlands of red flowers with red scents (such as red Sandal paste, Kumkuma, etc.), seeds (such as mustard, barley, etc.), honey, clarified butter and all sorts of victuals are the articles required general- ly for (propitiation of) all classes (of Grahas). 21. Specific Religious Treatment :- Clothes, wine, blood, flesh or milk should be offered to them according to their respective likings *. Offerings to the respective Grahas should be made on the day corresponding to that in which they gencrally strike their victims. Homas in the fire with the offerings of Kus'a, Svastika, cakes (Pupa), clarified butter, umbrella and Páyasa (porridge) should be made to the Deva (celestial) Grahas in divine temples. To the Asura Grahas the offering should the made in the yard * This S'loka corresponding to "cloth ...... likings" is only a variant according to Dallana. He does not seem to read this S'loka. 48

378 THE SUSHRUTA SAMHITK. [Chap. LX.

(Chatwara), etc. of a house at the proper time (viz. at evening); offerings to the Gandharva Grahas should be made with wine and the soup of Jangala animals in the midst of a gathering ; while those to the Yaksha Grahas should be made inside a house with the cakes of boiled Másha pulse (Kulmásha), blood, wine, etc. The Pitri Grahas should be propitiated with the offer- ings made on Kus'a grass together with Madhavi and and Kunda flowers on the banks of a river ; offerings to the Rakshasas should be dedicated in dreadful lonely forests or at the crossing of two roads, while to the Pisachas cooked or uncooked flesh should be offered in a lonely chamber. 22. Medical Treatment :- In case the preval- ent Mantras enjoincd to be recited on such occasions (in works on Demonology) are found to be ineffective the following medical measures, should be employed. Skin and hairs of a goat, a bear, a Salyaka (porcupine), or of an owl pasted togother with Hingu and goat's urine and made,into incense sticks, should be burnt before the patient, who would be fumigatcd with the fumes emitted therefrom. The attack even of a violent Graha would readily yield to it. The drugs known as Gaja- pippali, Pippali-roots, Tri-katu, Amalaka and Sarshapa, duly soaked in the biles of a lizard, mungoose, cat and bear should be employed as unguents, snuffs and wash by an experienced physician. Dungs of an ass, horse, mule, owl, camel*, dog, jackal, vulture, crow and boar pasted together with the urine of a she-goat should be duly cooked with an adequate quantity of oil. The oil thus prepared would be beneficial if used (as snuff, etc.) in the preceding manner. 23-25. * The word in the text is 'Karabha' which many mean a camel or an elephant. Dallana explicitly explains the word as a camel,

Chap. LX.] UTTARA-TANTRA. 379

S'irisha-seed, Las'una, S'unthi, Siddhárthaka, Vacha, Manjishthá, Rajani and Krishná should be pasted together with goat's urine and dried in the shade. Vartis (stick3) prepared with this should be applied with the bile (of a cow) along the eye-lids as an Anjana. Vartis prepared with Naktamála-fruit, Tri-katu, roots of S'yonaka and of Vilva as well as the two kinds of Haridra should be used as an Anjana in a similar way. Saindhava, Katuka, Hingu, Vayasthá (Guduchi) and Vachá, pasted together with goat's urine and with the bile of a fish, should be similarly used as an Anjana in cases of attacks by the Grahas which would not otherwise yield. 26-28. Matured clarified butter, Las'una, Hingu, Siddhar- thaka, Vacha, Golomi, Ajalomi, Blutakes'i (Jatámámsi), Jata (Gandha-mamsi), Kukkuti (a kind of bulb), Sarpa- gandhá, Kána, (Kshira-kákoli), Vishániká (Madhuriká), Rishya-prokta, Vayasthá, S'ringi, Mohana-Valli, (Vata- patrika), Arka-roots, Tri-katu, Lata (Priyangu), Anjana (Rasánjana), Srotonjana, Naipáli, Haritála and other articles which have the efficacy of exorcising evil spirits, as well as the dungs, hairs, skin, Vasá, urine, blood, bile nails, etc. of lions, tigers, bears, cats, elephants, horses cows, dogs, Salyakas, lizards, camels, mongooses, etc., should be used in the preparation of oil and clarified butter which should be used internally as well as in snuffing and as unguents. Pills made of the above drugs should be used in sprinkling (wash) and their powdered compound in dusting (the body of the patient). A paste prepared with the above drugs should be used as plasters. The due and proper application of the oil, Ghrita, etc. thus prepared would, in a very short time, surely cures all sorts of mental disorders. 29. Unholy and improper articles should not be em-

380 THE SUSHRUTA SAMHITA [Chap, LX.

ployed in a case due to the influence of any Deva Graha (divine spirit). No hostile measure should be adopted in a case of possession by a Graha other than that due to the influence of a Pisacha Graha in as much as the mighty Grahas, if offended, might kill both the patient and the physician for the act. A physician, treating such a case with discretion according to the rules laid dawn in the chapter known as the Hitáhita (Ch. XX, Sutra-Sthána) may acquire both fame and wealth. 30-31.

Thus ends the sixtieth chapter of the Uttara-Tantra in the Sus'ruta- Samhita which deals with the (symptoms and) treatment of the disease brought on through super-human influences.

CHAPTER LXL

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Apa- smára (Apasmara-Pratishedha). I. Derivative Significance :- The word "Smriti" signifies the faculty of past sense-perceptions and (the prefix) "Apa" denotes the privation (of any object or attribute). Hence, this disease (in which an in- dividual loses the faculty of past cognitions) is termed Apasmara (Epilepsy) and it turns fatal. 2. Causes :- Excessive, inadequate and improper attention to the objects of the sense as well as to their actions, partaking of filthy, impure, incompatible and uncongenial articles of fare and regimen of conduct, repression of any natural urging of the body or aggra- vation of the Rajas and Tamas (nescience), or going in unto a woman in her menses, or indulgence in amorous fancies, fright, anxiety, anger, or grief, etc., leads to an aggravation of the bodily Doshas which in their turn affect the mind (Chetas) very greatly and give rise to Apasmara. 3. The sense-carrying Srotas (channels) of the body overwhelmed by the concerted action of the deranged Doshas bring in a predominance of Rajas and Tamas (Nescience) causing the patient unconscious and forgetful of all past memories. He writhes in agony and throws his hands and legs in convulsive jerks with contracted eyes (D. R. tongue) and eye-brows. He gnashes his teeth, with foams at the mouth, ctc., and falls to the ground with open cyes, the consciousness returning a short while after. The disease is called Apasmara which is

382 THE SUSHRUTA SAMHITA [Chap. LXI.

classified into four distinct types-vis., Vátaja, Pittaja, Kaphaja and Sannipátaja. 4. Premonitory Symptoms :- The throb- bing of the heart, emptiness or lightness (of the chest i.e. a sense as if the external world is vanishing away fastly), perspiration, pensiveness, fainting, stupid appearance and sleeplessness are the symptoms, which are usually found to usher in an attack (of Apasmára). 5. Symptoms of Vataja and Pittaja types : - In the Vataja type of Apasmara the patient fancies that a dark supernatural being is coming after him to seize his person and is frightened and faints in consequence with shivering grinding of the teeth i. e. lock-jaw, laboured breathing and foaming at the mouth. Fainting is excited by a terror of being seized by a yellow and fierce-looking being in the Pittaja type which is further marked by thirst, increased heat of the body, perspiration, fainting, mild tremor of the limbs and restlessness. 6-7. Kaphaja and Sannipataja Types :- Where the patient is excited by a fancied dread as if a supernatural being of white colour is coming to apprc- hend him, it is a case of the Kaphaja type which is moreover characterised by the. exhibition of such symptoms as shivering, nausea, sleepiness, falling prostrate on the ground and vomiting of mucus. Pain in the heart, thirst and nausea are the specific charac- teristics of the three types respectively. But delirious talk and the making of indistinct and moaning sounds are present in all the types. The specific features of all the three foregoing types manifest themselves in concert in a case of Sannipatika type. 8-I0. Discussion on its cause :- The sudden appearance of the disease without any apparent cause

Chap. LXI.] UTTARA-TANTRA. 383

and also its sudden and spontaneous disappearance after a short while without any apparent treatment, have induced several medical authorities to hold that Apasmára is not due to any (aggravation of the) Dosha. Several authorities, on the contrary, have described, on the authority of other works on the subject, the gradual aggravation of the (suddenly) deranged Doshas as well as the concomitant symptoms of the disease in its various phases with the spontaneous and speedy nature of its abatement (though only temporary). Hence it may be presumed that as seeds sprout in autumn only, when the rains make the ground ready to receive them, the shortness of time being counted as no factor potent enough to obstruct the process (of sprouting), so the deranged Doshas of the body though gradually aggravated bring on, as a matter of fact, an attack of Apasmára with all its concomitant symptoms, only under conditions favour- able to its appearance which may, however, be short and transitory in its duration. Hence this dreadful Apasmára is certainly a disease of idiopathic origin. I1. General Treatment :- Medicinal agents and remedies to be mentioned in connection with insanity (Unmàda) may be as well employed in the present disease. The use of matured clarified butter both in- ternally and as unguents is recommended. Medicinal measures and compounds mentioned under the head of possession by the Grahas are also specially beneficial in the present disease. Oil duly cooked with S'igru, Katvanga, (Syonáka), Kinna (sediment of wine) and with the expressed juice of Nimba-barks and with cow's urine weiging four times as much, should be employed as unguents. Draughts and embrocations of oil duly cooked (separately) with the biles of a lizard, a mongoose, an elephant (or snake), a deer of the Prishata class, a bear

384 THE SUSHRUTA SAMHITÁ [Chap. LXI.

and a cow, are recommended. Strong medicinal errhines (Siro-virechana) as well as strong emetics and purgatives should be administered. The divine Rudra god and the host of his followers should be regularly worshipped and propitiated every day. 12-15. Specific Treatment :- Clarified butter duly cooked with goat's urine and with the decoction of Kulattha, Yava, Kola, S'ana-seeds, Palankashá (Guggulu', Jatámamsi, Das'a-mula and Pathyá may be given with advantage in a case of the Vataja type (of Apasmára). Clarified butter duly cooked with the decoction of the drugs of the first (i.e. Vidári-gandhadi) group and with the drugs of Kákolyádi group (as Kalka) if adminis- tered with milk, honey and sugar would be beneficial in a case of the Pittaja type. The use of (the medicated) Ghrita duly cooked with Krishna, Vacha and the drugs of the Mustakádi group (as Kalka) and with the decoc- tion of the drugs of the Aragvadhadi group* and with the five officinal kinds of animal urine is recommended in cases of the Kaphaja type of Apasmára. 16-18. Siddharthaka Ghrita :- Clarified butter duly cooked with (the Kalka of) Sura-druma, Vacha, Kushtha, Siddhartha, Vyosha, Hingu, Manjishtha, the two kinds of Rajani, Samanga; Tri-phala, Ambuda (Musta), Karanja-seeds, S'irish i-seeds, Giri-karnd (white Aparájita, and Hutas'ana (Chitraka) and with four times as much of cow's urine is called Siddharthaka Ghrita, which proves curative in cases of poisoning, worms (in the intestines), Kushtha, asthma, derangements of Kapha, Vishama-Jvara, Bhuta-graha, insanity and Apasmára. 19.

• According to Dallana, the Ghrita should be cooked with the decoc- tion of Krishna and Vacha, while the drugs of the Aragvadhadi group should be used as Kalka.

Chap. LXI.] UTTARA-TANTRA. 385

Pancha-gavya Ghrita :- Clarified butter duly cooked with the Kalka of Das'a-mula, barks of Indra-vriksha,* Murvá, Bhárgi t, Tri-phalá, Sampáka, (Aragvadha), S'reyasi (Gaja-pippali), Sapta-parni, Apá- márga and Pilu, and with the decoction of Bhu-nimba, Putika (Karanja), Vyosha, Chitraka, Trivrit, Páthá, the two kinds of Haridr, the two kinds of Sáriv, Push- kara-roots Katuka, Madayanti (Malliká), Ugrá (Vachá), Nilini and Vidanga, and with the milk, curd (Dadhi), urine and the expressed liquid of dung of a cow is called Pancha-gavya Ghrita. It proves curative in all forms of Apasmára, Bhuta-graha, Cháturthaka (quar- tian) fever, Phthisis, Asthma and Insanity. 20. General Treatment :- Vastis should be applied in the Vátaja, purgatives, in the Pittaja and emetics, in the Kaphaja types of Apasmára. 21. Milk should be duly cooked with Bhargi and Payasa (porridge) should be prepared by cooking grains of Sáli rice with this milk. This preparation should be given to a boar kept fasting for three days. When it is assured that the food taken has acquired a sweet taste (i.e. that the process of digestion has begun in the stomach of the boar) and when the symptoms of poisoning come to be exhibited in the boar, the contents should be taken out (of the boar's stomach) and (should be dried and) powdered. Three parts of this powder and one part of Kinva (the sediment of wine) should be mixed together and made to ferment in a cleansed earthen pitcher with the addition of the cooled decoction of Bhargi. The wine (Surá) thus prepared should be given in proper doses to

. By the term 'Indra-vriksha-twak' some mean (barks of) Kutaja and Twak (cinnamon). t Bhargi-Dallana explains it as Goshthodumbara-the wild fig. 49

386 THE SUSRUTA SAMHITA [Chap. LXI.

the patient as soon as it would acquire its (particular) taste and aroma. Venesection (in the forehead) as recommended before (Sárira-sthána, Chap. VIII, 25-26) should be resorted to and prophylactic and auspicious articles should be used (by the patient). 22-23.

Thus ends the sixty-first chapter in the Uttara.Tantra of the Sus'ruta Samhita which deals with the (symptoms and) treatment of Apasmára.

CHAPTER LXII.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatmentlof Insanity (Unmada-Pratishedha). I. Derivation :- In as much as (in this disease) the deranged bodily Doshas traversing the upper part of the body affect the up-coursing nerves and produce there- by a distracting state of the mind, it is called Unmada (Insanity), and it is a disease of the Manas (mind) 2. Classification :- This disease is divided into five different types according to the nature of their origin -viz., the three types due to the several actions of the three deranged and aggravated Doshas, the one due to their concerted actions and the one due to grief, etc. (real or imaginry). There is a sixth kind also, vis., that due to the effects of poison, which should be treated according to the nature and intensity of the deranged Dosha or Doshas lying at the root and which in its early stage, if not abnormally aggravated, goes by the name of Mada. 3. Premonitory Symptoms :- Fits of un. consciousness, agitated state of the mind, ringing of the ears, emaciation of the body, excessive energy of action aversion to food, eating filthy things in dreams, perturbation ie. palpitation (of the heart) due to Váyu and vertigo or giddiness are the symptoms in a patient which forebode a speedy and impending attack of insanity. 4. Specific Symptoms of Vataja, Pittaja and Kaphaja types :- Shaggy appearance, use of harsh language, appearance of a number of Dhamanis

388 THE SUSRUTA SAMHITA [ Chap. LXII.

(nerves) over the body, laboured breathing (D. R. experi- ence of excessive coldness), emaciation of the body and throbbing of the joints of the limbs are the specific fea- tures of a case of the Vataja type (of Unmada) and the patient in such a case reads clapping his hands, or sings while dancing, or shouts or wanders about. Excessive thirst, perspiration, burning sensation, voracious eating, insomnia, desire for shade, cold, wind and walks on the banks (of rivers or tanks), fits of anger, fancying fire in cold water and fancied sight of stars in the heavens in the day are the symptoms which characterise a case of the Pittaja type. Vomiting, dulness of appetite, lassi- tude or gone-feeling in the limbs, aversion to food, fondness for sexual propulsion and loveliness, stupidity, somnolence, reservedness in speech, eating little, fondness for warm things and aggravation of the disease in the night mark a case of the Kaphaja type of insanity. 5-7. Tri-doshaja Type :- A case of Sannipatika insanity exhibits all the symptoms belonging to the three aforesaid types origined from the three Doshas, vis., Váta, Pitta and Kapha. A case in which the specific symptoms of the disease are manifested in full should be deemed as incurable. Several authorities, however, hold the Sannipátika type to be sometimes curable. 8. Śokaja and Vishaja types :- A person frightened by a thief, a king's officers or his own enemy or any such person, or suffering from any distracted state of the mind owing to a loss of wealth, or from any grief (Soka) or bereavement or from any disappoint- ed love would likely have an attack of menta! dis- traction (insanity). In such cases he would uncon- sciously talk incoherently about subjects uppermost in his mind or would sing in a stupid fashion or laugh or

Chap. LXII.] UTTARA-TANTRA. 389 weep. (These are the symptoms of Sokaja insanity). Redness of the eyes, dulness of complexion and of the perceptive faculties, diminution of bodily strength, extreme dejection, blush on face and loss of conscious- ness are the symptoms which mark a case of insanity due to the effects of poisoning. 9-I0. General Treatment :- A patient suffering from insanity should be first treated with Sneha and Sveda and then subjected to a course of emetics, purga- tives and head-purgatives (Siro-Virechana). Powders of various sorts of (drugs used in) Avapida snuffing should be mixed with mustard oil and employed for the purpose (of snuffing). Fumigation with burnt putrid beef or dog's flesh should be constantly employed. Snuffing and unguents of mustard oil are also effica- cious in all cases. The patient should be surprised with wonderful sights and the news of the death of any of his dear ones should be related to him. He should be constantly frightened with sights of fierce-looking men, well-trained elephants or non-venomous snakes. The patient should be threatened with being fastened with ropes or being flogged, or frightened with bundles of blazing hay, after being fastened, while asleep. He should also be pierced in his body with pointed instru- ments, avoiding, however, the vulnerable parts*, or he should be made to reside constantly in a dry well with a cover over it. Barley gruel, powders of parched barley mixed with water alone should be given to him on every third day by an intelligent physician. The diet of the patient should consist also of palatable and appetising articles. II.

• Additional Text :- The patient should likewise be threatened with being forced into a burning hut. He should be also kept immersed in water or threatened with the fall of a thunder bolt.

'390 THE SUSRUTA SAMHITA [Chap. LXII.

.. Maha-Kalyana Ghrita :- Clarified butter duly cooked with twice as much of milk and with Vidanga, Triphald, Musta, Manjishthd, Dádima, Utpala, S'yámá, Ela-váluká, Elá, (red Chandana, Deva-dáru, Barhishtha (Bálaka), Haridrá, Kushtha, Parnini Sála- parni), Sárivá, Harenuká, Trivrit, Danti, Vacha, Tálisa- patra, Naga-kes' ara and Malati flowersas Kalka (is called Kalya'na Ghrita* and) proves curative in cases of Gulma, cough, fever, asthma, phthisis and insanity. Clarified butter duly cooked with four times as much of milk and with the aforesaid drugs as Kalka and with the drugs of the Kakolyadi group added to it by way of an after-throw is called Maha-kalyana Ghrita. The range of its therapeutic application includes (such ailments as) Apasmára, (attack by) Graha, consumption, impotency, emaciation and sterility as well as the diseases mention- ed above. 12. Phala Ghrita :- Clarified butter duly cooked with Bálaka, Kushtha, Manjishthá, Katuka, Elá, Haridrá, Tri-phalá, Hingu, As'vagandhá, Deva-dáru, Vacha, Yamáni, Kákoli, Medá, Yashti-madhu and Padmak: as Kalka), and with four times as much of milk and with sugar as an after-throw would be beneficial. It should also be prescribed for infants struck by malignant stars as well as for male adults of evil propensities and short intellect. This is known as Phala-Ghrita* and removes barrenness of women 13. Brahmi (Manduka-parni), Aindri, Vidanga, Tri-katu, Hingu, Sura (Deva-dáru), Jata (Jata-mamsi), Vishaghni (Haridrá), Las'unz (garlic), Rásná, Vis'alyá (Guduchi), Surasá, Vacha, Jyotishmati, Nága-vinná (a kind of

• According to Dallana the mentions of these two recipes (Kalyána Ghrita and Phala Grita) are interpolations.

Chap. LXII.] UTTARA-TANTRA. 391

Indra-váruni), Anantá, Abhayá and Souráshtri taken in equal parts should be pounded together and made into a paste with the addition of elephant's urine. It should then be dried in the shade, and Vartis should be prepared thereof. These should be used by an intelligent person as an Anjana, unguent, snuff, fumi- gation and Avapida. 14. Blood-letting from the Uras (chest), Apánga (outer corner of the eye) and Laláta (forehead) should be resorted to. Measures and drugs mentioned in connec- tion with the treatment of Apasmara and Graha-roga may be likewise employed in the present instance. Oily purgatives (Sneha-vasti) should be administered after the subsidence of the deranged Dosha. 15. In a case of the fifth kind (vis. Sokaja) of insanity the cause of grief should be first removed. In all forms of insanity the restoration of the serenity of mind should be first attempted. Mild and gentle forms of these remedies should be resorted to in a case of Mada (preliminary stage of insanity). Mild anti-venomous (anti-toxin) measures should be resorted to in a case (of insanity due to the effects of poison. 17-18.

Thus ends the sixty-second chapter in the Uttara-Tantra of the Sus'ruta Samhitá which deals with the (symptoms and) treatment of Insanity.

Here ends the Bhuta-vidya-Tantra.

CHAPTER LXIII.

Now we shall discourse on the chapter which deals with the different combinations of the (six) different Rasas (Rasa-bheda-vikalpa-Adhyaya). I. The fifteen different combinations of the Doshas already spoken of (in Chapter XXI, Sutra-Sthána) are meant only for the sixty-three different combinations of the (six) Rasas (taken one, two, three, four, five or all at a time). They (viz. the different Doshas) may be manifest separately (Avidagdha) or combinedly (Vidagdha) with one another and the number of their combinations should be taken to be sixty-three pari passu with the sixty- three different combinations of the (six) different Rasas. In other words, the combinations of the Doshas with one another already spoken of should be considered by an intelligent person to be sixty-three in all (and not fifteen only, as spoken of in Chapter XXI, Sutra- Sthána). 2-3. Enumeration-Taken two at a time :- The Madhura Rasa (sweet taste) coming first in the order of enumeration has got five combinations (with the other five Rasas) taken two at a time. Similarly Amla Rasa (acid taste) has got four combinations and Lavana Rasa (saline taste) has got threc. Katuka Rasa (pungent taste) has got two and Tikta Rasa (bitter taste) has got only one with Kasáya Rasa (astringent taste). The different combinations taken two at a time are thus fifteen in all. They are as follows :- (1) Sweet and acid, (2) sweet and saline, (3) sweet and pungent (4) sweet and bitter and (5) sweet and astringent-these are the five combinations of Madhura

Chap. LXIII.1 UTTRA-TANTRA. 393

(swect) Rasa. (r) Acid and saline, (2) Acid and pungent (3) Acid and bitter, and (4) Acid and astringent-these are the four combinations of Amla (acid) Rasa. (1) Saline and pungent, (2) Saline and bitter, and (3) Saline and astringent-these are the three combinations of Lavana (saline) Rasa. (1) Pungent and bitter, and (2) Pungent and astringent-these are the two combina- tions of Katuka (pungent) Rasa. Bitter and pungent is the only combination of Tikta (bitter) Rasa. Thus the fifteen different combinations (of the six Rases) taken two at a time have been enumerated. Now we shall speak of their combinations taken three at a time. 4. Taken three at a time :- The Madhura Rasa (sweet taste) coming first in the list has got ten combinations (with the other Rasas taken three at a time). Similarly Amla Rasa (acid taste) has got six ; Lavana Rasa (saline taste) has got half that number i. e. three ; and Katuka Risa (pungent taste) has got only one combination They are as follows :- (r) Sweet, acid and saline, (2) Sweet, acid and pungent, (3) Sweet, acid and bitter, (4) Sweet, acid and astringent, (5) Sweet, saline and pungent, (6) Sweet, saline and bitter, (7) Sweet, saline and astringent, (8) Sweet, pungent and bitter, (9) Sweet, pungent and astringent, and (10) Sweet, bitter and astringent-these are the ten combinations of the Rasas taken three at a time and beginning with Madhura (sweet) Rasa. (t) Acid, saline and pungent, (2) Acid, saline and bitter, (3) Acid, saline and astringent, (4) Acid, pungent and bitter, (5) Acid, pungent and astringent, and (6) Acid, bitter and astringent-thesc arc the six combinations (taken three at a time and) beginning with Amla (acid) taste. (1) Saline, pungent and bitter, (2) Saline, pungent and astringent, and (3) Saline, bitter, and 50

394 THE SUSHRUTA SAMHITA. [Chap. LXIII.

astringent-these are the three combinations (taken three at a time) beginning with Lavana (saline) taste. (t) Pungent, bitter and astringent is the only one combination (taken three at a time and) begin- ning with Katuka (puugent) tastc. Thus the twenty different combinations (of the six Rasas) taken three at a time have been explained. Now we shall speak of their combinations taken four at a time. 5. Taken four at a time :- The Madhura (sweet) Rasa has got ten different combinations of four at a time. Similarly Amla (acid) Rasa has got four, and Lavana (saline, Rasa only one. They arc as follows :- (1) Sweet, acid, saline and pungent, (2) Sweet, acid, saline and bitter, (3) Sweet, acid, saline and astrin- gent, (4) Sweet, acid, pungent and bitter (5) Sweet, acid, pungent and astringent, (6) Sweet, saline, pungent and bitter, (7) Sweet, acid, bitter and astiingent, (8) Sweet, saline, pungent and astringent, (9) Swect, saline, pungent and astringent, and (10) Sweet, pungent, bitter and astringent-these are the ten combinations (taken four at a time and) beginning with Madhmia (swect) Rasa. (1) Acid, saline, pungent and bitter, (2) Acid, salinc, bitter and astringent, (3) Acid, pungent, bitter and astringent, and (4) Acid, saline, pungent and astringent- these are the four combinations beginning with Amla (acid) tastc. (1) Saline, pungent, bitter and astringent- this is the only one combination beginning with Lavana (saline) taste. Thus the fifteen different combinations (of the six Rasas) taken four at a time have been enumerated. Now we shall speak of their combinations taken five at a time. 6. Taken five at a time :- Thore would bc five combinations (of the six Rasas) taken five at a time and beginning with the Madhura (sweet) Rasa,

Chap. LXIII.] UTTARA-TANTRA. 395

and only one with Amla (acid) Rasa. They are as follows :- (1) Sweet, acid, saline, pungent and bitter, (2) Sweet, acid, saline, pungent and astringent, (3) Sweet, acid, saline, bitter and astringent, (4) Sweet, acid, pungent, bitter and astringent, and 5) Sweet, salinc, pungent, bitter and astringent-these are the five combinations (of the six Rasas) taken five at a time beginning with Madhura (swcet) Rasa. (I) Acid, saline, pungent, bitter and astringent is the only one com- bination of the kind beginning with Amla (acid Rasa. Thus the six combinations taken five at a time have been cnumerated. Now we shall speak of their com- bination with (all the) six at a timc. 7. The combination (of the six Rasas) taken (all the) six at a time is only one. The only combination of this kind is (1) Sweet, acid, saline, pungent, bitter and astringent. S. Separately taken one at a time, the six Rasas will be-(1) Madhura (swcet), (2) Amla acid), (3) Lavana (saline', (4) Katuka (pungent), (5) Tikta (bitter, and (6) Kashaya (astringent). 9. Memorable Verse :- Sixty-three combina- tions of the six different Rasas have been enumerated by the experts on Rasa and these sixty-thrce combina- tions should be prescribcd by experienced physicians with due regard to (the aggravation or diminution of one or more of) the (three) different Doshas. 10.

Thus ends the sixty-third chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the different combinations of the (six) different Rasas.

CHAPTER LXIV.

Now we shall discourse on the chapter which dcals with the Rules of Hcalth (Svastha-Vritta- adhyaya). I. Health indicates a normal condition of the (three) Doshas (fundamental principles), Agni (the digestive fire), Mala (excrements vis, feces, urine, etc)*, and the (seven) Dhátus or root-principles of the body as well as a serene state of the body, mind and the sense-organs. It has alrcady been stated in the Sutra-sthana, that the primary object of medical treatment is to maintain this healthy state (of the body and of the mind) in its normal cquilibrium. A bricf outline of the means to be applied and of the rules to be observed for the realisation of that end, has also been given beforc. Now we shall enter into a lengthy and elaborate dissertation on the subject. 2-3. Regimen of diet and conduct in the Varsha (rainy) season :- Articles of parti- cular tastes which are remedial to the specific deranged bodily Dosha should be used or employed by experi- enced persons in the particular season of the year in which the Doshas are respectively aggravated. The bodily Váyu, ctc., of a person is generally aggravated during the Varshá (rainy) season owing to a slimy condition of the organism, producing an impairment of the digestivc fire as well as goose-flesh on the skin. Articles of astringent, bitter and pungent tastes should therefore be prescribed for a king and king-like personages during those months of the year for

• Some explain 'Kriya' separately as the organic functions e. g. sleep and awakening, etc .- Dallana.

Chap. LXIV.] UTTARA-TANTRA. 397

correcting or remedying the altered slimy condition of (things which obtain inside) the body, as well as for mitigating the aggravation of the bodily Doshas. The food should be non-liquid and made neither too emollient (fatty or lardacious) nor too Ruksha (dry), and should . be composed of articles which are appetising and heat- making in their potency. Water for drinking should be prescribed according to the rules laid down before (in chapter XLV, Sutra-sthána), or water, heated and subsequently cooled, should be taken in combination with honey, if the sky is overcast with clouds and the air is charged with humid vapours, making the water consequently very cold. 4 5. The herbs and vegetables being newly grown in this (rainy) season, are (over-juicy and) consequently not very easy to digest ; a wise man shouid, therefore, avoid the excessive use of physical exercise, water, dew, sexual intercourse and the sun's rays (which might lead to indigestion). One should, in this season, lic upon some higher place to avoid the cold damp due to the emission of earthly vapours at this time. When fceling cold one should protect oneself from it with warm clothes and should lie inside a room free from blasts of wind and with fire burning within. Fine Aguru should be used as pastes, and elephants should be used as conveyance in this season. Sleep at day-time and cating before the previous meal is digested should be strictly avoided. 6. Rules for Autumn :- Articles of astringent, sweet and bitter tastes, diffcrent preparations of milk and of sugar-cane-juice as well as honey, S'ali-rice, Mudga-pulse, oil and the meat of Jangala animals should be used in the Autumn (Sarat) season. All kinds of water are recommended in this season as they are all clcar and pure at this timc of the year. Swimming

398 THE SUSHRUTA SAMHITA. {Chap. LXIV.

and (immersion) in ponds full of Kamala (lotus) and Utpala (water lily), enjoying the moon's rays at dusk and the use of sandal-pastes are recommended. The aggravation of Pitta in the (previous) rainy season should, in this season, be duly remedied by the use of Tikta-Ghrita (Chapter IX, Chikitsita sthána), by means of venesection or by the use of purgatives. Tikshna (sharp- potencied or pungent), acid, hot and alkaline articles (of food) as well as the sun's rays, sexual excess and slecp at day-time and keeping late hours should be avoidcd. Sweet and cold water and purified wine as transparent as crystals are also recommended. All kinds of water are in this scason washed, as it were, by the clear white rays of the autumnal moon and being purified by the rising of the Agastya star,* become very clear and transparent and consequently beneficial. Clean and thin clothes scented with sandal-pastes or with camphor as well as garlands of autumnal flowers should be worn, and the Sidhu class of wine should be judiciously taken In short, all Pitta-subduing measures should be taken in this season. 7. Rules for Hemanta and winter seasons :- The season of Hemanta is cold but dry (Ruksha). The sun is weak and the atmosphere is very airy. Hence, owing to the outside cold, the bodily Vayu is also aggravated in this season. The abdominal fire becomes dull owing to the internal cold and dries up the bodily Rasa (liquid portion of the system). The use of oleaginous things is, therefore, beneficial in this

• The waters in the rainy season are generally muddy and impure. When, after the rains, the waters become purer, it is said in Hindu mytho- logy that owing to the rise of Agastya (a star making its appearance in the horizon after the rains-generally in the beginning of September) the waters become clear and transparent.

Cbap. LXIV.] UTTARA-TANTRA. 399

season. The use of saline, alkaline, bitter, acid and pungent articles of diet (prepared) with the addition of clarified butter or oil are beneficial. Food should not be taken cold, and drinks prepared with tikshna (hot- potencied) articles (such as strong wine should be taken,' after pasting the body all over with Aguru-pastes. Baths should be taken in tepid water after rubbing in oil all over the body. Large inner apartments completely surrounded by rooms on all sides and containing fire- pots (serving the purpose of chimneys) should be used as bed-rooms, and the bed-sheets should be silken. Sufficiently warm coverings for the body should be used. Kings (and king-like personages) should lie within the sweet cmbraces of maidens with big breasts and thighs and scented with the fumes of Aguru, and they can, in this season, enjoy the sexual pleasures to their heart's content and should take proper soothing food. Swcet, bitter, pungent, acid and saline articles of food and drink, as well as Tila (sesamum-seeds), Másha-pulse, pot-herbs, curd, different modifications of sugar-cane-juice, scented and newly husked S'áli-rice, flesh of Prasaha, Ánupa, Kravyáda, Bilcsaya, Audaka (aquatic), Plava and Pádin classes* of animals, as well as clear trans- parent wines and all other invigorating articles of diet should be used to his content at the advent of cold by a person wishing vigour (of the body and of the mind). The rules for Hemanta cnumerated above would hold equally good for the Sisira (winter) season. 8-9. Rules for Spring :- The bodily Kapha al- ready stored in the organism owing to the coldness of the body during the Hemanta season is aggravated during the spring by the (increasing) heat (of the sun * For a list of the animals of the different classes mentioned here, see Chapter XLVI, Sutra-sthána, pages 480 &c., Vol. I.

400 THE SUSHRUTA SAMIITÁ [Chap. LXIV.

and consequently of the organism) and gives risc to many diseases. Acid, swcet, demulcent and saline articles of food and drink as well as those that are heavy (of digestion) should, therefore, be avoided, and recourse should be had to vomiting, etc. Shashtika- rice, barley, articles of cold potency, Mudga-pulse, Nivara ricc, and Kodrava-rice, should be duly prescribed after the cold i. c. in the spring with the soup of the meat of the animals of the Vishkira class, such as Láva, etc., as well as with the soup of Patola, Nimba-lcaves, bringals and other bitter vegetables. All sorts of Asava and especially the Asava and Sidhu prepared from honey should be frecly used in the spring. Physical exercise should be had recourse to, Anjana (collyrium) should be applied (to the cyes), strong smokes should be inhaled and strong gargles used in the spring. Everything should be used with tepid water and a diet consisting of Tikshna (strong-potencied), Ruksha (non-demulcent), pungent, alkaline, astringent, tepid and non-liquid articles and esprcially the preparations of barley, Mudga pulse and honcy would be bencficial in the spring. Physical cxercise in the shape of mock-fight, walk, or the throwing of stones would be beneficial. Utsádana (massage) and bath should be had, and groves should be resorted to. Sexual pleasure may be enjoyed in this season. The bodily Kapha stored in the body during the Ilemanta season should be climinated by means of Siro- Vireka (errhines), vomiting, Niruha-vasti and gargles, ctc. Day-sleep and swect, demulcent aud liquid articles of fare as well as those hard to digest should be strictly avoided. 10. Rules for Summer :- Physical "exercise, toil, hot and excessively drying articles of fare (e.g. those prepared with pulses), as well as those abounding in

[Chap. LXIV. UITARA-TANTRA. 401

heat-producing (e. g: pungent, acid and saline) tastes should be avoided in summer. Large tanks, lakes and rivers as well as charming gardens and cold rooms should be resorted to, and the finest (refreshing) sandal-pastes and garlands of flowers of lotuses and lilies, soft breeze from palm-leaf-fans and necklaces (of precious stones and pearls) as well as light clothes should be used in summer. Sweet-scented and cooling Pánakas and Manthas with abundance of sugar should be used. Sweet, liquid and cold food mixed with clarified butter, and boiled milk sweetened with sugar, ctc, taken at night-time would be found (tasteful and) beneficial at that time. One should at that time lie on a bed strewn over with full- blown and fresh flowers in some palatial building with his body besmeared with sandal-pastes and refreshed by cooling breeze. II. Rules for Pravrit (rainy) season* :- Articles of the three (viz. sweet, acid and saline) heavy Rasas as well as milk, tepid meat-soup, oil, clarified butter, and everything which is Vrimhana (fat-making) and Abhishyandi (secreting) in its nature are beneficial after the end of the summer season i. e. in the rainy season. The bodily Váyu which is liable to be aggra- vated and which actually begins to aggravate in the summer sbould be pacified by wise men with Váyu- subduing remedies. 12 A. River-water, Ruksha (non-demulcent) and heat- producing articles, Manthas prepared with abundance of water, the sun's rays, physical exercise. day-sleep and sexual intercourse should be avoided in this season. Old barley, old Shastika-rice, old S'dli-rice, and old wheat

• A period of four months has been ascribed to the rains. Of these the first two months are ealled Pravrit, and the last two Varsha-both meaning the rainy season. See chapter VI, Sutra-sthana.

402 TIE SUSRUTA SAMHITA [ Chap. LXIV.

should be used as food, and the bed to lie upon should be stretched inside a room where there is no blast of wind and should be covered over with a soft bed-sheet. The rain-water (in and after its descent on the earth) becomes poisoned with the excretions, urine, salivation, sputum, etc., of poisonous animals as well as with the poisonous atmosphere peculiar to the rainy season; its use should, therefore, be strictly avoided in this season. The naturally aggravated bodily Váyu (in this season) should be duly pacified, or the rules for Varshá (ie. the rainy season) should be duly observed in this season *. 12. Whoever observes these rules for the different seasons of the year does not suffer from the evil consequences due to the change of seasons. 13. Different kinds of food :- Now we shall deal with the twelve different kinds of food (and drink). They are-Cold, hot, Snigdha (demulcent), Ruksha (non-demulcent), liquid, dry, taken once a day, twice a day, taken with medicine, taken in smaller quantity, taken for the pacification of (any aggravated Dosha) and taken for subsistence. 14. Persons afflicted with thirst, heat, alcoholism, burn- ing sensation, Rakta-pitta, poisoning and epileptic fits as well as those suffering from the effects of sexual excess should be treated with cold food (and drink) ; while persons afflicted with the aggravation of bodily Kapha and Vayu as well as those already treated with purgatives or Sneha and those whose bodies are full of Klcda (physical moisture) should be treated with warm food (and drink). 15-16. Persons suffering from the aggravation of bodily Váyu and from a parched (Ruksha) condition of the * The whole of this Para is an interpolation in as much as Jejjata does not read this .- Dallana.

Chap. LXIV.] UTTARA-TANTRA. 403

body as well as those suffering from the effects of sexual excess and those accustomed to physical exercise should be treated with Snigdha food (and drink) ; while persons with an excess of bodily Medas and Kapha as well as those suffering from Meha and thosc previously treated with a Sneha should be treated with Ruksha (or non-demulcent) food and drink. 17-18. Weak, parched and thirsty persons should be given Drava (liquid) food ; while those suffering from Meha and ulcers as well as those whose bodics are full of Kleda (bodily moisture) should be given dry (non- juicy) food. Persons with impaired digestion should be given only one meal every day, so that the digestive fire may have opportunities to) be rekindled ; while persons with the proper amount of digestion should be given two meals a day. 19-20. Medicine should be given with food and drink to a person averse to it, while food and drink in smaller quantity would be beneficial to persons suffering from impaired digestion or any other disease. Food and drink administered with due regard to the bodily Doshas is called Dosha-prasamana; while any kind of food and drink taken for the preservation of life by a hcalthy person would be called Vrittayrtha food and drink. These are the twelve different kinds of food and drink. 21-22. Proper times forthe administration of Medicines :- We shall now speak of the ten specific times (i. e. proper occasions) for the administra- tion of medicines. They are-Nir-bhakta, Prag-bhakta, Adho-bhakta, Madhye-bhakta, Antará-bhakta, Sa-bhakta, Sámudga, Muhur-muhuh, Grása and Grásántara. 23. Of the above medicines what is applied alone (with or without some vehicle but not with any food

404 THE SUSRUTA SAMHITA [Chap. LXIV.

or drink) is called Nirbhakta medicine. A medicine not applied wlth any food (but applied by itself with or without any vehicle) would havegreater effect and would soon and certainly destroy the disease it is applied in ; but a medicine should not be applied in this way to a child, an old man, a young woman and persons of mild temperament, for it is likely to produce lassitude and weaken the patient (in such cases). 24. A medicine taken (in an empty stomach) just before a meal, is called Pragbhakta. A medicine taken in such a manner, is easily digested, does not lead to any diminution of strength and is not ejected out of the mouth owing to its being covered over with the meal. On the other hand, taken before the meal, it adds to the bodily strength and proves the most convenient form in which a medicine can be administered to old men, infants, females and persons of timid disposition. A medicine taken just after a meal is called Adhobhakta. It conquers diseases which affect the upper part of the body and gives strength in many ways. 25-26. A medicine taken in the course of a meal is called Madhyebhakta. A medicine taken in this manner fails to be diffused all through. the organism and hence proves beneficial only in those ailments which are confined to the middle part of the body. A medicine taken between the two meals (i. e. after the morning-meal but before the evening-meal) is called Antarabhakta. It is invigorating to the mind, greatly appetising and Hridya (agreeable) and is beneficial in every respect. A medicine applied with* any food is called Sabhakta. It is most convenient to administer * "A medicine applied with food" may mean a medicine prepared before and taken with the meal ; or, it may mean that the meal is cooked (while being prepared) with the medicines to be applied.

Chap. LXIV.] UTTARA-TANTRA. 405

a medicine with food in cases of female, old and infant patients as well as in cases of those averse to taking any medicine. 27-29. A medicine taken at the beginning and again at the close of a meal is called Samudga. This form of administration is most beneficial in cases where the deranged bodily Doshas take both the (upward and downward) courses. A medicine taken at intervals, cither with or without food, is called Muhurmuhuh. This mode is to be adopted in severe cases of asthma, cough, hiccough and vomiting. A medicine taken with cvery morsel (Grasa) of food is called Grasa. In this form the medicine in the shape of a powder is administered for increasing the appetite in cases of weak patients. Vájikara (aphrodisiac) medicines are also better ad- ministered in this form. A medicine taken with each alternate morsel of food is called Grasantara. Emetics and Dhumas as well as the well-known and well-experi- mented lambatives for cases of asthma should be administered in this form. These are the ten proper occasions for administering medicines. 30-33. Proper time for taking food :- The proper time for giving diet to a patient is when he gets free stool, urine and eructations, and feels his body and sense-organs light and free, when he gets free actions of the heart as well as natural courses of his bodily (Apána) Váyu, when he feels hungry (D. R. feels easy) and has got relish for food and when his Kukshi (belly) becomes light (i. e. when his belly appears to be empty on account of hunger). 34.

Thus ends the sixty-fourth chapter in the Uttara-tantra of the Sus'ruta- Samhiti which deals with the Rules of Hygiene.

CHAPTER LXV.

Now we shall discourse on the chapter which dea's with the technical terms used in this treatise (Tantra- Yukti-Nama-Adhyaya). *I. Names of the technical terms :- There are thirty-two technical terms in this Treatisc. They are-(t) Adhikarana, (2) Yoga, (3) Padártha, (1) Hetvartha, (5) Uddea, (6) Nirdesa, (7) Upadesa, (8) Apadesa, (9) Pradesa, (10) Atidesa, (11) Apavarga, (12) Vákya-sesha, (13) Arthápatti, (14) Viparyaya, (15) Prasanga, (16) Ekánta, (17) Anekánta, (18) Purva- paksha, (19) Nirnaya, (20) Anumata, (21) Vidhána, (22) Anígatá-vekshana, ( 23 ) Atikrántá-vekshana, (24) Samsaya, (25) Vyàkhyána, (26) Sva-samjná, (27) Nirvachana, (28) Nidarsana, (29) Niyoga, (30) Samuchchaya, (31) Vikalpa, and (32) Uhya. 2. Necessity :- What is the necessity of the use of these technical terms (Tantra-Yukti) ? The answer is-For connecting words together, i. e., making up sen- tences and giving a sense or meaning to them. 3. Memorable verses :- By the usc of technical terms in a scientific treatise the points of argument of the opposite party are frustrated and the points of one's own argument are established. The meanings of the words, whether clearly used or not, whether direct or indirect, or partially used, if there is any such, in tbe trcatise are also made distinct (by the use of the techni- cal terms). Just as the sun shows a cluster of lotus and a lighted lamp (the inside of) a room at their best, so the technical terms used in a treatise clearly show i. e., explain the intended meaning. 4.

Chap. LXV.] UTTARA-TANTRA. 407.

Of these terms Adhikarana is the subject about which something is spoken of. For example-on (the subject of ) Rasa or on (the subject of) Dosha. 5. The term "Yoga" is the union of words or sentences together. For example-an oil duly cooked with Amrita-valli, Nimba, Himsrá, Abhayá, Vrikshaka, Pippali, the two kinds of Balá and with Devá-dáru should be prescribed for drinking as being efficacious in all cases of Gala-ganda. Here the main idea is 'Siddham pivet' i. e. should be cooked and taken internally ; but the word 'Siddham' is used in the first half of the second hemistich, far away from the word 'Pivet' in the sentence. This combining together of the different words, however distant in a sentence, is called a Yoga. 6. The term "Padartha" is the meaning implied by a word or an aphorism (i. e. a sentence). Padárthas are innumerable. For example-Sncha, Sveda, or Anjana, when used in a sentence, would each imply two or three meanings ; but only one meaning which tallies with the use of the previous or subsequent word (in the text) should be understood in each case. Thus, in the sen- tence "Vedotpattim Vyákhyá syámah" i. e. we shall discourse on the origin of the 'Veda', the use of the word "Veda" would put the hearer at a loss to under- stand which of the Vedas is going to be discoursed on, for there are several Vedas, vis, Rigveda, etc. But when we try to understand the expression in connection with the previous or subsequent usc of the expression -for the root 'vid' may mean either 'Vicharana' (discussion) or 'Vindati' (to get)-we can afterwards come to the conclusion that the subject to be discoursed upon is the origin of Ayurveda. This is what is meant by the term Padártha. 7. Hetwartha is the meaning indircctly implied by a

408 THE SUSHRUTA SAMHITA. [Chap. LXV.

word. For example-as earth is moistened by water, so an ulcer is moistened (and consequently secretes) by (the taking of) Másha-pulse, milk, etc. 8. Uddesa is the statement in brief. For example- Salya (ordinarily any foreign matter but secondarily implying any obstructing matter in the body). 9. Nirdesa is the statement in detail. For example- "Salya" is of two kinds "Sarira" (idiopathic) and "Agantu" (traumatic). 10. Upadesa is an instruction for the doing of a thing in a particular way. For example-one should not sit up at night and one should give up sleep at the day time. II. Apadesa is the statement of reason. For example- it has been specified that Sleshmá is increased by the use of the articles of sweet taste. 12. Pradesa is the determination of a present action from past events. For example-Devadatta's Salya has been extracted by this person, hence Yajnadatta's Salya will also be extracted by him. 13. Atidesa is the determination of some future event from some present event. For example-one's bodily Váyu courses upwards by such and such an action, hence one may get (an attack of Vátaja) Udávarta by such an action. 14. A pavarga is the extraction-i. e. exception of (some- thing) from something more comprehensive or extended, that is to say, it is an exception to the general rule. For example-fomentation should not be applied to persons suffering from the effects of poisoning excepting those suffering from insect-poison. 15, Vakya-sesha is the word the absence of the use of which does not make the sentence incomplete. For example-when we say of the head, the hands, the legs,

Chap. LXV.J UTTARA-TANTRA. 409

the sides, the back, the abdomen (Udara) and the chest" it becomes evident that these (parts) of a 'person' are intended. 16. Arthapatti (presumption' is the term used when the sense (of a sentence), though not specifically men- tioned, can yct be indirectly presumed or deduced. For example *- when onc says to another 'this rice (solid food) can be taken,' it becomes evident that he is not willing to drink a (liquid) Yavagu or gruel. 17. Viparyaya (reverse) is the term used when the words used (in a sentence) convey quite a different or opposite sense. For example, -when it is said that 'ema- ciated, weak and frightened persons are very difficult to be medically trcated', the opposite sense bccomes evident, vis., that strong, and such-like persons are very easy to be medically treated. 18. Prasanga (connected reasoning) is the term used when a different subject is introduced at the end. It is also the term used when the same sense is repeated in different words in different places (in the same topic). For example-it is said in the chapter on Vedotpatti (Chapter I, Sutra-Sthana) that "Purusha" (liv'ng organism) is the sum-total of the "Maha-bhutas" (or the five primary elements-vis., earth, water, fire, air and ether) and the Sariri (or the soul), that medical treat- ment should be made of him (Purusha) and that he is the subject matter of every action); and it has been repcated in the chapter on Bhuta-vidyá (demonology) that the Purusha has therefore been'said to be the combination of the five Maha-bhutas and the soul and

• The common cxample of an Arthápatti (presumption) in Sanskrit philosophy is 'Pino Devadatto divá na bhumkte,' (i. e., Fat Devadatta does not cat at day-time), from which it is evident that he certainly eats at night, otherwise he could not have become fat. 52

410 THE SUSHRUTA SAMHITA. [Chap. LXV.

that he is the subject-matter of all sorts of medical treatment. 19. Ekanta is the term used to denote a thing which is certain in every case. For example-Trivrit causes purgation, and Madana-fruit produces vomiting. 20. Anekanta is the term used to denote certainty in some cases and uncertainty in some other cases. For example-many authorities hold that 'Dravya' or the thing itself is the principal factor, some hold the Rasa' or taste (in a thing) to be. the principal factor, some again hold the "Viryya" or potency to be the principal factor and others hold "Vipaka" or digestive reaction to be the principal factor. 21. Purva-paksha is (the putting of) a question with an apparent objection. For example-(the question why are the four kinds of Vataja-Prameha incurable. 22. Nirnaya is the reply to a Purva-paksha or question. For example-the (bodily) Váyu affects i. e. spreads over the (whole) body and then forces the urine through (the passage with the (vitiated bodily Vasá (greasc), Medas (fat) and Majjan (marrow). The Vátaja cases (of Prameha) are, therefore, incurable. As has been said-the (bodily) Vayu affects i e. spreads over the whole body and coming in contaet with the (bodily) Medas (fat), Majjan (marrow) and Vasá (grease) becomes vitiated and courses downward. The Vátaja cases (of Prameha) are, therefore, incurable. 23. Anumata is the term used when an opinion of another is (quoted but) not refuted. For example-some authorities hold that there are seven Rasas or tastes. (Now, as this is not refuted it is said to be Anumata or sanctioned by the author). 24. Vidhana is the act of mentioning, at the beginning, the fact to be established. For example-the vulnerable

Chap. LXV.] UTTARA-TANTRA. 4II

or vital parts (Marmans) in the thigh are eleven in number, and this has already been stated to be established. 25. Anagatavekshana is the term used when something in the future is referred to in such terms as 'this will be dealt with hereafter'. For example-it can be said in the Sutra-sthana 'it will be dealt with in the Chikitsita- sthana'. 26. Atikrantavekshana is the term used when some- thing in the past is referred to. For example-it can be said in the Chikitsita-sthána 'it has already been said in the Sutra-sthana'. 27. Samsaya is the term used when cxamples of two opposite and dissimilar subjects are cited. For example-hurt to the Tala-Hridaya (Marmans in the hands and legs) is fatal ; amputation of the hand and of the leg is not fatal. 28. Vyakhyana is the description or explanation of the details. For example-Purusha as the twenty-fifth factor has been dealt with in this book. While only the twenty-four factors constituting this body have been dealt with in other works 29. Sva-samjna denotes the specific terms specially used in any work and not in common with any other work. For example-the term 'Mithuna' (in medical works) means the two things, vis., honey and clarified butter. 30. Udaharana* is the example of what is well-estab- lished or well-known in the world. For example-

• Udáharana has been recognised here as a technical term. But it should not have been recognised as such, since it has not been included in the list (see para 2). Had it been so, the number would have been 33 and not 32. Dallana prefers to regard the portion earq etc. as an interpolation and adding a ar after the sentence लोके प्रथितमुदाहरयम् takes jt in continuation of the example of खवसं्रा

412 THE SUSHRUTA SAMHITA. [Chap. LXV.

cooling measures should be had recourse to to guard against warmth. *. 31. Nirvachana is the derivation of a term. For ex- ample-Ayus (life) is the subject-matter of this work, and a man gets (the means of) Ayus (longevity) from this work and hence it is called Ayurveda. 32. Nidarsana is the term used when the meaning (of a word or sentence) is supported by examples. For example-just as the (digestive) fire in the Koshtha (abdomen) increases in contact with (the local bodily) Váyu, so also an ulcer increases when assisted by the (bodily) Váyu, Pitta and Kapha. 33. Niyoga is the enjoining of something to be done as a duty. For example-only what is beneficial (Pathya) should be taken. 34. Samuchchaya is the joining (of two or more con- nected but independent ideas) as such and suche For example-in the group of flesh, (those of) Ena and Harina (two kinds of deer), Láva and Tittira (two kinds of birds) and Sáranga (spotted deer) are the principal ones. 35. Vikalpa is the term used when something is said to be this or that, i. e., when alternatives are used. For example-either meat-soup or Yavágu (gruel) cooked with clarified butter (should be used in such and such a case). 36. Uhya is the term used when something more can be understood by an intelligent man, though not defi- nitely used. For example-it has been said in the chapter on Anna-pána-vidhi (Chapter XLVI, Sutra- Sthána) that Anna (food) is of four kinds, vis., (1)

in the previous para. His meaning is that the word forgw being not found in the sense referred to in para. 30, the reader is asked to find out a popular example.

Chap. LXV.] THE SUSHRUTA SAMHITA. 413

Bhaksh/ a (masticable) or the solid food that has to be bitten with the teeth before eating, (2) Bhojya (edible) or the solid food proper i. e., which has not to be bitten with the teeth, (3) Lehya (lambative) or the semi-liquid food that has to be licked like an electuary, and (4) Peya (drink) or the liquid food proper that has to be drunk; but of these four kinds, two kinds only (viz., Anna and Pániya) have been mentioned (in naming the chapter). Here it is (said that the other two kinds) are) understood. For, when only two arc mentioned in respect of food and drink, the inclusion of. all the four therein is easily comprehended. And why? Because the term ' Bhakshya' is included in the term ' Anna'- both being of the same kind, vis., solid food; and the term 'Lehya' is included in the term 'Peya'-both being of the same kind, viz, liquid. And the articles of food, though they are really of four kinds, are usually spoken of in the common language as being of two kinds only (vis, solid and liquid). 37. Here have been fully described by me the thirty- two technical terms for the investigation into the essence of this Tantra (work). The intelligent man who is fully conversant with these technical terms-which work like lights, as it were,-is to be regarded as the greatest physician and to be held in great esteem .- This is what the Sage Dhanvantari says. 38.

Thus ends the sixty-fifth chapter of the Uttara-Tentra in the Sus'ruta- Samhita which deals with the technical terms used in this work

CHAPTER LXVI.

Now we shall discourse on the chapter which (deals with and) is called the different modifications (combi- nations) of the different Doshas-Dosha-Bheda- vikalpa-namadhyaya. Revered Susruta, the son. of Visvámitra, asks (the following to) the high-minded Divodasa, well-versed in all the eight divisions of Ayurveda, with intellect sharp and as deep as an ocean, as it were, and with all the difficulties in the meanings of the Sastras fully solved. The question is-It has been already said that there are sixty-two* varieties of the Doshas, but how are they divided when taken one, two or all the three at a time' ? 2-3. On hearing his word the great sage and king (Divodása) with all his difficulties solved was greatly pleased and thus narrated the true conditions to Susruta. 4. The three Doshas, the (seven) Dhátus, feces and urine-these, in their normal state, hold together the corporeal frame in conjunction with the (six Rasas necessary (for the constitution). 5. Puru-ha or human body has sixteen sub-stratat. The Pránas (vis. the organs of sense) are eleven in num- ber while the number of diseases is one thousand one hundred and twenty and that of elementary sub-

• The reference is to chapter LXIII, but there the number is sixty-three and not sixty-two. The three Dhatus Vayu, Pitta and Kapha, in their normal state, cannot properly be called Doshas. The state in which all the three Dhátus are in their normal state, is said to be the 63 rd. combination (see also para. 8 below). t The sixteen sub-strata are the five elementary principles, (vis -Earth, Water, Fire, Air and Ether) and the eleven sense-organs.

Chap. LXVÌ ] UTTARA-TANTRA. 415

stances (Dravya) is five hundred and seventy-three, - these have already been explaincd in detail. The three qualities (viz., Sattva, Rajas and Tamas) have also been explained in connection with the (three) different Doshas (vis., Vayu, Pitta and Kapha) which are generally said to have sixty-tw. combinations. 6-8. Different Combinations of Doshas :- The three Doshas separately have three combina- tions, vis., where. 'one of the Doshas is aggravated and the other two are in their normal state. Taken two at a time, both of them aggravated, whether equally or unequally (with the third in its normal state), the number of combinations would be nine; while the number of combinations would be thirteen if they are taken three at a time-all of them aggravated, both equally and unequally (thus making twenty-five in all with the aggravated Doshas). With an equal number of combinations in cases of the diminution of the Doshas (taken one, two or three at a time) we have fifty combi- nations. The number of combinations (taken one, two and three at a time) with the aggravated and dimi- nished Doshas mixed together would be twelve only .- Thus making sixty-two in all. The number of combinations, when mixed together, would be innumerable. It, therefore, behoves a physi- cian to treat a patient with the different combinations of the (six different) Rasas after properly diagnosing the disease with a due regard to the aggravation, of the different Doshas and without going into any further details. In ameliorating a disease, the physician is the doer of that action the effect whereof is health and the instruments with which the action is performed are the Rasas while the Doshas are the causes. The oppo- site hereof is want of hcalth. 10.

416 THE SUSHRUTA SAMHITA. [Chap. LXYI.

The Uttara-Tantra, enriched with the sixty-six chapters wherein have been described and explained the order of the words and their meanings, and wherein have been explained very clearly the hidden meanings of the terms for making them clear to persons of weak intellect, has thus been duly explained to you in accor- dance with your question. Il. Persons reading, according to the rules laid down, this treatise together with the Uttara-Tantra coming from (the mouth of) Brahma himself, are not abondoned by their wished for objects, that is to say, they are sure to obtain them. This word of Brahmá is perfectly true. 12.

Thus ends the sixty-sixth chapter of the Uttara.Tantra in the Sus'ruta- Samhita which (deals with and) is called the different combinations of the different Doshas.

Here ends the Uttara-Tantra.

THE END