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An English translation of the Sushruta samhita, based on original Sanskrit text

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THE LIBRARY

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THE UNIVERSITY

OF CALIFORNIA

LOS ANGELES

Digitized by tine Internet Arciiive

in 2008 with funding from

IVIicrosoft Corporation

http://www.arcliive.org/details/englislitranslati03susr

AN ENGLISH TRANSLATION

OF

THE SUSHRUTA SAMHITA

Vol. in.

UTTARA-TANTRA

AN ENGLISH TRANSLATION

OF

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 BHISHAGRATNA,

M. R. A. S. (LoND.)

Vol. III. UTTAKA-TANTRA

PUBLISHED BY

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

1916

Ail Rights Reserved.

7hB Oriental Book-Supplying Agency, Poona.

PRINTED AT THE BHARAT MIHIR PRESS BY M. BHATTACHARYYA OF

Messrs. SANYAL & Co.,

25, ROV BAGAN STREET, CALCUTTA.

Kaviraj Kunja La!l Bhishgratna, M.R.ft.S, ( Lond.)

ritEFACE.

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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 ot 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. Xo words ol mine can adequately ex- press my admiration for the good he is doing to our country.

Now that the whole work is before the [)ublic. its worth and importance will be duly judged Our translation does not claim to have any 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 Samhilii cannot be

accurately translatod into English, as there are no corresponding words in that language which would convey the exact meaning of the original. We have therefore retained the Sanskrit terms, and have in some cases put within brackets such English words as may approximately render the meanino- 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, cmnot 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, aud 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

Ill

efficacy of faith in certain forms of disease, they treat it as a special method, fallinq- 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 Samhita. 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. I., 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 fair!)' ho|i(' thai now that the ancient Indian Medical System and the Indigenous iJrugs of

IV

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, V'idyabhusan, M. A., Kaviraj Madhav Chandra Tarkatirtha, Kaviraj Jnanendranath Sen, Kaviratna, B. A., Prof. Satyendranath Sen, Yidyji- vagis'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. Banerjee, 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 suoorestions whenever we have souo^ht their advice.

lO, KASHl GHOSE'S LANR, "j

Calcutta, | KUNJA LAT. RIIISHAGRATNA.

May 25, iQib. J

CONTENTS.

(Uttaka-Tantra.) CHAPTER I.

Diseases of the eyes, etc ; — Diseases o( llic eye and its append- ages— Description of Drishti — Mandalas and Sandhis — Description of Patalas — Premonitory symptoms — Causes of eye-diseases — Classification — Prognosis of \^ataja — Piltaja — Kaphaja — Raktaja and Tri-dosliaja eye- diseases — Seals of the eye-diseases. ... ... ... i — 8

CHATTER H.

Pathology of the diseases of the eye-joints —Their nomencla- ture— Number — Symptoms. ... ... ... ... 9 — 11

CHAPTER HI. Pathology of the diseases of the eye lids :— Causes and names

— Specihc symptoms of Utsangini — Kumbliil<a — Pjlbaki — Ars'ovarlma — Anjana — Klishta-vartma — Vartma-b.\ndhaka, etc. etc. ... 12 — 15

CHAPTER IV. Pathology of the diseases of the sclerotic coat :— Nanus and

number — Symptoms of S'uklarma— Lobilarma — S'uktika— Arjuna— Pish- laka— Sira-jiUa— Balasu-grathita, etc. etc. ... ... 16—17

CHAPTER V. Pathology of the diseases of the black part oftheeye:—

Number— Names— Symptoms— Prognosis— Avranas'ukra Jiita— Sa-vrana- S'ukra— Akshi-pakatyaya— Ajaka. ... ... ... iS— 19

11 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 — Vata-paryaya — S'ushkakshi-pdka — Anyato-vata — Amla-dhyushita — S'irot-pata — Sira- harsha. ... ... ... ... ... 20 — 24

CHAPTER VH.

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 Sanni- patika Timira — Parimlayi — Different colours of the pupil in cases of Linga-nas'a — Specific traits of Vataja — Pittaja — Kaphaja — and Sannipatika Linga-nas'a — Traits of Vataja — Pittaja — and Kaphaja Vidagdha-Drishti — Smoky sight — Ilrasva-Jatya — Nakulandhya, — Gambhirika — Symptoms of traumatic Linga-nas'a. ... ... ... ... 25 — 31

CHAPTER Vni. Classification and treatment of ocular affections :— Classi-

fication — Names of Chhedya — Lekhya — Bhedya — Vyadhya 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-paka. ... ... ... 34—37

CHAPTER X.

Treatment of Pittaja Ophthalmia -.—Tarpana measures— Wash —Snuff— Anjana—Rasa-kriya—A'b'chyolana— Treatment of S'ukti-paka and Dhuma-dars'i. ... ... •■• ••• 3^ — 4°

CONTENTS. Ill

CHAPTER XI.

Treatment of ^leshmaja Ophthalmia :— Fomentation— Anjana — Treatment of Balasa-grathita— Pishtaka— Praklinna-vartnia. ... 41—46

CHAPTER Xn.

Treatment of Raktaja Ophthalmia :— Venesection— Inhalation — Eye-elrop — Snuffs — Plaster — Vartis — Treatment of S'irotpata — Siri- harsha — Arjuna.— Scarifying — Anjana — Treatment of S'ukra — Kshara- Anjana — Soothing applications— Treatment of Ajaka — Akshi-paka— Puya- lasa— Praklinna-Vartma and Aklinna-Vartnia. ... ... 47—53

CHAPTER Xni,

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— 5^

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-pidaka— Parvanika.— 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 coxtI':nts.

CHAPTER XVII. Treatment of diseases of pupil and crystalline lens -.—General

treatment of I'itta and S'ieslima-Vjdagdha-Drishti. — Pushpanjana — Dravanjana — Gvidikanjana — Treatment of Day-blindness — Nocturnal blindness — Application of V^artis — Rasa-kriyanjana — Kshudrunjana — Treatment of a palliative type — Triphala-Ghrita — Navana-errhines — Puta- paka— Pratyanjana — Treatment of Fillaja — Vataja — Kaphaja and Tri- doshaja Kdcha — Fumigation — Treatment of Parimlayi — Diet— Blood- letting— Treatment ofTimira — 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'aldka — Description of the S'alaka — Derangements due to defective operations — Their treatment — Eye-sig'it- invigorating Anjanas and Varlis. ... ... ... 66 — S3

CHAPTER XVIII. Preparations and medicinal measures for ocular affections

in general ■• — Tne Tarpana measures— Mode of application — Symptoms of satisfiictory — excessive and defective Tarpana — Treatment of excessive and defective Tarpana — Cases of Tarpana — The Pula-paka measures — Emulsive — Scraping and Healing Puta-paka— Preparations of Snehana — Lekhana and Ropana Pula-paka — 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'irovasti — 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 — Prasadana Anjana — Ropana Anjana — Recipe of several principal Anjana;— Bliadrodaya-Anjana—Vartis — Pindanjana. ... S4 — loi

CHAPTER XIX. Treatment of hurt or injury to the eye :— General Treatment—

Prognosis— TreatmenI of sunk.-n t-ye — Sym|>toms and Iroatment of Kuku- naka— Cnnclusioiu ... ... ... ... 102—10^

CONTENTS.

CHAPTER XX.

Causes and symptoms of Ear-disease •—Classifications— Symp- toms of Karna-s'ula — Pranada — X'adhirya — Kshveda — Karna-srava — Karna- kandu — Karna-gulha — Karna-piatinaha — Krimi Icarna — Karna-vidradhi— Karna-paka — Puti-karna. ... ... ... ... 106—108

CHAPTER XXI.

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

CHAPTER XX H. Causes and symptoms of diseases of the nose :- Nomenclature

and Classification — Symptoms of Apinasa — Puti-nasya — Nasa-paka — Rakfa-pitta — Puya-rakta — Kshavalhu — Bhrams'athu — Dipti— Pratimiha — Parisrava — Pari-s'osha — Ars'as — S'opha — Arvuda — Pratis'yaya 118 — 120

CHAPTER XXHI.

Therapeutics of nasal diseases :— Treatment of Putina:ya— Ajnnasa. — Diet — Errhines — Treatment of Nasa-paka — S'onita-pitta — Puya- rakia — Kshavathu— Bhrams'athu — Dipii— Nasan:iha — Nasa-srava — Nasa- s'osha etc. ... ... ... ... ... 121 — 122

CHAPTER XXIV. Symptoms and treatment of Catarrh :— Causes— Premonitory

.symptoms — Specific symptoms of Vat.aja— Pittaja — Kapli.aja — Tri-dosh.nja types — Raktaja-pratis'y.aya — Prognosis— General treatment of Pratis'yaya — l\.eginien of diet and conduct— Treatment of X'i'itnja— Pittaja — Kapb.aja — and Tri-d<v,haja types. ... ... ... ... I2j — 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 — Treatment of Kaphaja — Tri-doshaja Kshayaja— Krimija— Ardhava-bhedaka — Ananta-vata — and S'amkhaka.— Conclusion. ... ... ... ... ... 134—140

Here ends the ^cblsCkya-Tantra.

CHAPTER XXVH. Specific features of nine malignant Grahas :— Different names

— General course of attack— Symptoms of attack by Skanda— Skandapa- smara — S'akuni — Revati — Putana — Andha-putana — S'ita putana — Mukha- mandika — Naigamesha —Prognosis — Rules to be observed. ... 141— 144

CHAPTER XXVHI.

Therapeutics of an attack by Skanda Graha ;— General treat- ment— Fumigation — Mantras ... ... ... 145 — 146

CHAPTER XXIX.

Therapeutics of an attack by Skandapasmsira:— General treat- ment— Sprinkling — Anoinlment — Utsadana — Fumigation — Religious pro- pitiation— Mantras. ... ... ... ... 147 — 1^8

CHAPTER XXX.

Treatment of an attack by ^akuni graha :— Sprinkling— Anoint- ment— Pradeha — Fumigation — Religious propitiation — Mantras. 149 — 150

CONTENTS. Vll

CHAPTER XXXI.

Theraputics of an attack by Revatigralia -.—Sprinkling— Anoint- ment— Plaster — Religious propitiation — Mantras.... ... 151 — :S2

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 l^ita-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 deities. ... 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 Eaumara bhritya-Tantra-

VIll CONTENTS.

CHAPTER XXXIX. Symptoms and Treatment of Fever :— Description of Jwaia—

Definition and classification — Pathology — Premonitory symptoms — Symp- toms of Vataja— Pittaja— Kaphaja and Tri-doshaja fever—Abhinyasa- fever — Ilataujas — Sannyasa — Dvvandaja fever — Vata-pilta-fever — Vafa- S'leshma-fcver— Pilta-S'leshma fever— Pralepaka—Tritiyaka (tertian) and Cliaturthaka (quartan) fever — Vishama-fever— Seat and duration of Vis^hama- jwara — Satataka — Anyedyushka — Tritiyaka — Chaturlhaka— Action — Influ- ence of Vayu on Vishama fever — Agantuka fever due to the effects of poison — Ilay-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 — -Vavagu — 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-jvvara — Ghrita in cases of Vishama fever — Guduchyadighrita — Kalasyadi-ghrita — Maha-kalyana-ghrita — ■ Pancha- gavya ghrita — Triphald-ghiita — Pancha-sara — Medicated Tailas — Fumiga- tions and Anjanas — Treatment of shivering and burning sensation — General and specific treatment of the complications — Application of Vaslis— Symp- toms of the remission of fever. ,.. ... ... 169 — 211

CHAPTER XL.

Symptoms and treatment of Diarrhoea, etc :— Causes— Patho- logy— Premonitory symptoms — Symptoms of Vataja — Pittaja — Kaphaja and Tri-doshaja types — Symptoms of S'okaja and Ainaja Atisara — Symp- toms of Ama and Pakva Atisara — Prognosis — General treatment — Twenty different Recipes for Amatisara — Fasting — Six Yogas for Pittaja Atisara — Astringent remedies — Application of Ghrita — Putapaka-preparations — Pey.'i. — Treatment of thirst — Use of milk — Asthapana and Anuvasana Vaslis — Pichchhbi-Vasti — Diet — Causes and symptoms of Pakviitisara — Treatment and Symptoms of PrajVahika — General Treatment — Application of Vastis — Diet — INIedical 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 Vataja — 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-yakbhiua — Eiiology and general symptoms — Specific syiuploms of Vataja — Pitlaja and Kapbaja types — Prognosis — Other causes of S'osha and their symptoms — Premonitory symptoms — Prognosis — Treat- ment— Diet — Meat, etc. — Utsadana — Medicated Ghritas — Ehidi-mantha — Use of goat's llesh, milk, etc. — Rules of conduct. ... 237 — 245

CHAPTER XLH.

Symptoms and Treatment of Gulma :— Delinition and Number- Localisation and Nomenclature — Premonitory Symptoms — Specific Symp- toms of Vataja — Pittaja — Kaphaja and Tvi-doshaja types — Symptoms of Raktaja Gulma — General Treatment of Vataja — Pittaja — Kaphaja — Tri- doshaja and Raktaja types — Uttara-Vasti — Anuvasana — Chitraka- ghrita — Hingvadi-ghrita — Dadhika-ghrita — Rasona-ghrita. — Ghritas in Pittaja — Raktaja and Kaphaja Gulma. — Internal use of Kshara — Vris'chi- rarishta — Blood-letting— Diet andSvcda. — 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 Vataja — Pittaja — Kaphaja and Tri-doshaja S'ula. — Symptoms and treatment of Pars va-S'ula.— Symptoms and treatment of Kukshl-S'ula.— Symptoms and treatment of Hrich-chhula. — Symptomsof Vasti-S'ula — Mutra-S'ula — Vit-S'ula and Annaja S'ula. — Their treatment. ,.. 246 — 2O4

CHAPTER XLH I.

Symptoms and Treatment of Heart-disease :— lOiioloj^y and Nomenclature— Number— Specific Symptoms of Vataja— Pittaja— Kaphaja and Krimija types— Supervening Symptoms— Medical treatment 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 Vataja— f'ittaja — Kapbaja and Tri-doshaja types — Symptoms of Kamala — Kumbha-Kiimald— Layharaka and llalimaka.— Supervening Symptoms**

-X CONTENTS.

General trealmenl — Trealinent of — Kamahi — Kuiubha-k^uiald — Lagha- raka. — Articles of Diet — Treatment of Supervening Syniplonis — Prog- nosis. ... ... ... ... ... 269 — 276

CHAPTER XLV.

Symptoms'and Treatment of Haemorrhage :— 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 — Astbapana and Anuvasana— Treatment of down-coursing type — Uttara-vasti. ... ... ... ... ... 277—284

CHAPTER XLVI.

Symptoms and Treatment of Fainting fits :— Detinition— Classi- fication — Premonitory symptoms — Specific symptoms — General trealmenl —Specific treatment. — Symptoms of Sanny^Csa — Treatment — Incurable type— Diet. ... ... ... ... ... 285—288

CHAPTER XLVH. Symptoms and Treatment of Alcoholism :— Properties and

action of wine — Evil etTecls of drinking — Three stages of Alcoholic intoxica- tion— Cases where wine is prohibited. — Specific symptoms of PainjCtyaya — symptoms of Vataja — Pittaja — Kaphaja and Tri-doshaja types — Symptoms of Para-mada — Panajirna — and Pana-vibhrama — Prognosis — Treatment of Valaja — Pittaja — Kaphaja— Tri-doshaja and Dvi-doshaja types. — Panaka— Treatment of Para-mada — Panajirna — Pana-vibhrama and Panatyaya — Treatment of Thirst — Remedies for Daha. — Symptoms and treatment of Raktaja-Daha. — Daha due to thirst — Accumulation of blood — Due to Kshaya — Due to hurt of Marma. — Their Treatment — Mode of drinking wine. ... ... ... ,., 289-— 30I

CHAPTER XLVni.

Symptoms and Treatment of thirst :— Etiology— Classification- Premonitory symptoms — Symptoms of Vataja — 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 treatmcni. .... 302 — 308

CONTENTS. XI

CHAPTER XLIX.

SymptomS'and Treatment of Vomiting :— Causes and Nomen- clature— Premonitory symptoms— Specific symptoms of Vataja — Pittaja — Kaphaja — and Tri-doshaja types — Traumatic cases — Prognosis — General treatment — Treatment of V;itaja — Kaphaja and Pittaja types. — Vomiting due to pregnancy. — Treatment of traumatic and Krimija types. — General treatment— Diet. ... ... ... ... 309— 3»3

CHAPTER L. Symptoms and Treatment of Hiccough :— Causes— Derivation

— Classification — Premonitory symptoms — Symptoms of Annaja — Yamala — Kshudrika— Gambhini— and Maha-hikka. — 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. — Ilinsradi-ghrita — S'ringvadi-ghrita — Suvahadi-ghrita — Tali- s'adi-ghrita— -Meat as diet. — The five Lambatives—Utkarika— Articles recommended — Application of Sneha and Dhuma — Purging and Vomiting. ... ... ... ... •■• 3'9--325

CHAPTER LH.

Symptoms and Treatment of Cough -.—Causes and Etiology- Classification— Premonitory symptoms —Specific symptoms of Vataja — Pittaja — Kshataja and Kshayaja types. — General Treatment — Inhalation of Dhuma — Treatment of Vataja — Pittaja — Kaphaja — Kshayaja and Kshataja Kasa.—Kalyana-guda—Agastya-leha. ... ... 326—337

CHAPTER LIH. Symptoms and Treatment of Hoarseness:— Etiology— Symptoms

of Vataja — I'itlaja — Kaphaja and Tri-doshaja types. — Symptoms of Kshayaja and Medoja types —Prognosis— General Treatment- Treatment of V.-itaja - - Pittaja — Kaphaja — Tri-doshaja — Kshay.ija and Medoja types. ... ... ... ••• — 335—337

Xll 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 V'awning — Tears — Sneezing — Eructation — Vomiting — Seminal discharge — Hunger — Thirst— Breath and Sleep. — Prognosis— 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 Visuchlka :— Causes— Definition — Symptoms— Alasaka—Vilambika —Prognosis — General Treatment — Kshirdgada — Kalyana-lavana — Diet, — Causes and Symptoms of Anaiha —Treatment. ... ... ... ... .- 352—356

CHAPTER LVn.

Symptoms and Treatment of Arochaka •.—Etiology— Classifica- tion— Symptoms of Vataja — Pittaja — Kaphaja and Tri-doshaja types. — Their Treatment — Eour specific Lambativcs — Regimen of diet — Use of decoction — Arishla and Asava. — Treatment of Manasa Arochaka. ... ... •.« ... ... 357 — 360

CHAPTER LYHI. Symptoms and Treatment of suppression of Urine :--ciasbirica.

tinn — Symptoms of \';i'a-knndalik;i— Viitu .thii.l— '\':lta-va:ti— Mulritita — Mutra-jathara — Mutra-sanga — Mulra-kshaya — Miitra-gianthi — Mutra- sarkar.'l— Ushna-vdta and two kinds of Mutrauka-suda. — General tre.itment —Application of Uttara-Vasti. .. ... ... 361— 36S

CONTENTS. xni

CHAPTER LIX. Symptoms and Treatment of the defects of Urine :— Classi-

ficalion — Symptoms of Vataja — Pittaja — Kaphaja and Sannipatika types — Ulcer or injury in the Urethra — Mvitraghdta clue to Stone or Gravel — General Treatment — Treatmet of Vataja — 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'iJcha-graha. — Progonosis— Times of their Possession — Ex- planation of Bhuta-vidya. — General and religious treatment — Their specific religious treatment — Medical treatment — Special treatment. ... 373 — 380

CHAPTER LXI.

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

CHAPTER LXH.

Symptoms and Treatment of Insanity :— Derivation— Classi- fications of Vataja — Pittaja — Kaphaja and Tii-doshaja types — Symptoms nf S'okaja and Vishaja types — General treatment — Treatment by frighten- ing acts — Diet — Mahd-Kalyana-ghrita — Kalyana-ghrita — Phala-ghrita — Varlis— Venesection. ... ... ... ... 387—391

Here ends the Bhuta-Vidysi 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. .» ... ... ... ... 392 — 395

CHAPTER LXIV.

Rules of Health :— Indications of Health — Its importance — Regimen of diet and conduct in the rainy season — Rules for autumn — Ilemanta — Winter — Spring — Simimer 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 UttaraTantra.

THE

SUSHRUTA SAMHITA.

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 c^f the Sus'ruta Samhita 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 Salaikya-Tantra (Diseases of the eye, ear, nose and throat) as narrated by the king of Videha ; the aetiology and symptomatology, etc. of diseases peculiar to infants and women (Kauma'ra- bhritya), the pathology, etc., of those diseases mentioned in the six books of the Practice of Medicine par excellence (Kaya-chikitsflk) compiled by the holy sages of old and diseases known as Upasarga {e.g. lihutopasarga

2 THE SUSHRUTA SAMHITA. [Chap. I.

— Demonology) as well as diseases 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 cure. 2.

I shall now begin with the description of the num- bers, the pathology and the curability or incurability of those specific ailments of the body which are peculiar to the region of the head out of a m)'riad 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 itsappend-

ag'es : — The e\-e-ball (Nayana-Budbuda) is two fingers (about an inch) in transverse diameter, about the breadth of one'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 'solid' earth (Bhu) contributes to the formation of its muscles, the element of 'heat' (Agni or Teja.s) is in the blood (that courses in its veins and arteries), 'the gaseous e'ement' (Va}^u) contributes to 'the formation of the black part (Iris, etc.) in which the pupil is situated, the fluid element (Jala) preponderates-in the -lucid

(l) The text has A'gantuka (traumatic 'diseases). Gayadasa explains it to mean Apasmara, Unmida, etc. (Hysteria, insanity, etc.),

Chap- I- ] UTTARA-TANTARAM. ^

(white) part (Vitreous body) and the void (ethereal) Space (Akas'a) is there to form lachrymal or the other ducts or sacs (As'rumarga) 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-mandaia — Choroid) forms one third part of its whole extent while the Drishti, according to them, occupies only one-seventh part of the Krishna-mandaia. The Mandalas or sub-divisions or circles of the eye-bail, 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.

IVIandala and Sandhi :— The Mandalas of

the eye are the following, viz., (i) the Pakshma-mandala (the circle of the eye-lashes), (2) the Vartma-mandala (the eye-lid) (3) the Sveta-mandala (the Sclerotic and Cornea), the Krishna-mandaia (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 finst binding the eye-lashes (Fak.sha-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-mandaia (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 (Apdngas) 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 SAMllITA. [ 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 disease 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 eye-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 Sleshma (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. 10.

Purva-rupa, etc. :— Cloudiness of vi.sion, 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 (Sira) carrying the (Tejas) known as the A'lochaka.

t D. R. vessels, muscles and aqueous humour (Medas) arc most important for the maintenance of Krishna-mandala.

Chap. I. ] UTTAKA-TANTARAM. 5

colours and in closing and opening the cye-Iids frech-. 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, other\vise 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 special remedial measures that would pacify the different Doshas, Vayu, etc. have been des- crited 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, sleep in the day time and keeping up late hours in the night, fixed and steady gaze, 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, Aranala (fermented rice-water), acid gruel, M^sha 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 originated by the deranged Viju, 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 SAMHITX. [Chap. I.

external causes i. e., they are traumatic in their origin. 15.

Prognosis of the Vataja Type :— Of the

diseases of the eyes which are due to the action of the deranged Vdyu, those known as Hatddhimantha, Nimi- sha, Gambhirika affecting the vision, and Vj^ta-hata- vartma (Vdyu-afflicted Sclerotic coat) is said to be incur- able. A temporary cure (Yapya) is all that can be effected in a case of Kdcha (cataract) due to the action of the deranged bodily Vdyu ; while the affection of the eyes known as the Anyato-Vata, Adhi-mantha (ophthalmia), Sushkakshi-pdka, 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-jadya and Jala-srava should be deemed incurable ; and palliative measures are the only remedies in cases of Kacha, Parimlayi and Nila, while Abhishynda, Adhi-mantha Amlddhyushita, Suktika, Pitta-Vidagdha-Drishti, Pothaki and Lagana arc 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) Kdcha (cataract) admits of only palliative treatment, while a cure may be be effected in the following cases, viz,, Abhishyanda (conjunctivitis), Adhi-mantha, Bali^sa- Grathita, Sleshma-Vidagdha-Drishti, Pothaki, Lagana, Krimi-granthi, Pariklinna-Vartma, Suklarma, Pishtaka, Sleshmo-panaha. 18.

Prognosis of the Raktaja Type— Of

the diseases of the eyes due to the vitiated condition of the blood, those known as Raktasrdva, Ajakdjata, Avalambita (pendent), Sonitdrsas and Sukra-roga should

Chap. I.] UTTARA-TANTARAM. 7

be re-^'arded as incurable, and the type of ^Kdcha (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 Sirotpata, Anjana, Sira-jala, Parvani, Avrana (non-ulcerated), Sukra- roga, SonitArma and Arjuna may be included within the group of curables. 19.

Prognosis of the Tridoshaja Type,

et.C. : — Of the eye-discascs due to the concerted action of the three aggravated Doshas, those known as Puya- srava, XakulAndhya, xA.kshipikdtyaya and Alaji are incurable and palliative measures are only possible in cases of Kacha (cataract) or Pakshma-kopa ; while those known as Vartmdvabandha, Sn'aja-pidaka, Prastdr- varma, Adhi-mansdrma, Snayvarma, Utsangini, Puya- lasa, Arvuda, Syava-vartma, Kardama-vartma, Ars'o- vartma, Sukrdrs'as, Sarkara-vartma, the two forms of inflammation with or without local swelling known as) Sas'opha-pdka and As'opha-paka, Bahala-vartma, Kumbhikd 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 (bindmg unions), twenty-one te) the Vartma (eye-lids), eleven to the Sukla-bha'ga (the Vitreous body), four to the Krishna bhaga (the region of the Choroid), seventeen to the entire region (eye-ball) and twelve to the^rcgion of the Drishti (pupil or the ^crystalline lens, etc.). The

*Thc 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 SAMHITX. [Chap. I.

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

Thus ends the first chapter of the Uttra-tantra in the .Sus'rula Sanihitd 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 arc peculiar to the joints or binding membranes of the eye (Sandhi-'

gata-Roga-Vijnaniya).

The names of those diseases :— Diseases

peculiar to the joining (Sandhi) of the eye are nine in number and are named Puyalasa, Upandha, (the four kinds of) Srava (viz. Puya-srava, Sleshma-srdva, Rakta- srdva, Pitta-srava), 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 -f of the locality passing through the lachrymal ducts into the binding tissues of the four different Sandhis (joinings) set up a painless .| secretion (Srdva) from the localities characterised by the specific symp- toms of the different Doshas involved. The.se are known as Srsivas, which according to some, are also called

* According to Madhava's reading, the swelling should be painful ('J^^'.)- There is no mention whether the pus should be dense (^cg) or otherwise.

t The term "Dosha" here means S'leshma, Pitta, Rakta (blood) and the concerted action of the above three Doshas. It should be noted that Viyu is excluded from the list as it does not produce any secretion.

X Madhava does not mention this (painlessness) to be a symptom.

10 THE SUSHRUTA SAMHITX. [ Chap. II.

Netra-nddi 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 Puysi-sriiva. 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 Sleshmsi-sra'va. The flow of thin, warm-f and blood-streaked copious discharge due to a contaminated state of the local blood is called Raktsk-srjfva. 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 Pitt^-sraiva. 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) \. 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-grantlii. Parasites of different forms in such a case are found to infest the regions where the inner lining of the Vartma-

* According to Madhava's reading, the absence of pain is not a necessary concomitant in this case.

t According to Madhava's reading thinness and warmness are not essential.

t 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. II. ] UTTARA-TANTARAM. 1 1

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 Samhita 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-Vijnaniyav 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, Kumbhika, Pothaki, Vartma-Sarkara. Ars'o-vartma, Sushkars'as, Anjana, Bahala-vartma, Vartmavabandha, Klishta-vartma, Kar- dama-vartma, Sy^va-vartma, Praklinna-vartma, Pari- klinna-vartma, Vatdhata-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 (Pidaka) 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 Kumbhikai *. 3—4.

* This disease (Kumbhika) is due to the concerted action of the three Doshas.

[ Char. ni« UTTARA-TANTAKAM. 13

A number of red and heavy (hard) boils or pustules (Pidakd) resembling red mustard seeds attended with pain, itching and exudation is called Pothaki. A rough and large pustule (Pidaka) surrounded by other very small and thick erythematous pustules (covering the entire length of the eye-lid) is called Vartma-s'arkarak. 5-6.

Vegetations of small (D. R. soft) and rough papilse (Pidakas) on the eye-lid resembling Ervdruka seeds and attended with very little pain arc called Arso-vartma. Long, rough, hard, and numbed papilse (Amkura) on the eye-lid (2) are called Snshkairsas. 7—8.

A small, soft, copper-coloured pustule (Pidaka). appearing on . the eye-lid and attended with burning, pricking sensation and a slight pain is called an Anjana. Vegetations of pustules (Pidaka) 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 chilled Klishta- vartma. 11-12.

A ca.sc 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 M^dhava, the papila: in such cases occur in the inner side of the eye-lid.

14 THE SUSHRUTA SAMHITX. [ Chap. III.

swelling (D. R. — pain) and attended with a discharge of pus and with burning and itching sensations is called ^yj^va-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 Vsitaihata-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) V^yu within the nerves or veins (Sira) 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 Sonit^^rsas 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 f- ^^ inflammatory swelling

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

Chap. HI. ] UTTARA-TANTARAM. !§

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 Ihe 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-Vijnjiniya). i.

Names : — The eleven different forms of diseases which are peculiar to the Sclerotic coat (white) of the eye, are Prastaryarma, Suklarma, Kshataj^rma (Rakt^- rma), Adhimansarma, Snayvarma, Suktika, Arjuna, Pishtaka, Sira-jala, Sira-pidaka, and Balasa-grathita. 2.

Symptoms :— A thin and extended glandular swelling (Granthi) coloured reddish blue and apearing on the Sclerotic coat (Sukla) is called Prastairyarma. A crop of soft and whitish growths slowly extending over the entire length of the Sclerotic coat is called Suklatrma. The fleshy growth on the white coat of the eye resembling a (red) lotus flower in colour is called Lohitatrma. The soft, extended, thick and dark- brown and liver-coloured growth of flesh on the white coat is called Adhi-mainsabrma. The rough, yellowish (D. R. white) growth of flesh on the white coat, and gaining (slowly) in size, is called Suakyvarma. 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 Suktikai. 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 SirSk-jSkla. The

Chap. IV. UTTARA-TAXTARAM. 1 7

crop of white pustular growths (Pidaka) on the Sclerotic coat (S'ukla), near the limit of the black coat (Iris) and covered over with shreds of veins are called the Sirsi- Pidaksi. The disease in which a speck coloured like the Indian bell-metal (K^msya) and covered over with a vein (Sira) appears on the region of the Scleratic coat is called the Balaisa*. 8-13.

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

* The reading in Madhava's Nidana 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.

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-Vijnsiniya). 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, P^kdtyaya and Ajakl. 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-^Ukra : — 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-Sakra. 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. 10

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-Ps&sityaya. 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 Ajak2^. 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 Nidana, 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.

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). r

Names and causes :— The four types of

Abhishyandha (Ophthalmatis), the four types of Adhi- mantha, the two forms of Akshi-pdka (suppuration of the eye) attended with or without swelling, these ten, as well as Hatddhimantha, Anila-Parjdya, Suskdkshi- pAka, Anyato-vdta, Amlddhyushita, Drishti, Sirot- pAta and S'ird-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 Vsiyu 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 Pit taja- Abhishyanda exhibits the following features, viz., 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, /". c, 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. T^-d.

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 Vattaja type 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 c}c is

2:^ THE SUSHRUTx^ SAMHITA. [ Chap. Vl.

swollen with a slight congestion (inflammation). Dis- charges with a sfensation 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. ro.

Symptoms of Raktaja Adhimantha :

— A pricking pain in and a blood-streaked secretion from the affected organ which looks (bright red) like a BandJiujiva 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 ArisJita fruit submerged in blood. 1 1.

The prog'nosis : — 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 VAtaja Adhimantha and instantaneously within three days of the attack) in the Pittaja type of {i. e., Adhimantha. 12.

Symptoms of Sa-sopha and A-sopha Akshi-paka :— A case of Sa-sopha-Netra-paika

exhibits the following symptoms, viz., itching sensation, deposit of mucous matter (in the eye), lachrymation and a redness of the eye like the colour of a ripe Udtimbara 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-TANTARAM. 23

discharge-;, and ultimately suppurates. All these symp- toms except swelling mark the (non-swollen) A-s'jpha- Netra-pa'ka type of the disease, 1 3.

The deranged Vdyu getting incarcerated in the optic nerve (Sira) impairs the faculty of sight, and gives rise to an incurable disease which is called Hataidhimantlia (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 e}'e, owing to the coursing of the deranged and incarcerated Vayu in those localities, is called Vata-Parya'ya. 14-15.

The disease in which the eye-lids become dry and hard and remain alwa\'s closed, the \-ision becomes cloudy and hazy, and it becomes very painful to open the eye-lids, is called the Sishkaikshi-pEika.t The excessive pain in the eyes or in the e\-e-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 Manyd (a particular nerve on either side of the neck), or in an\' other (adjacent) place, is called the Auyato-vaita. 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 Amlaidhyushita-Diishti. 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 Sirotpaita. iH -19.

* Mddhava in the Nidana <!oe.s not mention the eye-lashes.

t Mddhava in the Nidana reads "^^^^" which means that a liighly

burning sensation is produced in the affected eye, in place of «'f^f^^^" ,

» word which seems redundant.

24 THE SUSHRUTA SAMIIITX. [ Chap. VI.

A case of SirotpAta, 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 Sirai-harsha. 20.

Thus ends the sixth chapter of the Uttara-Tantra in the Sus'ruta Samhit^ 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 elements 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 nature 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 Mas^ra seed 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 (SirA) of the eye, 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 Madhava's commentary l)y S'rtkanlha, the dimension of th'.- Drishti ii equal to only a hall of that of a Masura- puhe.

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 seem 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 eye and hence from threading a needle. 4.

Symptoms— when third PataSa

attacked : — Objects situate high above are seen and those placed below remain unobserved when the de- ranged Dosha are infiltrated into the Third Patala (coat) of the Drishti. The Do-shas affecting the Drishti (cry.stal- line lens), if highly enraged, 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. VII. ] UTTAKA-TANTAKAM. 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-n^sa (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-nds'a. The Linga-nas'a (blindness) is also called Ni'lika and Kacha. 6.

Specific traits of Timira :— All external

objects are viewed as cloudy, moving, crooked and red- coloured in the Vaitaja type (of Timira), while in the Pittaja type 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 pea-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 (Chamara) seems to intervene in everything which look white and oily and dull and appear hazy and cloudy in a fine day, or as if laid under a sheet of water. In a case of the Raktaja type of Timira, all objects appear red or cnvoloped in gloom, and they assume a greyish, blackish or variegated colour. In a case of Sannipsitika Timira, the outer world looks varcigated 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'^'^-

Pari m lay i : — The quarters of the heaven look yellow and appear to the sight as if resplendent with the light of the rising sun, and trees seem as if sparkling with the tangles of fire-flics in a case of Parimla'yi,

28 THE SUSHRUTA SAMHItX. [ 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 Ling-a-nasa :— Now wc shall describe the colours of the pupil in the six different types of Linga-nas'a. The pupil assumes a reddish (Aruna) colour in the Vataja t)-pe of the disease ; looks blue or bluish yellow in the Pittaja, white in the Kaphaja and blood- red in the blood-origined one, while it assumes a varie- gated hue in the Satnuipatika type of Linga-nds'a. 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 diseased 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 spontaneous 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 Vflktaja Linga- nds'a is red-coloured, and is moving and rough to the touch, while that in a case of Pittaja Linga-nas'a is bluish or yellow or coloured like bell-metal. The circular patch in a case of Kapha] a Linga-nas'a 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-nas'a is red-coloured like a coral or a (red) lotus-petal. A Sainuipaktika 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

i.s twelve. The six types of Linga-nas'a (Drishti) have been described above. The six other forms of the disease, peculiar to the Drishti (pupil) are named as Pitta-vidagdha-Drishti, Slcshma-vidagdha-Drishti, Dhfima-dars'in, Hrasva-Jatya, Nakulandhyatd and Gam- bhirika. 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 see 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-Drisliti. 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. t Chap. Vlt.

coldness of the atmosphere (and a general cooling of the Earth's surface)* is called Hrasva-js^tyaf- -i-

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, I is called Nakulakcdhya. The form of occular affection due to the action of the deranged Vaiyu, 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-uas'a of traumatic origin, vi^., 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-heated § condition of the head (brain, etc.), and marked by the specific symptoms of (blood-origined) Abhishyanda, while the second comprises those in which the loss of one's vision is due to causes, such as the witnessing of divine halo or effulgence emanating from the ethereal person of a god, or a Gandharva (demi- god), a holy saint, a celestial serpent, or such other

* The latter pavt 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-jatya" is said to cause one of the four types of night-blindness.

t Some read Hrasva-jadya in place of Hrasva-jatya.

X 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 ] UTTAKA-TANTARAM. 3 1

highly bright object. In this case the eye is not out- wardly affected and the pupil (Drishti) looks as bright and clear as a Vaidurya 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 pursued in each case. 25.

Thus ends the seventh chapter of the Uttara-Tantra in the Sus'ruta .Samhita 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 (Nctra-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 (Ophthalmic surgeon) as in- curable. The two kinds of eye-disease 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 treated with incision are Ars'o-vartma, Sushkars'as, Arvuda, Sira- Fidak^, Sira-jala, the five types of Arman*, and Parvanikd (thus numbering cle\ en in all). Diseases in which scarification should be resorted to (numbering seven in all) are Utsangini, Bahala-vartma, Kardama- vartma, Sy^va-vartma, Vaddha-vartma, Klishta-vartma, Pothaki, Kumbhikini, and Sarkar^-vartma. 3-4.

Names of Bhedya and Vyadhya eye- diseases : — Optical diseases in which tlic affected

* See Chapter IV', para 2, Uttara-Tantara.

Chap. VIII, ] UTTARA-TANTARAM. 33

localities should be treated with excisions, are Sleshmo- panaha, Lagana, Visa-vartma, Krimi-granthi and Anjana — thus numbering five in all. The two kinds of eye-disease beginning with Sira viz., Sirotpata and Sira- harsha, the two kinds of Akshi-pdka attended or un- attended with swelling, viz., Sas'othakshi-paka and As'othakshi-pdka, and Anyatov^ta, Puyalasa, Vata- viparyaya and the four types of Abhishyanda and the four types of Adhimantha should be treated with Venesection (Sira-v}-adhana). 5-6.

Eye-diseases— not to be operated :—

Operations should not be resorted to in cases of Sushkd- kshi-paka, Kapha-Vidagdha-Drishti, Titta-Vidagdha- Drishti, Amladhyushita-Drishti, Sukra-roga, Arjuna, Pishtaka, Aklinna-vartma, Dhuma-dars'in, Suktikd, Prak- linna-vartma and Valasa — 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 Vayu-origined, two of the Pittaja, one of the Kaphaja, four of the blood-origincd 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'nita Samhita which deals with the classification of eyc-discascs according to the different modes of treatment.

CHAPTER IX.

Now we shall discourse on the remedial measures of Abhishyanda (Ophthalmia) due to the action of the

deranged v^yu (VsitsCbhishyancla-Pratish" cdha)* I.

The patient should be treated with old and matured clarified butter, both in a case of (V^taja) Abhishyanda (Ophthalmia) and (Vdtaja) 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- p&ka, fumigation, sprinklings (As'chyotana) f, snuffing (Nasya), oily washings, Siro-vasti (errhines) or washing the organ with Kanjika (Amla) or with any decoction prepared with the drugs of the Vayu-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.

t As'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 Vataja 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'alxla-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, Vesavdra, Salvana Poultice, Porridges (Pdyasa), etc., should be used by a physician in poulticing the affected organ. A portion of clarified butter cooked with the decoction of Triphald^ or simply old and matured clarified butter, or milk duly cooked with the drugs of the Vayu-subduing group, or of the first group (viz., Viddri-Gandhddi Gand) should be taken after the meal. 2. A.

The application of any lardacious substance other than oil cooked with the admixture of the Vayu-sub- duing drugs will prove beneficial for Tarpana purposes in such cases. The use of medicated Sncha in the shape of Putap^ka, Dhuma (fumigation) and Nasya (snuffs) is likewise recommended. Oil (duly) cooked with Sthird, milk and the drugs of the Madlmra 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 Kantakdri, should be employed lukewarm in washing (Sechana) the affected organ. A liquid compound con- taining half milk and half water, and boiled together with Saindhava, Vdld, Yashti-7nadhu 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 Hrivcra, CJiakra (Tagara), Maw jishthd, and Udumbaya-havks is considered to be the be.st eye-drop in cases of there being any pain (Sula) in the eye. 2. B.

A thin plaster compound of Yasthi-madhu, Rajani, Pathyd and Devaddni, pa.stcd 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 SAMHITX. [ Chap. IX.

very effective. Gazrika-tSiYth, SaindJiava^ K?ishnd, (Pippali) and S'unthi — the quantity of each subsequent one being double of that of the one preceding it in the order of enumeration, should be pasted together with water, made into Gutiki (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-VEita and Vaita-paryaya. Draughts of (medicated) clarified butter and of milk before the meal, are highly efficacious. Clarified butter duly cooked with (two parts of) Vrikshddani, KapittJia and major Paucha-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 (Ajamodd) 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 ^ushkakshi-p^ka :—

Saindhava, Devaddru and S'unthi and the expressed juice of Mdtuhinga, water, breast-milk and clarified butter mixed together and duly prepared (in the manner of Rasa-kriya) should be prescribed as an xA.njana in cases of Sushkaikshi-pakka. The taking of clarified

*' According lo Dallana and Gayadasa, this Ghrita should be pre- pared without any Kalka. S'rikanta holds that the drugs Vrikshaddni, Kapittha and the Pan'-ha-mula should be taken as Kalka and the Ghrita prepared with three parts of milk. S'ivadasa also seems to support this view.

Chap. IX.l UTTARA-TANTyVRAiM. 37

butter cooked with the drugs of Xhe Jivaiiiya 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-ddrii and mixed with (a little quantity of) Saindhava are efficacious. MaJiausJiadha (Sunthi) rubbed over a stone-slab with clarified butter and breast- milk is also recommended as an Anjana (eye-sal ve)i-. The Vasa (essence of the flesh) of aquatic animals or of those which frequent swampy grounds, mixed with a little quantity of powdered S'linthi and Sanidhava salt (and rubbed on stone-slab) should be applied to the eyes as an Anjana (collyrium) in a case of Sushkakshi- paka (Non-secreting type of conjunctivites). Let the • intelligent physician treat the sight-destroying Vdtaja 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 vSus'ruta Samhita which deals with the medical treatment of Vataja Abhishyanda.

* According to Dallana, this Ann-taila is not the one described in Chapter V of the Chikitsita Sthana ; but the one described in the vS'alakya- Tantra.

t This couplet may also be translated as follows :— Anjana (hlack- antiniony) 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 (OphthahTiia)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 Gundrd, S'dli (paddy), S'aivdla, S'aila-bheda, Ddni- haridrd, Eld, Utpala, two parts of Lodhra, Abhra (Mus- taka), Padnta-\&3.w&s, sugar, Dwvd, Ikshu, Tdla, Vetasa, Padmaka, Drdkshd, honey, (red) Chandana, Yashti- wrt;^ttw,breast-milk, Haridrd and Ananta-tnula, 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 Nasya-f*. 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 KsJiira- Sarpih (clarified butter churned from milk) at the interval of three days, as well as that of Anjana (colly- rium) with the expressed juice of Palds'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 (l) Pratiniarsha. (2) Avapida (3) Nasya (snuff) and (4) S'iro-virechana.

Chap. X. ] UTTARA-TANTARAM. 39

to. The thick liquid extract (Rasa-Kriyd)* of Pdlindi or Yashti-madhu mixed with honey and sugar, should be likewise employed. As an alternative, a com- pound consisting of Musta, Samudra-phcna, Utpala, Vidatiga, Eld, Dhdtri and Vijaka and prepared in the manner of Rasa-kriyd should be employed (as an Anjana). 4.

Acompound of Tdlisa (D. R. — Kdsis'a\ Eld, Gainka, Us'ira and S\i7nkha (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-kri)-d of Dhdtaki 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 Kmis'uka rubbed with honey, or of a compound of Rodhra, Drdks/id, sugar, Utpala, Vacha and Yashti-^nadliu rubbed with breast-milk should be used as an Anjana. J^arks of Variiaka\ pasted in cow's milk, or (red) Chandana \\'ood, Udumbara and Toya (Vila) pasted in the same, or Samud7'a-phena rubbed either in honey or breast-milk should be like- wise applied to the eyes in the manner of an Anjana. 5.

ASChyotana : — Rodhra, Yashti-madhu, Drdkshd, sugar and Utpala should be soaked in breast-milk. It should then be folded inside a piece of silk {Kshatona) and employed as an Aschyotana (eye-drop). Acompound of Yashti-madJm and Rodhra rubbed in clarified butter should be similarly used. A compound of Kds'mari (Gdmbh^ri) Z)/;rtV;7, /'(T/'^r^ (Ilaritaki) and 7<'y'rt: (Vala),

* For preparation of Rasa-kriya see Chapter XVIII, ibid.

t According to Dallana, '■Varnakai' liiieans ^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 Amhu (V^l^) 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 Amla- dhyushita-Drishti and Sukti-paka. The medicated Ghritas known as the Traiphala Ghrita or the Tilvaka Ghritaf should be prescribed, or simply old and matured clarified butter should be given in such cases. 7.

In a case of Sukti-paika an Anjana with cooling drugs should be speedily employed in the event of the Doshas being located in the lower part of the e\-e. Fine powder of Vaidurya gem, Spliatika (crystal), Vidru ma {cora.\) and Muktd (pearl), SamkJia (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-paka. 8.

Clarified butter should be administered in a case of Dhuma-dars'in 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 \ should be likewise employed there- in. 9.

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

* In the first two compounds, some take 'Toya' and ^AmbiC for water. But Dallana having explained '■Toyd as '■Valaka' in a preceding compound we adopt that meaning of the word here also.

t Traiphala-Ghrita is prepared by duly cooking clarified butter with the Kalka and decoction of Triphala'. For Tilvaka-Ghritaisee chapter III. Chikistsita-Sthana.

+ By Pitta-subduing remedies Dallana means the remedial measures laid down in connection with the treatment of Pitta-Vidagdha- Drishti.

CHAPTER XL

Now we shall discourse on the chapter which deals with the curative treatment of Abhish\-anda due to the deranged action of Sleshma (^leshmabhishyax

nda-Pratishedha) i.

General Treatment ;— An attack of s'lesh-

maja Abhishyanda or Adhimantha during the stage of acute aggravation should be treated by opening a local vein* or by the employment of fomentation, Avapida- Nasya, Anjana, fumigation, washes, plasters, gargles or non-fatty (Ruksha) eye-drops (As'chyotana) and Puta- p4ka. The patient shou'd be made to fast on each fourth day and to take a potion of Tikta-Ghrita-f- in the morning, and his diet should consist of such articles as do not lead to the aggravation of the bodil>' Kapha. 2-3.

Tender twigs or leaves of Kutaniiata, As/ipotd, Plumijjliaka, Vilva, Pattiira, Pilu, Arka and Kapittha\ should be employed in (mildly) fomenting the affected e\-c. A thin plaster composed of Vdlaka, S'uiithi, Dcva- ddru and KushtJia, should be likewise applied to the affected eye. 4.

Hingu, (Asafoetida), TripJiald, Yas/tti-niadku, Sain- dhava, Prapaundaika, Anjana (black Antimon}^, Tutt/ia (Sulphate of copper), and copper pasted together with

" The word 'Alha' (95fW) in the texl means says Dallana, that the local vein should be opened as the best resource, when tonientatinn, etc. would foil to effect a cure.

t See Chikitsila-sthana, chapter IX.

X In place of '■'■ Kutannata" and ^^Ar/:a" both N'rinda nnd Chakrapdni read "Sttrasa" and "'Arja", S'rikantha the commentator of \'rin<la how- ever is of oi>inion that .Xrka should be beltrr reading in place of thai ol

42 THE SUSIIRUTA SAAIIIITA. [ Chap. XI.

water and made into a stick (Varti) should be applied as an Anjana to the affected eye. As an alternative, sticks (Varti) composed of Pathyd, Haridrd, Yashti-madhu and Anjana should be similarly applied. Compounds made of the equal parts of Pippali, Maricha, S*untJii^ Haritaki, Am'ilaki, Vibhitaka, Haridrd and Vidan^-a-seeds, or of Vdlaka, Kushtha, Deva-ddni, (burnt) conch-shell, Pdthd (Akanidhi), Anala (Chitraka roots), Pippali, Maricha, S'unthi and Manah-s'ild (Realgar) and the flowers of Jdti, Karanja and S'obhdnjana^' pasted together with water should be applied to the eye. The seedsf of Prakiryd (Karanja), or of S'igru with the seeds and flowers of the two kinds of Vrihati mixed with Rasdn- jana, Chandana, Saindhava-?,3.\t, ManaJi-s'ild, 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 (e)'c-salve) in a case of VaWsa-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 BhcivanA saturation). It should then be burnt into ashes. These ashes should then be mixed with an equal part of burnt ashes of Arjaka, AshpJiotaka, Kapittha, Viha, Nirgiuidi and Jdti flowers and an alka-

* Dallana quotes the reading of '■'■Panjika'ka.'ra^ (another commen- tator of Sus'ruta) according to whom AJurva' and the flowers of Ja'ti only should be taken instead of the flowers of Jali, Karanja and S'obha'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'jgrtt should be taken.

Chap. XI. ] UTTAKA-TAKTKAiNI. 43

line solution should be duly prepared t.here^\ ith. Scu'/i- d/iava, TuttJia (Sulphate of copper) and RocJiand should now be added to the above alkaline solution and dul\- boiled. The compound thus prepared should 1 e applied as an Anjana with an iron pipe (Xadi). This is pres- cribed in a case of Va^asa-Grathita. Alkaline prepara- tions may be similarly prepared with (the flowers, etc. of) PJianijjJiaka etc., and ma\- be emp!o\-ed in a similar manner. 6.

A (thin) plaster composed of S' nut hi, Pip(-ali, Miista, SaincUiava and white MaricJia^'' pasted with the expressed juice of Mdtnliin^a and applied to the eye as an Anjana, would bring about a speedy cure of the eye- disease known as Pislitaka. /.

VrUiati fruits should be gathered when ripe and a pas _ v^ompound of (the equal parts of) Pippali and Srotdnjana 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. Paste may similarly be preserved inside a Vdrtdkii (brinjal), S'ioyu^ Indra-Vdruni, Patola.. Kirdta-tiktas.nd Amnldki -dud used for the same. 8,

Kas'is'a (Sulphate of iron), SdMUt/nr'r. Rasdnjaiui and buds of /«7/-flowcrs pasted together and rubbed in honey, is advised to be prescribed as an Alijaua in a case of Praklinna-Vartma. 9.

A single application as an Anjana of the compound composed of excellent Nddeya (Saindhava) \ salt,

* Dallana explains white Maricha as S'igrtt seeds.

t Samudra may either mean Samudra-phena or S.uiiiulra salt, i. e. Karakacha salt. The commentators are silent on this point.

* Dallana explains Nadeya as meaning Saindhava, Init il tienerally cans Srotanjana (black antimony).

44 THE SUSHRUTA SAMHITA. [ Chap. XI.

white pippcr* and Ncpdla-jdta (Realgar-lit., that which is produced in Nep^la) taken in equal parts -and pasted together with the expressed juice of Mdtulanga, would alleviate the itching sensation (Kandu) in the eyes. Similarly a compound of S'ringa-vera, Deta-ddrti, Musta, Saindhavd salt and buds oi Jdti flowers pasted together with wine and used as an Alljaiia would prove cffica- 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. lo.

Thus ends the eleventh chapter of the Uttara-Tantra in the Sus'rula Sanihita which treats of the curative treatment of S'leshmabhishyanda.

* Dallana explains "S'veta-Maricha"' as "S'igru-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-Pratishcdha). i General Treatment :— A wise physician

shall pursue the same course of medical treatment in those four diseases known as Adhimantha, Abhishyanda, Sirotpata and Sira-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 Kaiimbha Ghrita-', or with a copious quantity of clarified butter. Venesection should then be resorted to. The patient, having been made thus to bleed as much as required, should be treated with clarified butter dul\- cooked with Siro-virechana drugs and mixed with sugar, as an errhine for cleansing the head. Piasters, washes, snuffs (Xasya), inhalations (Dhuma) of medicated smokes, eye-drops ( As'chyotana), Abh\-anianat, Tarpana (sooth- ing measures). Sneha-karma (emulsive measures) and Puta-paka should then be prescribed according to the nature of the deranged Dosha involved in each case. 25.

A plaster (Pralepa) comj^osed of Nilotpahu (\s'iiv, Ddni-haridrd, Kdliya, VasJiti-madhn, M/ista, Lodlna and Padma-KdsJitha (taken in ccpial parts and) mixed w ith Ghrita — duly washed, should be applied round the region

* Sec Chaiilcr XL\', .Sutra-Slhana.

t Dallana explains "Abhyanjana" as CDllyrium, l)ul he also says that sonic coninicntalors take it in its usual sense of anointment with clarificl butter washed hundred times in water, or such other Sneha.

46 THE SUSHRUTA SAMHITA. [ Chap. XII.

of the affected eye. 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 Pittabhish\-anda, should be as well employed. 6-7.

Rain-\\'ater with pow dered Kas'eru and YasJiti-madhu added thereto may be squeezed with benefit through a piece of linen into the affected organ* as an Aschyocaua. FloM'ers of Pdtald, Arjiina, S'ripanii, Dhdfaki, Dhdtri, Vilva, the two kinds of Vrihati, and of Vhnbi-lota and ManjisJithd taken in equal parts and pasted together with honey or expressed juice of sugar-cane and applied to the affected organ as an Anjana (CoUyrium) is said to be a curative in cases of Raktabhishyanda. 8-9.

A similar compound consisting of CJiandana, Knmuda, Patra, S'ild-jatu, Kmnkuma, powders of dead iron and dead copper, Tuttha (Sulphate of copper), lead, bell-metal, Rasdnjana and the resinous exudation of a Nimba tree taken in equal parts should be pasted with honey and made into large Vartis (sticks). These are always recommended to be applied to the affected eye as an Aiijaiia. 10.

Treatment of ^irotpata :— A compound

consisting of honey and clarified butter and applied as an Anjana should be regarded as a patent cure in cases of SirotpSkta eye-disease. A compound composed of Saindliava (salt), Kds'is'a (Sulphate of iron) and pasted together with breast-milk should be similarly used. The

*" Both Dallana and S'ivadasa 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-TAXTRAM. 47

application as an Anjana of S'amklia (crnch-shcll), Manah-s'ild, Tuttlia, Ddru-hayidrd, and Sauidhnva pasted with hone\-, or of (\\ hite) Markka pasted with the juice of S'irisha flowers, hone}' and wine, or of Svarna-Garika pasted with honey would be attended with beneficial results in cases of Sirotpa^ta. 1 1.

^irsC-harsha : —A compound consisting of P]idnita[\.xz^.c\^ 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 Rasdnjana (Antimony) pasted with hone\-, or of Saindhava and Kds'is'a (Sulphate of iron) pasted with honey, or of Vetrd;nla^' and Saindhaza pasted with Plidnita and breast-milk would likewise prove highly efficacious. I2.

Treatment of Arjuna :— Ai the measures

and remedies for l'itt^bhish);inda should be employed in cases of Arjuna c\c-discasc. The expressed juice of sucfar-cane, honcx', susjar, breast-milk, Ddru-haridra, Yashti-madhii and Saindhava should be used in combi- nation as a wash (Seka), or as an Anjana. Amla (Kdnjika, &c.) should also be used as an Aschyotana (eye- drop) in such cases. The following drugs, vi.z., sugar, Yashti-7/iadhu, Katvajiga, Mastii, Arrila, hone\', SaindJiava, Vija-piiraka, Kola and Dddimba of acid taste and other acid fruits either singly or in combination of two or three should be judiciously used (as an Aschyotana with a due consideration of the vitiated Dosha \\\ each case). 13-14-

These two following compounds viz., of Spliatika

* Dallana explains '•'■VelrAmla" 0.% '^Amla velasa". Some, however, divide it into two words 7nz., "Vetra" and "Ainla" meaning thereby sprouts of Vetra (can'-) an I A'lila-vetasa respectively.

48 THE SUSIIRUTA SAAHIITA. [ Chap. XII.

(crystal), VidriDna (coral), S'amkJia (conch-shcll), and Yashti-7nadhii, pasted with honey, as well as of S'amkha, ■sugar, and Samudra-pJicna pasted with honey, if used as an Anjana would prove curative in a case of Arjuna eye- disease. Saindliava and Kataka pasted with honey, or Rasdnjana pasted with honey, or Kds'isa (Sulphate of iron) pasted with honey, should 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 [Manah-s'ild, 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 (Avasadana) * group, pulverised shells of hen's eggs, Las'una (garlic), Trikatu, Karanja seeds and Eld (cardamom) mixed together and used as an Anjana, should be regarded as Scarifying (Lekhya) in their action. 16.

Treatment of ^Ukra :— -In a case of non- ulcerated (A-vrana) Sakra (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-visravana (Venesection) and ending with Puta-paka (and these failing, the Lekhydnjana — colh-rium for scarifying) should be adopted. A case of ulcerated (Sa-vrana) Sakra whether superficial or deep- seated .; or rough should be treated in the same manner. 17-18.

* The group beginning with Kas'is'a — See Chapter XXX\'I, Siifra- .Slhana, page 334, Vol. I.

t Sec paras 3 and 4 of tliis Chapter.

J ".Supcrficiar" (Ultana) is here used in the sense of "seated in the first layer'" and ''deep seated'" (Avagadha) 'seated in the second layer',

Chap. \'ir. j UTTARA-TANTRAM. 49

In a case of S'.ikra the affected part should be rubbed (scarilied) with a compound consisting of S'lrisha- seeds, Marich.i, Pippali and Sniiid/Mva pounded together, or with SaindJuiva a'one. A compound composed of powdered copper, ManaJi-s'ild, Maric/ia and Sai/id/iciva each preceding drug being taken in a quantit)- 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'a/u/c/ia, stones of Kolas, Kataka, Drdkslid, Yashti-niadJiu, Mdkshika (hone}'), or of teeth (of cows, etc.), Sa;nndra~p]i:)ia and S'irisha flower anl hon:y should be applied to the affected locality inthe manner of applying an Anjana. The Kshai- raujana (alkaline coUyrium) mentioned in connection with the medical treatment of Valasa-grathita,-f may as well bj profitabh' employed as an Anjana (eye-salve) in the present disorder. Iwe-salves made of fried husk- le.ss Miid':^'Ti pulse, (burnt) S'amkha and sugar mixed with hone\-, or of the pith of Madhnka pasted with honey, or of the inner pulps of the stones of ]^ibltitaka pasted with honey should be constantl)' used as an Anjana, in ca.ses of the eye-disease known as .Sukra. A compound consisting of conch-shell, o\'ster-sheIl, Drdks/ui, Ynshti- niadhit, Kataka and honey may be used and soothing application (Tarpana) antidotal to the deranged bodily Vdyu, should be resorted to in cases of Sukra, if the second la)-cr (Patala) <.A the eye is attended w ith pain (^ula;. 19 2\.

* One part of 5a/«.7/i iz'Ji, two [)arls of Maricha, four of Manahs' ild, eight of 5'a/«/7/« and sixteen parts of copi)er slioulilh' taken in the nre- paralion of ih,- coniiiound.

I' See Cliajiler XI, para 6.

7

50 THE SUSIIRUTA SAMIirrX. [Chip. XII.

Young bamboo-jprquts, Aruslik.ira, Tdla (palm) and Ndrikela (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) timc^ with the above alkaline preparation in the manner of Bhjivana saturation. The application of this preparation in the manner of an Anjana tends to remove the discolouring nature (whiteness) of a case of S'ukra f. 22.

Treatment of Ajaka :— The thin watery

matter accumulated in the e}-c in a case of Ajakai should be drained by making a puncture on either side ( of the cornea ) 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 becoming raised. 23.

Treatment of Akshi-paka :— Applica- tions of Sneha and of Sveda (fomentation) to the affected locality should be made in cases of the two kinds of eye- disease known as Sa-s'opha and A-s'opha Akshi-paka (inflammation of the eye-lid whether attended with any local swelling or otherwise). Venesection should then be resorted to. Eye-washes, eye-drops (As'chyotana), errhi- nes (Nasya) and Puta-paka 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 cases of the two kinds

* The spathe (Jata) of the pahii tree and Ihe shell of the cocoanut fruit shoulil b; taken in prep.aring the compound — S'ivadasa.

t The prepared powder of elephant's bme should be mixed with honey and rubbed over th: affected part (S'ukra) with the tip of the finger or with a S'alaka (rod). The eye sh luld then be washed with the in- fusion of TriphaLi. — Dallana.

Cnap. Xri J UTTARA-TAKTKAM. 5 1

of Aksili-pa'ka). Sd/;/(///<!-c'ci and clarified butlcr pasted together in a copper vessel with flesh or Mc.ima or curd or with curd-cream shou'd be used as an Aiijana. As an alternative, the rust of bell-metal pasted with clarified butter, or Sairid/un'a pasted with breast-milk, or equal parts of the pith of M\hUi!il.\y tree and Gairika pasted with honey, or Saiiidliava and copper pasted with breast-milk and clarified butter should be used as Anjanas. The compounds of Dddimba, Aravcta, As'* fnanta. Kola, and SaindJiava pas'.ed with an)- acid juice* should be applied to the affected organ in the manner of a Rasa-kriyai measure for the cure of (the two kinds of) Akshi-pika. 25-26.

Animal flesh and SaindJiav.i salt soaked in clarified butter and mixed with S'linthi and breast-milk should be applied to the afifected organ in the manner of an As'chyotana or as an Aujana. A compound consisting oi Jdti flower, Saindliava, S'lait/ti, .Pippali and huskless Vidanga pasted together with honey, may as well be used as an Aujana with advantage in a case of Aksh'-paka. 27-28.

Treatment of Piiyalasa :— Blood-letting

(after the app'ication of Sneha and Sveda) and poultic ing (Upanaha) of the affec'.ed IccaHty are efficacious in the affecticn of the eye, known as Puyalasa. The measures and remedies which pro\ e curative in cases of Akshi-paka should as well be employed with dis- crcaon in this case b\- a physician. An Anjaua (eye-salve) compcjscd of Ardraka, SaindJuiViX and Kds'Isa (Sulphate of iron), or Kds'isa Sdiiid/inva, Ardraka, iron and copper dust pasted together w ith honc)', should be applied to the affected e\-e in the lUanner of an Anjana (in a case of Puyalasa). 29 30. * Sonic add iiontv in thr list.

52 THE SUSIIRUTxV SAMIIITA. [Chap. XII.

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 (Asch)'otana), snuffs (Nasya) and fumigation (Dhuma) should be resorted to according to the Dosha involved in each case. A compound composed of Miista, Harldrd, YasJiti-madlui, PriyaiigH, Siddhdrtha, Rod/ira, Utpala-sdrivd ^ pasted together \ should be employed in the manner of an As'chyotana measure. As an alternative, the compound consist- ing of Rdsdnjana and honey should be used as an Anjana. 11-12.

* The decoction of the leaves and fruits of Ainalaka should be duly prepared (in the manner of Rasa-kriya) and used as an Anjana. Rasa-kriyat preparations pre- pared with (the expressed juice of) the roots of bamboo, or Vartis prepared with the same by (condensing it b)-) cooking it (again) in a copper vessel, should be used for the above purpose. Rasa-kriya preparations prepared with TripJiald, flowers of J-'aldsa, or Khara-nianjar}, should be similarly applied to the affected organ. Eye- salves made of powdered Kdri-fs'ya-mxla and cotton fibres (Tantu) burnt together and pasted with the milk of a she-goat and mixed with (white) MaricJii and pDwdered copper should be used as a Pratyaujaua to the eye (already weakened by the use of Anjana.) ^^i -34.

* Dallana says that the deranged Doshas of the system should be cleansed with the application of Sneha, Venesection, purgative, errhines and A'sthapana.

t In place of ';cti|l-fqiJTgTn:^frH:' som: read '#cirfffrI^irf:^Tr«;', meaning in this case '.Syama-lata' by the term 'Asita-sariva'. Others again mean 'Rasanjana' by the term 'Asita'. — Dallana.

X Dallana recommends 'rain water' as the liquid for the preparation.

Chap. XII. ] UTTARA-TANTRA.M. 53

An eye-salve or an Anjana made of Saniudra-p/ic}ia. Saiii-JIiavd, conch-shell, 2fuiiga and white Mariclia mixed together (in the shape of a powder) should be prescribed in a case of Aklinna-V-irtma as it would promptly alleviate the local itching. The foregoing measures and remedies should be likewise emp^o\-ed in a case of Praklinua-vartina according to the nature of the deranged Doshas involved therein. An Anjana pre- pared with the admixture of Kajjala and Tnthhaka (Sulphate of copper) rubbed in clarified butter on the surface of a copper vesse', wouM be similarly used (in such cases). 35"36.

Thus ends the Uveli'tli chaptei of the Uitara-Tantra in ihc Sub'ruia Samhila which treats of thj curative treatment of Raktabhishyanda.

CHAPTER XLIL

Now we shall discourse on the curative treatment of cye-disc.ises in which Scarification shoukl be resorted to

(Lekhya-Roga-Pratishedha). r

The general course of treatment to be adopted in the nine kinds of eye diseases which are amenable to Scari- fying (Lekhana) operations is as follows : — The patient should be laid in a chamber not exposed to the sun and the gales of wind, after having been treated with proper emu'tsive measures (Sneha-karma)* and sub- jected to a course of emetics and purgatives. The c}'e- lid should be over-turned with the thumb and the index finger and should be very carefully fomented with a piece of linen soaked in lukewarm water and squeezed. The eye-lid should be covered with a piece 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 ^\•ith a linen and marked with a surgical instrument and the scraping should be effected therein with a scraping knife or any (rough) leaf acccjrding to the exigencies of the case. After the subsidence of the bleeding, the part should be fomented and then gently rubbed (Prati- sarana) with a medicinal compound consisting of J/if?'//^?'/'- s'i/d (Realgar), Kds'/S(7 (Sulpliate of iron). Trikatii, Aujaiia (black antimony), SaindJiava salt and Hfdks/iika finely pounded together. After tliis the part sliould be washed with lukewarm water and lubricated with clarified butter. The subsecpient treatment thereof should be

* It should be nofed th.it llie patient should also be foivienled (Svcda) after beinE; treated with the emulsive measures.

Chap. XIII. ] UTTARA-TAXTRAM. 55

like that of an u'ccr (X^rana)."-'- Fomentations, Avapida, etc., .should aiso be employed after three days. Thus I have described to \-ou the general measures to be observed in scraping" an affected localit}' 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 arc the features, which mark a prop3r and satisfactory scarification. Red- ness of the eyes, 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, heaviness, numb- ness, itching, horripilation and coating (as if with foreign matter) of the eye-Uds and a consequent high inflamma- tion of the e}'e if not attended to in time, are the s\-mp- toms which attend an iucomplete and unsitisfactory scarification, and this should be remedied by anointingf and scarifying the affected part again. 3-4.

Excessive Scarification :— Excessive dis- charge and pain in the locality together with an upturning of the ev^e-lids and spontaneous 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 diseases of the eye, tv'.c., Vartmd- vabandha, Klishta-vartma, Bahala-vartma and Pothaki, the affected part sliou'd first be gcntU- scraped and then

* For the first seven days the treatment should he like that of an incidental ulcer (Sadyo-vrana) after which period, the case should he treated, if necessary, as a case of .S'arira-Vrana.

t Dallana says thai some ri'ad '?q^f?)cci' (romcnliiii;) in place of '^?f?J«9r( ■'anointing).

56 THE SUSIIRUTA 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, Pidakds (pustules) occurring on (the inner membrane of) the eye-lid. Small and slightly swelling Pidakas (pustules) occurring on the exterior surface of the eye-lid should be remedied with fomentations, plasters and the general corrective remedies, 6,

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

CHAPTER XrV.

Now we shall discourse on the curative treatment of eye-diseases which require surgical incisions (Bhcdya-

Roga-Pratishedha). i

Treatment of Visa-granthi :— in a case

of suppurating Visi-grauthi, it should be firsc 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, Kds'is'a, Mdgadhi, Pushpdnjana, Manah-s'ild and Eld pounded together*. Honey and clarified 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, viz.^ RocJiand, Yava-ksJidra, TuttJia, Pippali and honey should be applied to the incised part ; while in serious (lit. — big) cases cauterization with alkali or with fire will be the remedy. 3.

Anjatia : — in a case of Anjana, the affected part should be duly fomented and if it spontaneously bursts open, it should be well pressed and rubbed (Pratisarana) with a plaster-compound of Manah-s'ild, Eld, Tagara- pddiikd and Saindhava, pasted together with honey. If, however, the surgeon wants to open it, it should be rubbed v>ith honc\- and Rasdjij'ana 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. Tiiey supply the next two lines of Sus'ruta, and notice the consequent ^Iteration in the sense.

58 THE SUSIIRUTA SAMHITX. [ 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-kriyd solution prepared with (the decoction of) Triphald (with the addition of) Tiitt)ia"\ Kd-sisa and Saindhava. In a case of Upanaiha (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 C3-e 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 these (incisable eye) diseases, the application of a Sneha should be first adopted. In cases, however, where suppuration had already set in, the remedies for the healing up of the ulcer, should be carefully adopted. 6.

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

* Both Vrinda and Chakrapani read ^Aliilra (cow's urine) in place of '■Tutthd. Both of ihr-m also recommend the addition of Rasanjana in the compound.

CHAPTER XV.

Now wc shall discourse on the curative treatment ot cyc-discascs, which should be cured with excisions

(Chh^dya-Roga-Pratishedha). i

Treatment of Armas :— The patient should

l:c 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 care- fully to sit at ease and the affected eye should then be irritated b\- casting powdered Saindhava-ssXi 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 Apdnga (the interior corner of his own affect- ed eye) and th2 cyst or the polypus (thus turned up), should be i:arefully secured with a hook (Vadis'a) and held with a Muchundi instrument or with a thread- needle. It is dangerous to suddenly uplift the eye-lid under the circumstances. The two eye-lids should be firmly drawn asunder so as to guard against their being anywise hurt during the operation. The polypus, thus made flabby and pendent with the means of the three aforesaid accessories, should be full)- got rid of by scraping it with a sharp Mandalagra instrument. The root of the polypus should be pushed asunder fro'm 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 oi)eration would not in any way hurt or injure the eye. An o[)eration at

60 Till"- SUSllRUTA SAMUITA. 1. Chap. XV.

a pjint beyond the aforesaid limit of the Kaninaka (might hurt the pupil and) would set up a haemorrhage and b3geL a sinui (a^ 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 (Jala) in the eye should be made pen- dent by rubbing it (with Saindhava-sdAt) and then cut with a bent Vadis'a instrument at the junction of the Sukla-mandala (cornea) and the Vartma-mandala (con- junctiva or eye-lid). The affected part should then be rubbed with a compound consisting of Yava-ksJidra, Trikatii and Saiudhava-sdXi (pounded together) and then (duly) fomented and bandaged up by the skilful physician. Lardaceous or oily (Sneha) application should thereafter 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 three days and the affected part should be (mildly) fomented with the application of heated palms of the hands and treated with corrective or purifying remedies. 3.

Milk duly cooked with Karanja seed, Amalaka and Yashti-madhiL 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 Z'/z/^^-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 *^' — the particular part and nature of the country, some rea'l '^j^' — -th > particular Djsha involved in each case.

Chap. XV. ] UTTARA-TAXTRAM. 6l

Any residue of the Armail, left after the excision, .should be removed with the application of Lekhya* (scraping) x'\njana or e}-e-salve. An Arman (Cyst-like papilla or protruberance) which is as white as curdled milk (Dadhi), or which looks blood-red or blue or grey, .should be treated like a case of Sukrarman (Opacity of the cornea or a flimy and flesh)- 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 f, 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 Si ra- Jala and Sira-

pidaka : — in a case of Sira-Jala, the hardened veins (.Sira) should be hung down with a hook (Vadi.s'a) and scraped with a Mandalagra (round-topped) instrument. Cysts or pimples (Pidakas) appearing on the diseased veins in a case of the aforesaid SirA-JAla and not pro\"- ing amenable to the application of medicines, should be excisioned as in a case of Arma with a Mandalagra instrument. Pratisarana (rubbing) as in a case of Arma and Lekhana (scraping) with due regard to the nature of the deranged Doshas involved in each case, are also recommendad in both the disea.ses (Sira-Jdla and Sird-PidakA) under discussion. 9.

Treatment of Parvanika :— In a case of

Parvanika the place of junction \ (of the lachrymal

* Fur Lekhya Anjana see Cliapler XII, para l6 of this UUara Tanlra. + Some here read 'f%TT' (veins) in place of* ^jf' | :J: The 'junction' is the junction of the Krishna-mandala and the .^'iikla-mandala of the eye. — Dallaiia.

62 rilK SUSHRUTA SAMlllTA. [ Chap. XV.

sac and the cornea) 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 rubbed (Prati- sarana) with a compound of honey and Saindhaua-sdAi. Scarifying (Lekhana) powders should then be applied to the affected part for the complete recovery of the disease (an)- comp'aint still remaining). lo.

Churna-Anjana :— Powders of S'amkha (conch-shell), SiDnitdra-pJiena, marine oyster-shell, crystal, ruby, coral, As'mantaka, Vaidurya (Lapis lazuli), pearl, iron, copper and Srotonjana (antimony) taken in equal parts and mixed together, should be 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 extremely efficacious in all types of Armans, Pidak;^s, Sir^-jala, ArsAs, Sushkars'as and Arvuda, e!.c., in the eye. ir.

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 diseased 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 Mandaldgra instrument. After that the affected part should be rubbed with a pulverised compound consist-

^ Ddllana explains ' Meih^i' ringd as a kind ot lugtidi tree.

Chap. X\^ 3 UTTARA-TANTRAM. 6^

ing of Saiiid/iova, Kdsisa (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) administered for the elimination of the Doshas (from the Vrana — ulcer). The measures and remedies mentioned in connection with x'lbhi- 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 ot 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 he 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 eye-lashes and hence on the eye-lid (Pakshma-kopa Pl'atl-

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 treated 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 eye-ball lying between) the Kaninaka (pupil) and the Apanga (exterior corner of the eye) leaving two parts below the eye-brow and one part above the eye-lashes. The surgeon should then diligently suture up the two edges of the incisions with (horse's) hair. After the application of honey 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 forehead 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 fire or alkali. As an alternative, the Pakshma-

* According to Vagbhata, the stitching liaif should be removed on the fifth day.

Chap, XVI. j UTTARA-TAMKAM. • 65

mal4 (eye-lashes) should be all removed and the affected eye-lid having been carefulU- secured with three hooks (Vadis'a) should be rubbed with pasted Haritaki and Tiivaraka (Lodhra). The four aforesaid measures* as well as purgatives, eye-drops (xAs'chyotana), medicinal snuffs, inhalations (fumigations), Plasters, CoUyrium, Sneha and Rasa-kriya, should be likewise held as beneficialf 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 drug?.

t It should be noted that this disease cannot be radically cured, but is amenable only to palliative treatments (?jixg).

CHAPTER XVII.

Now we shall discourse on the curative treatment of the diseases of the pupil and the Crystalline lens

(Drishtigata Roga Pratishcdha). i.

Of the diseases included within the present group, three are curable, three arc incurable, while the remain- ing six admit only of palliative treatment. The cura- tive remedies of the disease known as Dhuma-dars'i (smoky or dusky vision) has been already described (in conne:tion 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-paka and Tarpana (soothing) remedies with the exception of surgical operation should be respectively administered in cases of Pitta-affected (Pitta-vidagdha) and Kapha-affected (Sleshma-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, MaricJia, S^in's/ia-'-^eeds and Manali-sild, or wdth the stalk of a Kapitthi fruit together with honey, or with Atmagnptd pasted with honey ; these four

* See Chapter X, 9, Uttara-Tantra.

t Traiphala-Ghrita, Traivrita-Ghrita and Tailvaka-Ghrita should be prepared with both the decoction and Kalka of Triphala, Trivrila and of Tilvaka respectively.

Chap. XVII. ] UTTARA-TANTRAM. 6/

ADJanas may be used with advantage in both the types under discussion. 2-3.

Pushpa'njana :— Powders of the flowers of Kubjaka, As' oka, S dla, Amni, Priyangu, Nalini and of Utpala, as well as powdered Rcimkd, 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 Sleshmd-vidagdha eye- diseases. 4.

Dravanjana and Gudikanjana :— As

an alternative, Reniikd pasted with the expressed juice of the flowers of Amra (mangoe) 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 (blue lotus) as well as Gairika * pasted together with the Rasa (watery secre- tions) of cow-dung -f- and made into large pills (Gudikd) 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 \—Rasdn'

Jana, Rasa (Juice) ^, honey, Tdlis' a-patra and Svania- gairika should be pasted together with the Rasa of cow-dung and applied (in the manner of an Anjana) in cases of Pitta-affected vision i.e. day- blindness. S'ita

' Chakratlatta doca nol read '(iairika' in the list.

t In place of "4Tt3I3i?l" ^='"^'- ^^^'^ "jTt^Wrf" ^•^•> ^^e liver of a "jji" which may mean a cow or any animal, such as goat, sheep, etc.

:J: According to Dallana, Rasa (lit :^uice) means the juice of A'malika. According to others, however, it means the juice of the leaves of Jdti flower. Chakradatta, however, reads •*gcl" (clarified butter) in place of "tti".

68 THE SUSHRUTA SAMHITA. [ Chap. XVII.

(Rasanjana, or according to some Camphor), and Saiivira 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 RoJiita fish and dried and reduced to powder. The present compound is called the Churna-anjana (powdered CoUyrium) and may be used beneficially for the pacification of Pitta (in cases of Pitta-vidagdha-Drishti). Kds'man flowers, Yashti-madhu, Ddrvi, 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 Sauvirdnjana, Saindhava, Pippali and Renukd 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 Kdldnu-Sdrivd, Pippali, S'tmthi, Yashti-madhii, Tdlis'a-patra, the two kinds of Haridrd, and Musta, pasted with the Rasa of cow-dung i* and dried in the shade, proves beneficial in such cases. ManaJi- s'ild, Haritaki, Trikatu, Bald, Kalanu-sdriva and {S'amii- dra-) Phcna pasted together with the milk of a she-goat and similarly prepared in the shape of a Varti is also recommended. 9-1 1.

Rasa-Kriya'njana :— The urine, bile and dung of a cow \ together with wine, should be boiled (in the manner of Rasa-kriyanjana preparation) in the

* Rasa may also, from the context, mean the watery secretions of cow-dung.

t Dallana's heading is evidently '»n?(liiffT^' which he explains as meaning the juice or serum of the liver of a goat, &c.

X the text has "jft^i^f^Tl" | The term "jft" which literally means a cow, here stands for any female quadruped, such as a she-goat, etc.

Chap. XVII. ] UTTAKA-TANTKAM. 69

expressed juice of Dhdtri, or in the Rasa (serum) of the liver of an animal (e.g. a goat), or in the decoction of Triphald. It is called the Kshudrainjana, 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-phcna, 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-kriya preparations). It should then be mixed with honey and kept in a closed vessel made of KJiadira (Catechu) wood. The use of this (com- pound), known as th-e Kshudranjana, as an Anjana (collyrium) would be attended with good results. Harenu, Pippali-sQQds (without pericarps), Eld 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- Dri.shti). 12-14.

The liver of a Godha(a kind of wild lizard) should be partially opened and stuffed with Pippali and roasted in fire (ha\ ing been coated with clay ). The use of the compound * for only once i* as an i^njana (with honey)

* According lo Dallana ihc Pippali so roasted should be used with honey as an Anjana.

t Both Vrinda and Chakradatta read 'g^jrf' in place of '^ffgfjff' 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 lo use both of them together as an Anjana.

yo THE SUSHRUTA SAMIIITA. [ Chap. XVII.

would be found to be highly beneficial in cases of iiight-blindncss. 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 used as an Anjana with mustard oil, it would speedily cure an attack of night-blindness. 15-17.

An Anjana or a pill composed of Nadija (Saindhava), S'imhi (D, R. — Samkha — conch-shell), Kataka, Anjana (Rasanjana), Manah-s'ild, the two kinds of Nis'd, pasted together with the juice of the liver "I* (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 Vdtaja

* 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 "5J5fi5% ' ^•'-■* pasted with the juice of the liver (of a cow or any other animal), Chakradatta reads "Ty^j ^^(^^ ^■^- to say — the liver of a cow (and of no other animal) should be taken. Vrinda, however, reads and his commentator accepts the reading "'^[jr^ ??§ifT ' ('^e li^er of an animal other than a cow) . ; but this reading is objectionable on the ground of a faulty construction. "3i3i5%'' 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. /I

type (of any of these six affections) purging should l:c induced with castor oil taken through the vehicle of milk. Administration of Traiphala-Ghrita is also re:ommended for purgative purposes, especially in the Pittaja blood-origined t\-pes. Purging with (clari- fied butter dui)- cooked w itli) Trivrit should be induced in types having their origin in the deranged Kapha, while oil duly cooked with Trivrit should be adminis- tered (for the purpose) in cases of affections having their origin in the concerted action of all the three deranged Doshas. The use in an\- shape of old and matured clarified butter, kept in an iron vessel, proves beneficial in cases of Timira of any type. Clarified butter cooked ^\ ith (the Kalka and decoction) of Tripliald or Mcs/ta- sringi always proves efficacious in Timira of any type. The patient should be made to lick a compound of powdered TripJiald with a copious quantity of clarified butter in cases of I'ittaja blindness, with oil in the Vataja type, and with a copious quantity of honey 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. Clarified butter * alone is beneficial in the IMttaja type ; similarly clarified butter prepared by churning the milk (^f a ewe or a she-goat and cooked with the admixture of the drugs of the Maihiira (Kikolyadi) group \\()u!d prove beneficial in the Pittaja t\'j)e of Timira. Oil cooked with the drugs of the Stiiirdli f Vidari-gandhadi ) or the I\faii/iura

* Sopie say thai this clarified b\iltor i.s to be prepared from iho uiilk of a cwc or she-go^t

;2 THE SUSIIRUTA SAMIIITA. [ Chnp. XVII.

group •■■ as well as the Anu-taila (see Chapter V, Chikitsita Sthana), might be prescribed with the greatest advantage in the t}-pes 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 Sahd, As'va-gandJid, Ati-vald, S'atdvari, Trivrit and the three fatty substances, Ghrita, lard and marrow, mentioned before (in connection with the treatment of Mah^-Vata-Vyddhi, Chapter VI, Chikitsita Sthdna) might be advantageously employed as an errhine in cases of V^ataja Timira. Butter churned out of the milk dul\- cooked with the flesh of an\- aquatic or marsh-frequenting fowl or beast should be employed as an errhine ; it would prove curative in cases of Vataja Timira (loss of vision). 22-23.

The flesh of a vulture and of a deer of the Ena species, SaindJiava salt, honey and clarified butter should be prepared and applied (to the affected eye) in the manner of Puta-pa(ka (see next Chapter). The lard of vultures, snakes and cocks and Yashti-madim should be pasted together (with honey) and applied (to the affected organ) in the manner of an Anjana (eye-salve)-|'. 24.

Atl'tidotCS : — 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 Samhita.

t 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.

J Plesh of those animals which give strength to the si^hl should be used in the preparation of meat -juice.

Chap. XVII. ] UTTARA-TANTRAM. 73

the manner of Bhavand saturation and used as a Praty- anjana * (in cases of V^ataja Timira unattended with redness). In cases of Vataja Timira attended with red- ness of the eye, however, the Srotonjana should be placed inside the blades of Kusa grass and preserxcd for a month inside the mouth of a (dead) black cobra. Then it should be taken out and mixed with SaindJiava salt and the burnt ashes of Mdlati (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 applied to the seat of the disease in a case of (Vataja) Kacha (cataract) which is said by experts to be remediable by this Anjana. 25.

Treatment of Pittaja- Kacha :— Clari- fied butter skimmed from miik (and not from curd) and duly cooked with the drugs of the Madliura (Kako- lyadi) group -|- should be employed as a snuff (Nasya), or as a Tarpana in the Pittaja type of this disease. The flesh of Jangala animals (deer, etc.) and the drugs of the Kdkolyddi group should be used in the manner of Puta-pa'ka in the Pittaja type of Kacha. A Kshudrdn- jana composed of Rasdnjana, sugar, honey Manah-sild, and Yashti-madhu may likewise be applied. The use of an Anjana composed of Rasdnjana and Tuttliaka taken in equal parts and finely pounded, is also recom- mended by experts \ in such cases. J^owdcred Tutthaka soaked in the decoction of BJiiUota and the drugs of

* Pratyanjana (secondary eye-salve) is an antidote for the over-use of an Anjana.

t According to some commentators the milk should he first cooked with the drugs of the Muilhura group, and hutlcr should then be churned out of that milk.

X A benumbed condition of the eye through the abuse of eye- salves calls for the use of this Anjana as an antidote.

10

74 THE SUSHRUTA SAMIIITA. [ Chap. XYII.

the Elddi-gana would be used as a Pratyanjana, and would be found beneficial in such cases. The use (as an Anjana) of MesJia-s' ringi and Stotonjana taken in equal parts and two parts of conch-shell pounded together is efficacious in the Pittaja type of this disease (Kacha). The juice of Palds'a, Rohita and MadJmka (flower) mixed with honey and the surface layer of wine (taken in equal parts) should be prepared (in the manner of Rasa- kriya and applied as an eye-salve in this type). 26-27.

Treatment of Kaphaja Type :— The

drugs known as Us'ira, RodJira, TripJiald and Priyangii duly cooked together (with Tila oil) should be employed for the purposes of snuffing (Nasya) in the Kaphaja Type. Fumigation (Dhumana) with the vapours of Vidanga, Pdthd, KiniJii and Ingiidi-\iz.x^ 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 species of Indian holy fig) with pasted Haridrd and Us'ira (as Kalka). The essence of the meat of Jdngala (forest) animals, mixed with Pippali and profusely saturated with Saindhava and honey, should be prepared in the manner of Ptita-pdka (and applied to the affected part). Manah-s'ila„ Trikatu, Saindhava, MdksJnka (hone)'), S'amkha, Kdslsa and Rasdnjana should be combinedly used for the purposes of Rasa-kriyd (in the type under discussion). Kdsisa, Rasdnjana, Guda (old and matur- ed treacle) and Ndgara, may be likewise used with benefit. 28.

Treatment of Tri-doshaja Ka'cha :—

Anjana (Antimony) many times heated and (subsequcntl)-) soaked in the decoction of TripJiald prepared with (the

Chap. XVII.] UTTARA-TANTRAM. 75

eight kinds of) urine, should be put inside the hollow (marrowless) bone of a nocturnal bird (such as the vulture, etc.) and kept immersed for a month in unruffled (currentlcss) water. The Anjana thus prepared may be used with advantage, in combination with Madhiika (Yashti-madhu) and the flowers of Mesha- s'ringi in the Tri-doshaja types of Kaicha. As an alter- native, all the measures and remedies (e. g., Tarpana, Puta-paka, etc.) * applicable in all the three Doshas should be employed in such cases. 29.

Treatment Of blood origined Pari-

mlayi : — Measures and remedies mentioned in con- nection with the Pittaja t\'pe of Timira should be em- ployed in a case of blood-origined ParimWyi. 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 case. In case the deranged Do-has are not thereby subdued, Nasyas of the proper drug, as well as the many other Anjanas (coll3-rium) mentioned in the (next) Chapter on Kriya-kalpa should be employed. 30.

Diet : — A person carefully partaking of old and matured clarified butter, TripJiald, S'atdvari, Patola, Mudga, Amalaka, Yata (barley) as diet enjoys immunity from all attacks of the dreadful Timira. Simply the Pdyasa ■\ prepared with S'atdvari, 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 oi Rasa-kriya applicable in cases of Vataja, Pittaja and Kaphaja Timira.

t The PsCyaSa of S'ala'vari and A' malaki should be prepared by duly cooking S'ala'vari or A' malaki, as the case may be, with milk and sugar. According to others, however, it means the gruel (YaViigu) prepuretl with the CApreoocd juice uf S'ala'vari ur A' malaki.

76 THE SUSIIRUTA SAMIIITA. Chap. XVII.

of Triphald and a copious quantity of clariiicd butter would remove (an attack of) Timira. The use of such edibles ■A'a Jivanti, Sicnishannaka, Tandnliyaka, Vdstuka, Chilli, Mulaka as well as meat of birds (such as Lava, etc.) and Jangala animals (e g. deer, etc.) should be con- sidered as invigorating to eye-sight. The use of the leaves or fruit (as the case may be) of Patola, Karkotaka, Kdravella, Vdrtdku, Tarkdri, Karira (tender bamboo plant.s), 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 disease, is curable (Sa^dhya). 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-Saiclhya). The case in which the third coat or Patala of the organ is the seat of the disease (charac- terised by the redness of its outer coat) should be re- garded as (an incurable affection) admitting only of palliative treatment (Yapya). Proper palliative measures and remedies mentioned 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). },2>-

Surgical treatment of Kaphaja

Linga-nas'a : — Now we shall describe the (surgi-

Chap. XVII.] UTTARA-TANTKAM. 77

cal) measures to be employed for curing a case of Linga- naisa (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 docs 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 does not resemble a pearl or a drop of \\ater in shape, 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 fastenings and he should be made to sit, looking simultaneously (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 Apanga (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 eye, neither above nor below, care being taken not to pierce the veins. The left eye 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 drcjp of water i* from the affected region, following upon the perforation. 34-35-

* Bolh S'rikanlha Dalla and S'ivaiUsa, the conimcnlalurs respect- ively of Vrinda and Chakradatta, read 'aTwff^JJi fTT'?»T'2Jl' '"i-iining that tire S'alaka (rod) should be marlt; of copper.

t Blood would come out if the perforation be not aatibfactorily done.

;78 THE SUSHRUTA SAM HIT A. [ Chap. XVII.

Instantly with the perforation the affected organ should be sprinkled over with breast-milk. The Salaka should be retained in its place and the diseased growth or appearance (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 SaUkA. The mucus or phlegm (Kapha) accumulated in the affected eye should be removad 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 Salaka (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 comfortable chamber (free from dust and smoke), and be warned against indulging in all those bodily functions such as eructation, coughing, yawning, spitting, sneezing, 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

i The period during which these rules should l)c lollowed is 'seven days' according lo Vagbhata. Bui according lo D.dlana ii is only the period during which the operation lastii.

Chap. XVII.] UTTARA-TAXTRAM. 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 be 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 Niliksi except at the place mentioned before (viz. the natural aperture — Daiva-krita Chhidra). 37.

Symptoms and treatment of the disorders resulting' from an injudici- ous operation : — If the incidental haemorrhage (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 Yasliti-madhu and breast-milk. An incision (puncture) close to the exterior corner (Apanga) of the eye would usher in swelling, pain, lachrymation and redness of the eye, which should be remedied by poulticing (Upandha) 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 being punctured near the Krishna-mandala (region of the iris) and the Krishna-mandala being affected thereby, the affected part should be sprinkled over with clarified butter, pur- gative should be administered and blood-letting (by means of leeches) should be resorted to. A distressing pain ensues from the puncture being made on the upper part of the eye (Krishna-mandala) and this should be cured by sprinkling drops of lukewarm clarified butter on the scat of affection. ICxccssi\e laclirymation sets in

* S'arira-Slhana, Chapter \\\.

8o THE SUSIIRUTA SAMIIITA. [ 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 cases should be treated in the preceding manner. Emulsive (Sneha) application and fomentation (Sveda) of the parts as well as applica- tions of Anuvasana enema should be considered as remedies in cases of redness, lachrymation, pain, numb- ness and bristling (of the eyc-lashcs) in the eye, as the result of an excessive and improper handling of the instrument during the operation. 37-3!^.

If removed in its acute stage (in a case of Linga- n^s'a) the Dosha is liable to have an upward course and produce relapse in the red-coloured specks or films (opacity) in the Sukra (white part of the eye), 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 Madliura-gaiia, and in the application of the same in the nianner of Siro-vasti (errhine). Meat diet should be prescribed for the patient in such cases. As a full-bodied 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 Salaka (rod). 39-40.

Causes of Relapse ; —A relapse of the de- ranged Dosha is caused by a blow on the head, physi- cal exercise, sexual excesses, vomiting, epileptic fits, or by an act of piercing the Linga-nas'a (cataract) during its partial!}- developed (D. R. immature) stage. 41.

Symptoms produced by the defects

of the S'alaka' : — Care should be taken not to remove the cataract with a roughly shaped Salakai (rod) as it might usher in an acute and aching pain in the affected organ. A rod with an unsmooth body might

fChap. XVII. UTTARA-TANTRAM. Si

lead to an aggravation of the deranged Doshas. A thick- topped rod would necessaril}' create an extensive ulcer, whereas a sharp one begets the apprehension of hurting the eye in many ways. An excessive lachrymation sets 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 Salakd (rod) should be constructed and used for the purpose in such a manner as to preclude the possibility of the foregoing defects and injuries, 43.

Description of the ^aiaka:— The

Salaka (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 (Salakd) 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 (Sukarakshita) * 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 case. 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'drivd, Durvd, and barley pasted with milk i" and clarified butter, should be

* Both Virinda antl Chakradatta reads "Kekardkshita'' ;. e. a squinting look.

i Vrinda and Chakradatta following Vagbhala do not read ^^Payas" (milk) and they read the first line of this couplet in a different form.

II

82 THE Rl'SIIRUTA SAMIilTA. [Chap. XVII.

applied lukewarm (about the eyes) for the subsidence of pain and redness. A plaster (Lepa) prepared of SiddhdrtJiaka (white mustard seeds) and slightly fried sesamum seeds pasted with the expressed juice of Mdtuhmga, or one prepared of Payasjd (Kshira-kdkoli), Sdrivd, Patra, Manjishthd and Yashti-madhii pasted together with the milk of a she-goat, if applied luke- warm to the affected region, removes the pain and redness of the eyes. A plaster composed of Dam, Pad- maka, and S'ujithi, prepared and used in the same way is likewise recommended for the purpose. A plaster of Drdkshd^ Yasliti-mad/ni, KusJitha and SaindJiava should be likewise used. Cow's milk cooked with Snhi- dhava should also be used for the alleviation of pain and redness of the eye. Clarified butter duly cooked with the admixture of S'atdvari, Prithak-parni, Ulusta, Amalaka, Padmaka and the milk of a she-goat, should be applied (cold) to the affected organ (eye) for the alleviation of pain and burning sensation therein. Clarified butter duly cooked with the Kalka of the drugs of the Kdkolyddi group with a quantity of milk four times the weight of the clarified butter, previously cooked with the drugs of the Vayu-subduing {Bhadra- ddrvMi) group (in the manner of Kshira-paka) should be considered as efficacious in any form (internally or externally in cases of ocular affections. The affected organ should be treated with Sneha emulsive (applica- tions) and (Sveda), fomentation and opening of the veins (SirA) or cauterisation (by honey, clarified butter, or treacle) as described before, should be resorted to in cases where the foregoing remedies would fail to pro- duce an)' effect. 45-46.

Eye sight invigorating Anjana :—

Now hear me describe two beneficial recipes of Anjana

Chap. WII. ] UTTAKA-TANTRAM. 8

0

which would invigorate the eye-sight and impart a clear- ness of vision. Flowers of Mcsha-S'ringi, S'iris/ia, Dhava and of J/«V^?// 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 applied to the eyes in the manner of an Anjana. A Varti (stick) should be similarly prepared with Srotonjana, coral, Sanmdra-phcna, ManalL-s'ild and MaricJui and used similarly as an Anjana (eye-salve). It imparts steadiness of vision. The many other Anjanas to be described in the next Chapter (Kriya-kalpa) may also be beneficially applied for the purpose. 47-48.

Thus ends the sevenleenlh chapter in the Uttara-Tantra of the Sus'nita- Samhita which treats of the curative measures of the diseases of the Drishli (pupil).

CHAPTER XViri.

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 (KriySL-

kalpa). I.

Here follows a general exposition of the instructions which the sainted lord of Benares, the holy Dhanvantari of profound intellect imparted to his disciple the son of Vis'v^mitra (Sus'ruta) regarding the different medicinal measures (Kriyd) such as Tarpana (soothing), Seka (sprinkling), A'schyotana (eye-drops), Puta-patkas Anjanas (eye-salves), etc., mentioned before in different places to be employed in diseases of the eye. 2-3.

The Tarpana IVIeasure :— The measure

known as Tarpana should be employed in respect of an affected eye either in the fore-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. eye-lids) should be thickly coated with powdered Mdsha 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 V^yu-origined diseases of the e}'e. 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 general (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 -f .should be observed for one, 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 ameli(;rati()n fjf the disease, and lightness of the (jraan

* According to some, the 'Parana' shoi:Id 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.

t According to Gayadasa, this rule should be observed for one, three, or five days in cases of the jireponderance of Vayu, Pitta and Kapha res- pectively, and according to Jejjata, in cases of nnld, moderate and severe attack respectively.

^6 THE SUSHRUTA SAMHITA. [ Chap, XVIII.

are the .symptoms which result from a proper and satisfactory Tarpana of the eye. Cloudiness of vision, a sense of heaviness in the affected organ, excessive glossiness (of the eye), lachrymation, itching, sliminess and an aggravation of the Doshas are the features which mark a case of severe and excessive Tarpana. A sense 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 defective and excessive 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, parchedncss of the eye, hardness of the eye-lid and a severely diseased condition of the eye are amenable to the application of the Tarpana measure as giving t(Mie to the eye. The Tarpana measure should not to be applied in a cloudy day, nor in a day excessix eU' hot or cold. It should not be applied to the c\'e of a person engrossed by anxiety or fear, nor before the subsidence of the supervening symptoms (Upadrava) of the eye-disease. y-S.

The Puta-pa'ka :— The Puta-pa'ka measure

should be applied in the aforesaid cases. The Puta-paka is not applicable in cases w^iere Nasya (errhines), Tarpana and the internal application of Sneha (Sneha-pana) are forbidden. After a complete subsidence of the Dosha, the Puta-pdka should be applied to the (affected) eye

Chap. XVIII. UTTARA-T ANTRA M. 87

in cases \vhere the patient would be found capable of being treated with it. The Puta-paka measure may be divided into three classes, viz., Snehana (.emulsive), Lekhana (scraping) and Ropana (healing) Puta-paka. The Snehana (emulsive) Puta-pdka is recommended in cases marked by the extreme parchedness of the affected organ or locality, and Lekhana (scraping) ones are efficacious in cases of excessive applications of the .Sneha to the eye ; while the eye-sight is invigorated b\' the Ropana (healing) Puta-paka, which restores the Vata, * the Pitta and the blood of the affected locality to their natural conditions, and (consequently) heals the ulcer. 9-10.

Preparation of Snehana, Lekhana, and Ropana Puta-pa'kas :— The Snehaua

(emulsive) Puta-paka should be prepared with the flesh (of animals frequenting marshy places) abounding in Sneha -f and with the Vaira (lard), Majjan (marrow), and Medas (fat), and the drugs of the MadJiura 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 prepared with the flesh and the liver of an animal of the Jangala species and the drugs possessing the Lekhana or scraping properties, as well as powders of black iron (steel), copper, conch- shells, Vidrmna (corals), S'aindhva salt, Samudra-^hena, Kdsisa (sulphate of iron) and Srotonjana (pasted to- gether) with the cream of curd. The affected localit)' should be exposed to a Lekhana Puta-paka as long as

* A differenl reading, mentiori'^d by Dallana, does not read "Vata." t In place of "^vi^tfr' meaning flesh abounding in Sneha, a

different reading "j^fqjfjl^fi" (»■ e. clarified butter and (lesh) is quoted by

Dallana.

88 THE SUSHRUTA SAMHITX. [ Chap, XVIII.

one would take to utter a hundred syllables at most. The healing or Ropana Futa-paka 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-paka should be retained i.e., for a period as long as one would require to utter three hundred s\-llables. 11-13.

The fumigating measures mentioned in connection with the Tarpana of an affected eye, as well as theappH cations of Snsha and Sveda, should be resorted to in the cases of the application of the Puta-paka measures, except in cases of the application of the Ropana Puta-paka. Puta-paka applications ma\' be made on one day only or may be continued for two or three days.f. 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-paka till the time of actually administering the Putapaka itself). 14-15.

Prohibition and Remedies for in- fringement : — After the application of Tarpana and Puta-paka (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 ' f^^j^" (honey and clarified butter) Dallana quotes a variant ''^-t^jjsg" — lit. sacred clarified butter i e. , clarified bu'ter pre- pared from cow's milk.

t Dallana explains that the application of the Puta-paka measure should be made for one day only in Kaphaja eye-diseases, or if the Puta-paka 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 Vataja eye-diseases, or if it be a Ropana Puta-paka.

Ch.^p. XVIII.] UTTARA-TAXTRAM, 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 Futa-paka) measures should be remedied with the applications of Anjana (colly rium), A's'chyotana and Sveda (fomentation) to the deranged bodily Doshas, underlying each particular case. 16-17.

Satisfactory, excessive and detec-^

tive application of Puta-paka ".—Fresh- ness and clearness of the colour (of the cornea), capa bilit\- 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-paka applications. Darkness of vision, pain and swelling of the eye and the appearance of eruptions (Pidaka) in the affected organ, arc the evils which mark an excessive applica- tion of the Puta-paka measure ; while suppuration and lachrymations of the eye and a thrilling sensation (Harsha) in the affected organ, as well as a further aggravation of the Dosha (involved) are the characteris- tic features of a deficient Puta-paka application 18,

IVIode of preparing Puta-paka :— Now

I shall describe the mode of preparing a Puta-paka remedy. Two Viha (Pala) measures of cleansed and pasted meat, one Pala measure of the medicinal drugs pasted together and one Kudava (half a seer) measure (jf licpiid ingredients should be mixed together (and made into a ball), well covered with the leaves of Kadali, Kdsmari, Eranda, Ktimuda 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, Pdtald, 1 ''dsa/ca, Vadara, Kshira-Q.yi\\^\x\^ trees, or in the fire of the dried cakes

r3

90 THE SUSIIRUTA SAMHITA. [Chap. XVItl.

of cow-dung. When well cooked the bail should be taken out of the fire and broken and its contents with- drawn and squeezed. The fluid extract should then be collected and applied (to the affected organ) in the manner of applying a Tarpana. 19.

The mode of application :~-The patient

being laid on his back at the time, the fluid extract in both the cases (Tarpana and Puta-pdka) should be dropped cold into the Kaninik^ (Cornea) of the eye in cases of derangement of the blood and the Pitta ; it should be used lukewarm when the Vdyu 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 use of too hot (warm) or strong or keen-potencied (Tikshna) extract for the purpose. 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-potencied Puta-paka or Tarpana eye-drop. Red- ness and contraction of the eye attended with a jerking and throbbing sensation therein are the effects of an excessive (over-dose) application of the Puta-p^ka and Tarpana, whereas a deficient (under-dose) use of them produces an aggravation of the deranged bodily Doshas in the locality. Properly applied, the}- 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-paka 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-paka or Tarpana, are to be remedied with the application of errhines ( Nasya ), Dhuma and Anjana

Chap. XVIII. ] UTTAKA-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-paka 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 localit}-. 21.

As'Chyotana and Seka :— Properly pre- pared and applied, the As'chyotana and Seka measures would respectively subdue cases of slight and violent attacks of the eye. Like the Puta-paka measure these two also arc devided into three classes w'-c, (Lekhana, Snehana and Ropana). Seven or eight drops of the medicinal fluid should be used in Lekhana-As'chyotana (for the purpose of scraping the affected eye) ; ten drops in the Snehana (for emulsive purposes) and twelve drops in the Ropana As'chyotana ( 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-paka measure,* or until the disease is gradually and wholly removcd.-f" ]>oth the As'chyotana 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 ob.served in cases of Puta-psika- Some, however, hold that in cases of both Seka and As'chyotana the period would be twice as that for Puta-paka.

t 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 aliplies also to cases of I'uta-pi^ka and Tarpana, cle.

92 THE SUSIiRUTA SAMUITA. [Chap. XVIII.

ancc with the aggravation of the deranged Doshas),* or whenever there would be pain (in the affected eye), f The symptoms of proper and improper (excessive and deficient) applications of a Sneha (emulsive) Seka are identical with those of Tarpana. 22-23.

Siro-vasti : — The serious diseases peculiar to the head readily yeild to and arc 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 purpose) 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 measure, according to the nature of the disease. 24-25.

Anjana : — Proper Anjana for Lekhana (scraping), Ropana (healing), or Prasadana (invigorating) purposes should be applied after the cleansing ( purging, etc.) of the system in cases where the deranged bodily Doshas would manifest themselves in the region of the eye only. 26.

A Lekhana- Anjana should be prepared with the

'■^ The Lekhana-seka and As'chyotana should be applied in ihe 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 DiUana holds, that both th; Sjka and As'chyotana m:asiue.s may be applied when ver there is pain in the affected eye, but others hold that this rule 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 eye, as well as in the gristle of the nose would be secreted through the mouth, the nostrils and the corners of the eyes by the application of a Lekhana Anjana. A Ropana- Aujana 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 consetjuently gives natural colour and vigour to the eye. A Prasa'dana-Anjana, pre- pared wath 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 x-Xnjana should be made in the morning, evening or in the night i* 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 astringent, 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.

t The Anjana should be applied in the morning, in the evening and in the night respectively in the cases ol the derangement of the Kapha Viiyu and the Pitta. According to the others, the S'odhana, the Ropana and the Snchana Anjanas should be respectively used in the morning, in the evening and in the night. Others, however, are of opinion that these different limes should be judiciously selected in the different seasons of the year according to requirement.

94 THE SUSHRUTA SAMIIITA. [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-kriya) and powder * each succeeding, one being more effica- cious than the one preceding it, in the order of enu- meration. 31.

Their sizes and doses :— The size (dose) of

a Lekhana, Prasadana and Ropana Varti(Pill) should be equal to that of one and a half and twice as much as a Kaldya pulse for ocular affections in general. As regards the application of Rasa-kriya- Anjana in these disorders the quantity to be used in a dose should be equal to that of the Varti in the different cases respectively. As regards the dose of the powders (to be used in eye- diseases) it should be respectively twice, thrice and four times as much as would be contained at the end of a Salaka (rod). 32.

The materials of the vessel and rod

for the use of an Anjana :— The vessels

containing the different kinds of Anjana should be according to the different kinds of Anjana themselves, and these vessels as well as the Salaka (rod) for the use should be made of gold, silver, horn, copper, Vaidurya (a kind of precious stone), bell-metal and iron respectively (in accordance with the different tastes of the drugs the Anjanas are made of), -f The end of the

* Dallana says that Pill-Anjanas, Liquid-Anjanas and Powdei'- Anjanas should be preseribed in cases of severe, intermediate and mild attacks respectively.

t 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 lion, that of pungent laslc in a vessel made of Vaidurya,

Chap. XVIII. ] UTTARA-TANTRA.M. 95

rod should terminate in a bud-shaped ball with the ^jirth of that of a Kaldya 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, '^i.

How to apply an Anjana :— The lids of

the affected eye (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 b}- constantl)- moving the rod from the Kaninika to the Apanga 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 necessary 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.e., in the Kaninika and the Apdnga 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 he placed in a vessel made of bell-metal. The S'aldka (rod) for the use of the different kinds of Anjana should he also accordingly prepared.

According to Nimi, however, as quoted by Dallana and S'rikantha Datta, in their commentaries, the Ropana, Lekhana and Prasad ana 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 '^fq' in the text shows that a rod of gold may also be used with benefit — Dallana.

g6 THE SUSHRUTA SAMHITX. [Chap. XVIIT.

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, Udavarta, 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 applied before sun-rise, 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 — "f^TSM?! ^ ^<i% f^fif^ g'^TT^Ti?" 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 carelully made in such a manner as not to induce any of the aforesaid evils, and these rules should be specially observed in connection with a Lekhana-Anjaiia. These distressing symptoms should be treated with washes (lotions), As'chyotana, plasters, Dhuma (fumigation), Nasya and Kavala (gurgle) with due regard to the specific nature of the deranged bodily Dosha or Doshas involved in each case. 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 excessive purging of the eye (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, archedncss 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 Vayu-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 crrhines, Anjana and local fumigation. 37-39.

Symptoms Of satisfactory, excess- ive and deficient use of Prasadana

9S THE SUSHRUTA SAMHITA. [ Chap^ XVIIL

(Snehana) and Ropana Anjanas :~The action of the satisfactory application of a Prasaidana (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 remedies antidotal to the deranged bodily Dosha (Kapha) involved in the case. The symptoms which mark a satisfactory and excessive application of a Ropana (healing) Anjana, as well as the medical treatment to be applied in cases of excess, are identical with those mentioned in connec- tion with the satisfactory and excessive 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. 4043.

Thousands of remedial measures and remedies may be devised and employed in the manner of the Puta-pdka 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 (Kdcha, etc.) amenable only to the palliative measures. Eight parts of Rasdnjana (Antimony) having the hue of

* See S'loka 5 of this Chapter.

Ciiup. X\ IIJ.J UTTARA-TAiNTKAM. 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 b\- being covered with the burning charcoal of catechu or ^-///«^?///'c7/vVMvood, 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-gandJid group, grape-juice, sugar- cane-juice, the expressed juice of Triphald and the com- pletely cooled decoctions of the drugs of the Sdrivddi and the Utpalddi groups, should be separately 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 Kdlanii-sdriva. 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.

lOO THE SUSHRUTA SAMHITA. [ Chap. N.VU1.

Bhadrodaya-Anjana :— The drugs known

as Kushtha, Cha?idana, Eld, Patra, Yashti-madhu, Rasdnjana, flowers of Mesha-s'ringi, Chakra (Tagara), the seven kinds of jewels*, the pollens of the flowers of Utpala, Brihati, Kaittakdri and of lotus, Ndga-kes'ara, Us'ira, Pippali, the shells of hen's eggs, Ddru-haridrd, Haritaki, Gorocliond, Maricha, n^arrow or kernel of Vibhitaka-s,QQds 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 Bbadrodaya-Acjana and should always be used by a king. 46.

Equal parts of Chakra (Tagara), Markka, Jatd-mdmsi and S'ailcya with Manah-s'ild equal to the combined weight of the preceding drugs, four parts of Patra with Rasdnjana (antimony) twice the combined w^eight of all the preceding drugs and Yashti-madhu of equalf weight with the last-named drug (Rasanjana) shoiild be powdered together and used as an Anjana in the fore- going manner. 47.

Manah-s'ild, Dcva-ddru, the two kinds of Rajaiii, Tri- phald, Trikatu, Ldkshd, Las' una, Manjishthd, Saindhava, Eld, Mdkshika, Sdvaralca Rodhra, dead iron and copper, Kdldnu-sdrivd and the outer shells of hen's eggs taken in equal parts should be powdered together, resolved into a paste with milk and made into pills of ade- quate size. Diseases of the eye such as the itching sensation in the eye, Timira, Suklarma and Raktardji readily yield to the curative efficacy of this Anjana. 48.

* The seven kinds of gems are (l) Padmaraga, (2) Marakata, (3) Nila, (4) Vaidurya, (S) Mukta (pearl) (6) Pravala and (7) Hema (gold).

t According to some the weight of the Yaskti-tnadkit to be used in this Anjana should be equal to that of all the other drugs combined.

Chap. XVIII. ] UTTARA-TANTRAM. lOI

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 YashtimadJiu, Saindhava, Tagani and roots of Eratida, as well as two parts of Brihati. This compound should be pasted together with goat's milk and thinly plastered on a copper plate. This process should be continued for seven times in succession and dried in the shed. It should then be made into Vartis and (used as such) would relieve 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 Pindstnjanas 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 Uie eighteenth chapter of the Uttara-Tantra in the Siis'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-Pratishcdha). 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 injur}- 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 (/. c, during the first week) of the hurt or injury in the eye. After this period the affected eye 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 l — 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- ins three Patalas should be regarded as incurable.

Chap. XIX. ] UTTARA-TAXTRAM. IO3

Palliative measures arc all that arc possible in cases of looseness, dislocation, sunkenness and the thi ashed 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 an}- 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 cither by holding the breath (Prana-vayu) 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 remedies 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 Vdyu, Pitta, Kapha and blood, sometimes manifests itself in (the inner lining of) the eye-lids of an infant and this is known as Kuliunaka. 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-kntu and honey pastgd together.

* Seo Chikitita-sthana, CH.apter II, Tara 20-

104 THE SUSHRUTA SAMHITX. [ 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 Saitidhava salt, honey and powdered Khara-manjari (Apimarga) seeds, as well as those of powdered Pippali\ Saindaava-?,d.\i 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. 8-10.

To a child who takes both breast-milk and other solid food, the emetic should be administered with the admixture of Vnchd, 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. 1 1.

Decoction of the tender leaves of Ja7nbu, Amra and Amalaki should be used for washing and sprinkling purposes. Clarified butter duly cooked with Tri-phald or with Gudiichi should be dropped into the eye as an As'chyotana measure. 12.

Anjanas composed of Manah-s'ld, Maricha, S'mnkha (conch-shell), Rasdnjana and Saindhava pounded to- gether and pasted with honey and treacle should be applied to the affected organ. Compounds of Miirvd, 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 Gutikatnjana made up of Trikatu, Paldndu (onion), Yashti-madhu, Saindhava, Ldkshd (lac) and Gairika (earth) pasted together, should be used. The Anjana made of Niniba-\Q:?i\e.s, Yashti-7nadhu, Ddrvi, *

* ^'Ddrv€^ generally means Dani-haridrA ; but, here, on the authority ofVideha, Dallana takes it to mean the two VxaAi, oi HaridrA, viz., Havidra and Dj.'rii-haridrd.

Chap. XIX. ] UTTARA-TANTRAM. IO5

copper (powdered) and Lodhra taken in equal parts and pounded together, is also efficatious. 13.

An Anjana prepared with Rasdnjana (Antimony), S'amkha, curd and SaindJiava kept together for a period of half a fortnight, * should be applied to the 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 Science of medicine is as incomprehensible as the ocean. It cannot be fully described even 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 medicine), as explained in these pages, would, therefore, 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 Rasdnfana 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.

H

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 arc noticed in practice, e^^cr., Karna-Sula (ear-ache), Pra-nada (ringing or noise in the ear), Vadhirya (deafness), Kshveda, Karna-Srdva (discharge of pus, etc., from the ear), Karna-Kandu (itching in the ear), Karna-gutha, Krimi-karna (vermin-infested ears), Prati-niha, the two kinds of Vidradhi (local abscess), Karna-paka (suppuration of ear), Puti-karna (fetor in the ear), four kinds of Ars'as (Cysts or polypuses in the ear), seven kinds of Arvuda (tumour) and four kinds of Sopha (swelling). 2 .

Symptoms of Karna-^ula and Pra

nada : — The violent aching pain in the region of the ear and inside the tympanum caused by the deranged local Vayu, 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 Vayu 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-n£^da. 3-4.

Symptoms of Vadhirya and Kshve- da ;^Vaidhirya (deafness) results from the conti- nuance in the sound-carrying channels of the deranged local Vdyu 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 Vayu 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 Vayu 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-sraiva. 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

Kai*na-Prati-naha : — Any mucous accumulation in the ear dried and hardened by the heat of the local Fitta 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 -f and produces head-disease I it is called Karna- Prati-naha. 9-10.

■ Tha difference in the "Karna-nada" and "Kshveda" i.s that in the former the sound in the ear is [jroduced 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, Kaplia and blood. — Videha.

t Some explain "gT*!!^^" ^° nic'an the cavity of the nose and of the mouth.

X In place of "fajT^fsfVifn'T'T:" (producer of head-disease) Madhava in his Nidana reads ''fiitT^stw^gifl'' ^-e,, producer of the head- disease known as Ardha-vedhaka (see chapter XXV).

I08 THE SUSHRUTA SAMHITX. [ 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 Krini-kiraa 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. 11-12.

Symptoms of Karna-paka and Puti-

karna, etc. : — A process of suppuration setting in (in any of these boils) in the ear through the aggravated condition of the deranged Pitta is marked by a blocked and putrid condition of the passage of the ear. The disease is called Karna-paikaL (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 car). The symptoms of swelling (Sopha), tumours (Arvuda) and polypoid growths (Ars'as) * in general as have been described before should be carefully 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'iuta Samhita which deals with the causes and symptoms of the diseases peculiar to the ear.

* See chapter VI, XVIII and XXIII, Chikitsita-Sthana.

CHAPTER XXL

Now we shall discourse on the chapter which treats of the medical treatment of the diseases peculiar to the

car (Karna-g-ata Roga-Pratishedha). i.

General treatment :— Potions of clarified

butter (after meal), use of Rasayana-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) viz., Karna-s'ula, Prana'da, Vaidhirya and Karna-kshveda is the same and is as follows, Sneha should be first administered (both internally and externally) and the patient purged with emulsive purga- tives after which the affected locality should be fomented with Vdyu-subduing drugs administered in the manner of Nadi-sveda or Pinda-sveda. 3.

A case of Karna-s'ula (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-root^,, Arka, Var- shdbhu, Kapittha, Dhustura, S'igru, Ajagandhd, As'va- gandhd, Jayanti, barley and bamboo, boiled in Arandla (fermented rice-gruel) and administered in the manner of Nddi-sveda (fomentation through a pipe). An attack of Karna-s'ula (ear-ache) yieds to the application of

* In place of "Rasayana" (use of tonic) some read ''Rarias'anam" (use of mcat-ijoup with meal).

no THE SUSHRUTA SAMHITA. [ Chap. XXI.

Pinda-sveda made with pieces of boiled flesh of fish, cock or Lava (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, (y-y.

A rice diet should be foregone in the night, and draughts of clarified butter followed by potions of milk should be taken in its stead. The Sata-paka Vala-Taila-f* should also be prescribed as Siro-vasti, errhine, as well as Mastikya-Sirovasti and sprinkling. It may also be given internally. Goat's milk first cooked with Kaiita- kdri (in the manner of Kshira-paka) and then with the fat (Vasa) 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, Ahimsrd, Kmdrakd- roots, Sarala, Deva-Ddru, Las'tma (garlic), S'tinthi and the scrapings of bamboo-skin and with the liquids of acid:|:

* "Mastu" (curd-cream) is mentioned neither by Vrinda nor by Chakrapani. According to Videha's recipe, clarified butter should be used in place of oil in cases of the aggravation of the Pitta. )

t For "Vala-Taila"— See chapter XV, Chikitsita Sthana.

X The liquid acids here are Dadhi, Takra, Surd, Chukra (a kind of Kanjika) and the expressed juice of Mdltihinga.

Chap. XXI.] UTTARA-TANTRAM. ITT

taste (instead of water) should be used as an ear-drop in order to alleviate the aching pain therein. lo.

The expressed juice of Las'wia, S'igni, Ardraka, Murangi, Midaka and (branch of) Kadali jointly or severally poured lukewarnn 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 ear-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-j* 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-mida 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 ear-drop). It instantaneously removes the pain, and is know n as the Dipikai-Taila. Different kinds of Dipika-Taila may be likewise pre- pared with pieces of Deva-ddru, KushtJia or Sarala wood, and used in the same manner in cases of ear-ache. 14-15.

Tender sprouts of Arka plants pasted with Kdujika (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 Chakrapani read "Taila" (oil) in place of ".Sarpih" (clarified butler). But we have the authority of Videha (as quoted by S'rikanlha Datta in his commentary on Vrinda) in favour of clarified butler.

t Clarified butter should first be cooked with the urine of a ewe and then with that of a she-goat. — Dallapa.

112 THE SUSHRUTA SAMHITX. [ Chap. XXI.

leaves of the same plant. It should then be scorched in fire in the manner of Puta-paka. The juice should then be squeezed out of it and used lukewarm as an ear-drop to alleviate the pain in the car. i6.

Different kinds of Ear-drops :— The

expressed juice of Kapittha, Mdtulunga and Ardraka mixed together and made lukewarm, or the lukewarm Chukra (a kind of Kanjika) 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- phcna in such a case. As an alternative, the eight kinds of officinal urines made lukewarm and used as an ear- drop may prove efficacious in removing an ear-ache. Similarly, a case of an ear-ache yields to the curative virtue of an ear-drop, composed of the four officinal kinds of Sneha duly cooked with the different kinds of officinal urine and acids (wine, sour-gruel, etc.,) as well as with the Vayu-subduing drugs. 17.

General and Specific treatment of

Pittaja Ear-ache : — The above-mentioned mode • of treatment (ear-drops and fomentations, etc.) 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 Kdkolyddi 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 Vimhi with (the Kalka of) sugar, Yasthi-

* Dallana says that Jejjatacharya holds these two recipes as

unauthoritative.

Chap. XXI. ] UTTARA-TANTRAM. II3

madJin and the purgative drugs would also be found beneficial. 18-20.

Treatment of the Kaphaja Karna- SUla : — In cases of Kaphaja-Kama-sula mustard oil or Ingiidi 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 Surasddi, or the major PancJui-^nula group would be found bene- ficial. The expressed juice of Mdtulufiga, Las'una and Ardj-aka, as well as S'ltkfa^ 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 eame as that in the case of a Pittaja Karna- s'ula. 25

Thus wc have given a general outline of the course of treatment and remedial measures to be adopted in the four kinds of ear-affisctions, viz., Karna-s'ula (ear- ache), Pra-nada, V^dhirya and Karna-kshveda. Now we -hall deal with the special recipes and preparations of ear-drops to be employed in cases of deafness (Vaidhirya). 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 car-drop in cases of deafness. Oil should be first cooked with goat's milk or the decoction of Vimbi fruit with sugar and Yashti- madhii and Vimbi fruit (as Kalka). When cooled down (it should be churned with the hand and) the Sncha (oily portion) should be separated. This oily part, after being stirred in the decoction of

15

114 THE SUSIIRUTA SAMHITX. [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 Pratisyaya-f (catarrh) or have been already des- cribed in the chapter on Vdta-Vyadhi :J: Chikitsa may be as well employed with benefit in tlie present instances. 27-30.

Treatment of Puti-karna, Karna- sravaand Krimi-karna :— The general mcde

of treatment to be employed in cases cf Karna-srava, 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 ^s'ith an ear-drop), cleansing and washing should be employed according to the exigencies of each case. The affected ear should be washed ^\ ith the decoction of the drugs of the Rdja-vriksJiddi or the Surasddi group and filled with the powders of those drugs. In a case of Kama-Sra'va, the cavity of the affected organ should be filled in with the powders (D. R. decoction) of the P ancha-Kashdya § drugs mixed with honey and the expres'-ed juice of Kapittha. 31-32.

* In place of "Vilvarabu-gadham" some read "Vimbi-gadham",?. £,, mixed with an abundant quantity of powdered Vimbi fruit. — Dallana.

i Chap. XXIV, Uttara-Tantra.

X Chapter V and VI, Chikitsita-Sthana.

§ According to some, "Pancha-Kashaya" means the barks of A'ragbadha, S'irisha, Jambv, Sarja and of Asvamdra (Palas'a), Ijut Dallana, on the authority of the authors of the Tika and the Pan ilka, (the two commentaries) refutes this and holds that "Pancha-kashaya" means the barks of lindiika, Abhayd, Lodhra, Samanga! and of A'ma/aka enumerated b^low in this chajJter,

Chap. XXI. ] UTTARA-TANTRAM. II5

The use of the powders of Sa)ja-ba.vk mixed with honey and expressed juice of the Kdrpdsi fruit is recom- mended in cases of Karua-Srava. A compound con- sisting of pulverised Ldkshd and Sarja-rasa (D. R. Rasanji.na) 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'aivdla, Maha-iriksha, Jambu and of Amra, as well as with Karkata-S' ringi honey and Manduki is highly efficacious in these cases. Ponders of the barks of Tviduka, Abhayd, Rodhra, Sainangd and of Anialaka mixed with honey* and the expressed juice of Kapittha should be similarly used. 33-36.

The expressed juice of Antra, Kapittha, Madlmka flower, Dhava and of S'dla, or an oil duly cooked with these is likswise recommended as ear-drops in these cases. The oil cooked with Prijangu, YasJiti-madhu, Aihbdlikd, DJidtaki, S'ita-parni, Ma^ijisJitJid, LodJira, and Ldkshd (as Kalka), and with the expressed juice of the sprouts of Kapittha as the lic[uid, if used as an ear-drop, arrests the secretion in a case of Karna- srava. 37-38-

Treatment of Puti-karna i—Rasdnjana

rubbed and dissolved in the breast-uiiik 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 :— \ermi

fugcs should be employed tor the treatment of a case

* .S'rikantha Dalta in his conuucnlaiy <n\ Vrinda quotes this cou[)lcl, but cloos ii'H read 'honey' there. He reads "rioji" in place of ''jf^" |

Il6 THE SUSHRUTA SAMHITA. [ Chap. XXI.

Krimi-karua. Fumigation* of the affected parts with the fumes of (dried) Vdrtdku, or (the pouring of) mustard oil (into the cavity of the affected organ) is also beneficial in such cases. Viclauga and Haritdla (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 destro}- 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. I — Use of mustard oil as an car-drop is efficacious in cases of Kama-kshveda.t An abscess (Vidradhi) in the ear should be treated as an ordinary abscess. The afifected ear should be sufficiently fomented after being filled in with oil so as to soften the filth)- deposit in the cavity of the ear, after which the filthy matter should be extracted with a probe or a director (S'alaka). .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-pratinstha,

* 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 Vataja Vidradhi sesamurn oil should be used, whereas in cases of Kaphaja Vidradhi the use of mustard oil is recommended. — Dallana,

Chap. XXI. ] UTTARA-TANTRAM. II7

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 ear). Any filth or vermin, etc., lodged in the cavity of the ear should be removed with the help of a probe, or (b}' cutting it) \\ith a horn. Cures for the remaining cases of affections in the ear have been described before ( in the Chikitsita-sthana, Chapters XVIII, VI and XXIIl). 48-50.

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

* In place of 'Pitlaja-Visarpa', both Vrinda and Chakvadatta read 'KshatajaA'isarpa".

CHAPTEllXXn.

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 :—

Diseases which are specifically found to affect the organ of smell may be classified into Thirty-one different groups, viz., — Apinasa, Puti-nasya, NdsA-paka. Sonita- Pitta,Puya-s'onita, Kshavathu, Bhrams'athu, Dipta, Ndsa- naha, Pari-srava, NdsA-s'osha, the four kinds of Ars'as ( polypoids ), the four kinds of swelling, the seven types of tumours and the five types of Prati-s'yaya which will be described hereafter with the specific treatment of each. Thus the diseases of the nose are 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 filth\' 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 Pratis'yaya (catarrh). It is due to the concerted action of the deranged Vayu and Kapha. The disease in which the fetid breath is emitted through the mouth and the nostrils owing to the presence of the deranged V^yu mixed up with the other Doshas ( Pitta, Kapha and blood ) in the throat and about the root of the palate is called Piiti-nasya. 3-4.

Symptoms of Nasa-paka, Rakta

Pitta and Puya-rakta : - A purulent inflam- mation and the presence vf pimples (Arush) in the

Chap. XXII. ] UTTARA-TANTRAM. II9

nostrils owing to the vitiated condition of the local Pitta attended with sliminess and fcetid odor is called Natsa^- paka.. The four kinds of Rakta-Pltta ( h;-emorrhages) 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 highl\- heated condition of the local blood, Pitta and Kapha is called Puya-rakta ( blood}' pus ). 5-7.

Symptoms of KshavathU :— The disease in which the \"ayu 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. <S-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 Bhramsathu. The affection in which

* The four kinds are due to vitiated Vayu, Pitta and Kapha as well as their concerted action. The two origins arc {a) the spleen and the liver, or (3) the Amas'aya (stomach) and the Pakvas'aya (intestines). The two courses are (a) the upper and the lower orifice, or (d) the mouth and the nostiils. (2)

t The sneezing is here said to be of two kinds (i) Doshaja and (2) trau- matic. Here the former is Doshaja, while the latter is of traumatic origin.

120 THE SUSHRUTA SAMfllTA. [ Chap. XXIL

the V<iyu, 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. lo-ii.

Symptoms of Nasa-Pratlnaha, Nasa- parisrava and Nasa-Parisosha :— The

condition under .which the up-coarsing Uddna Vdyu 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 Na(sa(-Pratinaiha. The disease in which there is constant, transparent, slightly discoloured water-like secretion (of Kapha) through the nostrils, more particularly at night, is called Natsai-Parisraiva (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 Vayu and Pitta, is called Na'sSk- Paris'osha (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 diffisr- ent kinds of Arvuda (nasal tumour) as mentioned in the Sdlakya-Tantra, with the one of Sannipdtika origin are seven in all. The five t}'pes of Pratis'yaya (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-Vijn^na), as well as those of Arsas (hemorrhoid growths) in the •Niddna-sthAna should be understood to apply to those diseases affi^cting the locality of the nose as well. 15-18.

Thus ends the twenty-second chapter in the Uttara-Tantra of the Sus'ruta Samhita 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 (NaSSL-gata-

Roga-Pratishedha). r.

Treatment of Apinasa and Puti-

nasya : — in cases of the first-mentioned disease ij-.e, Apinasa) and in those of Pati-nasya, applications of Sneha and of Svcda 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 use, and inhalation of smoke (Dhuma-pana) should be indulged in at the proper time. Hingu, Tri- katu, Ijidra-Yava, S'ivdti*, Ldkshd, Katphala, Vacha, Kushtha, S'obhdnjana, Vidanga, and Karanja should be used daily with benefit in the manner of Avapida- Nasya. ^lustard 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-paika, all the Pitta-subduing measures both for internal and external use should be duly employed. Barks of the KsJiiri (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 (Haimorrhaege) from the nose shall be hercafterf described. A case of Puya-Rakta ( dis- charge of bloody pus from the nose ) should be treated

* S'ivdti may mean cither white Pimarnavd or S'iphdliki. Neither Chakrapdni nor Vrinda reads it in the text. t .See ch. XLIV of the Uttara-Tantra.

16

122 THE SUSIIRUTA SAMHITX. [Chap. XXIII.

as a case of sinus (Nddi) * 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- s'athu. The head should be duly fomented with Viyu- subduing drugs and inhalation of Sneha-Dhuma-f as well as similar other medicinal measures remedial to the deranged bodily VAyu 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-y.

Treatment of Nasa-naha, etc. —The

internal use of Sneha (Sneha-pana) forms the principal remedy in a case of Na(sa-uailia, in which fumigations with lardacious drugs as well as head-purgings may be likewise employed. The use of Bala-Taila or any other Vclyu-subduing remedy mentioned in the chapter on the treatment of Vdta-vy^dhi (Ch. V. Chikitsita Sth^na) 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 N£is£i-Sra^va. Strong fumes of (burnt) Deva-ddni 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-Sthdna. t See ch, XVII of the Chikitsita-Sthan^.

Chap. XXIII.] UTTARA-TANTRAM. 1 23

Treatment of Nasa-^osha :— 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 arc pre-eminently the best cures in a case of Ndssi-^osha. Potions of clarified butter, meals with Jdngala meat-soup, applications of Sncha 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. 10- 11.

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

CHAPTER XXIV.

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of catarrh

(Pratisyaya-Pratishcdha). r.

CauS6S : — Excessive indulgence in sexual inters 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 causss which may instantly usher in an attack of nasal catarrh (Pratis'yaya). The fundamental principles of Vayu, 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 (Pratis'yaya). 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 Vaitaja type of catarrh (Pratis'yaya). 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. XXIV. ] UTTARA-TANTKAM. 12$

whiteness) of the e)-es, 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 Pratis'yaya — be it acute or chronic — is the charracteristic symptom of Tri-doshaja Pratis'yaya, 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 Pratisyaya which has its origin in the deranged condition of the blood. In these cases i* hosts of extremely small worms of whitish or blackish :^' 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, g.

Prognosis :— The malignant nature of the disease (Dushta-Pratis'ydya) 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 "j^^q^ f^fl^?^: ' — some read ' ^f^^^^ffij?:! ^j;;" — i. e. "the man (patient) gets heaviness of the head." In this case the flabbiness of the face is not separately mentioned.

t 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.

X M^dhava Kar reads '^fll; f^»>^l»' '• ^.. gl<3ssy white in hue, in place of *^nffi; fi^;' '• '• whitish and blackish in hue.

126 THE SUSHRUTA SAMHITA. [Chap. XXIV.

fetour in the breath and loss of the faculty of smell. Such a case of Pratis'yaya should be regarded as extremely hard to cure. Neglected and not properly remedied at the outset of an attack, any type of catarrh (Pratis'ydya) 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). lo-ii.

General Treatment of Pratisyaya :—

Potions of clarified butter, various sorts of emetics, and fomentations (Sveda) may be prescribed in nasal catarrh (Pratis'ydya), except in fresh and acute cases. Errhines (Nasyaj 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-canei" 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 Asthapana 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" lo mean the expressed juice oi fresh ginger, while others explain it to mean the powder of dried gingtt.

f- In place of "f^^^IT^f^T"." — with any modification ol the expressed juice of sugar-cane, such as treacle, sugar, etc , sonic read "^Z^tq^fli;" i. e., with articles of pungent taste.

Chap. XKIV.] UTTARA-TANTRAM. 12/

Regimen of diet and conduct :— in a

case of Pratis'yaya 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 Vij'ayd (Haritaki) and partake of meals consisting of Paldnna* 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 (PAchana) and appetising (Dipaniya) remedies should be the medical treatment in cases of Pinasa (nasal catarrh) accompanied b\- such distressing symptoms as vomiting, aching, heaviness in the limbs, feverishne.^s, non-relish for food, apathy, and Atisara (diarrhcea). In case of an adult person suffering from an attack of Pinasa due to the concerted action of Vayu 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-Pratisy^ya clarified butter duly cooked with the drugs of the Viddri-gandhddi group or with the five officinal salts should be prescribed for internal

* Palanna 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.

I2S THE SUSHRUTA. SAMHITA. [Chap. XXIV.

use, according to the rules of taking Sneha (see chapter XXXL, 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 Pratis'yaya) the patient should be given draughts* of clarified butter duly cooked with the drugs of the Kdkolyddi group. Coldf washes and plasters should also be used. Sarjarasa (Resin), Pattanga (red-sandal), Priyangu, honey, sugar, Drdkshd, Madhidikd (Guduchi), Goji, S'ri-parni and Yashti-madlm should be pres- cribed as gurgles, and purgings (errhines ?) should be induced with the help of the drugs of sweet potency (such as Drdkshd, Aragbadha, honey, sugar, etc.). Oil duly cooked with (a paste composed of) Dhava-h3.xk, Tri-phald, S'ydmd, Ti/va/ca, Yashti-madhu, S'ri-parni, 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- Pratis'yaya, emulsive measures (Sneha-karma) should be performed with clarified butter, and the patient should be made to vomit by using YaVJlgU (gruel) prepared with Mdsha-^vXse 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 •f^f'^:' in place of 'q-q^,' This word means that the clarified butter for use in this case should be duly cooked with the fj^^ (bitter) drugs, viz,, the leaves oi Patola, etc.

t Both the commentators of Vrinda and Chakradatta explain the term ^1fi%»T (cold) to mean 'prepared with the drugs of cold potency such as the drugs of the Nyagrodhadi and Utpalddi groups.'

Chap, XXIV.] UTTARA-TANTRAIsr. ; 129

Vidanga, Tri-kantaka, S'vctd-roots, SaJid (Mudga- parni), Bhadrd (Gambhari) and Vai'shdhJiii should be employed as an errhinc. Sarald, Kinihi^ Ddru, Nikumbha (Danti) and Iiigudi should be pasted together and duly; formed as Vartis, These Vartis should be duly used, for the purposes of smokhig (Dhuma-pdna) 21-22. Treatment of Trs-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'yaya (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 Rasdnjana, Ati-vishd, Mttsta and Bhadra-ddru. Gargles prepared with the decoction of Musta, Tejovati, Pdthd, Katphala, Katuka, Vachd, SarsJiapa (mustard), Pippali-mula, Pippali, Saindhava, Agnika (Ajamoda), Tuttha, Karajija-seeds, Salt and Bhadra-ddru 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 Vayu-subduing drugs (Bhadra-ddrvddi) should be duly cooked in milk mixed with water weigh- ing half as much as the milk. * The li(|uid 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 again duly cooked \\ ith the drugs of the Sarvagaiidhd (i'^ladi) group, sugar, Aiiautd, Yas/iti-

* Some say that milk and water in ccjiial parts should be taken.

7

130 THE SUSHRUTA SAMHITX. [ 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 used in cases due to the existence of local parasites , and vermifuges {c. g., drugs of the Suras^di 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'yaya.

* In places of "gj^TT^' Chakradatta reads ''■sriefll^' ^ ^-y as an errhine. He also reads "^^T^ffq^T*." '•'^•» pasted with the urine (of a cow), and thus does not read the bile of a cow (fqfl) in the text. Vrinda, however, reads ^'^S(T^f\\f^^\'' in place of "?ijxj7fj^' 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 (^iro-roga-Vijnaniya). r.

Classification : — Diseases which are peculiar to the region of the head number eleven in all, viz.^ the four kinds respectively due to the action of the deranged V^yu, 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 Surydvarta, Ananta- v^ta, Ardhdvabhedaka 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 i"omentation round the head, should be ascribed to the action of the deranged Vatyu, and is known as the Vataja-Siroroga. A violent burning and aching pain in the head, in which the scalp seems 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 "fjijftJTfif" some read "fajft wtf|". This reading is adopted by Madhava. There seems to be no difference in the meaning sthp word faiTJ^ (head) may include both the palate and the throat.

132 THE SUSHRUTA SAMHITA. [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-Sii'oroga. 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 ^iro-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 VasA (fat) or Kapha* is marked by an intolerable pain ("Abhf-tapa) 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 ^iro-

rOg"a : — 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 ''Vasai" 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 '?l^ig?lT'^mj^lT<^T»Tt (^- ^-i ^T '■^^ waste) of blood, Vasa Kapha and Vayu. This;, however, seems to be the better reading.

Chap. XXV. ] UTTARA-TA^JTRAM. 1 33

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 Suryaivarta. 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. lo.

Symptoms of Ananta-vata ^iro-

fOgSL I — The disease of the head in which a violent pain is felt at the j\Ianya and the Ghata (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 Anaiita-V£ita and is due to the concerted action of the three Doshas. ir.

Symptoms of Ardhavabhcdaka and

^amkhaka: — 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 cither follows no distinct periodicity or recurs at a regular interval of ten days or of a fortnight, is called the Ardhaiva- bhedaka and is due to the concerted action of the three Doshas. A violent pain caused 'in the bead and more especially in the temples by the local Vayu in combination with the deranged Kapha, Pitta and blood is designated by the holy sages of A)'urveda as the S'imkhaka. 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 erifls the twcnly-fiflh chapter in the Uttara Tantia of the Sus'ruta Samhit:i which deals with the symptoms of the diseases of the head.

CHAFER XXVI.

Now we shall discourse on the chapter which deals with the therapeutics of the diseases of the head (Siro-

roga-Pratishcdha). i.

Treatment of Vataja-^iroroga :— Re- medial measures described in connection with the treat- ment of Vdta-Vyadhi should be employed in their entirety in the Vayu-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. Mtidga, Kulattha, or Mdsha pulse, unmixed with any other thing, as well as pungent and heat-making articles, saturated with clarified butter and followed 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 Vayu-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 applied luke- warm to the scalp. In the alternative, the scalp may be plastered over with the boiled flesh of fish or with Kris' ard (preparation of rice and sesamum) saturated with Saindhava salt, or with (the paste of) Chandana, Utpala, Ktishtha and Pippali, finely powdered together (all in a lukewarm state). 2-3.

Oil duly prepared with Kulira (crabs) should be used for Nasya (snufifing) 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 Varimddi group and taken down from the fire when the water has evaporated. Butter should be skimmed out

Chap. XXVI.J 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 MadJmra 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 Varunadi group) and with milk should be taken with sugar. Snaihika Dhuma (Chikitsa, XL.) should be administered in time when required, and Traivrita Ghrita and Bala Taila should be prescribed as a draught and as an errhine, as well as for the purposes of anointing, sprinkling and Vasti-Karma. The food in the present type of the disease should be taken with milk cooked with Vdyu- subduing drugs and with meat-soup saturated with Sneha (clarified butter). ^-5.

Treatment of Pittaja and Raktaja

^iro-roga : — Cooling plasters saturated with clari- fied 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-gruel (Dh^nyamla), curd-cream (Mastu), honey and sugar mixed in water — these should be used for sprinkling purposes. Plaster for the head should be prepared with Nala, Vetasa, Kahldra (red lotus), Chaiidana, Utpala, S'amkha (conch-shell), S'aivdla, Yashti-?nadhn, 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. Fhe drugs of the Madhurn group should be used in a tepid state as plasters and the Sneha (oil or clarified butter) duly cooked witli the same drugs should be used as an errhine, and appropriate medicines should be used as purgatives as well as in Astliapana and Sncha-Vasti measures.

136 THE SUSHRUTA SAMHItX. [ Clmp. XXVI.

Clarified butter skimmed from milk, and fresh Vasd (lard)* of J^ngala animals should be used as errhines, and, cooked with the drugs of the Utpalddi. 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 Anuvdsana 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 ^iro-rogas—

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 Meslia-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 Snrald, Kushtka, S'drn- gashtd, Deva-ddru, and RoJdsha 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 '^^[' (laid) some read '^^y' which means meat-soup. |- According to a variant matured clarified butter should be used in this case.

Chap. XXVI. ] UTTARA-TANTRAM. 13/

be judiciously taken with Yava-kshdra and powdered Tf'i-katii and with the soup of Miidga, Patola and Kulattha pulse. 8.

Treatment of Tri-doshaja and Kshay-

aja S'irorOg"a I — 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 recomm.ended in cases of the diseases of the head due to an\- waste or atrophy of the local fat, etc. (Kshay- aja siroroga). Clarified butter duly cooked with the admixture of the drugs of the Vayu-subduing and the Madhiira 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 efficacious in the present (Kshayaja) type. 9-10.

Treatment of Krimija S'iroroga :—

In a case of head-disease (head-ache ?) due to the germi- nation of parasites (Krimi) in the head, the patient should be made to snuff in a quantity of animal blood. The worms or parasites lured with the smell of the blood, would greedily 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 seeds of Hrasiva (small) S'igni mixed with Kdnsya (dead brass) and Nili (indigo) pounded together should then be used, if necessary, or an)- \-ermifuge drug (Vidanga, etc.) pasted \\ith the urine 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 Ol the Madhura drugs.

18

138 THE SUSHRUTA SAMIIITX. [ Chap. XXVI.

stufifed 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. 1 1.

Treatmcntof Suryavarta and Ardh^-

Vabhedaka : — Errhines etc. (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 remedial agents should be employ- ed in cases of the Ardhavabhedaka type of Siroroga. Sirisha* and Miilaka seeds or bamboo-roots camphor, or Vacha and Mdgadhi, or YasJiti-madJm and honey, or Manah slid, pasted with honey, or (pasted) Chandana should be stuffed into the nostrils in the manner of an Avapida Nasya m a case of the Suryd- varta type of Siroroga as well as in a case of Ardhava- bhedaka headache. After the use of the above, the patient should be made to snuff in the medicated clarified butter cooked with the drugs of the MadJmra ■\ (Kako- lyadi) group, in both the above cases. Plasters com- posed of Sdrivd, Utpala, Kushtha and YasJiti-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 affected region. This may be employed with equal success in the cases of the Kaphaja type \ of Siroroga. 12-14.

* Sripati DaUa, the commentator of Vrinda, prescribes the bark and S'ivadasa Sen, the commentator of Chakrapani, prescribes the seeds of S'irisha.

t Some take "ff^fijjf" to mean "?j^t" I

% In place of the Kaphaja type some read the Kshayaja type. But it is not accepted by Jejjata. Others again read "Anilatmake" i.e. in the Vataja type.

Chap. XXVI. UTTARA-TANTRAM. 1 39

Treatment of Ananta-vata ".—Cases of

Ananta-vata 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 subdue the Vayu and the Pitta and should cossist o{ Madhu-Mastaka, Sangydxa c.nd Ghrita-pura (different kinds of confectionery made of wheat, sugar, milk, clari- fied butter, etc.). 15.

Treatment of ^amkhaka :— Clarified

butter churned from milk should be given for a drink and used as an errhine in a case of Samkhaka and the diet should consist of (boiled rice mixed with) clarified butter and the essence of the meat of jangala animals. Plasters composed of S'atdvari, black sesannim, Yashti-niadhu, Nilotpala, Durvd and Punaniavd pasted together, or of Mahd-sugandhd (Utpla-asariva) or Pdlindi pasted with Kdnjika should be applied to the affected locality. Cooling washes and plasters as well as different Avapida Nasyas prescribed in cases of Suryavarta should also be prescribed for this disease (Samkhaka). r6.

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 oi mustard oil. In cases \\ here the preced- ing remedies would fail to produce any relief, the patient .should be treated with Sneha and Sveda, and bleeding should then be cffi^cted by opening a local vein. 17-rS.

The Conclusion: — The causes, symptoms and the therapeutics of the seventy-six kinds of ocular affection, of the twenty-eight kinds of the disease of the car, of the thiiU-due kinds of nasal disease, of the elc\cn kinds of the disease of the head as well a?

I40 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'iuta Samhita which deals with the treatment of the diseases of the head.

Here ends the ^alsikya Tantra (Surgery Minor).

CHAPTER XXVLi.

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-Vi jna- nam), r.

Different Names ".—Attentively hear me des- cribe, Sus'ruta, the origin, cause and medical treatment of the diseases 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 nine in all and are called Skanda-Graha, Skandapasmara, Sakuni, Revati, Putana, Andha-Futana, Sita-Putan^, Mukha- mandikd and Naigamcsha or Pitri-Graha. 2-3.

General course of attack :— These malig- nant stars (Graha) or demons aftect the person of a child in the cases where the directions laid down before (in the Sarira-sthana) 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 consetjuently where proper benedictory rites are 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 purpose of getting proper respect and worship. They being omnipotent and omnipresent are not capable of being seen 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 THE SUSIIRUTA SAMIIITA. [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 child emits a bloody smell and one 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 Skawda'- pasmaira-graha. 5-6.

^akuni and Rcvati ;— Looseness of limbs which emit a peculiar bird-like* smell are the indications of an attack of the child by the Sakuui Graha. The child in such a case 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 ensues 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 f^^f= (lit. a bird) in f%'?^iifj*?l is here meant meat- eating aquatic birds.

Chap. XXVII. ] UTTRA-TANTRAM. I43

or at nigh:, loose stools, emission of a crow-like smell from the i)ody, 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, (Atis^ra), cough, hic-cough, vomiting, fever, discolouring of the complexion, and swelling in the skin as well as an inclination to lie always on the fa:e are the symp- toms which are exhibited in a case of an attack by the Andha-Putana-Gralia. 9-10. ^ita-putana and lYIukha-mandika :—

Constant and frightened startling up, excessive shivering, comatose sleep, constant diarrheic stools and bloody smell of the limbs are the symptoms which characterise a case of an attack b)- S.ta-Patana. The child in this case cries almost unceasingly, and a rumbling sound is heard in the intestines. Paleness (emaciation) of the body (trunk) and a glossy line (swelling) of the face and the extremities attended with frightful n ess, voracious appetite, appear- ance of net-like veins on the abdomen and the emission of urine-like smell from the body are the symptoms of an attack of the child by Mukha-mandikai Graha. 11-12.

Naigamesha -Graha : — Frothy vomits, bend- ing of the middle of the trunk, anxious appearance, loud crying, upward gaze of the eyes, constant emaciation (fcvcr-D. R.), a fatty smell in the body and unconscious- ness arc the symptoms which mark a case of an attack b\- the Naigamesha. 13.

Prognosis : — A stupified state of the child attended willi anavcrsion 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.

144 THE SUSHRUTA 3AMHITA. [ 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 seeds 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 Sarua- gandhd and Sarxoushadhi * 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 KrittikA, obeisance to thee, O Skanda, obeisance to thee, O lord of the Grahas (which has cast this malignant influence). With head down with deep humilit}-, I supplicate th\- favour. Dost thou accept the offerings I have made to thee. May my child get rid of the disease it has been .-uffering from. Makest it hale and hearty again." 15.

Thus ends the twenty-seventh chapter of the Uttara-Tantra in the .Sus'ruta-Samhita which deals with the snecilic features of an attack by the nine (malignanl) ( Irahas.

* The drugs of the Eladi group are known as Sarva-gandha. Sr.rvaaushadhi drugs here mean Ya-J3, Dha'nya, I'ila, 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 (Vilvadi) possess- ed of Vayu-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 iwith Kaitaryya^' and Surd- nianda 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-ddru, Rdsjid, 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 seeds, the cast-off skin of a snake, VacJid^ Kdkddani, 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 [A.4- mantaka) and S'ami as well as the thorns of Vilva and the roots of Mrigddani, 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 behalf) should bathe in the night and worship the god vSkanla fcM- three successive nights in the inner quadrangle of the house of the child or at the crossing of roads with various offerings, z/Z-c, garlands of red flowers, red flags, red perfumes such as Kumkuma^ edibles of various

* Kaitaryy.\, accor.ling lo Dallana, means Nimha or Oiuluchi.

19

146 THE SUSIIRUTA SAMIIITX. [ Chap. XXVIII.

kinds and newly harvested barley grains, vS dli 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 used for bath (in course of worship), should be consecrated by reciting the Gaj^atri Mantra and the sacrificial fire should be dul}^ lit with (three, seven or ten) libations (of clarified butter). 6.

IVIantraS :— 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 sufifrage 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 Ganga, Umd 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 Samhila which deals with the Therapeutics of Skanda-Graha.

CHAPTER XXIX.

Xow we shall discourse on the chapter which deals with the Therapeutics of an attack by Skandapasmara

(Skandapasmara-Pratishedha). i.

A decoction of Vilva, S'in'sha, Golomi {Diirdlabhd\ and the drugs of the Surasddi %xo\.\\} 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 Sarvagandhd group should be used in anointing its body. Clarified butter duly cooked with milk and the decoction of the barks of the KsJiiri trees together with the drugs of the Kdkolyddi group as Kalka* should be prescribed for internal use. 2 A.

The body of the affected child should be rubbed (Utsadana) with the paste of VacJid and Hingu taken together. The dungs of an owl and a vulture, human hairs, the nails of an ciephant, clarified butter, and the hairs of a bull should be mixed together and used for fumigating the child's body. Anantd, Vhnbi, Markati, and Kukkuti sliould 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 MdsJia pulse for the ghosts, and the possessed child should be bathed at the crossing of roads by physician observing the

* Although Dallana prescribes ihe drugj of the Kdkolyddi group to be used as Kalka, we are inclined to take the sentence to mean that the decoction of those drugs should be used.

148 THE SUSllRUTA SAMHITX. [ Chap. XXIX.

necessary fast, etc. with the recital of the following Mantra : — "O thou, the trusted and beloved friend of the god Skanda, O Skand^pasmara, O thou ugly-faced one whom the world knows by the epithet of Visdkha, 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 Skandapasmara.

CHAPTER XXX.

Now we shall discourse on the chapter which deals with the medical treatment of an attack by SaT<uni

(^akuni-Pratishcdha). r.

A wise physician should sprinkle the body of the child possessed by Sakuni with the decoction (duly prepared) of Vetasa, Antra and KapittJia. Oils duly cooked with the drugs of the sweet and astringent groups should be used in anointing" its body. Pradehas (plasters) composed of Madhuka, Usira^ Hrivera, Sdrwd, Utpala, Padmaka, Rodhra^ Priyangu, Manjishthd and Gairika^ should be applied. 2A.

Various kinds of medicinal powders and diet and remedial measures in general described in connection with the medical treatment of Ulcers * as well as the fumigations (Uhupana) 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'atdvari, AI rigddani, Ervdru, Ndgadanti, NidigdJiikd, Lakshmatid, Sakadevd and Vrihati should be fastened (as a charm) to the body of the child (in the preceding manner). 2B.

The presiding deity of the disease (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, Haritdla (yellow c rpiment) and Manahs'ild (realgar) and the child should be bathed duly inside the bower (according to the rules laid down m the treatment of Skanda Graha). The medicated Ghrita prescribed foi

* See Chapter I, Chikitbhita Sthana.

i50 THE SUSIIRUTA 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 XXXL

Now \vc shall discourse on the chapter which treats of the Therapeutics of an an attack by Revati (Rcvatl -

Pratishcdha). i.

The dul)' prepared decoction o{ As'vagandhd, Sdn'vd, Ajasringi, Punarnavd, the two kinds of Sahd and Viddr-i 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 KusJitJia and Sarjarasa (resin) * should be used in anointing- the child's body. Medicated Ghrita duly cooked with the decoction of Dhava, Asva-k-^m.-i, Kakiihha, Dhdtaki and Tindiika and with the drugs of the Kdkolyddi group (as Kalka) should be employed internally as a draught. 2 A,

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 {Dhupand) morning and evening 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), RucJiaka, 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 ph)-sician with the offerings of white flowers, milk, parched

* There is an acklilional text in the lihnvaprakas'ii which says that fiuggulu (I'alainkashd), Nalada (Khus-khus) and (liri-kadaniha should also be used in the preparation of the medicated oil.

152 THE SUSHRUTA SAMHITX. [Chap. XXXI.

paddy and boiled S'dii 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 Uttiira-Tantra in the Sus^ruta Sanihita which deals with the Therapeutics of an atticl^ by Revati.

CHAPTER XXXII.

Now we shall discourse on the chapter which treats of the medical treatment of an attack by Putana

(Putana-Pratishedha). i.

A decoction of the barks of Kapota-bankd, Araluka, Varii/ia, Pdribliadraka and A'sphotd should be used in washing, and medicated oil duly cooked and prepared with (the Kalka and decoction of) Vacha, Vayasthd, (Brahmi), Golomi, Haritdla, Manah-s'ild, Kushtha and Sarja-rasa (resin) should be used in anointing the body of a child possessed by Putana. 2-3.

Clarified butter duly cooked with the Tugd-kshiri^ Kushtha, Tdlis'a, KJiadira and CJiandana, and the drugs of the Madhura group would be found beneficial. 4.

Dcva-ddru, VacJid, Kushtha, Hingu, (iiri-kada7nha. Eld and Harenu should be used in fumigating the body of the child. Fumigation of Gandhandkiili, Kimbhikd, marrow of Vadara-fruits, shells of crabs, and mustard-seeds pounded together and mixed with clarified butter may also be used. Kdkddnni, Chitra- phald, Vmibi and Gunjd should be worn on the body (as a charm) by the child. 5-6.

Putana, the presiding deity of the disease, should be worshipped in the interior of a lonely chamber with oblations and with the ofiferings 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 shf)uld be bathed with the \\atcr left behind after worship, 7 A.

The worshipping Mantra is as follows : — "Ma\' the slovenly shag-huirod goddess, J'utani, wlio is dressed in dirt\' clothes, rind who loves to haunt lond)-

20

154 THE SUSHRUTA SAMHITA. [Chap. XXXII.

dwellings, preserve the child. Ma}- 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 bod\- gives off filthy odours protect the child from all evils." 7.

Thus ends the thirly-second chapter of the Utlara-Tantra in the Sus'nita Samhita which deals with the medical treatment (of an attack) by Putana.

CHAPTER XXXILI.

Now we shall discourse on the chapter which deals vvith the medical treatment of (an attack by) Andha-pu-

tana (Andha-putana-Pratishedha). i.

The decoction of the leaves of the trees of the Tiktaka gana (trees of bitter taste) should be used in sprinkling (the body of the possessed child). Surd (wine), Sonviraka (a kind of acid gruel), Knshtha, Haiitdla, MauaJi-s ild and Sarjcxrasa (resin) should be used in due proportion in medicating the oil (for the child) and medicated Ghrita should be duly cooked with the Kalka and decoction of Pippali, Pippali-mida. the drugs of the JMadhura group, S'dlaparui and the two kinds of VriJiati w ith the addition of honey (as an after-throw). 2 A.

Plasters of the drugs of the Sarva-gandJid (Eladi) group should be applied to the body of the child and its eyes 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) monkf should be used for fumigating the child's bod\-. The child should be made to wear (the roots of) Ktikkuti, Markati, S'imbi and Aiiantd as a charm. 2B.

Offerings of meat, cooked or uncooked, and of blood should be made (to Andhaputan^) at the crossing of roads or inside a house for the [)rcservation of the

* Some explain "|i^ti»|" (hair) and ■^■^ (skin) as thobe of man and not of a cock.

i Uhavaprakas'a reads '^1»n^IHl'?'n^t ^Tfl'." '• ^•. very old cloth. This reading does not suggest that ihu cloth to be used should have been worn by a Buddhibl monk.

136 THE SUSHRUTA SAMllITA [Chai-. XXXIIT

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-putana, wearing a red-coloured garment be pleased to save this child." 2.

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

CHAPTER XXXIV.

Now we shall discourse on the medical treatment of (an attack by) S'ita-putana (^ita-putana-Prati-

shedha). i

The decoction of KapittJia, Suva/id (Rasna), Vimbi, Viha,Prachivala (?), Namii (Vata.) and B/iaZ/dta/ci should be used in sprinkling tthe child's body). The urine of a cow and of a she-goat, as well as Jlliista, Deva-ddrii, KiishtJia and the drugs cf the Sarva-gaud/ui (Eladi) group should be used in dul\- preparing a medicated oil (for the purpose) and medicated Ghrita should be dul\- cooked with (three parts of) the decoction of Rohiiii. Sdrjayasa (resin\ Khadira, Paldsd and barks of Arjiitia and (one part of) milk. 2 A.

Dungs of an owl and a vulture, the cast-off skin of a .snake as well as Ajagandhd and Nimba leaves and Yashtlii-madJiii should be used for f ami gating purposes, and Lambd (Tiktalavu), Gunjd and Kdkddani should be be worn (as a charm) by the child. 2B.

The goddess Sitaputana should be worshipped with the offerings of the preparation of rice and Miidga pulse (cooked together) as well as with Vdru;/i wine and blood, and the child should be bathed near a river or a tank. The Mantra is as follows : — "May the goddess Sita-putana, who is fond of the preparation of rice and Miidga 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-fourlh chapkr in the Uttara-Tantra u( the Sua'ruta Samhila which deals n'ith the medical ttealment of (an attack by) S'itapulana.

CIIAl^TER XXXV.

Now wc shall discourse on the chapter which deals with the medical treatment of (an attack by) Alukha-

mandikd(lVIukha-mandika-PratishccIha). i

The decoction of A'^;/ />//•<:;:, Viha, Tarkdri (Jayanti), Vamsa-lochana (D.R. Vas^), GandJiarva-Jiastakd (Eranda) and A'/ZTrr^'/^.s-/// (Patala) 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 Bhringardja, Ajagand/ui and Harigandhd (As'wa- gandh^) and be used in anointing the child's body. Medicated Ghrita .should be duly cooked with Madkulikd (Murva), 71?/_wrt-X'.y ///;-/ and the drugs of the Madhura and the minor Panchd-fniila groups and with milk. 2. A.

Fumigation with Vnchd, Sarjarascr and KiisJitha mixed with clarified butter would be found bsneficial and the child should be made to wear the tongue of a CJidsa bird, a CJiiralli bird or a snake (as a charm). 2. K.

Offerings of Varnaka (Kampillaka), Chiirnaka, gar- lands of flowers, Rasdnjana, Pdrada (merciu'y), ManaJi- S'ild, Pdyasa (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, Mukhamandika, who is decked with ornaments, who can assume different forms at will and who resides in cow-sheds, preserve thee".

Thus ends the ihirly-fifth Chapter of the Ultara-Tantra in the Sus'ruta Samhita which (kal.s with the medical treatment of (an attack by) Mukhamandika.

CHAPTER XXXVI.

\o\v we shall discourse on tlic chapter which deals with the medical treatment of (an attack by) Naigame-

sha (Naigamcsha-Pratishcdha) r.

The decoction of Vilva, Agnimantha and Piitikd should be used in sprinkling (the body of the possessed child) and sprinkling with Surd, Sauvira and Dhdny- d^nla (Kanjika) is also advisable in such cases. A medicated oil should be duh- cooked with Priynngu, Sixrald, Aiumtd, S'ata-piis/ipd and Kiitannata and with cow's urine, the liquid of the milk-curd (Dadhi-mastu) and Kanjika. Medicated Ghritas shoulJ be duh- pre- pared with the drugs of the Mnd/iin-n group as Kalka, with the decoction of the Dasdmiila and w ith milk or with the head of a date-palm tree 2. A.

The child should be made to wear Vachd, Vayasf/id, Gflhnii and Jatild as a charm and the utsadana measures recommended in the treatment of Skanddpasmara should be used in this case also. SiddJidrtJiaka (white mustard), Vachd, Ih'noii, k'lts/itlin, parched rice, liJiaUd- taka and Ajamodd should be used in fumigating' the body of the child. In cases of attacks b\- Navagraha the dungs of a monkey, an ow 1 and a \ulture should also be used by persons wishing the good (^f the child for a fumigating purpose and that at the dead of the night w hen all persons are asleep. 2. H.

Offerings of huskless sesamum, garlands of flowers and \arious dishes should be made to the deit\- Xaigamesha (the ])rcservci' of the child) at the foot of a Vntn tree on the- sixth day of the foilnight and the child should be bathed there at the fool of the tree.

l6o THE SUSIIKUTA SAMIIITA. [Chap. XXXVI.

The Mantra runs as follows : — "Ma}- the far-famed god, Naigamesha, the preserver 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 XXXVIL

Now we shall discourse on the chapter which deals \vith the oriL^-in of the (nine) Grahas (Grahotpattl-

Adhyaya). i

The nine presiding deities — z'/.s., Skanda and otlicrs — of the nine diseases of infant life are all possessed of ethereal frames, divine effulgence and specific sex- distinction of their own. They were created by the gods Agni, Mah^deva and the goddesses Krittika and Uma for guarding the person of the new-born Guha though protecting himself with his own divine prowess amidst the stems of S'ftra grass. Of these Grahas the females who are possessed of \-arious shapes as described before are considered as originally made of the Rdjasa essence of the goddesses Ganga, UmA and Krittika. 2A.

The Xaigamesha 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 dear to him as his own self. Skanddpasmara, the presiding deity of the disease named after him, was created by Agni, the fire-god (Vulcan). He is as bright as fire itself and is a constant companion of the god Skanda and is also known by the name of Vis'akha, The god .Skanda, the tutelar 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 Kumara (lit. a child, t'/c, of Maha- deva). 2JI

It is impossible that the god springing from Rudra and Agni, with his exalted parentage would find pleasure in such a dangerous disease even out of childish frolic-

21

l62 THE SUSIIRUTA SAMIIITA. [Chap. XXXVlI.

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 disease under discussion (Skanda) is no other than the invincible Skanda. 2.

On the effulgent god Skanda's being elevated 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 same query. Mahddeva, the Destroyer of Bhaga's eyes, replied "Gods, men and other animals, O, ye Grahas, exist on the principle of reciprocal benefit*. The gods minis- ter to the wants of men and beasts, etc., by marshalling different seasons 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 reverence, and by repetition of prayers, religious vows and other religious observances. All services and their emokmients in consequence have been filled up and settled and there remains nothing for you to fiii. Your proper means of subsistence will, therefore, be in the life of an infant (though the emoluments you shall receive shall be stained with the tears of man\' an anxious, \vatchful and night-worn parent). 3 A.

" Exchange or reciprocity of services underlies the foundation of all distinct and cognitive existences, whether beasts, men or gods. The worlds are linked to one another by bonds of service. (Hve-and-takc is the law of the universe. Duty implies obligation.

Chap. XXXVII. ] UTTARA-TANTKA. 163

Children of the tamilics in which the gods, the Fitris (departed fathers), the Brahmans, the pious, the precep- tors and the seniors and the guests are not properly worshipped and attended upon and wherein the rulc> of cleanliness and virtues are not observed and the mem: bers of which do not make daily ofrerin""s to the aods and give alms to beggars and live on food prepared by others and eat from broken bowls and plates of Indian bell-metal would be the proper persons whom you might strike with impunit}-, and by your malign influence lay them up with diseases peculiar to infant life. (It shall be your dut\- to see that iniquities of the parents are visited on their children. Attack them without least compunction of heart and ample means of subsistence will be thereby secured to you). There the parents of tho^e children will worship you in their 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 an\- 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 inciu'able. 3.

Tliub cndb llic thirly-bcvcnth chapter uf (he UUdra Tanlra in the Sus'rula .Samhila whicli dcalo with Uic origin of the Grahab.

CHAPTER XXXVllI.

Xow \vc shall discourse on the chapter which deals with (the symptoms and) the therapeutics of the diseases of the female* organ of generation (YonLvyapat-

Pratishcdha). i.

Causes :— The bodily (as well as the local) Vayu 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 diseases 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 affect the female organ of generation (yoni) have been classified into twenty different kinds^j'. The injudicious conduct of life which is usually found in females, menstrual disorders, the diseased or defective nature of the seed (of the parents of the girl), or an}- accidental cause may be fairly set down as causes of these female diseases. Xow hear them discussed separately. 3.

Enumeration and Classification :—

Udavarta (dysmenorrhcea), Bandhya (sterility), Vipluta (introversion of the uterus), Paripluta (retroversion or retroflexion of the uterus) and Vatala are the five kinds

* The term "yoni" is here used in a very comprehensive sense and means the whole female organ of generation, /. e., Uterus, Vagina, etc.

)• Tlicbe three lines correspond verbatim with three lines in the Charaka Samhidl {vide Charnka Samhila. Chapter XXX, Chikitsita- sihana).

Chap. XXXVIII.] UTTARA-TANTRA. • 165

of Vataja vaccinal diseases. Rudhiiakshara (mciiorrhrea), Vamini, Sramsini, riiltraL^'lini and PittalA arc the Pittaja iJiics. Atyanaiida (nymphomania), Karnini, the i\\\) kinds of Charana and Slaishmiki find their origin in Kapha, and Shandi, Phalini, Mahati, Suchivaktra and Sarvaja arc said to be due to the aggravation of the three Doshas. 4.

Symptoms of the Vataja types :— An

Uddvarta \'oni discharges painful and frothy menses and a Baildhyai yoni is marked b}^ the absence or suppression of the catamenial flow. A local pain is always complained of in a Viplutsi yoni and in a Paripluta yoni an excessive local pain is experienced at the time of sexual congress. A Vatalai yoni is marked by an aching and piercing pain in the organ which .seems rough and numbed. The peculiar pain due to the derangement of the V^yu is also felt in the first four types of the series. 5.

Symptoms of the Pittaja types :—

Discharge of the menses \\ ith 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 ejected with V^yu (sound) is called Vaimiiii ; the coming out (prolapsus) of the organ (uterus) when disturbed and a difficult or painful [)arturiti()n arc the symptoms of a Prasramsini \oni. The>'oni\in the case of repeated abortions due to the excessive discharge of catamenial blood during the period of gestation is called Puttraghni. An extremely burning sensation and suppuration in the organ attended with fever are the .symptoms which mark a Pittala yoni. The four previous vaginal diseases arc also marked by the specific .symptoms of the aggravated Pitta. 6.

l66 THE SUSliRUTA SAMUITA. [Chap. XXXVIII.J

Symptoms of the Kaphaja types :—

All Atyauandai yoni knows no satisfaction in matters of sexual pleasures. Hiemorrhoid growths or polypii due to the aggravation of Kapha and vitiated blood appear on the living membrane of the organ in a Karnini yoni. In an Acharaca > oni a greater quc.ntity of ovum is secreted before the completion of sexual act, and in the other /. (-., in an Aticharansi yoni the semen is not retained in consequence of over-indulgence. A Sleshmalat v^oni is very cold and slimy and has a local itching sensation. The first four kinds of this series of vaginal disease (lit. diseased vagina) are also characterised by the actions of the deranged 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 Plialini yoni. An extremely dilated vagina is called Mahaiyoni, while an extremely constricted one is called a Suchivaktra (lit. a vagina with a needle-eyed vulva). The yoni marked with the symptoms of the aggravation of all the three Doshas is said to be a SarvaJEl yoni. The four preceding kinds of vaginal malformations or diseases are also due to the concert- ed action of the three deranged Doshas in the locality and these last (five) kinds of Tridoshaja \aginal diseases are incurable. 8.

Medical Treatment :~rhe 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 MadJmra group mixed with Ves'avara (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 / c. medical injection (prepared with the Va}-u-subduing drugs) should also be emploN'ed ; cooling measures should be adopted in the cases marked by dryness and sucking pain (Osha and Chosa) in the affected localit}-. The vagina should be filled up with the powders of the five officinal kinds of drug [Pancha-kashdyd) in a case, marked by fetour and slimy mucous secretion, and the decoction of the drugs of Rajavrikshadi 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 \agina marked In- the discharge of pus. 9 — 12.

A yoni (\agina) marked b\- an itch and impaired sensibility should be fumigated \\\\.\\ the \-apour of Vrihati and the two kinds of Haridrd 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 \'<)ni ; and a prolapsing (Prasramsini) \'oni should be fomented with

l68 THE SUSMRUTA SAMIilTA. [Chap. XXXVIII.]

hot milk and rubbed with clarified butter. It should then be restored to its proper place and. being pasted with Ves'avara, should be duly bandaged. 13 — 14.

Diet. — Sural, Asava, Arishta, (wines of medicinal drugs) should be prescribed according to the Do.sha involved in each case and the patient should be made to take the expressed juice of garlic {Laskuna) every morning and her diet should consist inainU' 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 diseases of the semen, menstrual complaints, affections of the mammae, impotcnc}-, cases of false presentation of child and diseases during the period of pregnancy and motherhood, and all those ma}- be employed with equal benefit in these diseases peculiar to the female sex. Other diseases (such as fever etc.) which ma}- 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'tuta Samhita which deals with the therapeutics of the female organ o generation.

Here ends the Kaumarabhritya Tantra.

CriAPTER XXXtX.

Now wc 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, Sus'ruta and others "You have instructed us, O, you, the foremost of physicians, the subject on all the concomitant distressing symptoms (Upadrava) of Ulcer Vrana). Now let us have a general outline and detailed description of the concomitant dis- tressing symptoms, physiological an 1 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 because of the loss of his Doshas and Dh^tus. 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 em])loyed in their cure". 2.

Description 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 distempcr^i

22

I^O THE SUSHRUTA SAMHITX. [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 ma>' 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 sense 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 dominance-f 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 wlule that due to an extranfous cause is the eighth.

t Kapha is aggravated in the morning, Pitta, at noon and Vdyu, in the evening. Fever follows a distinct periodicity determined by the

Chap. XXXIX. J UTTARA-T ANTRA. I^I

spreading through the whole organism. The deranged bodily Doshas augmented or enraged by their specific aggravating causes, enter into the Amas'aya 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 expelthc inherent heat (Ushman) out of its seat in the Takvasaya, and spreading all o\er 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.

PathoIOg"y : — 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-fat'guc, any process of physical waste, indigestion, introduction of any extraneous 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 planeis (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 Dvijdoshaja fever {due to the combined action of the two deranged bodily Doshas) the heal 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 strongL-st 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).

1/2 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

of deadly incantations or charms, curses (from Brih- manas and superiors), any fancied diead 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 bodv 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 Dh^tu 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 premoi:itory 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 V^yu, Pitta and Kapha respectively. The derangement of all the three Doshas is marke:l by the presence of all the symptoms, while, in the derangement of any two of these, the special symptoms of those two Doshas appear. 10.

Symptoms of Vataja fever :— Shivering,

Chap. XXXIX.] UTTAKA-TANTRA. 1 73

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 Vayii of the body. 11.

Symptoms of Pittaja fever :— High

fever (hyperpyrexia), diarrhoaa, 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, yellowness of the stool, urine and of the eyes and vertigo are the symptoms which mark the Pittaja type of fever. 1 2.

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, sweet taste in the mouth, slight Iieat in the body, vomiting, lassitude, mal-assimilation (Avi- pdkata), 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 diflkult 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 riiUghness 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 fjecal matter at long intervals, are the symptoms which are exhibited in a case of fever due 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, dulncss 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 Sannipataja fever can be cured only with the greatest difficulty, while others hold it to be almost incuraSle. A case of Sannipataja fever atten- ded with somnolence is called Abhitiy^sn, it is called Hataujisa when the vitality of the patient is greatly diminished and it is called Sauuyasa when there is an innertness of the limbs. 16

. * "rrP!rf'TWtT»T?I*T;" is a different reading in place of ' f[T^ T^TW- ^'f^g;' I The term fift?^ is more apjiropriatcly applicable to flTq?T than to ^{CT both grammatically and in sense.

Chap. XXXIX.] UTTARA-TANTRA. 175

When (in a case of SannipAtaja fever), the Ojo-dh^tu (one of the fundamental principles) of the organism being disturbed or agitated by the deranged and aggra- vat'cd Pitta and Vdyu, 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 fe\-er (due to an obstruction or an overwhelmed condi- tion of the Ojo-dhatu) by the experts. 17.

Tiie 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 three different types {e.g. Vata-pitta-fever. Vata-s'leshma-fever and Pitta-s'leshma-fever). Yawning, distension of the abdomen, lo« 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 derange! Pitta and Vayu). Aching pain (Sula), cough, the \'omiting 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 Vayu predominates gets aggravated on the 7th, that in which Pitta predominates becomes ag^^ravaled on the loth and thai in which Kapha predominates comes to be aggravated on the 12th day. According to some authority, however, Abhiny;isa, Hataujasa, and Sannydsa types of fever are pacified on the 7th, loth and 12th. day respectively. — Dallana^

176 THE SUSHRUTA SAMIIITX. [Chap XXXIX.

symptoms of a case of Vatta-sleslima-f 3ver (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-Biesh'ii?.-ftver (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, /\nyedyushka, Tritiyaka, Chaturthaka and the Pralepaka ^. The (residue of the) deranged Dosha of the body, shifting from one location of Kapha to the next in the course of the entire day

* Dallana in his commentfiry has quoted in eight lines with different wordings the symptoms of these kinds of Dwxndvaja fever and these lines have been adopted by Midhava in his Nidana Th.-; lines when translated 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 ( f^f'TfT ) ^'^ °^'^'' ^^^ body, pain in the joints, excessive sleep, heaviness of the limbs, pain in the head, catarrh, cough, scanty persjiiration, slight sensation of heat, and pulsation not too quick nor too slow, are the symptoms of Vaita-s'leslima-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

^lesbmapitta-fever .

t The five locations of Karha are the Amas'aya, chest, throat, head and the joints.

t There is another kind of Vishama Jwara named Santata (cL S'loka 31 of this Chapter) and Dallana remarks that it is begotten wh-n the residue of the deranged Dosha is lodged in all the five seats of Kapha.

Chap. XXXIX.] UTTARA-TANTRA. 1^7

and night, ultimately finds lodgment in the Amds'aya (stomach) and thus brings on the virulent attack of (those) fevers. Of these the t)^pc known as the Prale- paka appears in cases of Sosha (consumption) and though its attak is a mild one, it puts almost insurmountable diiificultics in the way of its cure, brings about a loss or waste of Dhatus (the seven fundamental principles of the organism) and thus ultimatch- ends in death. There arc cases of Vishama-jwara known as the Viparyyaya type (reverse of the abo\-e t)'pe) which arc the result of the deranged bodiU- Doshas being simultaneously located in two or four specific seats of the deranged bodil}' Kapha and are hard to cure. 22 — 2^,.

Se\-eral authorities hold Vishama Jvara to be sia'- gcjiois in its origin. But whether spontaneously idio- pathic or not, an extraneous fact (cither a passing psN'chic condition such as fear, grief, etc. or the presence of an\- foreign poisonous matter in the system) is alwa)-s involved in and intimatel)' connected with a case of Vishama fever. The pre-dominance of the deranged and aggraxated Va\-u is marked in cases of Tritiyaka (tertian) and Chaturthaka (quartan coming on every fourth day) fevers. A case of fever due to the abuse of an\' w ine or ardent spirits as well as the one occuring in a low land at the foot of a mountain, should be supposed to involvs a predominant action of the deranged and aggravated Pitta. A case of Pralepaka fever is due to the concerted action of the deranged and aggra\ated Va)'u and Kaplia, o{ which the action of the latter should be regarded as more dominant. Ca.ses of Vishama fc\-er ushered in b)' epileptic 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 \^\\\ of the ])ody, if lo-

1/8 THE SUSIIRUTA SAMIIITA. [Chap. XXXIX-

cated under the surface of the skin, produce cold (shiver- ing) during the first istagc of fever, while the deranged Pitta brings on the characterstic burning sensation at its latter stage after the subsidence of the deranged Kapha and Yayu. In certain cases the burning sensation is engendered by the deranged Pitta at the outset, cold (shivering) being brought on by the deranged Kapha and Vayu at the latter stage after the subsidence of the deranged Pitta. Both these two types of fever are brought on through the combined action of two deranged Doshas of the body and of these two, the type \\ hich is ushered in by a burning sensation in the body is extreme- ly hard to cure. A case of continued fever resulting from an abnormal ps)'chic 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 t}'pe attacks a man in various ways and follows a distinct periodicit)-, 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 emaciation. It is called Vishama-jwara because 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 onl}' 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.

* Sec chai ter XXI. — Sutra-sthan.i.

Chap. XXXIX.] UTTARA-TANrRA. 179

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 * ^vhich is known as the Vishami Jwara. A case of Siiitata (remittent or continuous) fever has its seat in the vitiated Rasa (serum) and blood i* of the organism ; while a case of Anyedyah finds location in the contaminated flesh of the body. The type known as the Ti'i-tiyaka (tertian-fever coming on every third day) affects the principle of Meda (fat), while the one called Chaiturthaka ((juartan-fever coming on every 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 fatall}'. Several authorities include cases of fever due to the malignant influence of evil spirits within the categor\- of Vishama Jwara. 30.

Duration of Vishama Jwara :~The type

</ fever which continues for seven, ten or twelve days M ithout 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. I'^cver of the Anyedyushka type comes on only once a day and one of the Tri-tiyaka type comes on every third i. e. on every alternate day, while a case of Chaiturthaka fever sets in every fourth day. jt.

* A case ot fcVcr may lapse iiUo a Visliaiua type even from Llit very coinmenccmenl of the aUack.

|- Vijaya Kakshita, Uie coiuiiienlalor un Madhava Nidana, says, un 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 resiJcctively.

l80 THE SUSHRUTA SAMHITX. [Chap. XXXlX-

Influence of Vayu on Vishama

J^vara : — Just as the ocean is overflown when its water is swollen up by the gusts of wind (Vdyu), so the bodily Doshas are aggravated by the bodily Vayu, 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 ebb-tide, so fe\cr being augmented b>' the deranged Doshas of the body, rushes out of its lurking place ill 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 deeper tissues and vital principles of the bod)' 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.

Agantuka 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, diarrhoea, 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 oi llic mind, drowsiness, languidness.

Chap. XXXIX.] UTTARA-TAiSTRA. l8r

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 ushurcd in through the dynamics of deadly incantations. Anxiety, laughter, shivering and weeping mark a case due to the malignant influence of e\-il genii. 33—34.

The bodily Vayu deranged and aggravated b\' fatigue, physical waste or by a blow spreads through the entire organism and begets (traumatic) fever. There is another kind of fever which is due to an\' extraneous cause or which results from the acute stage of any other disease attendant on the body. It exhibits all the symptoms characteristic of each of the deranged 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 -f* and presence of supervening .symptoms (e. g. hard breathing, cough, etc.) in cases of both Gambhira (inward (jr latent) and

* "Abhichar,' niuans incantations or Atharvan rites liy which disease, death and any other injuries arc brought about.

"Abhis'apa" means the curse pronounced by Brahmins, preceptors, seniors and alters possesed of puissance.

t Dallana says in his commentary that some read a few ailditiona! lines after this. He, however, does nol comment on those lines and further adds that Jejjata does not read them. So wc, too, refrain from translating those lines.

t82 the SUSHRUTA SAMHITX [Chap. XXXIX

Tikshna (high) fever are the indications which point to the hopeless nature of the case, ly — 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 symptcms 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 be given as soon as the premonitory symptoms would make their appearance and the patient would get relief thereby. 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 each case. In the cases in wh'ch emulsive measures (Sneha-Karma) and exhibition of purgatives and emetics are forbidden, such measures should be employed 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 Amas'aya (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 ha\e been full}- assimi- lated in (to) the s}-smtcm. 41.

Prohibition of Fasting :— Fasting is pro- hibited in a case of fe\'er due to a wasting process in the bod}' or incidental to the action of the deranged bodil}' V^yu 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 been forbidden as in the chapter < n Di\ i-\rana (Chapter I, 25 — Chikitsa- sthana). 42.

Effect of Fasting :— Fasting in the case of a patient in whom the bodily Doshas have been deranged and of whom the digestive fire has become dull, lead to an assimilation of the deranged Doshas and kindles the digestixe fire, produces remission of fever, lightness of the body and relish for food. 43.

Satisfactory and excessive fast- ing : — Easy and natural passing of Yayu and stool and urine, intolerable keenness of thirst and appetite, lightness of the body, sprightl}', action of the mind and the sense-organs and a weakness of the bod}' are the results ^\hich spring from Satifact' ry fasting ; while such symptoms as loss of strength, thirst, dry- ness (of the mouth), insomnia, vertigo, doziness, fatigue and such other super\-ening s}'mptoms (as diffi- cult breathing, cough, fc\cr, 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 Fitta and

184 THE SUSIIRUTA SAMHITX. [Chap. XXXIX.

Vayu to their normal condition. The use of tepid water which allays thirst is highly efificacious in cases of fever due to the actions of the deranged bodily Kapha and Vayu, as it tends to cleanse the internal passages of the body and helps in the easy movement of the deranged bodily Doshas in the organism. The effect of cold water is just the reverse and its inherent cold tends to aggravate fever. 46

Pcya : — A potion consisting of water boiled w ith the admixture of the following bitter drugs viz. Gdngeva (Musta\ Ndgara, Us'ira, Pdrpata, Udichya (Balaka) 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 gi\-en to the patient when hungr)- 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 sy.stem, would not abate even after the obser\-ance of fasting and the subsequent use of Yava'gU and where the digestive power of the patient has been impaired. 47 — 49.

A decoction of PancJia-mula assimilates the bodily Dosha in a case of Vataja fever, while a decoction of Musta, Katuka and Indra-yava mixed with hone\' (when cold) proves curative in a case of Pittaja fe\^er, and a decoction of the component drugs of the Pippalyddi group helps the assimilation of the deranged bodily Dosha in a case of Kaphaja fe\er. Decoctions remc-

" According to different authoii 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 eating, 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 s\'mptoms 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 ph)-sical languor and increased virulence and continuity of the attack of fe\-er (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 he 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 (I'dka).

24

l86 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 produce a recrudescence of the disease. Corrective, purifying and soothing (Samaniya) remedies (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 sufifering from fever should not be stopped unless they are excessive, >vhen the case should be medically treated as one of Atisdra (Diarrhea). 55.

Preliminary Treatment:— A suitable

purgative should be administered even in a case of acute fever if the digested Malas (frecal 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, Asthapana-enemas, purgatives, Siro-virechana and errhines should be successfully em- ployed for the purpose. Emitics 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 purgatives should be given in a case of

Chap. XXXIX.] UTTAKA-TAKTRA. 1 8/

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 Vataja fever attended with aching pain in the limbs and with Udavarta (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- virechaiia (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 thereb\' to their normal functions. 56-A.

A plaster composed of Deva-ddru, Vacha, Kushthd, S'atd/ivd, Hiiigii and SaUidhava pasted together with Kdiijika should be applied lukewarm to the abdomen in a case of fever attended with painful tympanites if the patient be weak, whereas 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 Vayu attended with suppression of stool and urine, and Yava^U prepared with Pippali, roots of PippalL Vanidni and Chavya should be given to the patient as a potion, it being remedial for the deranged bodily Va)'u 56.

Administration of Ghrita: -The residue

of the deranged bodily Dosha having lurked in the s)-.stem (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

1 88 THE SUSIIRUTA SAMHITA. [Chap. XKXIX

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 preponderance of the bodily

Vayu, 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 Mtidga pulse. In a case of Pittaja fever

it should consist of boiled rice and a soup of Miidga

pulse and be taken, when cold, with the admixture of

sugar. In a case marked by the concerted action of the

deranged V^yu and Pitta, the diet should consist of

Mudga soup mixed with (the expressed juice of) Ama-

laka or Dddima. In a case of Vata-s'leshmA fever

the diet 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 Niniba

and Patola. 59 — 60.

Laja-tarpaua — 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 ^t% (mild type), and his read- ing appears to be the belter one, it being supported by Charaka as well.

Chap. XXXIX.] UTTAKA-T ANTRA. 1 89

boiled rice) to a patient suffering from fever marked by burning sensation, vomiting, thirst and weakness. Yavdgu 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 Jdngala 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.

IVIilk 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 Vata-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 b)- thirst or burning sensation. But milk taken in a case of fe\er in its acute stage is highly injiu'ious. C^l.

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 death in the end. A food which is Jieavy of digestion (Guru), oi- sccretin<T ' Kapha-producing) in its effect should by no means

190 Till-: SUSUKUTA SAMlllTA. [Chap. XXXIX.

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 Maktishtaka, etc. may be given with benefit as diet to the hungry patient suffering from fever. 6^. A

IVI cat -diet : — The meat of Ldva, Kapinjala, Bna, Prishata, S'nrabha, Kdla-puchchha, Kuranga, Mriga-mdtrikd (different kinds of deer) or S'asa (hare) may be prescribed as diet for a fever-patient accustomed to the use of animal food *. Several authorities, however, i* do not recommend the use of the meat of Sdrasa, Krotmcha, Mayma (peacock), Kukkiita (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 (Avagaha. 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 oi fever, may be given with or without the addition of an acid juice (e.g. Dadima, A'mlaki, etc ) t Charaka also holds the same opinion as Sus'ruta.

Caap. XXKIX] UTTARA-TAXTRA. 1 91

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 fulh' regained. 69

A very small amount of physical exertion, in cases of fever, is likeU' 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 tlic use of astringent, heavy and dry food as well as fatty and secreting food. In short he should also discourage mental emotions of ^"gC) gfi'^fj etc. as well as the use of newly collected corns. This is evidently Dallana's reading.

193 THE SUSHRUTA SAMIIITA. [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 tSams'amana) remedies according to the deranged bodily Dosha involved therein. Now we shall deal with the recipes of Dosha-subduing (Sams'amana) 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, Sdrivd, Drdkshd, S'atapushpd and Harcnu should be given with the admixture of treacle in a case of Vdtaja fever or a cold infusion \ of Guduchi should be taken by the patient. Similarly a decoction of Vald, Darbha and S'wa-danshtyd boiled down to a quarter part of the original quantity of water and mixed with sugar and cla- rified butter ; or a decoction o{ S atapnshpd, Vackd, KusJi- tha, Dcvaddru, Harcimkd, Kiistiimburu Nalada and JZ/^j'/rt mixed with sugar and honey should be given to a patient in a case of Vataja fever. A decoction of Drdk- shd, Guduchi, Kds'marya, Trdyamdnd and Sdrivd mixed with treacle should be prescribed in a case of Vdtaja fever, A potion of the expressed juice of Gtiduchi mixed with an equal quantity of that of S'atdvari and with treacle proves almost instantaneously efficacious in a case of fever of the same type. Rubbing of the

X According to Dallana the cold infusion of Guduchi should be given in a case of Vataja fever involving the action of vitiated Pitta also ; whereas the decoction duly prepare