Chapter XVII - Treatment of diseases of pupil and crystalline lens

Now we shall discourse on the curative treatment of the diseases of the pupil and the Crystalline lens (Drishti-gata-Roga Pratishedha). 1.

Of the diseases included within the present group, three are curable, three are incurable, while the remaining six admit only of palliative treatment. The curative remedies of the disease known as Dhuma-darshi (smoky or dusky vision) has been already described (in connection with the medical treatment of Pittaja Ophthalmia)^[1]. All the remedies applicable in cases of deranged Pitta and Kapha as well as application of Nasya (snuff), Seka (sprinkling), Anjana (Collyrium), Alepa (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 (Shleshma-vidagdha) vision. Traiphala-Ghrita should be prescribed in a case of Pitta-vidagdha-Drishti and Traivrita-Ghrita in a case of Shleshma-vidagdha-Drishti. Potions of old and matured clarified butter as well as of Tailvaka-Ghrita are equally efficacious in both cases ^[2]. Collyriums (Anjanas) should be prepared with Gairika, Saindhava, Pippali, and the charred remains (Masi) of cow’s teeth, or with beef, Marica, Shirisha -seeds and Manah-shila, or with the stalk of a Kapittha fruit together with honey, or with Atmagupta pasted with honey; these four Anjanas may be used with advantage in both the types under discussion. 2–3.

Pushpanjana:—

Powders of the flowers of Kubjaka, Ashoka, Sala (Shala?), Amra, Priyangu, Nalini and of Utpala, as well as powdered Renuka, 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 Shleshma-vidagdha eye-diseases. 4.

Dravanjana and Gudikanjana:—

As an alternative, Renuka 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^[3] pasted together with the Rasa (watery secretions) of cow-dung^[4] and made into large pills (Gudika) may be profitably applied to the eye as an Anjana alike in cases of day-blindness and night-blindness. This Anjana is called the Gudikanjana. 5.

Treatment of Day-blindness:—

Rasan-jana, Rasa (Juice)^[5], honey, Talisha-patra and Svarna-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. Shita (Rasanjana, or according to some Camphor) , and Sauvira should be soaked in Rasa (meat-juice)^[6] and then pasted together. It should then be soaked again in the bile of a tortoise or of a Rohita fish and dried and reduced to powder. The present compound is called the Churna-anjana (powdered Collyrium) and may be used beneficially for the pacification of Pitta (in cases of Pitta-vidagdha-Drishti). Kashmari flowers, Yashti-madhu, Darvi, Rodhra and Rasanjana, should be pounded together and mixed with honey. Used as an Anjana it is always efficacious in the affections of the eye. 6–8.

Treatment of nocturnal blindness:—

The application of a medicinal Varti (stick) composed of Sauviranjana, Saindhava, Pippali and Renuka pasted together with the urine of a she-goat would prove highly beneficial in cases of nocturnal blindness. Similarly the application of a medicinal Varti (stick) composed of Kalanu-Sariva, Pippali, Shunthi, Yashti-madhu, Talisha-patra, the two kinds of Haridra, and Musta, pasted with the Rasa of cow-dung^[7] and dried in the shade, proves beneficial in such cases. Manah-shila, Haritaki, Trikatu, Bala, Kalanu-sariva and (Shamudra-) Phena pasted together with the milk of a she-goat and similarly prepared in the shape of a Varti is also recommended. 9–11.

Rasa-Kriyanjana:—

The urine, bile and dung of a cow^[8] together with wine, should be boiled (in the manner of Rasa-kriyanjana preparation) in the expressed juice of Dhatri, or in the Rasa (serum) of the liver of an animal (e.g. a goat), or in the decoction of Triphala. It is called the Kshudranjana, and should be applied to the affected organ in the manner of an Anjana (coilyrium). An Anjana consisting of cow’s urine, clarified butter, Samudra-phena, Pippali, Ratphala, Saindhava and honey mixed together should be first kept inside a hollow bamboo and subsequently applied (in night-blindness) as a coilyrium. 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 cooked 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 Khadira (Catechu) wood. The use of this (compound), known as the Kshudranjana, as an Anjana (coilyrium) would be attended with good results. Harenu, Pippali- seeds (without pericarps), Ela and the liver (of a goat, etc.) should be pasted with the Rasa of cow-dung. Used as an Anjana, it would prove efficacious in a case of Kapha-affected vision (Shleshma-Vidagdha-Drishti). 12-14.

The liver of a Godha (a kind of wild lizard) should be partially opened and stuffed with Pippali and roasted in fire (having been coated with clay). The use of the compound^[9] for only once^[10] as an Anjana (with honey)  would be found to be highly beneficial in cases of night-blindness. Similarly a single application of an Anjana made of a goat’s liver stuffed with Pippali^[11] 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), Shimbi (D. R.—Shamkha—conch-shell), Kataka, Anjana (Rasanjana), Manah-shila, the two kinds of Nisha, pasted together with the juice of the liver^[12] (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 Vataja type (of any of these six affections) purging should he induced with castor oil taken through the vehicle of milk. Administration of Traiphala-Grhrita is also recommended for purgative purposes, especially in the Pittaja blood-origined types. Purging with (clarified butter duly cooked with) Trivrìt should be induced in types having their origin in the deranged Kapha, while oil duly cooked with Trivrit should be administered (for the purpose) in cases of affections having their origin in the concerted action of all the three deranged Doshas. The use in any shape of old and matured clarified butter, kept in an iron vessel, proves beneficial in cases of Timira of any type. Clarified butter cooked with (the Kalka and decoction) of Triphala or Mesha-shringi always proves efficacious in Timira of any type. The patient should be made to lick a compound of powdered Triphala with a copious quantity of clarified butter in cases of Pittaja 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^[13] alone is beneficial in the Pittaja type; similarly clarified butter prepared by churning the milk of a ewe or a she-goat and cooked with the admixture of the drugs of the Madhura (Kakolyadi) group would prove beneficial in the Pittaja type of Timira. Oil cooked with the drugs of the Sthiradi (Vidari-gandhadi) or the Madhura group^[14] as well as the Anu-taila (see Chapter V, Chikitsita Sthana), might be prescribed with the greatest advantage in the types of the disease due respectively to the action of the deranged Vayu and vitiated blood of the system. A medicated oil duly cooked with an admixture of Saha, Ashva-gandha, Ati-vala, Shatavari, Trivrit and the three fatty substances, Ghrita, lard and marrow, mentioned before (in connection with the treatment of Maha-Vata-Vyadhi, Chapter VI, Chikitsita Sthana) might be advantageously employed as an errhine in cases of Vataja Timira. Butter churned out of the milk duly cooked with the flesh of any 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, Saindhava salt, honey and clarified butter should be prepared and applied (to the affected eye) in the manner of Puta-paka (see next Chapter). The lard of vultures, snakes and cocks and Yashti-madhu should be pasted together (with honey) and applied (to the affected organ) in the manner of an Anjana (eye-salve)^[15]. 24.

Antidotes:—

Srotonjana should be successively soaked in meat-juice,^[16] milk and clarified butter in the manner of Bhavana saturation and used as a Pratyanjana^[17] (in cases of Vataja Timira unattended with redness). In cases of Vataja Timira attended with redness of the eye, however, the Srotonjana should be placed inside the blades of Kusha grass and preserved for a month inside the mouth of a (dead) black cobra. Then it should be taken out and mixed with Saindhava salt and the burnt ashes of Malati (Jati) flowers. It should then be applied as an Anjana to the affected organ. As an alternative, Srotonjana should be soaked in milk for three successive days and 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:—

Clarified butter skimmed from milk (and not from curd) and duly cooked with the drugs of the Madhura (Kakolyadi) group^[18] 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 Kakolyadi group should be used in the manner of Puta-paka in the Pittaja type of Kacha. A Kshudranjana composed of Rasanjana, sugar, honey Manah-shila, and Yashti-madhu may likewise be applied. The use of an Anjana composed of Rasanjana and Tutthaka taken in equal parts and finely pounded, is also recommended by experts^[19] in such cases. Powdered Tutthaka soaked in the decoction of Bhillota and the drugs of the Eladi-gana would be used as a Pratyanjana, and would be found beneficial in such cases. The use (as an Anjana) of Mesha-shringi and Srotonjana 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 Palasha, Rohita and Madhuka (flower) mixed with honey and the surface layer of wine (taken in equal parts) should be prepared (in the manner of Rasa-kriya and applied as an eye-salve in this type). 26–27. Treatment of Kaphaja Type:—The drugs known as Ushira, Rodhra, Triphala and Priyangu 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, Patha, Kinihi and Ingudi -bark would also prove beneficial in the Kaphaja type of cataract (Timira). The affected part should be likewise lubricated with the medicated Ghrita duly cooked with the decoction of Vanaspati (the milk-exuding trees, e. g., those of the species of Indian holy fig) with pasted Haridra and Ushira (as Kalka). The essence of the meat of Jangala (forest) animals, mixed with Pippali and profusely saturated with Saindhava and honey, should be prepared in the manner of Puta-paka (and applied to the affected part). Manah-shila Trikatu, Saindhava, Makshika (honey), Shamkha, Kasisa and Rasanjana should be combinedly used for the purposes of Rasa-kriya (in the type under discussion). Kasisa, Rasanjana, Guda (old and matured treacle) and Nagara, may be likewise used with benefit. 28.

Treatment of Tri-doshaja Kacha:—

Anjana (Antimony) many times heated and (subsequently) soaked in the decoction of Triphala prepared with (the 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 (currentless) water. The Anjana thus prepared may be used with advantage, in combination with Madhuka (Yashti-madhu) and the flowers of Mesha-shringi in the Tri-doshaja types of Kacha. As an alternative, all the measures and remedies (e.g., Tarpana, Puta-paka, etc.)^[20] applicable in all the three Doshas should be employed in such cases. 29.

Treatment of blood origined Parimlayi:—

Measures and remedies mentioned in connection with the Pittaja type of Timira should be employed in a case of blood-origined Parimlayi. In the alternative, the remedial agents prescribed for the treatment of the different kinds of Ophthalmia (Abhi-shyanda) should be as well prescribed according to the nature of the deranged Doshas involved in the case. In case the deranged Doshas are not thereby subdued, Nasyas of the proper drug, as well as the many other Anjanas (collyrium) mentioned in the (next) Chapter on Kriya-kalpa should be employed. 30.

Diet:—

A person carefully partaking of old and matured clarified butter, Triphala, Shatavari, Patola, Mudga, Amalaka, Yava (barley) as diet enjoys immunity from all attacks of the dreadful Timira. Simply the Payasa^[21] prepared with Shatavari, or with Amalaka or a meal of barley corns cooked with the decoction of Triphala and a copious quantity of clarified butter would remove (an attack of) Timira. The use of such edibles as Jivanti, Sunishannaka, Tanduliyaka, Vastuka, Chilli, Mulaka as well as meat of birds (such as Lava, etc.) and Jangala animals (e g. deer, etc.) should be considered as invigorating to eye-sight. The use of the leaves or fruit (as the case may be) of Patola, Karkotaka, Karavella, Vartaku, Tarkari, Karira (tender bamboo plants), Shigru 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 (Sadhya). The case in which the eye assumes a bright red hue and the second coat or Patala of the organ is the seat of the disease, may be regarded as a curable one though only with the greaterst difficulty (Kricchra-Sadhya). The case in which the third coat or Patala of the organ is the seat of the disease (characterised by the redness of its outer coat) should be regarded 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). 33.

Surgical treatment of Kaphaja Linga-nasha:—

Now we shall describe the (surgical) measures to be employed for curing a case of Linga-nasha (obstruction or choking up at the pupil with a cataract) due to the action of the deranged Kapha. In cases where the deranged Dosha in the organ, i.e., the affected part of the organ does not appear semicircular 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 water 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^[22] 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 presumed from the characteristic report or sound and the emission of a drop of water^[23] from the affected region, following upon the perforation. 34–35.

Instantly with the perforation the affected organ should be sprinkled over with breast-milk. The Shalaka 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 Shalaka. The mucus or phlegm (Kapha) accumulated in the affected eye should be removed by asking the patient to snuff it off by closing the nostril on the other side of the operated eyeball. 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 Shalaka (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^[24] 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-sthana). 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 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^[25] should not be subjected to any surgical operation, in cases of Nilika except at the place mentioned before (viz. the natural aperture—Daiva-krita Cidra). 37.

Symptoms and treatment of the disorders resulting from an injudicious operation:—

If the incidental hemorrhage (from a puncture in a wrong place) fill in the cavity of the eye, in that case the eye should be beneficially sprinkled over with clarified butter duly cooked with Yashti-madhu and breast-milk. An incision (puncture) close to the exterior corner (Apanga) of the eye would usher in swelling, pain, lachrymation and redness of the eye, which should be remedied by poulticing (Upanaha) the part between the arches of the eye-brows, and sprinkling (Secana) 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, purgative 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 seat of affection. Excessive lachrymation sets in 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 applications of Anuvasana enema should be considered as remedies in cases of redness, lachrymation, pain, numbness and bristling (of the eye-lashes) in the eye, as the result of an excessive and improper handling of the instrument during the operation. 37–38.

If removed in its acute stage (in a case of Linga-nasha) the Dosha is liable to have an upward course and produce relapse in the red-coloured specks or films (opacity) in the Shukra (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 Madhura-gana, and in the application of the same in the manner of Shiro-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 Shalaka (rod). 39–40.

Causes Of Relapse:—

A relapse of the deranged Dosha is caused by a blow on the head, physical exercise, sexual excesses, vomiting, epileptic fits, or by an act of piercing the Linga-nasha (cataract) during its partially developed (D. R. immature) stage. 41.

Symptoms produced by the defects Of the Shalaka:—

Care should be taken not to remove the cataract with a roughly shaped Shalaka (rod) as it might usher in an acute and aching pain in the affected organ. A rod with an unsmooth body might lead to an aggravation of the deranged Doshas. A thick-topped rod would necessarily 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 irregular top or mouth, whereas its unsteadiness (in the course of the operation) makes the operation an abortive one, Hence a Shalaka (rod) should be constructed and used for the purpose in such a manner as to preclude the possibility of the foregoing defects and injuries. 42,

Description of the Shalaka:—

The Shalaka (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 (Shalaka) 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, hoglike eye (Shukarakshita)^[26] and ophthalmia etc. 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, Shariva, Durua, and barley pasted with milk^[27] and clarified butter, should be applied lukewarm (about the eyes) for the subsidence of pain and redness. A plaster (Lepa) prepared of Siddharthaka (white mustard seeds) and slightly fried sesamum seeds pasted with the expressed juice of Matulunga, or one prepared of Payasya (Kshira-kakoli), Sanva, Patra, Manjishtha and Yashti-madhu 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 Daru, Padmaka, and Shunthi, prepared and used in the same way is likewise recommended for the purpose. A plaster of Draksha, Yashti-madhu, Kushtha and Saindhava should be likewise used. Cow’s milk cooked with Saindhava should also be used for the alleviation of pain and redness of the eye. Clarified butter duly cooked with the admixture of Shatavari, Prithak-parni, Musta, 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 Kakolyadi group with a quantity of milk four times the weight of the clarified butter, previously cooked with the drugs of the Vayu-subduing (Bhadra - darvadi) 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 (applications) 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 produce any effect. 45-46.

Eye sight-invigorating Anjana:—

Now hear me describe two beneficial recipes of Anjana which would invigorate the eye-sight and impart a clearness of vision. Flowers of Mesha-Shringi, Shirisha, Dhava and of Malati 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, Samudra-phena, Manah-shila and Marica 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 seventeenth chapter in the Uttara-Tantra of the Sushruta-Samhita which treats of the curative measures of the diseases of the Drishti (pupil).

Footnotes and references:

[1]:

See Chapter X, 9, Uttara-Tantra.

[2]:

Traiphala-Ghrita, Traivrita-Ghrita and Tailvaka-Ghritā should be prepared with both the decoction and Kalka of Triphalā, Trivrita and of Tilvaka respectively.

[3]:

Chakradatta does not read ‘Gairika’ in the list.

[4]:

In place of “gośakṛt” some read “goyakṛt” i.e., the liver of a “go” which may mean a cow or any animal, such as goat, sheep, etc.

[5]:

According to Dallana, Rasa (lit:—Juice) means the juice of Āmalaka. According to others, however, it means the juice of the leaves of Jāti flower. Chakradatta, however, reads “ghṛt” (clarified butter) in place of “rasa”.

[6]:

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

[7]:

Dallana’s reading is evidently ‘goyakṛtrasa’ which he explains as meaning the juice or serum of the liver of a goat, &c.

[8]:

The text has “gosūtrapitta” | The term “go” which literally means a cow, here stands for any female quadruped, such as a she-goat, etc.

[9]:

According to Dallana the Pippali so roasted should be used with honey as an Anjana.

[10]:

Both Vrinda and Chakradatta read ‘yakṛt’ in place of ‘sakṛt’ and the commentators of both of them say that the sentence means—the liver should be taken internally and the Pippali should be used as an Anjana. The commentator of Vrinda further says that the practice is to Use both of them together as an Anjana.

[11]:

Both Vāgbhata and Dallana plainly say that the roasted Pippali only should be used with honey as an Anjana in cases of night-blindness.

[12]:

There is a confusion in the reading of this couplet. In place of “yakṛdrase” i.e., pasted with the juice of the liver (of a cow or any other animal), Chakradatta reads “gavāṃ yakṛt” i.e., to say—the liver of a cow (and of no other animal) should be taken. Vrinda, however, reads and his commentator accepts the reading “agavāṃ yakṛt” (the liver of an animal other than a cow); but this reading is objectionable on the ground of a faulty construction. “śakṛdrase” i.e., pasted in the watery secretions of cow-dung, is yet another variant noticed by both the commentators of Vrinda and of Chakradatta.

[13]:

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

[14]:

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 Vrincla 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 Suśruta Samhitā.

[15]:

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.

[16]:

Flesh of those animals which give strength to the sight should be used in the preparation of meat-juice.

[17]:

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

[18]:

According to some commentators the milk should be first cooked with the drugs of the Madhura group, and butter should then be churned out of that milk.

[19]:

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

[20]:

According to some, the measures and remedies to be applied in such cases are the measures of Rasa-kriyā applicable in cases of Vātaja, Pittaja and Kaphaja Timira.

[21]:

The Pāyasa of Śatāvari and Āmalaki should be prepared by duly cooking Śatāvari or Āmalaki, as the case may be, with milk and sugar. According to others, however, it means the gruel (Yavāgu) prepared with the expressed juice of Śatāvari or Āmalaki.

[22]:

Both Śrikantha Datta and Śivadāsa, the commentators respectively of Vrinda and Chakradatta, read ‘śalākayā tāmramayyā’ meaning that the Śalākā (rod) should be made of copper.

[23]:

Blood would come out if the perforation be notsatisfactorily done.

[24]:

The period during which these rules should be followed is ‘seven days’ according to Vāgbhata. But according to Dallana it is only the period during which the operation lasts.

[25]:

Śārira-Sthāna, Chapter VII.

[26]:

Both Virinda and Chakradatta reads “Kekarākshitā” i.e., a squinting look.

[27]:

Vrinda and Chakradatta following Vāgbhata do not read “Payas” (milk) and they read the first line of this couplet in a different form.