Chapter IX - The medical treatment of cutaneous affections

Now we shall discourse on the medical treatment of cutaneous affections in general (Kushtha). 1.

A cutaneous disease (Twag-dosha) originates through injudicious conduct of life such as, partaking of large quantities of unwholesome food, or taking it before the previously eaten one is digested (i. e., eating too often), indulgence in incompatible articles of fare, voluntary suppression of the natural urgings of the body, and improper application of medicated oil, clarified butter, or other lardacious articles. It is attributed even to the dynamics of sinful acts done by a man in this or in some prior existence. 2.

Conduct of diet and regimen:—

A person afflicted with any kind of skin disease should refrain from taking meat, lard, milk, curd, oil, Kulattha pulse, Masha pulse, Nishpava, preparations and modifications of sugarcane juice, acid substances, incompatible food, meals taken before the complete digestion of the preceding one, unwholesome and indigestible food, or food causing a burning sensation and some kind of internal secretion, day-sleep and sexual intercourse. 3.

Regulation of diet and conduct:—

The old and matured grain of Shali, Shashtika, barley, wheat, Koradusha, Shyamaka, Uddalaka, etc., boiled and taken along with the soup (Supa) or a decoction^[1] (Yusha) of either Mudga pulse or Adhaki pulse mixed with Nimba leaves and Arushkara are wholesome in a case of Kushtha. Preparations of any of the aforesaid grains may be taken with Manduka-parni, Avalguja, Atarushaka and Rupika flowers cooked in mustard oil or clarified butter, or with the soup prepared of the articles of the Tikta-varga (bitter group, mentioned in the Sutra- sthana). The cooked flesh of Jangala animals, devoid of all fatty matter, should be given to a patient, habituated to the use of meat diet. The medicated oil, known as the Vajraka-Taila should be used for anointing the body. A decoction of the drugs of the Aragvadhadi group should be used for rubbing (Utsadana) purposes. Decoctions of Khadira should be employed in drinks, baths, washes, etc. The preceding rules are intended to regulate the diet and regimen of one suffering from Kushtha (cutaneous affections). 4.

Preliminary Treatment:—

In the premonitary stages of the disease the system should be cleansed by the application of both emetics and purgatives. When the disease is found to invade the Tvak^[2] only, a plaster prepared of the purifying drugs should be applied to the affected parts; blood-letting and the use of medicinal decoctions and purifying and disinfecting plasters are the remedies to be employed when the disease would appear to infect the blood. The same remedies and Arishta, Mantha, Prasha, etc, should be employed when the disease would be found to have invaded the principle of the Mamsa (muscles). Palliation and temporary respite are the only cure that can be offered in a case of the sin-begotten type^[3] of the disease which is the fourth (in order of enumeration) and that even is purely contingent on the willingness and capacity of the patient to conform to a strict regimen of diet, conduct and dress. Blood-letting and purifying measures (emetics and purgatives) should be resorted to in such a case and then the special medicinal remedies prepared from Bhallataka^[4], Shilajatu, Guggulu, Aguru, Tuvaraka, Khadira, and Asana and the Ayaskriti should be used in accordance with the prescribed rules. The disease in its fifth form (is found to invade the bones and) should be given up as incurable. 3–6.

??^[5]??

Treatments of Doshaja Types:—

In the first stage of Kushtha, the patient should be treated in accordance with the prescribed maxims (rules) of Sneha-pana. In a case of Vataja-Kushtha, o il or clarified butter, cooked with (a decoction and Kalka of) Mesha-shringi, Shvadamshtra, Shamgashta, Guduci and the drugs included in the group of Dashamula should be used as drink and ointment. In cases of the Pittaja type, the patient should be made to drink (a potion consisting of) clarified butter prepared with (a decoction and Kalka of) Dhava, Ashvakarna, Kakubha, Palasha, Pichu-mardha, Parpataka, Madhuka, Rodhra and Samanga. In the Kaphaja type, clarified butter cooked with (a decoction and Kalka of) Piyala, Shala, Aragvadka, Nimba, Saptaparna, Citraka, Marica, Vaca and Kushtha should be prescribed. The clarified butter cooked with (a Kalka and a decoction of) Bhallataka, Abhaya and Vidanga, or (the medicinal oils known as) the Tuvaraka Taila and the Bhallataka Taila should be used in all types of Kushtha. 7–8.

The Maha-tikta Ghrita:—

A paste or Kalka should be made by pounding equal parts of Saptaparna, Aragvadha, Ativisha, Patha, Katu-rohini, Amrita, Triphala, Patola, Pichu-marda, Parpataka, Duralabha, Trayamana, Musta, Chandana, Padmaka, Haridra, Upakulya, Vishala, Murva, Shatavari, Shariva, Indra-yava, Atarushaka, Shadgrantha (vaca), Madhuka, Bhu-nimba and Grishtika^[6]. This paste (Kalka) should be cooked with four times its own weight of clarified butter, with the juice of Amalaka, weighing twice as much as the clarified butter and with water weighing four times the quantity of the Amalaka juice. It should be constantly stirred (with a ladle), while being cooked. This medicated Ghrita is called the Maha-tikta Ghrita, which proves curative in Kushtha, chronic fevers, hemorrhage, heart-disease, insanity, Apasmara, Gulma, postular eruptions, menorrhagia, goitre, scrofula, elephantiasis, jaundice, erysipelas, impotency, itches and Pama, etc. 9.

The Tikta-Sarpih:—

Two Pala weight of each of the following drugs, viz., Triphala, Patola, Pichu- marda, Atarushaka, Katu-rohini. Duralabha, Trayamana and Parpataka^[7] should be taken and boiled together in a Drona measure of water. The boiling should be continued till it is reduced to one fourth of its original quantity. Then half a Pala weight of each of the following drugs, viz., Trayamana, Musta, Indra-yava, (red) Chandana, Kirata and Pippali should be pasted together. This pasted Kalka and the decoction should be cooked with a Prastha measure of clarified butter. The medicated Ghrita thus prepared is called the Tikta-Sarpih. Diseases such as Kushtha, chronic fever, Gulma, Hemorrhoids, Grahani, edema, jaundice, erysipelas and impotency readily yield to the curative efficacy of this Ghrita. 10.

Medicinal Plasters for Kushtha:—

Having first soothed the patient with any of the preceding medicated clarified butters and having his body fomented, the surgeon should have recourse to the venisection. One, two, three, four, or five s'iras (veins) of the patient may be opened (according to the circumtances). The raised or elevated patches on the skin should be scraped off, or should be kept constantly covered with a medicinal plaster. As an alternative, the characteristic patches of the disease should be first rubbed with the substance known as the Samudra-phena or with the leaves of Shaka, Goji_y or Kakodumbara and a plaster (Lepa) composed of Laksha, Sarja-rasa, Rasanjana, Prapunnada, Avalguja, Tejovati and the roots of Ashva-maraka, Arka, Kutaja, and Arevata, pasted with the urine or bile of a cow, should be applied to them; or Svarjika, sulphate of copper, sulphate of iron, Vidanga, Agara-dhuma, Citraka, Katuka, Sudha, turmeric and Saindhava pounded together with the urine or bile of a cow should be applied to the diseased localities.

As an alternative, the alkali, prepared from the ashes of Palasha wood in the prescribed manner, should be boiled with the powders of the preceding drugs; it should be removed from the oven after reducing it to the thickness or consistency of a Phanita and used in plastering (the diseased patches); or a plaster composed of Jyotishka fruits, Laksha, Marica, Pippali and the leaves of the Jati flower pasted together; or a plaster composed of yellow orpiment, Manah-shila, the milky juice of Arka, sesamum, Shigru and Manca, pasted together; or a plaster composed of Svarjika, Kushtha, sulphate of copper, Kutaja, citraka, Vidanga, Manca and Manah-shila pasted together; or a plaster of Haritaki, Karanjika, Vidanga, white mustard seeds, rock-salt, Gorocana, Somaraji and Haridra pasted together should be applied to the diseased localities.

Metrical Text:—

The preceding seven medicinal plasters are possessed of the virtue of destroying or curing Kushtha in general. Now hear me deal with the remedies to be specifically employed in cases of ringworm (Dadru) and leucoderma (Svitra). 11.

Treatment of Dadru:—

A plaster composed of Kushtha, mustard seeds, Shri-niketa, Haridra, Trikatu and the seeds of Chakra-marda and of Mulaka pasted together with Takra (butter milk?) should be applied to the ringworm. The disease is found to readily yield to the curative efficacy of a medicinal plaster, composed of Saindhava, Chakra-marda seeds, treacle, Keshara (Vakula), and Tarksha-shaila (Rasanjana) pasted together with expressed Kapittha juice. Preparations of Hema- kshiri, Vyadhi-ghata (Aragvadha), Shirisha, Nimba, Sarja, Vatsaka and Aja-karna (a species of Sarja) should be used in cases of ringworm of a virulent type for baths (D. R. Drinks),^[8] plasters and rubbing. 12.

Treatment of Shvitra:—

In cases of Shvitra and Pundarika, the patient should be made to drink a lukewarm decoction prepared with equal parts of the roots of Bhadra (Udumbara) and Malapu. The use of this potion would produce blisters on the patches. These blisters should be treated, after their bursting,with a plaster (Pralepa) composed of the ashes of the burnt skin of leopards and elephants and made into a thin paste with (mustard) oil. A plaster composed of the insect known as the Puti and the Kshara (alkali) of Aragvadha should be found to be the best remedy for Svitra. 13.

All kinds of Svitra are found to readily yield to the application of a medicinal plaster made of the black ashes of a well-burnt cobra (Krishna-Sarpa) pasted with the oil of Vibhitaka. The white ashes of the said cobra mixed with one andahalf time of its own weight of water should be filtered seven times in the manner of preparing an alkali. Mustard oil^[9] should be cooked with this alkaline water weighing four times as much. An application of this oil proves curative in cases of Svitra. 14.

The Prapunnada seeds. Kushtha and Yashti-madhu should be pasted together with clarified butter. The plaster thus prepared should be given to a domestic white cock, purposely kept without food for a day and a half when it would evince any sign of hunger after the period. The dung of the said cock should then be collected after a full digestion of the said medicated drugs and applied as plasters on the affected patches for a month. It would bring about the cure (even) of internal^[10] Shvitras. 15.

Well burnt ashes of the dung of an elephant^[11], mixed with elephant’s urine, should be filtered several times (twenty-one times or seven times) after the manner of an alkaline preparation. A Drona measure of this alkaline solution should be boiled with the seeds of the Somaraji weighing a tenth part thereof. This compound should be taken down from the oven as soon as it assumes a glossy hue and should then be made into boluses. Having rubbed the diseased patches of Shvitra, a plaster of these boluses should be applied to them which would soon assume a healthy and natural complexion. 16.

The leaves and bark (Dala tvaca) of the amra (mango) and the Haritaki^[12] should be well soaked in a decoction of the same drugs (after the manner of a Bhavana-saturation) and made into Vartis (i.e., plugs). These Vartis should again be well soaked in the milky exudation of the Vata tree and lighted (with mustard oil) in a copper vessel used as an Indian lamp. The lamp black, thus produced, should be collected and well soaked in a decoction of Haritaki. Kilasa (a particular kind of Kushtha) is destroyed, if rubbed with this preparation for several times after having been lubricated with mustard oil.^[13] 17.

A case of leucoderma would (undoubtedly) yield to the curative virtue of a medicinal plaster composed of Somaraji seeds, Makshika, Kakodumbara, Laksha, powdered iron, Pippali and Rasanjana, taken in equal parts and black sesamum equal to their combined weight, pasted with the bile of a cow and applied to the diseased patches. Similarly, a case of Shvitra would prove amenable to the application of peacock’s bile, or of burnt Hrivera mixed with the said bile. 18.

Various types of Shvitra are cured with the application of either of the two following medicinal plasters. The first consists of Tuttha (sulphate of copper), Haritala (yellow oxide of arsenic), Katuka, Trikatu, Simha (Rakta- Shobhanjana), Arka, Karavira, Kushtha, Avalguja, Bhallataka, Kshirini, mustard seeds and Snuhi; and the second consists of the leaves of the Tilvaka, Arishta (Nimba), Pilu and Aragvadha pasted together with the seeds of the Vidanga and Karavira and Haridra, Daruharidra, Vrihati and Kantakari. 19.

Nila-Ghrita:—

Vayasi, Phalgu and Tikta each weighing one hundred Palas, two Prastha measures of powdered iron, three Adhaka (eight seers) measures of Triphala and two Adhaka measures of Asana should be boiled together with three Drona measures of water. This decoction should be taken down when reduced to one quarter of its original measure and cooked again with a quantity of clarified butter (weighing a quarter part of the former (decoction) and with a Kalka consisting of Indra-yava, Trikatu, Tvak, Deva-daru, Aragvadha, Paravata-padi, Danti, Vakuci, Kesharahva (Vakula) and Kantakari. The patient should be made to drink this medicated clarified butter when the disease would be found to have attacked the Dhatus (fundamental principles of the organism), or to have become involved in the aggravated Doshas of the system. The diseased patches should be rubbed with it, in the event of the affection being found to be confined to the Tvak (skin) alone. Even the type of Kushtha, commonly held to be incurable, has been found to prove amenable to the use of this medicated clarified butter, which is known as the Nila-Ghrita. 20.

Maha-Nila-Ghrita:—

A Tula^[14] weight of the drugs known as Triphala, Tvak, Trikatu, Surasa, Madayantika, Vayasi and Aragvadha and ten Pala weights of each of the drugs known as Kakamachi, Arka, Varuna, Danti, Kutaja, Citraka, Daru-haridra and Kantakari should be boiled together with three Drona measures of water. This decoction, boiled down or reduced to six Prastha measures, should be again boiled with the watery secretion of cowdung, cow’s urine, milk, curd and clarified butter, each weighing an Adhaka, and with the Kalka (weighing one-fourth as much of clarified butter) of Bhu-nimha, Trikatu, Citraka, Karanja- fruit, Nilika, Shyatna, Avalguja, Pilu, Nilini and Nimba -flowers. It is a curative for Kushtha. The rubbing of the diseased patches with this Ghrita imparts a healthy and natural colour to the skin in cases of Svitra or white leprosy. It also cures diseases like fistula-in-ano, worms in the intestines and Arshas. It is known as the Maha-Nila-Ghrita.^[15] 21.

A compound consisting of cow’s urine, Citraka, Trikatu and honey should be kept for a fortnight in a closed earthen pitcher which formerly contained clarified butter. A Svitra-patient would do well to take this medicine after this period. He should also observe the rules of diet and regimen of a Kushtha-patient. The application of a Lepa (medicinal plaster), prepared by pasting the tender twigs of the Putika, Arka, Snuhi, Aragyadha and of the Jati flower with cow’s urine, would prove curative in cases of Svitra, ringworm, ulcer, bad types of hemorrhoids and sinus. 22–23.

In case the foregoing medicinal remedies prove ineffective, the patient should be duly bled for the purpose of letting out the vitiated blood from the system, and after sufficiently recouping his strength (after blood-betting) his body should be anointed with clarified butter. Copious vomitings should be induced with the help of strong emetics and the patient should be treated subsequently with a judicious administration of purgatives (so as to remove the aggravated Doshas from the system). The aggravated Doshas of the body, not being fully expelled from the organism of a Kushtha-patient by means of the preceding emetic and purgative measures, tend to extend all over the organism and the disease in consequence thereof is sure to lapse into one of an incurable type. Hence the aggravated Doshas should be fully eliminated from the organism. 24–25.

Emetics should be administered to a Kushtha-patient once a fortnight and Sramsana (purgatives) once a month. He should be bled twice a year though not profusely and medicated snuffs should be administered to him every fourth day. 26.

Internal application of Haritaki, Trikatu and treacle (prepared from the juice of the sugarcane) mixed with oil would lead to the early recovery of a case of Kushtha.

As an alternative, he should use a lambative medicinal compound of Amalaka, Aksha, Pippali and Vidanga mixed with honey and clarified butter. Or he should take a Pala weight of Haridra with an adequate quantity of cow’s urine every day for a month in order to get free from Kushtha; or the same quantity of the fine powder of Pippali or of Citraka should be given to him through the same vehicle and for the same period which would cure him of Kushtha. The same quantity of the fine powder of Rasanjana should be given through the said vehicle and in the same manner for a period of one month and the same should also be repeatedly applied externally. 27–28.

The bark of Arishta (Nimba) and Sapta-parni, Laksha, Musta, Dasha-muli, Haridra, Daru-haridra, Manjishtha, Aksha, Vasaka, Deva daru, Pathya, Citraka Trikatu, Amalaki and Vidanga taken in equal parts and pounded together should be mixed with powdered Vidanga weighing as much as the total weight of the preceding drugs; the patient should be made to take a Pala weight of this pulverised compound every day (for a month), or he should be made to drink (in adequate doses) a Drona measure of medicated clarified butter, cooked with the powders of Triphala and Trikatu. As an alternative, Aksha-pida should be boiled in a Drona measure of cow’s^[16] urine. Clarified butter, cooked in this preparation may be used, as a remedy for Kushtha. An adequate quantity of old and matured clarified butter should be boiled with Aragvadha, Sapta-parna, Patola, Vrikshaka, Naktamala, Nimba, the two kinds of Haridra and Mushkaka. This medicated Ghrita, thus prepared, would lead to the destruction of Kushtha.^[17] 29-30.

Drugs such as Rodhra, Nimba, Padma-kashtha, Rakta - chandana, Sapta-parni, Aksha, Vrikshaka and Vijaka should be administered in the bath^[18] of the patient in the event of there being any burning sensation; or a potion consisting of honey and pasted Tri-bhandi (Trivrit) should be given to him. Old and matured Mudga, boiled in the decoction^[19] of Nimba and mixed with oil, should be given to the patient as drink where sloughing would be detected in the diseased localities. A decoction of Nimba or that of Arka, Alarka and Sapta-cchada should be given him if there be any worms in the diseased locality. The affected part of the body should be plastered over with the roots of the Ashva-ynara and Vidanga, pasted with cow’s urine, in the event of its being eaten away by the worms. Cow’s urine should be sprinkled over the diseased locality and all food (of the patient) should be given with the powders of Vidanga. 31-32.

As an alternative, the affected parts should be rubbed with the oil of Karanja, mustard, Shigru, or Koshamra, or with an oil (any one of the preceding oils) cooked with (a decoction of) pungent, bitter and heat- producing substances. Measures laid down under the head of Dushta-Vrana (malignant ulcer) should be resorted to in a case where the aforesaid remedies would fail to produce any beneficial effect. 33.

Vajraka-Taila:—

The roots of Sapta-parna, Karanja, Arka, Malati, Karavira, Snuhi, Shirisha, Citraka and asphota as well as of Visha (aconite root), Langala, Vajrakhya (mica), sulphate of iron, Haritala, Manah-shila Karanja-seeds, Trikatu, Triphala, the two kinds of Haridra, white mustard-seeds, Vidanga and Prapunnada should be pasted together with the urine of a cow. The paste thus prepared should be cooked in an adequate quantity of oil^[20] This oil known as the Vajraka-Taila, used as uguents, proves remedial to Kushtha etc., sinus and malignant ulcers in general. 34.

Maha-Vajraka Taila:—

The drugs and substances known as white mustard-seeds (Siddharthaka), the two kinds of Karanja, the two kinds of Haridra, Rasanjana, Kutaja, Prapunnada, Sapta-parna, Mrigadani Laksha, Sarja-rasa, Arka, Asphota, Aragvadha, Snuhi, Shirisha, Tuvara, Kutaja, Arushkara, Vaca, Kushtha, Vidanga, Manjishtha, Langali, Citraka, Malati, Katutumbi, Gandhahva, Mulaka, Saindhava, Karavira, Grihadhuma, Visha (aconite), Kampillaka, Sindura (mercuric oxide), Tejohva and sulphate of copper should be taken in equal parts and made into a paste. This paste (Kalka) should be cooked with either Karanja-oil or mustard-oil^[21], both of which have great curative potency, with double the quantity of cow’s urine. It may also be prepared with sesamum-oil, but in this case four times as much of cow’s urine should be taken. As an anointment it is undoubtedly efficacious in a case of Kushtha of whatsoever type as well as in cases of scrofula, fistula-in- ano, sinus and malignant ulcers. This oil is known by the name of Maha-Vajraka oil and is possessed of supreme and unquestionable efficacy. 35.

The drugs which constitute the Lakshadi group should be pasted with an adequate quantity of cow’s urine and cooked^[22] with sesamum-oil and mixed with Pitta cow’s bile). The oil, thus prepared, should be preserved for a week inside the body of a Katukálávu. The oil should be taken out (after this period) and the patient should use it both internally and externally (in an adequate quantity). After doing this, he should expose himself to the heat of the sun whereby all the Doshas would be eliminated from his organism. After the complete elimination of the Doshas from the system, the patient should be removed from the sun and bathed with a decoction^[23] of Khadira, and a gruel, prepared with the decoction of Khadira, should be given him as diet. Similarly, oil or clarified butter boiled and prepared with the drugs constituting the Samshodhana group (mentioned in chap, xxxix, Sutra.) or with the drugs possessing anti-Kushtha properties should be used as hot plasters and rubbings (in the diseased localities) Purgatives should be administered every morning with good results. The preceding remedies should be taken and continued for five, six, seven, or eight days, or till the Doshas of the system producing the disease are not perfectly eliminated. As an alternative, camel’s urine and after its full digestion, camel’s milk should be taken. Even parasitic types of Kushtha are sure to disappear within six months (under the course of this treatment). 36.

A Kushtha-patient desirous of being perfectly cured should constantly use preparations of Khadira in his drinks, food, bath, etc. Khadira, if properly used, is potent enough to curb the virulence of the disease in the same proportion as the latter is in invading the successive strata of the human organism and ultimately in bringing on the death of the patient. 37.

The paring of the nails and shaving the hair off, light physical exercise, the use of wholesome food, regularity in using medicines, abstinence from wine, women and meat-diet are the rules of conduct which should be strictly observed by a patient affected with Kushtha. With the strict observance of the above rules a Kushtha-patient may be expected to recover. 38.

 

Thus ends the ninth Chapter of the Chikitsita Sthana in the Sushruta Samhita which deals with the medical treatment of Kushtha.

Footnotes and references:

[1]:

An unsalted decoction of any substance not seasoned with any spices whatever is called Yusha, while the one salted and seasoned with spices is called Supa. In preparing the soup of any pulse, all husks should be carefully thrashed out and the grain should be slightly fried before boiling.

[2]:

Tvak here means Rasa or serum.

[3]:

The type of Kushtha affecting the principle of Medas (fat) is generally supposed to be sin-begotten.

[4]:

Oil should be used in a case of Kapha-predominance, whereas clarified butter in that of Pitta-predominance. Others assert that clarified butter should be used for drinking purposes and oil for anointments.

[5]:

Bhallataka-preparations have been described in the treatment of Arshas, preparations of Shilajatu, Guggulu, Aguru and Tuvaraka in the treatment of Prameha-pidaka, and Khadira, Asana and Ayaskriti preparations in the treatment of Maha-kushtha.

[6]:

Chakradatta does not read “Grishtika” but read “Ushira” instead. He also takes both the kinds of “Haridra,” of “Upakulya” (Pippali) and of “Sariva”.

[7]:

Chakradatta reads “Nisha” in addition to the above drugs.

[8]:

In drinks or baths, a decoction should be used and in plasters and rubbings the ingredients should be pasted with Takra and the expressed juice of Kapittha.

[9]:

This is the best medicine for curing Shvitra.

[10]:

The internal Shvitras are those under the blisters produced by the application of the remedy mentioned first in the list.

[11]:

Shivadasa, the commentator of Chakradatta, says that some read jalagaṇdaje in place gajalaṇdaje which case it would mean “Shamatha.”

[12]:

According to some, both the leaves and bark of the “amra” and of the “Haritaki” should be taken.

[13]:

The leaves and bark respectively of the Amra and the Haritaki should be taken in the preparation. The whole stanza seems to be of faulty construction. Dallana, in his commentary, says that some read the fourth line as

“tailena siktaṃ kaṭuna samastamalepayedevamupaiti shantim ||”

This seems to be a better reading. It removes the difficulty in the construction, but it omits also the word “Kilasa” from the text. This, however, is also an improvement, inasmuch as this preparation seems to be a remedy for Shvitra (which is only a variety of Kilasa) like the preceding and the following ones; and it seems unlikely that Sushruta would introduce a remedy for Kilasa in general in the special treatment of Shvitra.

[14]:

A Tula is equal to a hundred Palas or twelve seers and a half of our modern measure.

[15]:

Dallana, in his commentary, says that the two Ghritas (Nila and Maha-Nila) seem to be spurious (Anarsha). But he has included them in his commentary as Jejjata and Gayadasa have read and explained them before him.

[16]:

Cow’s urine and water in equal parts should be taken according to some commentators. Dallana, however, recommends cow’s urine only and no water.

[17]:

Dallana says that the authorship of this remedy should not be attributed to Sushruta, inasmuch as Jejjata does not mention it in his commentary.

[18]:

The drugs are to be boiled in water in which the patient should take his bath.

[19]:

The decoction should be prepared in the manner of “Shadanga-kalpa.”

[20]:

Shivadasa, the commentator on chakradatta, asserts, on the authority of Vagbhata, that the oil should be sesamum-oil and it should be boiled with cow’s urine.

[21]:

According to Gayadasa mustard-oil should be used.

[22]:

In cooking the oil, cow’s urine weighing four times of oil should be taken.—Dallana.

[23]:

The decoction of Khadira in the bath as well as in the preparation of the gruel should be prepared after the manner of Shadanga-Kalpa.—Dallana.