Chapter XX - The medical treatment of the minor ailments

Now we shall discourse on the medical treatment of the minor ailments or diseases (Kshudra-roga) 1.

Treatment of Aja-gallika:—

Leeches^[1] should be applied to the affected part in a case of non- suppurated Aj vgallika; it should be subsequently plastered with the alkalies (Kshara) of oyster-shells, Shrughni (Svarjika),^[2] and of Yava; as an alternative, it should be plastered with the paste compound (Kalka) of Shyama, Langalakì and Patha. When suppurated it should be treated in the manner of an ulcer (Vrana). 2

Treatment of Yava-prakhya, etc.:—

Fomentation (Sveda) should be the first remedy to be resorted to in cases of Antralaji, Yava-prakhya, Panasi, Kacchap i and Pashaua-gardabha (in their non-suppurated stages). They should then be plastered with the pastes (Kalka) of Manahshila, Haritala_} Kushtha and Deva-daru An incision should be made as soon as suppuration would set in; and the treatment should be similar to that of an ulcer. 3-4.

Treatment of Vivrita, etc.:—

The remedies mentioned in connection with the treatment of the Pittaja type of Erysipelas (Visarpa) should be employed in cases of Vivrita, Indra-vriddha, Gardabhi, Jala-gardabha, Irivelli, Kaksha, Gaudha- namui and Visphotaka. Clarified butter cooked with the drugs of the Madhura (Kakolyadi) group should be applied in healing up the ulcers in the suppurated stages. 5.

Treatment of Chipya, etc:—

In a case of Chipya, the affected part should be first washed^[3] with hot water and (the incarcerated pus, etc.) drained (Visrava) by cutting it away (with a knife). Then after anointing it with (the oil known as) the Chakra-taila it should be dusted over with the powders of Sarja (resin) and duly bandaged. If this process of treatment fail, the affected part should be cauterised with fire and an oil cooked with (a decoction of) the drugs of the Madhura (Kakolyadi) group should be applied to heal (the incidental ulcer). The same course of treatment should also be adopted in a case of Ku-nakha (bad nail). 6-7.

Treatment of Vidarika:—

In a case of Vidarika, the affected part should be first anointed (with oleaginous substances) and then fomented. It should then be rubbed (with the fingers); and a plaster composed of Naga-Vrittika, Varshabhu and Vilva- roots, well pasted together, should be applied to it. Purifying and disinfecting (Samshodhana) remedies should hi employed as soon as the affected part would be found to have been changed into the state of an ulcer (Vrana), and it should then be healed up with the application of an oil cooked with the decoction of (the drugs of the Kashaya (Nyagrodhadi) and Madhura (Kakolyadi) groups. In the non suppurated stage of Vidarika, the vitiated blood therein should be let out by means of Pracchana (scarification), or by applying leeches. The affected part should then be plastered with the roots of the Aja-karna and of the Palasa pasted together. A case of fully suppurated Vidarika should be lanced and plastered with a paste compound of Patola, Pichumarda and sesamum, mixed with clarified butter and should then be duly bandaged. The incidental ulcer should then be washed with a decoction (of the barks. of the Kshiri trees and Khadira. Healing remedies should be applied after it has been properly purified (disinfected) 8-9.

Treatment of Sharkararvuda, etc.:—

A case of Sharkararvuda should be treated like that of an Arvuda (tumour) of the fat-origined type. Cases of Kacchu, Vicharchik a and Pama should be treated in the manner of a Kushtha. A medicinal plaster composed of Siktha (wax), Shatahva and white mustard seeds, or of Vaca, Daru-haridra and mustard seeds, pasted together, should be applied (to the seat of the disease). As an alternative, Naktamala (Karanja) oil, or Sara-taila^[4] boiled with (the drugs of) the Katuka (Pippalyadi) group should be applied for anointing purposes. 10-11.

Treatment of Pada-dari:—

In a case of Pada-dari, the prescribed vein should be opened, and the affected part should be treated with fomentations and unguents.^[5] The affected part should be plastered with (an ointment composed of) wax, lard, marrow, powder of Sarja (resin),^[6] clarified butter, Yava-Kshara and Gairika. 12.

Treatment of Alasa and Kadara:—

In a case of Alasa, the legs should be sprinkled with Aranala (a kind of Kanjika); and a plaster composed of sesamum, Nimba leaves, sulphate of iron (Kasisa), Haritala and Saindhava, or of Haritaki pasted with the decoction of Laksha (Laksha-rasa)^[7] should be applied to the affected parts. Blood-letting should also be resorted to. As an alternative, mustard oil boiled with the expressed juice of Kantakari should be applied to them or the affected localities should be rubbed or chafed (Pratisarana) with a pulverised compound of sulphate of iron (Kasisa), Gorocana and Manah-shila. In a case of Kadara, the seat of the disease should be scraped off (with the aid of a knife) and cauterised with (the application of) heated oil^[8] 13-14.

Treatment of Indra-Iupta:—

In a case of Indra-Iupta (baldness or Alopecia), the bald part or seat should be anointed and fomented, and then bleeding (by venesection) should be resorted to, after which a plaster composed of Manah-shila, Kasisa, Tuttha and Marica, or of Kutannata and Deva-daru pasted together, should be applied to it. As an alternative, it should be deeply scraped and constantly kept covered with a paste of Gunja -seeds. As an alternative, Rasayana medicines should be administered for its cure. An oil cooked with Malati, Karavira, Citraka and Naktamala is highly efficacious in curing a case of Alopecia, if used as an unguent. 15.

Treatment of Arumshika:—

Blood-letting^[9] from the affected part should be first resorted to in a case of Arumshika; and it should then be affused with the decoction of Nimba Medicinal plasters prepared with the Rasa (?) (liquid) pressed from horse-dung, mixed with Saindhava, should be applied to it. As an alternative, it should be plastered with the paste compound (Kalka) of Haritala Haridra, Nimba and Patola, or with that of Yasthi- madhu, Nilotpala, Eranda, and Markava. 16.

Treatment of Darunaka, etc.:—

Anointment and fomentation of the diseased patches are the (preliminary, remedies in a case of Darunaka, after which bleeding should be effected by opening the vein in the forehead Remedial measures such as, Avapida-Sirovasti and Abhyanga (anointment) should be employed as well; and the affected parts should be washed with the alkaline solution of burnt Kodrava weeds. Measures for arresting the premature greyness of hair (Palita) will be described later on (in the Mishraka Chapter XXV). Curative plasters and remedies, etc, mentioned in connection with the treatment of Kushtha should be employed in cases of Masurika; or those, laid down under the treatment of Erysipelas (Visarpa) originated through the concerted action of the deranged Pitta and Kapha should as well be used. 17-19.

Treatment of Jatu-mani, etc.:—

The seats of affection should be scraped (with a knife) and gradually and judiciously cauterised^[10] by applying an alkali or fire in cases of Jatu mani (congenital moles), Mashaka and Tila-kalaka (freckles) An opening of the local veins in the temporal region, etc., should be effected in cases of Nyaccha, Vyanga and Nilika, in accordance with the prescribed rules. The affected parts should be rubbed (with Samudra-phena, etc.) and plastered with the barks of Kshiri trees,pasted with milk; or with Vala, Ati-vala, Yashtimadhu and Rajani, pasted together. As an alternative, plasters composed of Payasya, Aguru and Kaliya pasted together with Gairika, or of a tooth of a boar pasted with clarified butter and honey, or of Kapittha and Rajadana pasted together, may also be used with benefit 20 21.

Treatment of Yuvana-Pidaka, etc.:—

Emetics are specially efficacious in cases of Yuvana- pidaka (pimples) which disfigure the face in youth. The application of medicinal plasters composed of Vaca, Lodhra, Saindhava and (white mustard seeds or of Kustumburu, Vaca, Lodhra and Kushtha pasted together is also recommended. In a case of Padmini-Kantaka, a decoction of Nimba bark should be given as an emetic, and the patient should be made to drink a potion of clarified butter cooked with a decoction of Nimba and mixed with honey. A decoction^[11] of Nimba and Aragvadha should be used for chafing (Utsadana) the diseased locality. 22–23.

Treatment of Parivartika, etc.:—

In a case of Parivartika (retroflexion of the prepuce) the glans penis should be rubbed with clarified butter and duly fomented, and Salvana and such other Vayu- subduing plasters (Upanaha) should be applied for three or five days. Then having lubricated the part (with Ghrita), the glans penis should be gently pressed and the prepuce should be smoothly drawn over the glans penis, so as to cover it entirely within its fold. The prepuce, being so drawn, should be fomented with warm poultices. Vayu-subduing Vastis (Clysters) should be employed and emollient diet should be prescribed (during the course of the treatment). A case of Ava- patika should be similarly treated, after a due consideration of the nature and intensity of the Doshas involved in the case. 24-25.

Treatment of Niruddha-Prakasha:—

In a case of Niruddha-Prakasha (constriction or stricture of the urethra¹, a tube (open at both ends) made of iron, wood, or shellac should be lubricated with clarified butter and gently introduced into the urethra. The marrow or lard of a boar, or of a porpoise, or the Chakra-taila, mixed with Vayu-subduing drugs should be sprinkled over the affected part. Thicker and thicker tubes should be duly introduced into the urethra every third day. The passage should be made to dilate in the aforesaid manner, and emollient food should be given to the patient. As an alternative, an incision should be made (into the lower part of the penis), avoiding the sevani (raphe of the perineum), and it should be treated as an incidental ulcer Sadyo-vrana). 26.

Treatment of Sanniruddha-Guda, etc.:—

Cases of Sanniruddha-Guda (stricture of the anus), Valmika and Agni-Rohini should be duly treated with regard to the nature and intensity (of the Doshas engendering the disease, but without holding out any definite hope of recovery. The treatment of a case of Agni-Rohini should be like that of Visarpa (Erysipelas), while the remedial measures, mentioned in connection with Niruddha-prakasha, should be employed in a case of Sanniruddha-Guda. 27.

Treatment of Valmika:—

The diseased patches should be scraped off in a case of Valmika and cauterised with fire or with an alkali; while the purification and healing up (of the incidental ulcer) should be effected as in the treatment of an Arvuda (tumour). A case of Valmika appearing in any part of the body other than a Marma, and not of a considerable growth should be duly treated with venesection after the application of Samshodhana measures (purgative, emetic, etc.). The affected part should be plastered (Pralepa) with a medicinal compound composed of the roots of (Vana-) Kulattha, arevata, Danti and Shyama, pasted together with Guduci, rcck-salt, Palala (pastes of sesamum) and powdered barley. It should be poulticed (Upanaha) with the same compound, well mixed with clarified butter and made lukewarm (in case suppuration be desired). When found to be fully suppurated, the course of the pus-channels should be ascertained by an experienced surgeon. The ulcer should then be opened (with a knife) and cauterised, and after being fully purified of the putrid flesh (in its cavity), it should be again cauterised with an alkali. Healing (Ropana) remedies should be applied to it after it has been found to be thoroughly cleansed Nimba-oil cooked with Sumanas (Jati leaves, Granthi, Bhallataka, Manah shila, Kalanusari, small Ela, Aguru and red Chandana should be applied with advantage to heal up the (incidental ulcer in a case of) Valmika. A patient suffering from an attack of Valmika appearing either on his hands or feet and attended with swelling and a large number of cavities should be abandoned by a wise physician. 28.

Treatment of Ahi-putana, etc.:—

In the treatment of an infant laid up with an attack of Ahi putana the breast-milk of its mother or nurse should be first purified. Cases of Ahi-putana yield to the use of a potion of clarified butter, cooked with Triphala, Rasanjana and Patola leaves, and a decoction of Triphala, Kola and Khadira should be used (as a wash) to heal the ulcer. Plasters composed of sulphate of iron, Gorocana, sulphate of copper (Tuttha), Haritala and Rasan- jana, pasted together with Kanjika, or of Vadari bark and rock-salt, should be applied (to the diseased locality¹. It should be dusted as well with the pulverised compound of a burnt earthen pot and sulphate of copper. The preceding measures should be adopted in cases of Vrishana-Kacchu as well. 29–30.

Treatment of Guda-Bhramsha:—

In a case of Guda-Bhramsha, the protruded part should be fomented and lubricated with Sneha.^[12] It should then be gently re-introduced. The region of the anus should then be bandaged with apiece of hide in the manner of a Gophana Bandha, with an opening in it (lying immediately below the anus), so that it may not in any way interfere with the emission of Vayu. The affected part should then be constantly fomented. A quantity of milk, Maha-panca-mula and the body (flesh) of a mouse, bereft of its entrails should be first boiled together (with water). An oil cooked with the milk thus prepared (with water) and the Vayu-subduing drugs should be administered as drink and unguents. By these measures the most difficult cases of prolapsus ani would be cured. 31-32.

 

Thus ends the twentieth Chapter of the Chikitsita Sthana in the Sushruta Samhita which deals with the treatment of minor ailments.

Footnotes and references:

[1]:

Gayadasa explains that a non-suppurated Aja-gallika should be first plastered with Yava-kshara, oyster-shells and Saurashtri. Leeches should be next applied to it.

[2]:

Chakradatta reads “shuktisauraṣṭrakashara (?)” in place of “shuktishrughnīyavashara”, evidently, after the commentary of Gayadasa.

[3]:

Vrinda and Chakradatta prescribe fomentation (Sveda), and not washing, with hot water and they do not prescribe secretion (Visrava).

[4]:

By “Sara-taila” is meant the oil pressed from the Sara (essential parts) of Shimshapa, Aguru, Sarala, Deva-daru and such other trees. Some, however, read “Sarala-taila” in place of “Sara-taila.”—Dallana.

[5]:

According to Dallana and Shivadasa, fomentations and unguents should be first applied, and the vein should be next opened.

[6]:

Chakradatta also prescribes a similar remedy, but there he does pot read “Sarja” and “Gairika.”—Ed.

[7]:

Chakrapani reads “lakṣabhayarasalepaḥ” in place of “lakṣaraso'bhaya” Sivadasa explains as “lakṣaraso'bhaya vapi”—Ed.

[8]:

Chakradatta prescribes cauterisation with fire as well, in such 3 ease.—Ed.

[9]:

According to Chakradatta blood-letting should be resorted to in such cases only by means of venesection, or with leeches.

[10]:

The cauterisation should be effected with an alkali, when the disease is superficial and with fire when it is deep-seated.

[11]:

Chakrapani prescribes the powders (kalka) in place of the decoction (kvatha?) of Nimba and Aragvadha. He also reads “udvarttana” in place of “utsadana”, but here they mean the same thing. —Ed.

[12]:

According to Shiva-dasa, cow’s fat only should be used.