Sushruta Samhita, Volume 3/Chapter 12
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 (Raktábhishyanda-Pratishedha). 1.
General Treatment:— A wise physician shall pursue the same course of medical treatment in those four diseases known as Adhimantha, Abhishyanda, Śirotpáta and Śirá-harsha due to the vitiated condition of the blood. Persons suffering from any of the aforesaid four complaints should be first anointed and lubricated with old and matured clarified butter technically known as Kaumbha Ghrita*, or with a copious quantity of clarified butter. Venesection should then be resorted to. The patient, having been made thus to bleed as much as required, should be treated with clarified butter duly cooked with Śiro-virechana drugs and mixed with sugar, as an errhine for cleansing the head. Plasters, washes, snuffs (Nasya), inhalations (Dhuma) of medicated smokes, eye-drops (Aśchyotana). Abhyanjana†, Tarpana (soothing measures), Sncha-karma (emulsive measures) and Puta-pâka should then be prescribed according to the nature of the deranged Dosha involved in each case. 2-5.
A plaster (Pralepa) composed of Nilotpala, Uśira, Dáru-haridrá, Kâliya, Yashti-madhu, Musta, Lodhra and Padma-Kâshtha (taken in equal parts and) mixed with Ghrita — duly washed, should be applied round the region 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 Pittâbhishyanda, should be as well employed, 6-7.
Rain-water with powdered Kaśeru and Yashti-madhu added thereto may be squeezed with benefit through a piece of linen into the affected organ* as an Aschyotana. Flowers of Pátalá, Arjuna, S'riparni, Dhâtaki, Dhátri, Vilva, the two kinds of Vrihati, and of Vimbi-lota and Manjishthâ taken in equal parts and pasted together with honey or expressed juice of sugar-cane and applied to the affected organ as an Anjana (Collyrium) is said to be a curative in cases of Raktábhishyanda. 8-9.
A similar compound consisting of Chandana, Kumuda, Patra, S'ilá-jatu, Kumkuma, powders of dead iron and dead copper, Tuttha (Sulphate of copper), lead, bell-metal, Rasânjana and the resinous exudation of a Nimba tree taken in equal parts should be pasted with honey and made into large Vartis (sticks). These are always recommended to be applied to the affected eye as an Anjana. 10.
Treatment of Śirotpáta:— A compound consisting of honey and clarified butter and applied as an Anjana should be regarded as a patent cure in cases of Śirotpáta eye-disease. A compound composed of Saindhava (salt), Káśiśa (Sulphate of iron) and pasted together with breast-milk should be similarly used. The application as an Anjana of S'amkha (ccnch-shell), Manah-śilâ, Tuttha, Dáru-haridrá, and Saindhava pasted with honey, or of (white) Maricha pasted with the juice of S'irisha flowers, honey and wine, or of Svarna-Garika pasted with honey would be attended with beneficial results in cases of Sirotpáta. 11.
Śirá- harsha: — A compound consisting of phânita(treacle boiled down to a sticky consistency) and honey should be applied to the affected organ as an Anjana in a case of Sirá-harsha. Similar applications of compounds composed of Rasánjana (Antimony) pasted with honey, or of Saindhava and Káśiśa' (Sulphate of iron) pasted with honey, or of Vetrámla* and Saindhava pasted with Phánita and breast-milk would likewise prove highly efficacious. 12.
Treatment Of Arjuna:— All the measures and remedies for Pittábhishyanda should be employed in cases of Arjuna eye-disease. The expressed juice of sugar-cane, honey, sugar, breast-milk, Dáru-haridra, Yashti-madhu and Saindhava should be used in combination as a wash (Seka), or as an Anjana. Amla(Kánjika, &c.) should also be used as an Áśchyotana (eye-drop) in such cases. The following drugs, viz., sugar, Yashti-madhu, Katvanga, Mastu, Amla, honey, Saindhava, Vija-puraka, Kola and Dádimba of acid taste and other acid fruits either singly or in combination of two or three should be judiciously used (as an Áśchyotana with a due consideration of the vitiated Dosha in each case). 13-14.
These two following compounds viz., of Sphatika (crystal), Vidruma (coral), S'amkha (conch-shell), and Yashti-madhu, pasted with honey, as well as of S'amkha, sugar, and Samudra-phena pasted with honey, if used as an Anjana would prove curative in a case of Arjuna eye-disease. Saindhava and Kataka pasted with honey, or Rasânjana pasted with honey, or Káśisa (Sulphate of iron) pasted with honey, should constantly be applied as an Anjana to the affected organ. 15.
Scarifying-Anjana:— All kinds of powdered (dead) metals (Gold, Silver, Iron, Copper, etc.) and metallic substances (Manah-s'ilá, Gairika, etc.), (the five officinal kinds of) salt, all kinds of gems ( Vaidurya, coral etc.), the teeth (of cows, horses, etc.), the horns (of cows, etc.), the drugs of the sedative (Avasádana) * group, pulverised shells of hen's eggs, Las'una (garlic), Trikatu, Karanja seeds and Elá (cardamom) mixed together and used as an Anjana, should be regarded as Scarifying (Lekhya) in their action. 16.
Treatment of ŚUkra:— In a case of non-ulcerated (A-vrana) Śukra (milky film or white fleshy growth in the eye) a skilful physician shall (first) adopt all the preceding measures prescribed in the treatment of (Blood-origined) Abhishyanda,† beginning with Rakta-visrávana (Venesection) and ending with Puta-pâka (and these failing, the Lekhyánjana —collyrium for scarifying) should be adopted. A case of ulcerated (Sa-vrana) Śukra whether superficial or deep-seated‡ or rough should be treated in the same manner. 17-18. In a case of Sukra the affected part should be rubbed (scarified) with a compound consisting of S'irisha-seeds, Maricha., Pippali and Saindhava pounded together, or with Saindhava alone, A compound composed of powdered copper, Manah-s'ila, Maricha and Saindhavaeach preceding drug being taken in a quantity double the one immediately succeeding it in the order of enumeration*, should be pounded together and made into a thin paste. Applied as an Anjana to the seat of the disease, it will cure a case of Sukra. As alternatives, the two compounds composed of S'amkha, stones of Kolas, Kataka, Drákshá, Yashti-madhu, Mákshika (honey), or of teeth (of cows, etc.), Samudra-phena and S'irisha flower and honey should be applied to the affected locality in the manner of applying an Anjana. The Ksháránjana (alkaline collyrium) mentioned in connection with the medical treatment of Valása-grathita,† may as well be profitably employed as an Anjana (eye-salve) in the present disorder. Eye-salves made of fried huskless Mudga pulse, (burnt) S'amkha and sugar mixed with honey, or of the pith of Madhuka pasted with honey, or of the inner pulps of the stones of Vibhitaka pasted with honey should be constantly used as an Anjana, in cases of the eye-disease known as Sukra. A compound consisting of conch-shell, oyster-shell, Drákshá, Yashti-madhu, Kataka and honey may be used and soothing application (Tarpana) antidotal to the deranged bodily Váyu, should be resorted to in cases of Śukra, if the second layer (Patala) of the eye is attended with pain (Śula). 19-21. Young bamboo-sprouts, Arushkara, Tála (palm) and Nárikela (cocoanut)* should be burnt to ashes and alkaline water should be duly prepared therewith. The burnt ashes of elephant's bones should be soaked several (seven) times with the above alkaline preparation in the manner of Bhávaná saturation. The application of this preparation in the manner of an Anjana tends to remove the discolouring nature (whiteness) of a case of Śukra †. 22.
Treatment of Ajaká:— The thin watery matter accumulated in the eye in a case of Ajaká 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-páka:— Applications 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-śopha and A-śopha Akshi-páka (inflammation of the eye-lid whether attended with any local swelling or otherwise). Venesection should then be resorted to. Eye-washes, eye-drops (Áśchyotana), errhines (Nasya) and Puta-páka measures should also be employed. 24.
After having cleansed the system of the patient both internally and externally the following compounds should be used as an Anjana (in cases of the two kinds of Akshi-páka). Saindhava and clarified butter pasted together in a copper vessel with flesh or Maireya or curd or with curd-cream should be used as an Anjana. As an alternative, the rust of bell-metal pasted with clarified butter, or Saindhava pasted with breast-milk, or equal parts of the pith of Madhuka tree and Gairika pasted with honey, or Saindhava and copper pasted with breast-milk and clarified butter should be used as AnJanas. The compounds of Dádimba, Araveta, As'manta, Kola, and Saindhava pasted with any acid juice* should be applied to the affected organ in the manner of a Rasa-kriyá measure for the cure of (the two kinds of) Akshi-páka. 25-26.
Animal flesh and Saindhava salt soaked in clarified butter and mixed with S'unthi and breast-milk should be applied to the affected organ in the manner of an Áśchyotana or as an Anjana. A compound consisting of Játi flower, Saindhava, S'unthi, Pippali and huskless Vidanga pasted together with honey, may as well be used as an Anjana with advantage in a case of Akshi-páka. 27-28.
Treatment of Puyálasa:— Blood-letting (after the application of Sneha and Sveda) and poulticing (Upanáha) of the affected locality are efficacious in the affecticn of the eye, known as Puyálasa. The measures and remedies which prove curative in cases of Akshi-páka should as well be employed with discretion in this case by a physician. An Anjana (eye-salve) composed of Ardraka, Saindhava and Káśisa (Sulphate of iron), or Káśisa Saindhava, Árdraka, iron and copper dust pasted together with honey, should be applied to the affected eye in the manner of an Anjana (in a case of Puyálasa). 29-30. ^ TtiE SUSHRUTA SAMHITA. [ Chap. Xtl. 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 (As'chyotana), snuffs (Nasya) and fumigation (Dhuma) should be resorted to according to the Dosha involved in each case. A compound composed of Musta, Haridrd, Yasliti-madJm, Priyangn, Siddhdrtha, Rodhra, Utpala-sdrivd f 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. 31-32. The decoction of the leaves and fruits of Amalaka should be duly prepared (in the manner of Rasa-kriyd) and used as an Anjana. Rasa-kriy£i preparations pre- pared with (the expressed juice of) the roots of bamboo, or Vartis prepared with the same by (condensing it by) cooking it (again) in a copper vessel, should be used for the above purpose, Rasa-kriya preparations prepared with Triphald, flowers of Paldsn, or Khara-manjari, should be similarly applied to the affected organ. Eye- salves made of powdered Kd?ns'ya-jnala and cotton fibres (Tantu) burnt together and pasted with the milk of a she-goat and mixed with (white) MaricJia and powdered copper should be used as a Pratyanjana to the eye (already weakened by the use of Anjana.) 33-34-
- Dallana says that the deranged Doshas of the system should be
cleansed with the application of Sneha, Venesection, pursative, errhines and A'sthapana. t In place of '^yffqsfgjf^^ff;^:" soms read '^WTf%tT^rTf^mf«:','"'^^"'"S in this case 'Syama-lata' by the term 'Asita-sariva'. Others again mean 'Rasdnjana' by the term 'Asita'. — Dallana. % Dallana recommends 'tain water' as the liquid for the preparation. An eye-salve or an Anjana made of Samudra-phena, Saindhava, conch-shell, Mudga and white MaricJia mixed together (in the shape of a powder) should be prescribed in a case of Aklinna-vartma as it would promptly alleviate the local itching. The foregoing measures and remedies should be likewise employed in a case of Praklinna-vartma according to the nature of the deranged Doshas involved therein. An Anjana prepared with the admixture of Kajjala and Tuthhaka (Sulphate of copper) rubbed in clarified butter on the surface of a copper vessel, would be similarly used (in such cases). 35-36.
Thus ends the twelfth chaptei of the Utlara-Tantra in the Sus'ruta Samhita which treats of the curative treatment of Raktabhishyanda.
- * See Chapter XLV, Sutra-Sthána,
- † Dallana explains "Abhyanjana" as collyrium, but he also says that some commentators take it in its usual sense of anointment with clarified butter washed hundred times in water, or such other Sneha.
- * Both Dallana and S'ivadása 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'ivadása, however, supports this latter view.
- * Dallana explains "Vetrámla" as "Anla vetasa". Some, however, divide it into two words viz., "Vetra" and "Amla" meaning thereby sprouts of Vetra (cane) and Amla-vetasa respectively.
- * The group beginning with Káśiśa— See Chapter XXXVI, Sutra-Sthana, page 334, Vol. I.
- † See paras 3 and 4 of this Chapter.
- ‡ "Superficial" (Uttâna) is here used in the sense of "seated in the first layer" and "deep seated" (Avagádha) 'seated in the second layer'.
- * One part of Saindhava, two parts of Maricha, four of Manahs'ilá, eight of Śamkha and sixteen parts of copper should be taken in the preparation of the compound.
- † See Chapter XI, para 6.
- * The spathe (Jatá) of the palm tree and the shell of the cocoanut fruit should be taken in preparing the compound —S'ivadása.
- † The prepared powder of elephant's bone should be mixed with honey and rubbed over the affected part (S'ukra) with the tip of the finger or with a S'aláká (rod). The eye should then be washed with the infusion of Triphalá— Dallana.
- * Some add honey in the list.