Mathomathis would like to present an article on Sushruta Samhita | Medical treatment of inflamed ulcers based on the book Sushruta Samhita, volume 4: Cikitsasthana by Kaviraj Kunja Lal Bhishagratna | 1911 | 123,229 words. The article was adopted from the website: https://www.wisdomlib.org/, a detailed explanation is available on the website. The following article is on The diseases affecting the nervous system, which is a continuation from the previous article on Sushruta Samhita | Medical treatment of nervous disorders | Chikitsita Sthana
Several authorities group the disease Vata-Rakta under two different sub-heads, such as superficial and deep-seated. But such a classification is arbitrary and unscientific, inasmuch as this disease first manifests itself on the surface (layer of the skin) like Kushtha and gradually invades the deeper tissues of the body. Hence there are no (two) forms of this disease.
Causes of Vata-Rakta:— The Vayu of the body is enraged or agitated by such causes as wrestling with a man of superior and uncommon physical strength, etc., while the blood is vitiated by such causes as constant over-eating of edibles which are of difficult digestion and heat-making in their potency or ingestion of food before the digestion of the previous meal. The Vayu thus enraged and agitated enters into the bloodcarrying channels of the body and being obstructed in its passage, becomes mixed with the vitiated blood. The deranged Vayu and the blood thus combine to give rise to a disease characterised by the specific symptoms of each, which is known as Vata-Rakta. The characteristic pain, which at first confines itself to the extremities, gradually extends over the whole body.
Premonitory symptoms of Vata-Rakta:— The disease is ushered in with a pricking pain, a burning and an itching sensation (in the affected part), a swelling, roughness and numbness (anesthesia) of the diseased locality, throbbing of the veins, ligaments, nerves and arteries, a weakness in the thighs and sudden appearance of red or brownish circular patches on the palms of the hands and soles of the feet, fingers and heels, etc., (A. R.—wrists). If neglected and immoderately treated in its premonitory stages, the disease soon develops its characteristic symptoms in succession, which have been described before; whereas (a lifelong) deformity (of the affected part) is the penalty for neglecting it (in its fully patent or developed stage).
Memorable Verse:— Men of a mild and delicate constitution, as well as those who are (inordinately) stout or sedentary in their habits or are addicted to unwholesome and incompatible food, etc., are generally found to be susceptible to an attack of Vata-Rakta.
Prognosis:— A physician is advised to take in hand the medical treatment of a Vata-Rakta-patient who has as yet not lost much strength and muscle, nor is afflicted with thirst, fever, epileptic fits, dyspnea, cough, numbness (of the affected part), aversion to food, indigestion, extension and contraction of the limb, as well as of a person who is strong and temperate in his living and can afford to pay for the diet and other necessary accessories of the treatment.
Preliminary remedial measures:— In the first stage of the disease the blood, having become vitiated owing to its being obstructed in its course (by the unusually agitated Vayu in the system), should be gradually and not profusely bled, except when the body would be found to have become extremely dry or to have lost its natural healthful glow or complexion through the action of the aggravated morbific principle (Vayu), for fear of further aggravating the Vayu. Emetics, purgatives, and Vasti (enemas), etc., should be administered and the patient should be made to take a diet consisting of old and matured clarified butter (and boiled rice), in the case where the aggravated condition of the deranged Vayu would be found to predominate. As an alternative, he should be made to drink a potion consisting of goat’s milk mixed with half its quantity of oil, with two Tola weight of Yashti-madhu or goat’s milk cooked with Prishniparni (two Tola weight) with honey and sugar (added after cooking), or cooked with Shunthi, Shringataka, and Kasheruka, or cooked with Shyama, Rasna, Sushavi, Prishniparni, Pilu, Shatavari, Shvadamshtra and Dasha-mula.
Oil, cooked with the addition of milk previously boiled with the decoction of Dasha-mula of eight times its own weight and a Kalka of Madhuka, Mesha-shringi (A. R. Sharngashta), Shvadamshira, Sarala, Bhadra-daru, Vaca and Surabhi pasted together, should be administered in drinks, etc, (viz, anointment, sprinkling, etc.). As an alternative, the oil cooked with the decoction of Shatavari, Mayuraka, Madhuka, Kshira-Vidari, Vala, Ati-vala and Trina-panca-mula, with the paste of the drugs belonging to the Kakolyadi group, or the oil cooked with the decoction and a Kalka of Vala for a hundred times should be prescribed for the patient. The affected part should be washed with the milk, boiled with the roots of the Vata-hara (Vayu-subduing) drugs (i.e., Dasha-mula), or simply with Amla (gruel, etc.), or a plaster composed of barley, Madhuka, Eranda (castor) and Varshabhu (pasted together and heated), should be applied to the part
Plasters, etc.:— Barley, wheat, sesamum, Mudga pulse aud Masha pulse should be taken in equal parts and pounded separately; and the paste of the following drugs, viz., Kakoli, Kshira-kakoli, Jivaka, Rishabhaka, Vala, Ati-vala, Visa-mrinala (lotus stem), Prishniparni, Mesha-shringi, Piyala, Sharkara (sugar), Kasheruka, Surabhi, and Vaca should be mixed with each of the preceding powders and each of these compounds (so formed) should be boiled with milk, oil, lard, marrow and clarified butter. The five compounds, thus prepared, are called Payasas, which should be applied as a hot poultice (Upanaha) to the affected part; or an Utkarika, made of the pulp of oily fruit (seeds) (prepared by cooking them with milk) should be applied; or powders of wheat, barley, sesamum, Mudga pulse, or Masha pulse, and Veshavara, made of various kinds of fish and flesh, should be used as a plaster. Vilvapeshika, Tagara, Deva-daru, Sarala, Rasna, Harenu, Kushtha, Shata-pushpa, Ela, Sura and cream of milk-curd pasted together, should be applied to the affected part as a plaster (Upanaha). As an alternative, the expressed juice of Matulunga, mixed with Kanjika, Saindhava salt and clarified butter, pasted together with the root of the Madhu-shigru and with sesamum, should be used in a similar way. The preceding remedies should be administered in a case of Vata-Rakta marked by a preponderance of the aggravated Vayu.
Vata-Rakta with a preponderance of Pitta:— In cases of Vata-Rakta where the Pitta preponderates, the patient should be made to drink a potion consisting of a decoction of Draksha, Aragvadha, Katphala, Kshira-vidari, Yashti-madhu, Chandana and Kasmarya sweetened with a quantity of sugar and honey. As an alternative, a decoction of Shatavari, Yashtimadhu, Patola, Triphala, and Katu-rohini, or a decoction of Guduci, or a decoction of the drugs belonging to the Chandanadi group, which are possessed of virtues for allaying pittaja fever, should be administered to the patient, sweetened with sugar and honey. Clarified butter, cooked and prepared with a decoction of bitter and astringent drugs also proves beneficial in such cases.
The affected part should be washed (Parisheka) with a decoction of Visa-mrinala, Chandana and Padmaka (taken in equal parts and) mixed with half its quantity of milk. As an alternative, the affected part should be sprinkled with a compound composed of milk, the expressed juice of Ikshu (sugar-cane), honey, sugar, and washings of rice (taken in equal parts); or with curd- cream, honey, and Dhanyamla (fermented paddy-gruel), mixed with a decoction of grapes and Ikshu; or the affected part should be anointed with clarified butter cooked with the drugs of the Jivaniya group, or with the clarified butter washed a hundred times in water, or with clarified butter cooked with the Kalka of the Kakolyadi group.
Pradeha (plaster) composed of Shali, Shashtika, Nala, Vanjula, Talisha, Shrigataka, Galodya, Haridra, Gairika, Shaivala, Padma-kashtha, leaves of padma (lotus), pasted with Dhanyamla and mixed with clarified butter, should be applied to the affected part. This plaster (Pradeha) may be applied lukewarm even in cases of Vata-Rakta, marked by a preponderance of the aggravated Vayu. All the remedial measures (laid down above) may also be advantageously applied in cases marked by a preponderance of the vitiated blood, with this exception that cold plasters and repeated blood-lettings should be resorted to in the latter (Raktaja-Vata-Rakta).
Vata-Rakta with a preponderance of Kapha:— Incases where the Kapha preponderates, the patient should be made to drink a potion consisting of a decoction of Haridra and Amalaka, sweetened with honey; or a decoction of Triphala, or a Kalka of Madhuka, Shringavera, Haritaki and Tikta-rohini mixed with honey. As an alternative, Haritaki and treacle with either cow’s urine or water, should be given to them.
The affected part or limb should be sprinkled or washed with cow’s urine, oil, alkaline water, Sura, Shukta, or with a decoction of Kapha-destroying drugs. A hot decoction of the drugs constituting the Aragvadhadi group may be used with benefit in sprinkling the affected part. The body of the patient should be lubricated or anointed with clarified butter, boiled with the cream of milk-curd, cow’s urine, wine, Shukta and with the Kalka of Yashti-madhu, Sariva and Padma- kashtha. A plaster (Pradeha), composed of pounded sesamum, mustard seed, linseed and barley (taken in equal parts) and mixed and pasted with Shleshmataka, Kapittha,Madhu-shigru and cow’s urine, and Yava-kshara should be applied (hot to the seat of the disease).
The Five Pradehas:—
- A paste of white mustard seed,
- That of sesamum and Ashvagandha,
- A similar paste of Piyala, Shelu and Kapittha bark,
- That of Madhu- shigru, Punarnava &
- A paste of Vyosha, Tikta, Prithakparni and Vrihati,
These five kinds of Pradehas should be separately pasted with alkaline water and (any of them) applied lukewarm to the affected locality.
As an alternative, a plaster composed Shalaparni, Prishniparni, Vrihati and Kantakari, pasted together with milk and mixed with Tarpana, should be applied (to the seat of the disease). In cases of Vata-Rakta involving the concerted action of two or three of the Doshas, the remedy consists in applying such drugs in combination as are possessed of the efficacy of subduing the action of each of them.
Gucla-Haritaki and Pippali-Vardhamana Yogas:— Haritaki with treacle may be used in all types of Vata-Rakta. As an alternative, the patient should be enjoined to use Pippali, pasted with milk or water, every day (in the following way). The number of Pippali should be increased by five or ten respectively on each successive day till the tenth day of its use; after which period the number of Pippali should be decreased (by a similar number) on each successive day till it is reduced to the original five or ten. The patient should live on a diet of milk and rice only (during the entire course of this treatement). This medicine which is known as the Pippali-Vardhamana, proves efficacious in cases of Vata-Rakta, chronic fever (Vishama-Jvara), aversion to food, jaundice, enlarged spleen, piles, cough, asthma, edema, phthysis, loss of appetite, heart-disease and ascitis.
Clarified butter, cooked in milk with the paste of the drugs of the Jivaniya group, should be used in anointing (the body of the patient). A plaster, composed of Saka, Sahadeva, Chandana, Murva, Musta, Piyala, Shatavari, Kasheru, Padma-kastha Yashti-madhu, Shata- pushpa (A. D. Vidari) and Kushtha, pasted together with milk and mixed with the cream of clarified butter, should be applied (hot) to the affected locality. A plaster composed of Saireyaka, Atarushaka, Vala, Ati-vala Jivanti and Sushavi, pasted together with the milk of a she-goat, should be likewise applied (to the seat of the disease). As an alternative, the diseased locality should be plastered with the pastes of Kashmarya, Yashti- madhu and Tarpana mixed together; or it should be treated with Pinda-Taila, prepared by cooking Madhucchishta (bee’s wax), Manjishtha, resin, and Ananta-mula in milk (and oil taken together).
In all cases of Vata-Rakta, old and matured clarified butter boiled with the expressed juice of Amalaka should be prescribed as drinks. The affected part should be washed or sprinkled with old and matured clarified butter, boiled with a decoction and paste (Kalka) of the drugs belonging to the Kakolyadi group, or with those of the Jivaniya group, or with the decoction of Sushavi, or of Karavellaka. The Vala-Taila should be used for sprinkling and immersing purposes, and as drink and Vasti-karma (enemas).
Diet:— The diet should consist of articles made of old and matured Shali or Shashtika rice, wheat or barley, taken with milk or with the soup of Mudga pulse or flesh of Jangala animals and devoid of any acid combination. Frequent blood-letting should be resorted to and measures, such as, emetics, purgatives, asthapana and Anuvasana should be adopted in cases of the aggravated Doshas (involved in the case).
Memorable Verses:— A case of Vata- Rakta of recent growth, proves readily amenable to the remedial measures described before. Long-standing, i.e., chronic cases (of Vata-Rakta) are never perfectly cured, but can only be palliated. The application of poultices (Upanaha), of medicinal washes or sprinkles (Parisheka), hot-plasters, anointings (Abhyanga), spacious and comfortable bed-chambers which do not admit of too large an influx of air, shampooing, and the use of soft and pleasant beds and soft pillows, are chiefly recommended in a case of Vata-Rakta; whereas physical exercise, sexual intercourse, display of anger, the use of heat-making, saline, acid and difficultly digestible food and eatables producing effuse serus or slimy matter in the bodily channels, and sleep in the day-time (should be deemed extremely injurious and hence) should be studiously refrained from.
The Medical Treatment of Apatanaka:— The medical treatment of a patient suffering from Apatanaka (hysterical convulsions), not exhibiting fixedness of gaze and arched eye-brows, with an absence of perspiration, quivering, delirium and the numbness of genitals, found not to fall on the ground but capable of being supported on his arms (Akhatta-pati) and whose trunk is not bent or arched on its posterior (dorsal) side (Vahirayama), may be attempted (with success). The body of the patient should be first anointed with emulsions (Sneha) and then fomented; strong medicated snuff should then be administred for purifying (the accumulated mucus in) the head. After that the patient should be made to drink a clear potion prepared of clarified butter, cooked in combination with a decoction of the drugs constituting the Vidari-gandhadi group, extract of meat, milk and milk-curd, so as to arrest the further expansion of the deranged Vayu into the system.
Traivrita Ghrita:— A decoction of the Vayu- subduing drugs, such as, Bhadra-darvadi, etc., barley, Kulattha pulse, Kola, and the flesh of the Anupa and Audaka animals with the Panca-Vargas should be made. The decoction, thus prepared, should be mixed with milk and fermented rice-gruel, etc., and then cooked with an adequate quantity of clarified butter, oil, lard and marrow by casting Kalka (paste) of the Madhura (Kakolyadi group) into it This Traivrita Ghrita (lit. consisting of clarified butter with three other lardaceous articles), thus prepared, should be administered to Apatanaka-patients in potions and diet, in effusions and immersions, in anointings and errhines, as well as in Anuvasana measures. Diaphoretic measures should be applied according to the prescribed rules. In a case marked by an unusually aggravated condition of the Vayu, the patient should be made to stand neck-deep in a pit tolerably warmed or heated with burning husks, and cow-dung. As an alternative, Palasha leaves should be strewn over a hot stone-slab or over a hot oven, after having sprinkled wine over them, and the patient should be laid full length upon these leaves, or fomentations should be made with Veshavara, Krishara and Payasa.
An oil, cooked in combination with the expressed juice of Mulaka, Eranda, Sphurja, Arjaka,Arka, Saptala and Shamkhini should be used in washing (Parisheka), etc., the body of an Apatanaka-patient. Potions consisting of sour Dadhi (milk-curd) mixed with powdered pepper and Vaca, or of oil, clarified butter, lard, or honey, mixed with the same things and taken in an empty stomach, prove curative in cases of Apatanaka.
These remedial measures are applicable in cases of Apatanaka when the action of the aggravated Vayu alone preponderates. In a case involving the concerted action of two or mere of the Doshas, drugs, remedial to each of them, should be combinedly employed. Medicinal liquid errhines (Avapida) should be employed after the subsidence of a severe attack. The fat or lard of a cock, crab, Krishna-fish, porpoise or of a boar should be taken by the patient. As an alternative, he should be made to drink (a potion consisting of) milk boiled with Vayu-subduing drugs (Dasha-mula, etc.), or a gruel (Yavagu) composed of barley, Kola, Kulattha – pulse and Mulaka, cooked with curd, oil and clarified butter. Oily purgatives, asthapana and Anuvasana measures, should be employed if the paroxysm does not subside even in ten days. Medicines and remedial measures laid down under the head of Vata-vyadhi and the process of Raksha-karma, should be likewise adopted (in cases of Apatanaka).
Treatment of Pakshaghata:— A physician is enjoined to take in hand the medical treatment of a patient laid up with Pakshaghata, unattended by a discolouring of the skin, but having pain in the affected part, and who habitually observes the rules of diet and regimen and who can afford to pay for the necessary accessories. The affected part should be first anointed and then fomented. Mild emetics and purgatives should be subsequently employed for the purpose of cleansing the system. Medicated Anuvasana and asthapana measures should then be employed, after which the general directions and remedial measures, laid down under the treatment of akshepaka, should be followed and employed at the proper time Applications of the Mastikya-Shiro-vasti with the Anu-taila for anointing the body, of the articles of Shalvana-Sveda for the purpose of poulticing, and of the Vala-taila as an Anuvasana measure, are the marked features of the medical treatment of this disease, and should be followed carefully for a continuous period of three or four months. These preceding remedies as well as dry fomentations (Ruksha-sveda) and errhines, which possess the virtue of subduing the deranged Vayu and Kapha should be likewise employed in cases of Manya- stambha.
Treatment of Apatantraka:— Fasting is prohibited in cases of patients suffering from Apatantraka (Apoplectic convulsions). Emetic, asthapana and Anuvasana measures are likewise forbidden. The passage of respiration should be blown open by violent breathings in the event of its being choked up with an accumulation of the deranged Vayu and Kapha. The patient should be made to drink a potion consisting of Tumburu, Pushkara, Hingu, Amla-vetasa, Haritaki and the three (officinal) kinds of salts, with a decoction of barley. As an alternative, four seers of clarified butter, cooked in combination with sixteen seers of milk, two Pala weight of Sauvarchala salt and fifty of Haritakis should be prescribed for the use of the patient. All other remedial agents, possessing the virtue of subduing the deranged Vayu and Kapha should be likewise employed.
Treatment of Ardita:— A patient suffering from Ardita (facial Paralysis) should be treated with the measures and remedies laid down under the head of Vata-vyadhi in the event of his being found to be sufficiently strong and capable of affording the necessary expenses for his treatment. Errhines, Mastikya- Siro-vasti, inhalation of the smoke (Dhuma-pana) from medicated drugs, poulticing (Upanaha), unguents and Nadi-sveda, etc., are the special features of the medical treatment of this disease. After that, a decoction should be made of the drugs constituting the groups of Trina- Panca-mula, Maha-Panca-mula, Kakolyadi and Vidari- gandhadi groups, aquatic bulbs, and the flesh of animals which are aquatic in their habits (Audaka) and those which frequent swampy places (Anupa), by boiling them together with a Drona measure of milk and double the quantity of water. The decoction should be considered boiled when three quarter parts of its original weight of the liquid has been evaporated and should then be strained. The decoction thus prepared should be boiled with a Prastha measure of oil (four seers) and be removed from the fire when the oil is well mixed with the milk. The compound (oil and milk) thus prepared should be allowed to cool down and then churned. The churned off cream (Sneha) should be again boiled with the drugs of the Madhura (Kakolyadi) group, Masha-parni and milk (four times that of the original oil). This medicated oil is known as the Kshira-Taila and should be administered as potions and unguents, etc, to an Ardita-patient The above preparation with clarified butter in the place of oil is known as the Kshira-sarpih and it should be used as an Akshi-tarpana (eye- lotion).
Venesection should be duly resorted to in the affect ed parts, according to the directions given before, in cases of Sciatica, Gridhrasi, Vishvaci (Synovitis of the knee- joints), Kroshtuka-shirah, Khanja (lameness), Pangula, Vata-kantaka, Pada-daha, Pada-harsha, Ava-vahuka and Vadhiryya and in cases where the deranged Vayu would be found to be seated in a Dhamani. Measures and remedies laid down under the head of Vata- vyadhi should be adopted, except in a case of Ava-vahuka
The expressed juice of green ginger, made lukewarm after mixing it with (equal quantities of) oil, honey and Saindhava salt, should be poured into the cavity of the ear in a case of (acute) ear-ache. As an alternative, the urine of a she-goat, or oil and honey, or oil with the urine (of a cow) mixed with the expressed juice of Matulunga, pomegranate and tamarind, or the oil boiled and prepared with Sura, Takra, Shukta, salt and the urine (of a cow), should be poured into the cavity of the ear; fomentation should be given (to the interior of the affected organ) after the manner of Nadi-sveda. The remedial measures for Vata-vyadhi should be resorted to. We shall, however, revert to the subject in the Uttara-Tantra.
The patient should be made to drink a potion of Sneha-Lavana dissolved in an adequate quantity of water, or the powders of the Pippalyadi group (with an adequate quantity of water), or clarified butter, thickened or saturated with pulverised asafetida and Yava-kshara (Carbonate of Potass), in cases of Tuni and Prati-tuni. Applications of Vastis should also be resorted to. 35.
In a case of Adhmana (Tympanites), the remedy should consist in the applications of powders of the Dipaniya (appetising) group, of suppositories (Phala-varti), Vastis and digestive drugs (Pachaniya group). The patient should also be advised to observe a rigid fast and his abdomen should be fomented with hot palms. After that he should break his fast with boiled rice prepared with appetising (Dipana) drugs such as, Dhanyaka, Jiraka, etc. Similarly, a case of Pratyadhmana should be treated with fasting, emetics and appetising drugs. Cases of Ashthila or Pratyashthila should be treated as a case of Gulma and internal abscess, to all intents and purposes.
Hingvadi-Vati:— A compound consisting of asafetida, Trikatu, Vaca, Ajamoda, Dhanya, Ajagandha, Dadimba, Tintidi, Patha, Citraka, Yava-kshara, Saindhava salt, Vid salt, Sauvarchala salt, Svarjikakshara, Pippali-mula, Amla-vetasa, Shathi, Pushkara-mula, Hapusha, Cavya, Ajaji and Pathya, powdered together and treated many times with the expressed juice of Matulunga in the manner of Bhavana saturation, should be made into boluses, each weighing an Aksha (two Tolas) in weight. One (such) pill should be taken (in an empty stomach) every morning in all diseases of the deranged Vayu. This compound proves curative in cough, asthma, internal tumour (Gulma), ascites, heart-disease, tympanites, aching pain at the sides, in the abdomen and in the bladder, in cases of an aversion to food, retention of stool, strangunary, enlarged spleen, piles, Tuni and Prati-tuni.
Memorable Verses:— From the symptoms or leading indications, exhibited in each case and from a close examination thereof, it should be inferred whether the Vayu alone has been deranged or whether it has combined with any other Dosha, or has affected any other fundamental principle (Dhatu) of the organism as well; and the medical treatment should follow a course, so as not to prove hostile to the Doshas or the Dhatus (organic principles) implicated in the case, in its attempt to subdue the aggravated Vayu. In a case of cold, compact and painful swelling (appearing in any part of the body) owing to the combination of the deranged Vayu with fat, the treatment should be identical with that of a swelling in general.
Uru-stambha:— The deranged Vayu, surcharged with the local fat and Kapha gives rise to a swelling in the region of the thigh which is known as Uru-stambha; others designate it as adhya-Vata. This disease is marked by lassitude and an aching pain in the limbs, by the presence of fever, horripilation and somnolence and by a sensation of coldness, numbness, heaviness, and unsteadiness in the thighs, which seem foreign to the body.
Its Treatment:— The patient should be made to drink a potion consisting of the pulverised compound known as the Shad-dharana-yoga; or of the drugs constituting the Pippailyadi group, dissolved in (an adequate quantity of) hot water without using any oleaginous substance; or a lambative, composed of pulverised Triphala and Katuka mixed with honey, should be used; or a potion, consisting of Guggulu or Shilajatu dissolved in cow’s urine, should be administered. These compounds subdue the aggravated Vayu surcharged with deranged fat and Kapha and prove curative in heart-disease, an aversion to food, Gulma and internal abscesses. A medicinal plaster composed of Karanja fruits and mustard seeds, pasted with a copious quantity of cow’s urine should be applied hot to the affected part, which may be as well fomented with cow’s urine mixed with alkali (Kshara); or the locality should be shampooed with articles devoid of any oily substance. The diet of the patient should consist of old and matured Shyamaka, Kodrava, Uddala and Shali rice with the soup of dry Mulaka or Patola, or of the flesh of animals of the Jangala group cooked without clarified butter or vegetables (Shaka) cooked without salt. The use of oil and of lardaceous substances in general (Sneha-karma) should, however, be prescribed after the deranged fat and Kapha have (totally) subsided.
Therapeutic properties of Guggulu:— Guggulu is aromatic, light, penetrating into the minutest parts of the body, sharp, heat-making in potency, pungent in taste and digestion, laxative, emulsive, slimy, and wholesome to the heart (Hridya). New Guggulu is an aphrodisiac and a constructive tonic. Old Guggulu is anti-fat and hence reduces corpulency. It is owing to its sharpness and heat-making potency that Guggulu tends to reduce the Vayu and the Kapha; it is its laxativeness that destroys the Malas (refuge deposits in the Srotas) and the deranged Pitta; its aroma removes the bad odours of the Koshtha; and it is its subtle essence that improves the appetising faculty. Guggulu should be taken every morning with a decoction of Triphala, Darvi and Patola or with that of Kusha roots; it may also be taken with an adequate quantity of cow’s urine, or with alkaline or tepid water. The patient should take boiled rice with soup, milk, or extract of meat after the Guggulu has been digested. Diseases such as internal tumour (Gulma), urinary complaints (Meha), Udavarta, ascites, fistula-in-ano, worms in the intestines, itches, an aversion to food, leucoderma (Svitra), tumour and glands (Arvuda), sinus, Adhya-Vata, swelling (edema), cutaneous affections (Kushtha) and malignant sores and ulcers readily yield to it, if used for a month (with the observance of the regimen of diet and conduct laid down previously). It also destroys the deranged Vayu incarcerated in the Koshtha, bones and joints, just as a thunderbolt will destroy trees.