Surgical Treatment

in a case of Pakshma-kopa which is an affection of the eye-lid and which has been described before as admitting only of palliative treatment, the patient should be first treated with a Sneha and made to take his seat (in a proper position). A cut in the shape and size of a barley corn should be made in the eye-lid horizontally parallel to (the part of the eye-ball lying between) the Kaninaka (pupil) and the Apanga (exterior corner of the eye) leaving two parts below the eye-brow and one part above the eye-lashes. The surgeon should then diligently suture up the two edges of the incisions with (horse's) hair. After the application of honey and clarified butter to the operated part, it should be treated in the manner of an (incidental) ulcer. A piece of linen should be tied round the forehead and the horse's hair sewing up the operated part should be attached thereto. The stitching hair should be carefully removed after the complete adhesion * of the two edges of the incidental ulcer. 2.

Cauterisation

In case of the failure of the preceding measure, the eye-lid should be carefully examined and lifted up in an inverted posture and the diseased cyst (Bali) should be very carefully cauterised with fire or alkali. As an alternative, the Pakshmamala (eye-lashes) should be all removed and the affected eye-lid having been carefully secured with three hooks (Vadis'a) should be rubbed with pasted Haritaki and Tuvaraka (Lodhra). The four aforesaid measures * as well as purgatives, eye-drops (As'chyotana), medicinal snuffs, inhalations (fumigations), Plasters, Collyrium, Sneha and Rasa-kriya, should be likewise held as beneficial † in cases of Pakshma-kopa. 3-5.

* According to Vagbhata, the stitching hair should be removed on the fifth day.

Thus ends the sixteenth chapter of the Uttara-Tantra in the Sus'ruta Samhita which treats of the remedies of Pakshma-kopa.

* The four measures are (a) operation, (3) cauterisation with fire, (c) cauterisation with alkali, and (d) application of medicinal drug?.

† It should be noted that this disease cannot be radically cured, but is amenable only to palliative treatments