A case of the Vataja type is accompanied by a severe aching pain at the anus, thorax (Hridaya), sides, abdomen and the head. A case of the Pittaja type is marked by a burning sensation in the body, while the one of Kaphaja origin is characterised by a sense of heaviness in the limbs. A case of Tri-Doshaja Grahani exhibits symptoms belonging to all the symptoms of the three cases (Vataja, Pittaja and Kaphaja types). The deranged bodily Dosha involved in a case imparts its characteristic colour to the finger-nails, eyes, face and excreta (stool and urine) of the patient. Thus it furnishes a satisfactory clue to the diagnosis of the disease, which, if neglected or unchecked at the outset, may usher in an attack of Hrid-roga (disease of the heart), Pandu (chlorosis), Udara (ascites, etc), Gulma, piles and enlargement of spleen. 106.
Appropriate emetics and purgatives should be exhibted (for cleansing the upper and lower parts of the body) in accordance with the aggravation of the Dosha or Doshas involved, and Pcyas (gruels) and other articles of diet duly prepared with appetising drugs should then he prescribed in their due order. Therapeutic agents possessed of digestive, astringent and appetising virtue should then be employed through the vehicles of Sura, Arishta (wine), Sneha (oil or clarified butter), cow's urine, tepid water, or Takra. The use of Takra in the morning is in itself an excellent cure lor the disease (Grahani). Remedies mentioned in connection with the treatment of worms in the intestines, Gulma, ascites or piles may also be adopted with benefit in the disease uuder discussion. The compound known as the Hingvadi-churna or the medicated clarified butter described as remedial in a case of enlarged spleen, or the one duly cooked with the expressed juice of Changeri and with the drugs of the Magadhadi (Pippalyadi) group as Kalka may be likewise prescribed with beneficial results. Clarified butter duly cooked with four times as much curd (Dadhi) may also be used with benefit. Whatever is appetising (medicines, drugs and diet, etc.) would be beneficial in cases of Grahani. Complications (Upadrava) such as fever, etc. should be subdued with drugs not incomptible with the main treatment of nor in any way aggravative of the main disease. 107
Thus ends the fortieth chapter of the Uttara-Tanlra in the Sus'ruta Samhita which deals with the (symptoms) and medical treatment of Atisara.