A fire (cautery) is better than an Alkali as far as its healing property is concerned. A disease burnt with fire, is cured for good and knows no recrudescence; and diseases which ordinarily baffle the skill of a surgeon or a physician, and never prove themselves amenable to medicinal or surgical remedies, are found to yield to fire (cauterisation).
The following drugs, articles and substances should be understood as accessories to an act of cauterisation, viz., Pippali, the excreta of goats, the tooth of a cow (Godanta), Shara, a rod, the surgical instrument known as the Jamvavaustha, articles made of copper or silver, honey, treacle, oil, or any other oily substance. Out of these, Pippali, the Godanta, Shara and the rod should be (made red hot and) used in cauterising the affected part in a disease which is restricted only to the skin; similarly the surgical instsument known as the Jamvavaustha, as well as the appliances made of copper or silver should be used in a disease which is seated in the flesh. Honey, treacle and oil should be (boiled and employed in cauterising the disease which affects any of the veins, nerves, bones or bone-joints.
Cauterisation is admissible in all seasons of the year except summer and autumn; but no such distinction should be observed in cases of impending danger, when it should be practised with the help of such appliances of a contrary (cooling) nature, [as wet sheets, cooling drinks and cooling plasters, etc.]
In all diseases and in all seasons of the year, the patient should be fed on a diet of slimy (mucilaginous) food before actually applying the cautery; while the patient should be kept on an empty stomach before the act where the complaint would be a case of Mudagarbha (false presentation), fistula in ano, haemorrhoids or a disease affecting the cavity of the mouth.
According to certain authorities the processes of cauterisation may be grouped under two heads according as the skin or the flesh is cauterised. The present work does not lay any injunction against the cauterisation of any nerve, vein, bone or bone joint (as stated before). A burning of the skin is accompanied by a peculiar bursting or cracking sound. The skin becomes contracted and emits a fetid smell. Similarly, in a case where the flesh is burnt, (the affected part) assumes a dove color of (blackish brown), marked by pain and a little swelling, and the incidental ulcer becomes dry and contracted. In the case where a nerve or a vein is burnt, the ulcer presents a raised (elevated) and black aspect with the stoppage of all secretions; while an ulcer incidental to the cauterisation of any of the bone joints has a parched red hue and becomes hard and rough.
The regions of the eye-brows, forehead and temple-bones, should be cauterised in diseases affecting the head as well as in a case of Adhimantha (Ophthalmia). In diseases affecting the eyelids the eye should be covered over with a moist piece of Alaktaka (a thin pad of red pigment principally used in dyeing the feet of ladies) and the roots of the eyelashes should be duly cauterised. Cauterisation is specifically enjoined to be resorted to incases of glandular inflammation, tumour, fistula in ano, scrofula, elephantiasis, Charmakila, warts, Tilakalaka, hernia, sinus hoemorrhage, and on the occasion of cutting a vein or a bone joint, as well as in the event of the vital wind (Vayu) being extremely agitated and lodged in the local skin, flesh, vein, nerves and the bone-joints and giving rise to excruciating pain in and about the ulcer which in consequence presents a hard, raised and inert surface.
The modes of cauterisation vary according to the seat of the disease, and number four in all, viz., the Ring, the Dot, the Lateral or Slanting lines, and the Rubbing modes.
A physician, after having carefully considered the seat of the disease and judiciously ascertained the patient's strength and the situations of the Marmas (the vital parts of the patient's) body, should resort to cauterisation with an eye to the nature of the malady and the then prevailing season of the year.
The part, after being properly cauterised, should be rubbed with an unguent composed of honey and clarified butter. A man of bilious temperament or with a quantity of bad blood lying stagnant and locked up in any part of his body, or of lax bowels, a person with any foreign substance (such as a thorn or a splinter still lodged in his body), a weak or an old man, an infant, or a man of timid disposition, or a person afflicted with a large number of ulcers, as well as a patient suffering from any of the diseases in which diaphoretic measures are forbidden, should be regarded as a subject unfit for cauterisation.
Now we shall describe the characteristic symptoms of the several kinds of burns other than those caused (for surgical purposes). Fire feeds both upon fatty and hard fuels, [such as oil and logs of wood etc.]. Hot or boiling oil has the property of permeating or entering into the minutest nerves and veins, and hence, it is capable of burning the skin, etc. Accordingly an ulcer incidental to such a burning (scald) is characterised by extreme pain, etc.
Burns may be grouped under four distinct heads viz., the Plushtam, the Dur-Dagdham, the Samyag-Dagdham and the Ati-Dagdham. A burn characterised by the discolouring of its seat and extreme burning and marked by the absence of any vesicle or blister, is called the Plushtam, from the root "plusha" to burn. A burn, which is characterised by the eruption of large vesicles or blisters, and assumes a red colour, and is characterised by excessive burning and a kind of drawing pain, and which suppurates and takes a long time to heal, is called the Dur-Dagdham (bad burn or scald). A burn, which is not deep (superficial) and assumes the colour of a ripe Tala fruit, and does not present a raised or elevated aspect and develops the preceding symptoms, is called the Samyag-Dagdham (fully burnt one). A burn in which the flesh hangs down, and where the veins, nerves and bones are destroyed, accompanied with fever, burning, thirst, fainting and such like disturbances, and which leads to a permanent disfiguration of the body, retarding the healing of the incidental ulcer which leaves a discoloured cicatrix even after healing, is called the Ati-Dagdham (over burnt one). A physician should try to heal any of these four types of burns with the measures already laid down before.