The nine kinds of abscesses (Pidakás), such as Saráviká, etc., have been described before. Of such abscesses those, appearing in a strong person but small in size, affecting (only) the Tvak (skin) and the flesh, soft to the touch, slightly painful, easily suppurative and after a time bursting, are curable. 2.
Patients suffering from Prameha and afflicted with the above kinds of abscesses (Pidakás) should be treated (in the following manner). Measures, such as fastings (Apatarpana), etc., decoctions * (of Vata, etc.) and the urine of a she-goat, should be employed in the incubative stage of the disease. The urine, perspira-tion and the Sleshmá (sputum, etc.), soon acquire a sweetish taste, if the aforesaid preliminary measures are not resorted to and if the patient goes on using sweet articles of food in utter disregard of the instructions, thus developing fully the specific indications of Prameha. In this stage the system of the patient should be cleansed (Sams'odhana) with both emetics and purgatives. If the disease is not checked (even at this stage) with the aforesaid measures (emetics and purgatives), the aggravated Doshas of the body go on increasing in intensity and tend to affect or vitiate the flesh and the blood and produce an inflamatory swelling of the body, or bring on other supervening distresses in their train, venesection as well as the aforesaid remedies and measures should be resorted to in such cases. 3.
* Astringent drugs of fig-tree (Vata-tree), etc. - D. R.
The swelling increases in size attended with excessive pain and burning sensation, if the aforesaid remedies be not employed at this stage of the disease. Surgical operations and other remedial measures, described in connection with abscesses or inflammatory swellings (Vrana) in general, should be resorted to in such cases. If these be not done (at this stage), the pus eats into the deeper tissues of the locality, creates large cavities in its inside, and is accumulated there and the abscess (Vrana) becomes incurable. * Hence a case of Prameha should be remedied at its very outset. 4-6.
Ten Pala weight of each of these drugs, viz,, Bhallátaka, Vilva, Ambu, roots of Pippali, Udakiryyá, Prakiryyá, † Varshábhu, Punar-navá, ‡ Chitraka, S'athi, Snuhi, Varunaka, Pushkara, Danti and Haritaki and one Prastha measure of each of the following, viz., barley, Kola and Kulattha pulse should be boiled with a Drona measure of water, The decoction should be boiled down to its quarter part, removed from the fire, and strained. It should then be cooked with a Prastha measure (four seers) of clarified butter with half a Pala weight of each of the following drugs, viz., Vachá, Trivrit, Kampilla, Bhárgi, Nichula, S'unthi, Gaja-Pipplali, Vidanga and S'irisha as Kalka.
* On the failure of the above treatment it would spontaneously burst out and secrete pus and force its way inside, which would lead gradually to widen its mouth or fissure, and help its running into an incurable stage. - Dallana.
† "Udakirya and Prakirya" are the two kinds of Karanja.
‡ "Varshábhu and Punarnava" are the two kinds of Punarnava (i.e., red and white).
It is called the Dhánvantara-Ghrita * and covers within the range of its therapeutic application Meha (urinary diseases), swelling, (S'otha), Kushtha, Gulma, Ascites, haemorrhoids, enlargement of the spleen, carbuncles (Pidaká) and abscesses. 7.
Ordinary purgatives fail to produce any satisfactory effect in cases of Madhu-Meha owing to the excessive accumulation and pervasion of Medas (fat) in the or-ganism of the patient. Hence strong Sodhana (purgatives) should be employed in such cases. In all types of Meha, attended with Pidaká (eruptions or abscesses) and other complications, the perspiration and expectorations, etc. of a Prameha-patient acquire a sweet taste and smell like that of honey. Hence they are technically known as Madhu-Meha (to all intents and purposes . Fomentation (of any kind) is forbidden in the case of a patient suffering from Madhu-Meha, since it might lead to the gradual emaciation of his frame by drying up the organic fat (Medas), which is usually found to abound in his organism. The aggravated Doshas of the body fail to make an upward passage in the organism of a Prameha-patient, owing to the weakness of the channels of chyle, blood. Kapha and Pitta (as well as for an exhausted condition of the nerves in his body) and the Doshas are thus forced to course in and confine themselves into the lower part of the body where their incarceration helps the easy formation of Pidakás (abscesses), etc. Such a Pidaka should be remedied with the measures described in connection with Vranas, as soon as the process of suppuration would set in: whereas it should be treated as a swelling in its unsuppurated stage. Medicated oils should be likewise employed for the purposes of healing (Ropana), etc. 8.
* According to Dallana, the introduction of this medicated Ghrila into the text is an interpolation. Since Jejjata has not explained it in his commentary, Dallana does not explain it. Cbakradatta, however, mentions this Ghrita in his compilation, though with some additions and alterations under the treatment of Prameha. - Ed.
A decoction of the drugs of the Aragvadhádi group should be used for the purpose of raising up (Utsádana) the cavity of the incidental ulcer; that of the S'ala-sára'di group should be used for sprinkling purposes; that of the drugs of the Pippalyádi group should be given as food and drinks. A pulverised compound of Páthá, Chitraka, S'ármgashtá, Kshudra, Vrihati, S'árivá Soma-valka, Saptapama, Aragvadha and Kutaja roots mixed with honey should be internally given to the patient.