In a case of the Sarshapi type of the disease, the affected (ulcerated) part should be scarified and dusted with the (powdered) drugs of an astringent taste (as described in the Misraka chapter), and an oil, cooked with (the Kalka and decoction of) the same drugs, should be applied for healing purposes. In a case of the Ashthi-liká type of the disease, the skilful physician should apply leeches to the seat of affection. In case the swelling does not still subside, it should be removed and treated as a Kaphaja Granthi (glandular swelling). A Granthi type of the disease should be constantly fomented in the manner of Nádi-Sveda, and should be poulticed with a lukewarm medicinal compound mixed with a profuse quantity of Sneha (oil). 2-4.
An incision should be made into the suppurated seat of affection in a case of the Kumbhiká type of the disease, and the incidental ulcer should be purified (disinfected) and healed up with the application of the oil, cooked with Triphalá, Lodhra, Tindnka and Amrátaka * In the Alaji type of the disease, the affected part should be bled by applying leeches to it and should then be affused with a decoction of the astringent drugs. An oil, cooked with the decoction of the same drugs, should be used to heal up the (incidental) ulcer. 5-6.
* S iva-dása in his commentary on Chikra-datta quotes this couplet from Sus'ruta, but there he reads in place ofthat is to say, he says that A'mra should be used in place of Amrátaka. He fiuther adds that the stones of Amra and Tinduka fruits should be taken.
In the Mridita type of the disease, the affected part should be affused with tepid Valá oil and poulticed with a lukewarm plaster (Upanáha) of the drugs of the Mad-hura (Kákolyádi) group, pasted and mixed with clarified butter. Leeches should be speedily applied to the condyl-omatous growths (Pidaká) in a case of Sammudha-Pidaká In cases of suppuration, they should be opened and plastered with honey and clarified butter. In a case of Avamantha, the growths (Pidaká) should be opened, when suppurated, and healed up with the application of an oil, cooked with Dhava, As va-Karna, Pattanga, S'allaki and Tinduka. 7 - 9
In a case of Pushkariká, all kinds of cooling measures should be applied and the vitiated blood should be extracted by applying leeches. The affected part should be subsequently affused with clarified butter. In a case of the Spars'a-háni type of the disease, blood should be let out and plasters (Pradeha) of Madhura (Kákolyádi) drugs should be applied. The affected part should be affused with a very cold compound of milk, clarified butter and the expressed juice of sugarcane. In the type of the disease known as Uttamá, the Pidakás condylomatous growths) should be removed with the help of a Vadisa instrument, and powders of astringent drugs with honey should be applied to the seat of affection. 10 - 12.
In a case of the Sata-ponaka type of the disease, the affected part should be scarified and the measures laid down in connection with Rasa-Kriyá should be resorted to.
After this, an oil, cooked with the Prithak-parnyádi drugs * should be likewise applied to the seat of the disease. The medicinal treatment, in a case of Tvak-páka, should be the same as described in connection with Erysipelas (Visarpa). The remedial measures, laid down under the head of Rakta-vidradhi, should be employed in a case of the Sonitáirvuda type of the disease. 13 - 14.
General Treatment:. - Remedies such as medicinal decoctions, pastes (Kalka) medicated clarified butter, powders, Rasa-Kriyá, etc., and the measures for purifying and healing (incidental sores or ulcers) should be employed with due consideration to the nature and intensity of the aggravated Doshas involved in the case. The application of specifically prepared medicated clarified butter, purgatives, blood-letting and light diet should be similarly prescribed. † 15
Prognosis: -The medical treatment of the patient affected with any of the following types of the disease, viz., Arvuda, Mámsa-páka, Vidradhi and Tila-Kálaka should be undertaken without holding out any definite prospect of recovery. 16.
Thus ends the twenty-first Chapter of the Chikitsita Sthánam in the Susruta Samhitá which deals with the treatment of Suka-Roga.
* For Rasa-kriya and the Prithak-parnyadi drugs, see Chapter XXXVI (Medical Treatment Of An Attack By Naigarhesha (Naigamesha-Pratishedha)) - Sulra-sthana.
† This seems to be the general treatment of all the types of S uka-Roga.