It has been stated before that blood-letting is the remedy in diseases of the Páli (ear-lobes). Now hear me describe in detail the treatment of those affections which are confined to the lobes of the ears. They are five in number and are called the Paripota, Utpáta, Unmantha Duhkha-Vardhana and the Parilehi. 2-3.
If the lobe of an ear be suddenly pulled and kept in that position for a long time, a numbed and painful swelling of a blackish red colour is produced on the lobe, owing to its soft and delicate nature. This is found to spontaneously burst or crack, and is called the Paripota, which should be ascribed to the action of the deranged Váyu (of the system). 4.
A painful swelling attended with a burning sensation and suppuration, appearing in the lobe of the ear, owing to the friction and movements of a heavy ornament worn in the lobe, is originated from the vitiated condition of the blood and the Pitta. Its colour is either brown or red and is called the Utpáta. 5.
Pulling the ear-lobes down by force tends to enrage the Vayu (of the localities) which in union with (the deranged) Kapha gives rise to a painful swelling in those regions, attended with itching and tinged with the specific colours * and symptoms of the Doshas involved. The disease is called the Unmantha, and is originated through the concerted action of the deranged Váyu and the Kapha. 6.
* Mádhava in his compilation reads (that the swelling is attended with a numbness and no pain) in place of 'Vágbhata also supports this. - Ed.
A swelling in an ear-lobe attended with pain, burning and itching sensations owing to its being pulled down and) lengthened, when found to suppurate (in the end) is called the Duhkha-vardhana; it * restricts itself only to the skin (of the affected part . 7.
Small exuding pustules resembling mustard-seeds (in size) and attended with pain, burning and itching sensations, appear in the lobes of the ears owing to the action of the vitiated blood, or the deranged Kapha, or to the presence of parasites (in those localities). The disease soon spreads itself (and assumes an erysipelatous character). It is called the Parilehi from the fact of its eating away the affected lobe with the entire helix. 8.
These dreadful diseases (which invade the lobes of the ears are highly dangerous and tend to destroy and eat away the affected appendages, if not properly attended to at the outset and specially when the patient is addicted to unwholesome food and drink and to an injudicious conduct of life. Hence a physician should speedily remedy these complaints with applications of medicated Sneha, Sveda, etc., ointments, washes, plasters, poultices and blood-letting.† This is the general treatment of those diseases. 9.
* Madhava adds "an unsuccessful perforation (in the ear lobe)" to be an additional causa of this disuse. He also raads i.e., "due to the concerted action of the three Doshas" in place ofMadhava has Vagbhata's support in this. - Ed.
† In cases of the predominance of the Váya anointment, Anuva-sana and poultices should be resorted to. In cases of Pitta-predominance, purgatives should be applied. Emetics should be applied in cases of Kapha-predominance and lastly blood-letting, purgatives and washes,
Now we shall describe the medical remedies which should be specially used in anointing (the affected parts in these diseases). Drugs, such as Khara-Manjari, Yashti-madhu. Sain-dhava, Deva-dáru, As'va-gandhá and the seeds of Mulaka and of Avalguja should be pasted together and cooked with a compound of milk, oil, clarified butter, lard, marrow and wax. This preparation should be applied lukewarm to the affected lobe in a case of the Pari-potaka type. 10-11.
Manjishthá, Sesamum, Yashti-madhu, Sárivá, Utpala, Padma-káshtha, Rodhra, Kadamba and the tender leaves of the Valá, Jambu and Antra (mango) should be cooked together with (an adequate quantity of) oil and Dhányamla (Kánjika). This oil proves curative in a case of Utpáta. 12.
Similarly (a medicated) oil cooked with Tála patri, As'va-gandhá, Arka, Vákuchi-seeds. Saindhava, Saralá * Lángali, lard of a Karkata (crab) and of a Godha (a kind of lizard), proves beneficial in cases of Umnantha-The affected lobes should be washed (Sechana) with a decoction of the leaves of the As'mantaka, Jambu and Amra (in such cases). 13.
In a case of Parilehi, the affected lobe (Pali) should be dusted with powdered Prapaundarika, Yashti-madhu, Manjishthá and the two kinds of Haridrá after lubricating it with the oil cooked with the Kalkas of Lákshá and Vidanga. It should be as well fomented with heated cow-dung and plastered with the lukewarm pastes of Vidanga alone, or in combination with Trivrit, etc., should be resorted to in cases of the affection being due to the concerted action of the vitiated blood and the Pitta.
* Saralá here means Dhupa-káshtha, according to Dallana.
S'yámá and Arka pasted together (with cow's urine) or with the pastes of Karanja-seed. Ingudi seed, Kutaja and Aragvadha (pasted with cow's urine). Mustard oil cooked * with the admixture of all the foregoing drugs and with Marietta, Ninba-leaves and wax, proves efficacious as unguents (in such cases;. 14-15.
In cases where the car-lobes are affected and have become either thin, or hard, an ointment should be applied to them in order respectively to increase their growth, or to soften them. 16.
The marrow of a jackal and of an animal frequenting and living in swampy grounds (Anupa, such as a buffalo, etc.), together with lard, oil and fresh clarified butter, should be cooked with a quantity of milk weighing ten times their combined weight and with the drugs of the Madhura (Kákolyádi) group, As'va-gandhá and Apá-márga and Lákshá Rasa (decoction or infusion of Lákshá). The oil thus prepared should be filtered and preserved carefully in an earthen pitcher. The affected ear-lobes should be constantly fomented and well-lubricated with it. The use of this medicated oil helps the growth of the ear-lobes and makes them healthy, soft, smooth, painless, evenly developed and capable of bearing the weight of ear-pendants. 17.