In a case of Sira-Jala, the hardened veins (Sira) should be hung down with a hook (Vadisa) and scraped with a Mandalagra (round-topped) instrument. Cysts or pimples (Pidakas) appearing on the diseased veins in a case of the aforesaid Sira-Jala and not proving amenable to the application of medicines, should be excisioned as in a case of Anna with a Mandalagra instrument. Pratisarana (rubbing) as in a case of Anna and Lekhana (scraping) with due regard to the nature of the deranged Doshas involved in each case, are also recommendad in both the diseases (Sira-Jala and Sira-Pidaka) under discussion. 9.
In a case of Parvauika the place of junction ‡ (of the lachrymal sac and the cornea) should be duly fomented. A quarter part only of the protuberance or growth should be kept apart, while the remaining upper three quarters should be secured with a hook and cut with a knife. Half of the aforesaid quarter part should then be cut away (very carefully), as lachrymal sinus (and consequent lachrymation) would otherwise set in. The seat of operation should be subsequently rubbed (Prati-sarana) with a compound of honey and Saindhava-salt. Scarifying (Lekhana) powders should then be applied to the affected part for the complete recovery of the disease (any complaint still remaining). 10.
* For Lekhya Anjana see Chapter XII, para 16 of this Uttara Tantra. † Some here read (veins) in place of|
‡ The 'junction' is the junction of the Krishna-mandala and the S'ukla-mandala of the eye. - Dallana.
Powders of S'amkha (conch-shell), Samndra-pheua, marine oyster-shell, crystal, ruby, coral, As'mantaka, Vaidurya (Lapis lazuli), pearl, iron, copper and Srotonjana (antimony) taken in equal parts and mixed together, should be stuffed in a ram's horn * and then let the intelligent one apply this Churna-anjana (powder) to the affected locality, morning and evening everyday, as such applications are extremely efficacious in all types of Armans, Pidakas, Sira-jala, Arsas, Sushkarsas and Arvuda, etc, in the eye. II.
The mode of treatment in a case of any affection in the inner lining of the Vartma (eye-lid) is given below. The affected part should be first fomented and then the eye-lid should be over-turned (held at an angle), and the diseased growth or swelling should be carefully lifted up with a needle, when an experienced physician should cut it at its root or base with the help of a sharp Mandalagra instrument. After that the affected part should be rubbed with a pulverised compound consisting of Saindhava, Kasisa (Sulphate of iron) and Pippali. The affected eye-lid should then be carefully cauterised with a (red-hot) rod after a complete) cessation of the bleeding. The residue of its root or base, if any, should be scarified with a scarifying alkaline (caustic) preparation. Decoctions of strong emetic and purgative drugs * should be (internally) administered for the elimination of the Doshas (from the Vrana - ulcer). The measures and remedies mentioned in connection with Abhi-shyanda (Ophthalmia) should also be prescribed with regard to the nature of the bodily Doshas involved in the case. The patient shall observe strict regimen of diet and conduct for a month after the surgical operation. 12.
* Dallana explains 'Meska-s'ringa as a kind of Ingudi tree.
Thus ends the fifteenth chapter in the Uttara-Tantra of the Sus'ruta Samhita which treats of the remedies of eye-diseases requiring excisions or surgical operation.
* Some commentators say that emetics and purgatives should be internally administered, but Dallana and the Panjika-kara oppose this view.