In the first stage of Kushtha, the patient should be treated in accordance with the prescribed maxims (rules) of Sneha-pána. In a case of Vátaja-Kushtha, oil or clarified butter, cooked with (a decoction and Kalka of) Mesha s'ringi, S'wadamshtrá, S'arngashtá, Guduchi and the drugs included in the group of Das'amula should be used as drink and ointment. In cases of the Pittaja type, the patient should be made to drink (a potion consisting of) clarified butter prepared with (a decoction and Kalka of) Dhava, As'vakarna, Kakubha, Palás'a, Pichu-mardha, Parpataka, Madhuka, Rodhra and Samangá. In the Kaphaja type, clarified butter cooked with (a decoction and Kalka of) Piyála, S'ála, Aragvadha, Nimba, Saptaparna, Chitraka, Maricha, Vacha and Kushtha should be prescribed.
* Bhallataka-preparations have been described in the treatment of Ars'as, preparations of S'ilájatu, Guggulu, Aguru and Tuvaraka in the treatment of Prameha-pidaká, and Khadira, Asana and Ayaskriti preparations in the treatment of Mahá-kushtha.
† Oil should be used in a case of Kapha predominance, whereas clarified butter in that of Pitta-predominance. Others assert that clarified butler should be used for drinking purposes and oil for anointments.
The clarified butter cooked with (a Kalka and a decoction of, Bhallátaka, Abhayá and Vidatiga, or (the medicinal oils known as) the Tuvaraka Taila and the Bhallátaka Taila should be used in all types of Kushtha. 7-8.
A paste or Kalka should be made by pounding equal parts of Saptaparna, Aragvadha, Ativishá, Páthá, Katu-rohini, Amritá, Triphaiá, Patola, Pichu-marda, Parpataka, Durálabhá, Tráyámáná, Mustá, Chandana, Padmaka, Haridrá, Upakulyá, Vis'áiá, Murvá, S'atávari, S'árivá, Indra-yava, Atarushaka, Shadgranthá (vacha), Madhuka, Bhu-nimba and Grishtikd *. This paste (Kalka) should be cooked with four times its own weight of clarified butter, with the juice of Amalaka, weighing twice as much as the clarified butter and with water weighing four times the quantity of the Amalaka juice. It should be constantly stirred (with a ladle), while being cooked. This medicated Ghrita is called the Mahá-tikta Ghrita, which proves curative in Kushtha, chronic fevers, haemorrhage, heart-disease, insanity, Apasmara, Gulma, postular eruptions, menorrhagia, goitre, scrofula, elephantiasis, jaundice, erysipelas, impotency, itches and Pama, etc. 9.
Two Pala weight of each of the following drugs, viz., Triphalá, Patola, Pichu-marda, Atarushaka, Katu-rohini. Durálabhá, Tráyamáná and Parpataka † should be taken and boiled together in a Drona measure of water. The boiling should be continued till it is reduced to one fourth of its original quantity. Then half a Pala weight of each of the following drugs, viz., Tráyamáná, Musta, Indra-yava, (red)
* Chakradatta does not read "Grisbtika" but read "Us'ira" instead. He also takes both the kinds of "Haridra," of "Upakulya" (Pippali) and of "Sariva".
† Chakradatta reads "Nis'a" in addition to the above drugs.
Chandana, Kiráta and Pippali should be pasted together. This pasted Kalka and the decoction should be cooked with a Prastha measure of clarified butter. The medicated Ghrita thus prepared is called the Tikta-Sarpih. Diseases such as Kushtha, chronic fever, Gulma, Haemorrhoids, Grahani, edema, jaundice, erysipelas and impo-tency readily yield to the curative efficacy of this Ghrita. 10.