Váyasi, Phalgu and Tiktá each weighing one hundred Palas, two Prastha measures of powdered iron, three Adhaka (eight seers) measures of Triphalá and two Adhaka measures of Asana should be boiled together with three Drona measures of water. This decoction should be taken down when reduced to one quarter of its original measure and cooked again with a quantity of clarified butter (weighing a quarter part of the former (decoction) and with a Kalka consisting of Indra-yava, Trikatu, Tvak, Deva-dáru, Aragvadha, Párá-vata-padi, Danti, Vákuchi, Kes'aiáhva (Vakula) and Kantakári. The patient should be made to drink this medicated clarified butter when the disease would be found to have attacked the Dhátus (fundamental principles of the organism), or to have become involved in the aggravated Doshas of the system. The diseased patches should be rubbed with it, in the event of the affection being found to be confined to the Tvak (skin) alone. Even the type of Kushtha, commonly held to be incurable, has been found to prove amenable to the use of this medicated clarified butter, which is known as the Nila-Ghrita. 20.
A Tula * weight of the drugs known as Triphalá, Tvak, Trikatu, Surasá, Madayantiká, Váyasi and Aragvadha and ten Pala weights of each of the drugs known as Kákamachi, Arka, Vanuia, Danti, Kutaja, Chitraka, Dáru-haridrá and Kantakári should be boiled together with three Drona measures of water. This decoction, boiled down or reduced to six Prastha measures, should be again boiled with the watery secretion of cowdung, cow's urine, milk, curd and clarified butter, each weighing an Adhaka, and with the Kalka (weighing one-fourth as much of clarified butter) of Bhu-nimba, Trikatu, Chitraka, Karánja-fruit, Niliká, S'yámá, Avalguja, Pilu, Nilini and Nimba-flowers, It is a curative for Kushtha. The rubbing of the diseased patches with this Ghrita imparts a healthy and natural colour to the skin in cases of Svitra or white leprosy. It also cures diseases like fislula-in-ano, worms in the intestines and Ars'as. It is known as the Maha-Nila-Ghrita.† 21.
A compound consisting of cow's urine, Chitraka, Trikatu and honey should be kept for a fortnight in a closed earthen pitcher which formerly contained clarified butter. A Svitra-patient would do well to take this medicine after this period. He should also observe the rules of diet and regimen of a Kushtha-patient. The application of a Lepa (medicinal plaster), prepared by pasting the tender twigs of the Putika, Arka, Snuhi, Aragvadha and of the Játi flower with cow's urine, would prove curative in cases of Svitra, ringworm, ulcer, bad types of haemorrhoids and sinus. 22-23.
* A Tula is equal to a hundred Palas or twelve seers and a half of our modern measure.
† Dallana, in his commentary, says that the two Ghritas (Nila and Mahá-Nila) seem to be spurious (Anársha). But he has included them in his commentary as Jejjata and Gayadása have read and explained them before him.
In case the foregoing medicinal remedies prove ineffective, the patient should be duly bled for the purpose of letting out the vitiated blood from the system, and after sufficiently recouping his strength (after blood-betting) his body should be anointed with clarified butter. Copious vomitings should be induced with the help of strong emetics and the patient should be treated subsequently with a judicious administration of purgatives (so as to remove the aggravated Doshas from the system). The aggravated Doshas of the body, not being fully expelled from the organism of a Kushtha-patient by means of the preceding emetic and purgative measures, tend to extend all over the organism and the disease in consequence thereof is sure to lapse into one of an incurable type. Hence the aggravated Doshas should be fully eliminated from the organism. 24-25.
Emetics should be administered to a Kushtha-patient once a fortnight and Sramsana (purgatives) once a month. He should be bled twice a year though not profusely and medicated snuffs should be administered to him every fourth day. 26.
Internal application of Haritaki, Trikatu and treacle (prepared from the juice of the sugarcane) mixed with oil would lead to the early recovery of a case of Kushtha.
As an alternative, he should use a lambative medicinal compound of Amalaka, Aksha, Pippali and Vidanga mixed with honey and clarified butter. Or he should take a Pala weight of Haridrá with an adequate quantity of cow's urine every day for a month in order to get free from Kushtha; or the same quantity of the fine powder of Pippali or of Chitraka should be given to him through the same vehicle and for the same period which would cure him of Kushtha. The same quantity of the fine powder of Rasánjana should be given through the said vehicle and in the same manner for a period of one month and the same should also be repeatedly applied externally. 27-28.
The bark of Arishta (Nimba) and Sapta-patni,Lákshá, Musta, Das'a-muli, Haridrá, Dáru-haridrá, Manjishthá, Aksha, Vásaka, Deva dáru, Pathyá, Chitraka Trikatu, Amalaki and Vidanga taken in equal parts and pounded together should be mixed with powdered Vidanga weighing as much as the total weight of the preceding drugs; the patient should be made to take a Pala weight of this pulverised compound every day (for a month), or he should be made to drink (in adequate doses) a Drona measure of medicated clarified butter, cooked with the powders of Triphalá and Trikatu. As an alternative, Aksha-pida should be boiled in a Drona measure of cow's * urine. Clarified butter, cooked in this preparation may be used, as a remedy for Kushtha. An adequate quantity of old and matured clarified butter should be boiled with Aragvadha., Sapta-pama, Patola, Vrikshaka, Naktamála, Nimba, the two kinds of Haridrá and Mushkaka. This medicated Ghrita, thus prepared, would lead to the destruction of Kushtha * 29-30.
* Cow's urine and water in equal parts should be taken according to some commentators. Dallana, however, recommends cow's urine only and no water.
Drugs such as Rodhra,Nimba, Padma-kashtha, Rakta-chandana, Sapta-parni, Aksha, Vrikshaka and Vijaka should be administered in the bath † of the patient in the event of there being any burning sensation; or a potion consisting of honey and pasted Tri-bhandi (Trivrit) should be given to him. Old and matured Mudga, boiled in the decoction ‡ of Nimba and mixed with oil, should be given to the patient as drink where sloughing would be detected in the diseased localities. A decoction of Nimba or that of Arka, Alarka and Sapta-chchhada should be given him if there be any worms in the diseased locality. The affected part of the body should be plastered over with the roots of the As'va-mara and Vidanga, pasted with cow's urine, in the event of its being eaten away by the worms. Cow's urine should be sprinkled over the diseased locality and all food (of the patient) should be given with the powders of Vidanga. 31-32.
As an alternative, the affected parts should be rubbed with the oil of Karanja, mustard, S'igru, or Kos'áwa, or with an oil (any one of the preceding oils) cooked with (a decoction of) pungent, bitter and heat-producing substances. Measures laid down under the head of Dushta-Vrana (malignant ulcer) should be resorted to in a case where the aforesaid remedies would fail to produce any beneficial effect. 33.
* Dallana says that the authorship of this remedy should not be attributed to Sus'ruta, inasmuch as Jejjata does not mention it in his commentary.
† The drugs are to be boiled in water in which the patient should take his bath.
‡ The decoction should be prepared in the manrer of " Shadanga-kalpa."