A physician is enjoined to take in hand the medical treatment of a patient laid up with Pakshágháta, unattended by a discolouring of the skin, but having pain in the affected part, and who habitually observes the rules of
* Vriddha Vágbhata recommends external application with these lards, diet and regimen and who can afford to pay for the necessary accessories. The affected part should be first anointed and then fomented. Mild emetics and purgatives should be subsequently employed for the purpose of cleansing the system. Medicated Anuvásana and Asthápana measures should then be employed, after which the general directions and remedial measures, laid down under the treatment of Akshepaka, should be followed and employed at the proper time Applications of the Mastikya-Siro-vasti with the Anu-taila for anointing the body, of the articles of Sálvana-Sveda for the purpose of poulticing, and of the Valá-taila as an Anuvásana measure, arc the marked features of the medical treatment of this disease, and should be followed carefully for a continuous period of three or four months. 2g.
These preceding remedies as well as dry fomentations (Ruksha-sveda) and errhines, which possess the virtue of subduing the deranged Váyu and Kapha should be likewise employed in cases of Manyá-stambha. 29
Fasting is prohibited in cases of patients suffering from Apatantraka (Apoplectic convulsions). Emetic, Asthápana and Anuvásana measures are likewise forbidden. The passage of respiration should be blown open by violent breathings in the event of its being choked up with an accumulation of the deranged Váyu and Kapha. The patient should be made to drink a potion consisting of Tumburu, Pushkara, Hingu, Amla-vetasa, Haritaki and the three (officinal) kinds of salts, with a decoction of barley. * As an alternative, four seers of clarified butter, cooked in combination with sixteen seers of milk, two Pala weight of Sauvarchala salt and fifty of Haritakis should be prescribed for the use of the patient. All other remedial agents, possessing the virtue of subduing the deranged Váyu and Kapha should be likewise employed. 30.
* Chakradatta quotes this in the chapter on the treatment of colic (s'ula), but does not read 'Amla-vetasa' there.
A patient suffering from Ardita (facial Paralysis) should be treated with the measures and remedies laid down under the head of Váta-vyádhi in the event of his being found to be sufficiently strong and capable of affording the necessary expenses for his treatment. Errhines, Mastikya-Siro-vasti, inhalation of the smoke (Dhuma-pána) from medicated drugs, poulticing (Upanáha), unguents and Nádi-sveda, etc., are the special features of the medical treatment of this disease. After that, a decoction should be made of the drugs constituting the groups of Trina-Pancha-tnula, Malta- Pancha-mula, Kákolyádi and Vidári-gandhddi groups, aquatic bulbs, and the flesh of animals which are aquatic in their habits (Audaka) and those which frequent swampy places (Anupa), by boiling them together with a Drona measure of milk and double the quantity of water. The decoction should be considered boiled when three quarter parts of its original weight of the liquid has been evaporated and should then be strained. The decoction thus prepared should be boiled with a Prastha measure of oil (four seers) and be removed from the fire when the oil is well mixed with the milk. The compound (oil and milk) thus prepared should be allowed to cool down and then churned. The churned off cream (Sneha) should be again boiled with the drugs of the Madhura (Kákolyádi) group, Masha-parni and milk (four times that of the original oil). This medicated oil is known as the Kshira-Taila and should be administered as potions and unguents, etc. to an Ardita-patient The above preparation with clarified butter in the place of oil is known as the Kshira-sarpih and it should be used as an Akshi-tarpana (eye-lotion). 31 - 32.
Venesection should be duly resorted to in the affect ed parts, according to the directions given before, in cases of Sciatica, Gridhrasi. Vis'vachi (Synovitis of the knee-joints), Kroshtuka-s'irah, Khanja (lameness), Pangula, Vata-kantaka, Páda-dáha, Páda-harsha, Ava-váhuka and Vádhiryya and in cases where the deranged Váyu would be found to be seated in a Dhamani. Measures and remedies laid down under the head of Váta-vyádhi should be adopted, except in a case of Ava-váhuka. 33.
The expressed juice of green ginger, made lukewarm after mixing it with (equal quantities of) oil, honey and Saindhava salt, should be poured into the cavity of the ear in a case of (acute) ear-ache. As an alternative, the urine of a she-goat, or oil and honey, or oil with the urine (of a cow) mixed with the expressed juice of Mátulunga, pomegranate and tamarind, or the oil boiled and prepared with Sura, Takra, Sukta, salt and the urine (of a cow), should be poured into the cavity of the ear; fomentation should be given (to the interior of the affected organ) after the manner of Nádi-sveda. The remedial measures for Vata-vyádhi should be resorted to. We shall, however, revert to the subject in the Uttara-Tantra. 34.
The patient should be made to drink a potion of Sneha-Lavana * dissolved in an adequate quantity of water, or the powders of the Pippalyádi group (with an adequate quantity of water), or clarified butter, thickened or saturated with pulverised asafoetida and Yava-kshára (Carbonate of Potass), in cases of Tuni and Prati-tuni. Applications of Vastis should also be resorted to. 35.
* Sneha-Lavana has been described in Chap. 4. (treatment of Váta-vyádhi) para. 24.
In a case of Adhmána (Tympanites), the remedy should consist in the applications of powders of the Dipaniya (appetising) group, of suppositories (Phala-varti), Vastis and digestive drugs (Páchaniya group). The patient should also be advised to observe a rigid fast and his abdomen should be fomented with hot palms. After that he should break his fast with boiled rice prepared with appetising (Dipana) drugs such as, Dhányaka, Jiraka, etc. Similarly, a case of Pratyádhmána should be treated with fasting, emetics and appetising drugs. Cases of Ashthilá or Pratyashthilá should be treated as a case of Gulma and internal abscess, to all intents and purposes. 36-38.