In cases of snake bites, collyrium to the weight of one Máshaka (Máshá) should be used at a time. The dosage of medicated snuff (Nasya), potions and emetics being respectively double, quadruple and eight times thereof. But a wise physician should treat a case of snake-bite with a full regard to the nature of the country, season, temperament, as well as to the intensity and the particular stage of poisoning the case has reached. 12-13.
We have described the anti-venomous measures and remedies applicable to the different stages of poisoning (by a snake-bite). We shall now deal with the specific treatment of poisoning of either kind according to the physical symptoms developed in the patient. Bloodletting should be speedily resorted to in the case where the poisoned limb had become discoloured, rigid, swollen and painful. Curd, Takra, honey, clarified butter and meat-soups should then be given to the patient affected with a poison marked by a preponderance of the aggravated Váyu and by a craving for food. A person affected with a poison marked by a predominance of the aggravated Pitta would have thirst, epileptic fits, perspiration and a burning sensation in the body and should be treated with shampooing with cold hands and with cold baths, and cooling medicinal plasters. A person affected with a poison marked by a predominance of the aggravated Kapha and bitten in the winter would have cold salivation, epileptic fits and intoxication and should be treated with strong emetics. 14.
Purgatives should be exhibited in the event of the patient being oppressed with such symptoms as pain and burning sensation in the abdomen, Adhmána (tympanites), retention of urine, stool and flatus, painful urination and other troubles of the deranged Pitta. Collyrium should be applied (along the eyelids) in the case of a swelling of the eyeballs, somnolence, discolouring of the eye, cloudiness of vision and discoloured appearance of all objects. The head of the patient should be cleansed (purged) with medicinal errhines (Nasya) in the case of pain and a heaviness of the head, lassitude, lock-jaw, constriction of the throat (Gala-graha) and violent wryneck (Manyá-stambha). Powders of such drugs of the S'iro-virechana group as are of strong potency, in the shape of Pradhamana Nasya should be blown into the nostrils of the patient suffering from the effects of poisoning in the case where such symptoms as loss of consciousness, upturned eyes and drooping of the neck would set in. The veins of his forehead and of the extremities should be instantly opened. When such opening of the veins would not be attended with (the desired) bleeding superficial incisions in the shape of cow's feet (Káka-pada) should be made by an experienced surgeon on the scalp of the patient. These failing, the incisioned bits of flesh mixed with blood should be removed and the decoction or powders of a Charma-vriksha (Bhurja patra) should be applied to the incisions. Dundubhis (small drums) smeared with anti-venomous plasters should be sounded around the patient. The patient thus restored to consciousness should be treated with both purgatives and emetics. A complete elimination of the poison from the system is a very difficult task but it is indespensably necessary, since the least remnant of the poison may again be aggravated in course of time and cause lassitude, discolouring of the complexion, fever, cough, headache, swelling, emaciation (Sosha), cataract, blindness, catarrh (Pratisyáya), aversion to food and nasal catarrh (Pinasa). These diseases and any other supervening symptoms of poisoning should be treated according to the injunctions laid down under their specific heads with a careful consideration of the Dosha or Doshas involved in each case. 15.
The ligature should then be removed, the seat of the bite incisioned and an Agada plaster should be applied there, so inasmuch as the poison is found to be lodged in a condensed form (in the puncture of the fangs) and is likely to be afterwards aggravated (if not fully eliminated). 16.