Alkaline preparation should be duly made with the following drugs, viz., the ashes of (dried stems of) Tila, Ikshnraka, Sarshapa and Yava and of (the barks of) Palas'a and of Mulaka with the urines (weighing four times as much) of a cow, she-goat, ewe, she-ass and she-buffalo. This alkaline preparation should then be cooked in an iron vessel and on a slow fire with one Pala weight of each of the following pulverised drugs, viz, Kushtha, Sain-dhava, Yashti-madhu, Nagara, Vidanga and Ajamoda and with ten Pala weight of Samudra-salt thereto added and, should be taken in the form of a lambativc with one or the other of clarified butter, curd, wine, fermented rice-boilings (Dhanyamla), warm water or the soup of Kulattha. The alkaline compound, thus prepared, undoubtedly proves curative in cases of Gulma and in the derangements of the bodily Vayu. Compounds consisting of Sarjika-Kushthra, Kushtha and the ashes of Ketaki taken with oil * or of Sarjika-Kshara, Kushttha and Saidhava taken with tepid water, would subdue an attack of the deranged bodily Vayu. 25-26.
* According to Dallana, Sarjika-Kshain, Kushtha and Yava-Kshara with oil would form the 1st compound and the Kilaka-Kshara with oil would form a separate compound.
The drugs known as Vrischira, Uruvuka, Varshabhu, the two kinds of Vrihati and Chitraka should be duly boiled together with a Drona-measure of water and taken down from the oven after three-fourths of the water are evaporated by boiling. It should then be poured into an earthen pitcher of which the interior has been previously coated with pastes of Magadhi, Chitraka and honey. One Seer of powdered Pathya and four Seers of honey shonld be subsequently added to its contents and the pitcher should be then kept buried in a heap of husks for ten days, after which it should be taken out and its contents should be given to the patient after the digestion of his daily food. The Arishta (fermented wine) thus prepared proves curative in cases of Gulma, indigestion and aversion to food. 27.
Powders of Patha, Nikumbha, Rajani, Tri-katu, Tri-phala, Agnika (Chitraka), Saindhava-salt and Vriksha-vija (Indra-yava) in equal parts should be taken with matured treacle of their combined weight; or the powders of the above drugs with pulverised Pathya (weighing a fourth part only of the other powders taken together) should be cooked with cow's urine (weighing four times) to a thick consistency and made into pills which should be taken in an empty stomach (by the patient). These medicines would radically cure the cases of Gulma, enlarged spleen, indigestion, heart-disease, chronic diarrhaea and violent forms of chlorosis 28.
Blood-letting by the application of leeches or by vein lection should be effected in a case of elevated and immobile (unshiftlng) Gulma characterised by Sula, burning sensation, inflamation and piercing pain. 29.
Drinks composed of the meat-essence of an animal of the Jangala group, profusely salted with Saindhava and mixed with clarified butter and Tri-katu and taken lukewarm are good for Gulma-patients Peyas prepared with the Yayu-subduing drugs and the soup of Kulattha-pulse cooked with a Sneka as well as the Khada-yusha prepared with Pancha-mula also are likewise efficacious as Diet. Draughts of milk with Ardraka should be prescribed in a case of Gulma attended with the suppression of stool and flatus. Fomentation (Sveda) after the manner of Kumbhika, Pinda and Ishtaka (see Chapter XXXII (Prognosis Based On The Perversion Of The External Appearances Of The Body (Svabhava-Vipratipatti - Madhyayam))) Chikitsita Sthana) are also efficacious 30 - 32.
Purgatives preceded by the application of fomentation should be exhibited to a Gulma-patient, since it is extremely difficult to purge him. Vilepana (massage of the Gulma), application of unguents and poultices, Samdahana (cauterisation) as well as tepid fomentation after the manner of Salvana-Sveda and the like are likewise applicable. Medicated Ghritas, powders and Vartis mentioned in connection with the treatment of Udara as well as medicated salts mentioned under the head Udaramaya * are likewise applicable in the present disease. 33 - 34.
Medicated Plugs or Vartis made of Sdmudra †
* Udaramaya may mean either indigestion or ascites. Anilamaya (Vata-vyadhi) is a variant addopted by Dallana and is undoubtedly preferable since there are several medicated salts e. g., Patra-Lavana, Kanda-Lavana, in the treatment of Vata-Vyadhi. See Chap. IV, Chikitsita Sthana.
† According to some 'Samudra' means Samudra-salt and others, it means Samudra-Phena.
Ardraka, Sarskapa (mustard) and a profuse quantity of Maricha pasted together should be inserted into the rectum in suppression of stool and flatus in a case of Gulma. Arishtas made with Danti -roots, Chitraka-xooxs, or with the Yayu-subduing drugs according to the manner laid down in the Sutra-sthana should be prescribed, or the patient should be made to use the duly fried tender sprouts of Putika and Nripa-Vriksha. A Gulma patient with the upward coursing of his bodily Vayu should not be treated with Nirudha-Vasti. 35 - 37. Compounds of Trivit and S'unthi or of treacle and powdered Haritaki * as well as of Guggulu, Trivit, Danti, Dravanti, Saindhava and Vacha should be administered through milk, wine or the expressed juice of grapes, according to the strength (of the disease and of the patient). Pilu made into ,a paste and salted with the addition of Saindhava should also be similarly taken. Wine surcharged with Pippali, Pippalt-roots, Chavya, Chittaka and Saindhava and taken at an opportune moment (i. e., when attended with tympanities, etc.) would prove readily curative in a case of Gulma. A Gulma-paticnt afflicted with a suppression of stool and of flatus should take barley with milk or Kulmdslia (Masha-cakes) profusely saturated with salt and clarified butter. 38-39.
If Sula which is its supervening symptom anyhow appears whereupon the patient suffers a kind of digging and piercing pain resembling that arising from the piercing of ;i dart, there will also appear the following distressing concomitants according to the Dosha or Doshas involved, viz,, supression of stool and urine, difficult respiration, and numbness or stiffness of the limbs (in cases of aggravated Vayu), thirst, burning sensation, vertigo, ill-digestion of food, and excess of the colic pain (in cases of aggravated Pitta), and goose-flesh, aversion to food, vomiting, increase of pain after the taking of food and a sense of lassitude in the limbs (in cases of aggravated Kapha). The course of medical treatment in such cases should be determined by the nature and number of the deranged bodily Doshas specifically lying at the root and should be as follows. 40.
* According to some commentators the first two compounds should he taken with water.
The following three compounds, viz., (I) Pathya, the three kinds of salt (Saindhava, Sauvarchala and Vit) Yava-Kshara, Hingu, Tumburu, Pushkara, Yamani, Haridra, Vidanga and Amla-vetasa; (2) Vidari, Triphala, Satavari, S'ringata, Guda-s arkara (Gangeri-phala), Kas'mari-phala, Yashthi-madhu, Parushaka, Hima (sandal wood) and (3) Shad-grantha (Vacha), Ativisha, Deva-daru, Pathya, Maricha, Vrikshaka, Pippali-mula, Chavya, Nagara, Kshara (Yava-kshara) and Chitraka should be respectively given in the Vataja, Pittaja and Kaphaja types of the disease. The medium through which these compounds should be given would be tepid Amla-Kanjika, luke-warm milk and tepid water respectively. The preceding three compounds should be jointly administered in sets of two or three when two or three Doshas arc involved in any case. 41.
Sprinkling (of water), baths, plaster (Pradcha) unguents and dietetic treatment should be similarly applied in Vataja cases. Contacts with vessels filled with cold water should be applied in Pittaja cases, while the use of emetics, rubbing, fomentation (Sveda), fasting and ether Kapha-subduing remedies should be recommended in Kaphaja types. Applications of Sneha and su:h-likc remedial measures are specifically recommended in the disease, according to the Dosha or Doshas involved in each case. 42.