It is improper to arrest the emission of blood immediately at the outset of the disease if the patient be a sufficiently strong man, in as much as such a procedure may bring on an attack of * Pandu-roga, Graham, Kushtha (cutaneous diseases), Gulma, or fever or enlargement of the spleen. An attack in which the blood makes a downward course should be arrested with emetic medicines, while purgatives should be exhibited in a case in which the blood finds an upward course. But weak patient, under the circumstances, should be treated in both cases with soothing remedies. Fasting should be first enjoined in the case of an excessive emission † of blood in respect of a strong patient with an unimpaired digestion and an unemaciated frame. A Pcya prepared with a small quantity of rice should be given to the patient after fasting ‡. Tarpana measures, decoctions of digestive drugs, as well as a variety of medicinal lambatives and Ghritas should be the proper applications in the disease under discussion. Purgation should be induced with the compound of Draksha, Yashti-madliu, Kds'marya and sugar, while vomiting should be induced with an emetic compound consisting of Yashti-madhu mixed with honey. 8 - 11.
The use of milk, the drugs of cold-producing potency (e g. the drugs of the Utpaladi group), essence of the meat of an animal of the Jangala group, soup of Satinet (cerials), S'ali-ricc, Shash-tika-grains, leaves of Patola, S'elu, Sunishanna, Yuthika and Sindhuvara (Nirgundi) as well as the tender sprouts of Vata and Atimukta (Tinduka) as pot-herbs and cooked with clarified butter are recommended as diets. Soup of the meat of pigeons, S'amkha (conch) and tortoise as well as the gruels mentioned before mixed with the expressed juice of Dhatri and pomegranate and with a profuse quantity of clarified butter should be given to the patient as diet. Milk should be duly cooked in combination with the drugs of the Utpaladi group, and the cream therefrom should be likewise prescribed with a copious quantity of honey and sugar. Cold Pradehas, honey, sugar, and clarified butter are said to be beneficial in cases of Rakta-pitta. 12 - 13.
* Both Chakrapani and Yrinda read etc." i.e., they say that it may bring on an attack of heart-disease also.
† Both Chakrapani'and Vrinda read ' i.e. in cases of upward emission. There is also another variant i.e. in cases of excessive upward emission or in cases where a good deal of the vitiated Doshas takes an upward course.
Meat-essence (Rasa) and soup (Vusha) seasoned with clarified butter prepared from cow's milk.
An experienced physician should prescribe any one of the four Iambatives composed of the powders of the flowers of Madhuka, S'obhanjanay Kovidara or of Priyangu, mixed with honey to be licked up by a patient suffering from Rakta-pitta. Similarly Iambatives of Durba, or the tender leaves of Vata, or of white Karnika pasted together with the honey should be given to be licked up by the patient *. Dates and other friuts of the same therapeutic virtue, taken with honey, would prove efficacious in the disease. 14 - 15.
Medicinal compounds mentioned in connection with the treatment of Raktatisara (blood-dysentery) may be as well employed with advantage in the present instance. A piece of sugar-cane devoid of its skin and crushed should be kept immersed in cold water contained in a new earthen pitcher. The picther with its lid off should be kept in an open place for a night. Its contents duly strained in the morning should be given with powdered Utpala and honey to a patient suffering from Rakta-pitta. A cold infusion of Jambu, Amra and Arjuna should be taken with honey. As an alternative, the expressed juice of Udumbara fruit should be taken (with honey). 16 - A.
* Dallana takes only Durba and Vata under one recipe. Some commentators would prescribe all these together under one recipe.