In a case of Salyaja Nádi (incidental to any foreign matter into the body), the Salya should be first extracted by an incision into the sinus. Then having fully cleansed the channel, the ulcer should be purified with a plaster of sesamum profusely saturated with honey and clarified butter. It should be then healed up. Oil cooked with the decoction of the tender fruits of the Kumbhika, Kharjura, Kapittha, Vilva and the Vanaspatis (Vata, etc.), and with the Kalkas of Mustá, Saraiá, Priyangu. Sugandhiká, Mocharasa, † Ahi-pushpa (Nágesvara), Rodhra and Dhátaki flowers leads to a speedy healing up (granulation) of ulcers (Vrana) and traumatic sinuses. 15.
* Dallana's reading evidently is "Táli-lala" and he explains it as the roots of "Bhumyámalaki". Chakradatta also prescribes this oil but he takes "Nilika" instead of "Tali". S'ivadása, again, in his commentary quotes from Sus'rula but reads "Nili-Nala' in place of "Tála-Nala."
† "Mocha-rasa" is explained by Dallana to be "S'obhánjana," but it generally means "S'almali-veshta,"and S'ivailása explains it as such. - Ed.
An erudite surgeon should open a sinus, occurring in any of the Marmas, or in a weak, timid, or emaciated person with an alkalined string (Kshára-Sutra) and not with a surgical knife. The course of the sinus should be first ascertained with a director; and a needle, threaded with a string of alkalined thread should be passed from one end of the sinus and quickly drawn out through the other. Then the two ends of the thread should be firmly fastened together. An intelligent surgeon should likewise pass another alkalined thread in the event of the alkali of the first thread being comparatively weak. This should be repeated till the sinus completely bursts out. The surgeon should know that the same procedure may be as well adopted in cases of fistula-in-ano. Similarly in cases of tumours (Arvuda), etc. they should be lifted up (with the hand) and tied round at their base with an alkalined thread, or it should be punctured around with a kind of needle with their mouth resembling a barley corn and then tied again at their base with an alkalined thread. After their bursting (and falling off), they should be treated as common ulcers (Vrana) 16, pasted together with the milky juice of the Snuhi and Arka leads to the speedy healing up of a sinus. The powdered * stones of Vibhitaka, mangoe fruits, Vata-sprouts, Harenu, S'amkhim-seed, Váráhi-kanda mixed with oil can also be used in a case of sinus. 17-19.
The different kinds of Plug-Stick (Varti) described in the Dvi-Vraniya Chapter (Chikitsita - chap.1.) may be similarly used with advantage in all cases of sinus. The use of a plug made of the following drugs, viz., the bark and fruit of the Ghonta, (the five officinal kinds of) salt, * Lákshá, Puga and the leaves of the Alavaná †
* According to Chakradatta's reading and S'ivadás's commentary there-on, only the Saindhava (instead of the five officinal kinds of salt) should be taken. We, however, follow Dallana's interpretation with good results.-Ed.
† "Alavaná" has been explained by Dallana as "Káka-mardaniká" and by S'ivadása as "Jyotishmati". S'ivadása is, however, followed in practice in this case.
The seeds of the Dhustura, Madana and Kodrava, Kos'átaki, S'uka-nasá, Mriga-bhojani and the seeds and flowers of the Amkota should be pounded together and applied to a sinus (Nádi) after having washed it with a decoction of Lákshá. Cases of sinus speedily yield to the curative efficacy of the application of these powders mixed with oil. The use of the oil cooked with cow's urine and with the preceding drugs (as Kalkas) brings about the healing up of a sinus in seven nights. 20-21.
The application of the oil cooked with the roots of the Pinditaka treated with the expressed juice of the Varáha-kanda in the manner of a Bhávaná saturation and with the bulbs of Suvahá brings about a speedy and effective remedy for a sinus. The same effect is produced by an application of the oil cooked with the bulbs of the the Vajra-kanda. 22.