Clarified butter cooked with the fruit of Jimutaka and Kosha-vati, and with (the roots of) Danti, Dravanti and Trivrit, is a very powerful and efficacious remedy. † Administered internally as well as externally, it leads to the cure of the advanced cases of Apachi. 12.
A strong emetic composed of Nirguudi, fáti (flower) and Varihistha (Válá) together with Jimutaka, profusely mixed with honey and Saindhava, should be given warm to the patient. It is a very powerful emetic, and leads to the recovery of even a malignant form of Apachi. An oil, cooked with the pastes (Kalka) of Kaitaryya,. ‡ Vimbi and Karavira, may be profitably used as an errhine (Siro-virechana). Oil cooked with the expressed juice of S'akhotaka may also be used profitably as an errhine. § Avapida errhines (used in drops A glandular swelling Granthi), occurring in any part of the body other than a Marma, should be opened in its non-suppurated stage and cauterized with fire; † or it should be rubbed with an alkali ‡ after scarification as already advised. 16.
† In preparing this medicated Ghrita, the quantity of clarified butter should be taken four times as much as the combined weight of the Kalka (paste). These should be boiled with water, taken four times as much as the quantity of clarified butter. Some authorities, however, are of opinion that both the paste (Kalka) and the decoction of the drugs are to be taken in its preparation, into the nostrils should be applied with Madhuka-sára, S'igru-seeds and Apámárga-seeds * 13-15.
‡ Some read 'Nirgundi' after it.
§ This medicated oil should be cooked without any Kalka. But some are of opinion that both the decoction and the Kalka of S'akhotaka should be used.
A length of twelve fingers should be measured (Mitvá) from and above the Párshni, i.e., the posterior side of the ankle (and the space of Indra-vasti above this part should be ascertained). The Indra-vasti (occupying a space of half a finger, or, according to others, two fingers) having been carefully avoided, an excision (on the opposite side of the affection) should be made and the spawn-like glands having been removed (therefrom) the excisioned part should be cauterised with fire.
Others say that the excision should be made straight above the ankle (Ghoná) after carefully avoiding the space of Indra-vasti, measuring two fingers (and to make sure an additional space of half a finger should be left out), which would be found out by taking one-eighth part (of the Janghá, i.e., the leg - excluding the foot and measuring twenty fingers) from the Khulaka (ankle-joint) of which the (two) Gulphas (ankles) look like the (two) ears. § 17-18.
* Madhuka-sára mixed with tepid water and the expressed juice of S'igru-seeds and of Apámárga-seeds should be used.
† In cases of the preponderance of Váyu and of Kapha.
‡ In cases of the preponderance of Pitta.
§ There is a good deal of difference as to the reading and explanation of this passage amongst the different commentators. The different explanations arise from the different interpretations put upon the word in the Text,etc." The wordsmay mean either of the following. (1)On the opposite side of the Párshni. Vágbhata subscribes to this view. (2) On the opposite (i.e., the other) Párshni, that is to say, if the affection be on the right side of the body the operation should be made on the Párshni of the left leg and so on. Vriddha Vágbhata subscribes to this interpretation in the clearest language. (3) In the region of the Párshni, i.e., on the dorsal side of the leg.
As an alternative, the region of the wrist (Mani-bandha) should be branded by a physician with three mark lines, one finger apart, for a radical cure of Apachi. 19.
The different commentators, again, do not agree as to the seat and extent of the excision. Some say that the operation should be made above the Indra-vasti and the extent should be two fingers in length. Vágbhata seems to subscribe to this view. Others hold that the operation should be made below the Indra-vasti and the extent should be two fingers' length: Dallana is of this opinion. A third class of commentators assert that the whole extent of the length from above the Párshni up to the Indra vasti should be opened.
As to the extent of the Indra-vasti, again, there is a difference. According to Dallana it occupies a space of two fingers. But Jejjata holds that it occupies a space of half a finger only. The Indra-vasti (Marma) is situated twelve fingers above (i.e., in the thirteenth finger of) the Párshni. The reading in the printed editions of the text is whereas Vrinda and Chakradatta readDallana's reading also evidently iswould be quite redundant and asgives a better meaning, we accept this reading.
Now we come to the second stanza. Commentators differ more in the exposition of this stanza than of the former. By the expression
is meant by some commentators "from the Gulpha to the Karna." Others, however, mean to take it as an adjective to 'and explain it as meaning "from above the Khulaka whereof the Gulphas look like the Karnas." As regards the expression 'some are inclined to think that the excision should be made straight above the Ghoná (i.e., the posterior part and especially the big vein there which looks like the nose (Ghona) of the ankle-joint).
Oters, however, read it as ' and explain it
as meaning "in a straight line with the Ghoná (which may mean The ashes (Masi) of the skins of a peacock, cow, lizard (Godhá) and snake and of tortoise shells should be dusted (over an Apachi after lubricating it) with the (expressed) oil of the Ingudi. Medicated oils to be described under the treatment of Slipada (elephantiasis) and Vairechanika fumes should also be applied in a case of Apachi and the diet should consist of cooked barley and Mudga pulse. 20-21.