ln cases of the curable type of Upadams'a, Sneha (oleaginous substances) should be first applied, and the affected part should be fomented. Then the veins of the penis should be opened, or leeches should be applied (to the organ) for the elimination of the contaminated blood † (according as the affections are more or less severe). 13.
The system of the patient should be cleansed with both emetics and purgatives in the event of an excessive aggravation of the Doshas inasmuch as the local pain and swelling would subside simultaneously with the elimination of the aggravated Doshas from the system Medicinal Vastis (enemas) should be injected (into the rectum) in the way of a Niruha-Vasti for the elimination of the aggravated Doshas, where the weakness of the patient would prohibit the application of purgatives. 14.
In a case of the Vataja type of the disease, drugs such as, Propaundarika, Yashti-madhu, Varshábhu, Kushtha, Deva-dáru, Saralá, Aguru and Rásná, should be used as a plaster (over the affected organ). Similarly plasters composed of Nichula, castor-seeds, and pulverised wheat and barley grains pasted with Sneha (clarified butter, oil, etc.) should be applied lukewarm to the seat of the disease, which should also be affused with a decoction of the above-mentioned drugs, viz., Prapaundarika, etc. 15.
* See note, Chapter XII (Curative Treatment Of The Type Of Abhishyanda (Ophthalmia) Which Has Its Origin In The Vitiated Condition Of The Blood (RaktáBhishyanda-Pratishedha))., Nidána Sthanam.
† Jejjata holds that leeches should be applied in a case of superficial Upadams's.
In a case of the Pittaja type of the disease, a plaster composed of Gairika, Anjana, Yashti-madhu, S'árivá, Us'ira, Padmaka, (red) Chandana and Utpala mixed with a Sneha (clarified butter), * or that composed of Padma, Mrinala, Sarjja, Arjuna, Vetasa, and Yashti-madhu mixed with clarified butter should be applied to the affected organ which should be sprinkled with a solution of milk, clarified butter, sugar, sugar-cane juice and honey, or with a cold decoction of the drugs of Vata, etc. 16.
In a case of the Kaphaja type of the disease, a plaster composed of the barks of S'ála, As'va-karna, Aja-karna and Dhava pasted with Sura, and mixed with oil, should be applied hot to the affected part. As an alternative, the drugs such as, Haridrá, Ativishá, Musta, Saralá, Deva-daru, Patra, Patha, and Pattura should be used for similar purposes and the affected organ should be affused with a decoction of the drugs of the Sn-rasadi and A'ragvadkddi groups. 17.
The above remedial measures, viz., plasters, sprinkling (Parisheka), blood-letting and Sams'odhana (i.e., application of purgatives, emetics, etc.) as well as those described in the Sutra Sthanam (and the first Chapter of the Chikitsita Sthanam), should be resorted to in a case of (non suppurated) Upadams'a. The physician should try his best to arrest the setting in of suppuration (in a case of Upadams'a) inasmuch as suppuration in (and consequent putrefaction of) the (local) veins, ligaments, skin and flesh would lead to th.3 destruction of the organ (Dhvaja). An incision should be made as soon as suppuration would set in, and the pus and other putrid matters being drawn out, the incised part should be plastered with the paste of sesamum mixed with honey and clarified butter. The incidental ulcer should be washed with a decoction * of the leaves of Karavira, of Jati and A'ragvadha, or of Vaijayanti and Arka. 18.
* According to S'ivadása the Sneha to be used in the plaster should be clarified butter washed a hundred times.
The use of a medicinal plaster composed of the fine powders of Sauráshtra-mrittiká, Gairika, Tuttha, Pushpa-Kásisa, Saindhava, Rodhra, Rasánjana, Daru-Haridrá, Haritála, Manahs ild, Harenuká and Ela, mixed with honey is highly recommended in all cases of Upadams'a. 19.
A decoction of the tender leaves of Jambu, A'mra, Sumanas, Nimba, S'vetá, and of Kámboji † and the barks of S'allaki, Vadara, Vilva, Palas'a, Tinis'a and of the Kshiri trees, as well as Triphalá should be used by the physician for constantly washing the ulcer. Oil cooked with the preceding decoction, with the Kalkas of Goj'i, Vidanga and Yashti-madhu, as well as with the different spices (Eladi group) should be used as the best remedy for the purpose of the healing up (Ropana) of an Upadams'a-ulcer of whatsoever type. The use of a pulverised compound composed of Svarjiká, Tuttha, Kásisa, S'aileya, Rasánjana, and Manahs'ilá taken in equal parts arrests the extension of an ulcer and Visarpa. Cases of Upadams'a and Visarpa readily yield to the application of a pulverised compound of the ashes of Gundrá, Haritála and Manahs'ilá. An (external) application of Bhrimgarája, Triphalá and Danti mixed with the powders of copper and iron, destroys Upadams'a just as the thunder bolt of Indra (completely) destroys a tree. 20.
* According to Chakradatta the five kinds of leaves should be separately used in the preparations of the decoctions for washing, † "Máshaparni" according to Gayadása.