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264 stuffing or choking the channels of the intestines. The pain is first experienced in the region of the right or left Kukshi (loin), but it soon extends over the whole abdomen with rumbling sounds therein. Thirst becomes unquenchable and vertigo and epileptic fits follow in its train, and the patient finds no relief even after the evacuation of the bladder and of the bowels. This disease is called Vit-Śula and is a very violent one. 71.

Treatment: — An experienced physician should instantly employ m such cases) the medicinal remedies which have the virtue of eliminating the deranged Doshas from the system. Fomentations, emetics as well as Sneha-Vastis and Nirudha-Vastis should be applied, and the bowel-cleansing compounds dealt with before should be administered. Medicinal measures mentioned in connection with the treatment of Udávarta should be likewise employed with advantage. 72. Symptoms of Annaja Śula:— A voracious eating in an impaired state of digestive fire, aggravate the local Váyu which makes the food taken remain stiffed in the Koshtha. The food thus undigested in the Koshtha causes an intolerable colic, which brings on a distension of the abdomen, epileptic fits, eructation, nausea and an attack of Vilambiká. The patient shivers, vomits, or passes stool, and even loses consciousness. Anti-colic (pain-killing) pills, powders and medicinal Ksháras are recommended in the case. All the medical remedies applicable in cases of Gulma should likewise be applied in cases of Śula. 73 — 74.

Thus ends the forty-second chapter of the Uttara-Tantra in the Sus'ruta Samhitá which deals with the medical treatment of Gulma.