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आनूपवारिजानां मांसानां पोट्टलैः सुखोष्णैश्च। स्विन्नोत्सन्नं [१] विलिखेत् कुष्ठं तीक्ष्णेन शस्त्रेण ॥५१॥
[Local treatments] If the patches are elevated then swedana with lukewarm poultice of meat of aquatic animals should be followed by scrubbing with sharp edge surgical instrument for blood letting.
english translation
रुधिरागमार्थमथवा शृङ्गालाबूनि [२] योजयेत् कुष्ठे। प्रच्छितमल्पं कुष्ठं विरेचयेद्वा जलौकोभिः ॥५२॥
For blood letting shringa (horn), alabu (gourd) may be used. Especially in alpa kushtha, prachana, virechana and/or use of jaluka should be done.
english translation
ये लेपाः कुष्ठानां युज्यन्ते निर्हृतास्रदोषाणाम्। संशोधिताशयानां सद्यः सिद्धिर्भवेत्तेषाम् ॥५३॥
Lepa explained in kushtha become efficient if applied after raktamokshana and other shodhana procedures.
english translation
येषु न शस्त्रं क्रमते स्पर्शेन्द्रियनाशनानि यानि स्युः। तेषु निपात्यः क्षारो रक्तं दोषं च विस्राव्य ॥५४॥
When there is loss of sensation and/or surgical interventions is prohibited, kshara should be used after rakta and dosha are eliminated.
english translation
पाषाणकठिनपरुषे सुप्ते कुष्ठे स्थिरे पुराणे च। पीतागदस्य कार्यो विषैः प्रदेहोऽगदैश्चानु ॥५५॥
If kushtha is hard like stone with numbness, it is stable (not spreading) and chronic in such cases antidotes should be given internally prior to the application of poison in the form of lepa followed by application of antidote.
english translation