The Sushruta Samhita — trans. Bhishagratna

Then the intestine should be moistened with honey and clarified butter. It should then be gently replaced in its original position and the mouth of the incision in the abdomen should be sewn up. 20.

Treatment of Parisrsivi-Udara :— In

cases of the Parisrsivi type of Udara, the obstructing matter should be similarly removed (from the intestines), as in the preceding case, and the secreting intestine should be purified. The (two ends of the severed intestines should be firmly pressed and adhered together and large black ants should be applied to these spots to grip them fastly with their claws. Then the bodies of the ants having their heads firmly adhering to the spots, as directed, should be severed and the intestines should be gently reintroduced into their originalp. 401 position (with the severed heads of the ants adhering to the ends of the incision) and sutured up, as in the preceding case. A union or adhesion of the incidental wound should then be duly effected. The «=eam should now be plastered with black earth mixed with Yashtimadhu and duly bandaged. The surgeon should cause the patient to be removed to a chamber protected from the wind and give him the necessary instructions. The patient should be made to sit in a vessel full of oil or clarified butter and his diet should consist only of milk. 2r.

Treatment of Udakodara :— A patient

afflicted with Jalodara (ascites) should be first anointed with medicated oils, possessed of Vdyu-subduing virtues, and fomented with hot water. Then his friends and relatives should be asked to hold him firmly by his arm-pits, when the surgeon would make a puncture with a surgical instrument, known as the Vrihi-mukha, on the left side of the abdomen below the umbilicus, to the breadth of the thumb in depth and at a distance of four fingers to the left of the dividing line of hairs in the abdomen, Simultaneously with that, a metal tube or a bird's quill, open at both ends, should be introduced through the passage of the puncture to allow the morbific fluids (Doshodoka), accumulated in the abdomen, to ooze out. And then having removed the tube or the quill, the puncture should be lubricated with oil and Saindhava salt and bandaged in the manner described in connection with the bandaging of ulcers.

And then having removed the tube or the quill, the puncture should be lubricated with oil and Saindhava salt and bandaged in the manner described in connection with the bandaging of ulcers.

The entire quantity of the morbific fluid should not be allowed to ooze out in a single day, inasmuch as thirst, fever, aching of the limbs, dysentery, dyspnoea and a burning of the feet (Pdda-djiha) might supervene in consequence, or as it might lead to a fresh accumulation

p. 51

402 THE 5USHRUTA SAMHITA. |[Chap. XIV.

of matter in the abdomen, in the event of the patient being of a weak constitution. Hence it should be gradually tapped at intervals of three, four, five, six, eight, ten, twelve, or of even sixteen days. After the complete outflow of the fluid, the abdomen should be firmly tied with a piece of flannel, silk-cloth or leather, inasmuch as this would prevent its flatulent distention.

Diet;— For six months the patient should take his food only with milk or with the soup (Rasa) of Jdngala animals.

The diet* for the next three months should consist of (meals taken with) milk diluted (and boiled) with an equal quantity of water or with the soup of flesh of animals of the Jdngala group seasoned with the juice of acid fruits. During the next three months it .should consist of light and wholesome meals. This rule observed for a year brings about a cure. 22.

IVIemorable Verse :— Skilled physicians

should prescribe boiled milk and the soup of the flesh

* The use of water is forbidden during these nine months.

During ihe first six months, drinking, washing, etc., should be done with milk or the soup of Jangala animals. After this period, the said purposes should be served with half.diluled milk or meat-soup seasoned with the juice of acid fruiis. Water may be used during the period of the next three months. —Dallana.

Vagbhata following Charaka says: —

The patient should live only on milk for six months. After this period, he should live on porridge (Peya) boiled with milk ; and for the next three months he shoull live on boiled S'y^ma-rice with milk, or with the soup of meat seasoned with the juice or acid fruits and mixed with clarified butter and a small quantity of salt.

The water of tender and green cicoanuts is used in cases of Udara in place of pure drinking water with benefit. — Ed.

Chap. XIV.] CHlkltSA STHANAM. 403

of animals of the Jdngala group as food and drink in all cases of Udara and use these as Asthapana measures and as purgatives as well. 23.

— Ed.

Chap. XIV.] CHlkltSA STHANAM. 403

of animals of the Jdngala group as food and drink in all cases of Udara and use these as Asthapana measures and as purgatives as well. 23.

Thus ends the fourteenth Chapter in the Chikitsita Sth^nam of the
Sus'rula Samhitd which deals with the treatment of Udara.

CHAPTER XV.

Now we shall discourse on the (surgical and medical) treatment of the cases of difficult malpresentation of the foetus and of difficult labour (Mudha-Garbha). i.

The extraction of a foetus, acting (^in the womb) as an obstructing Salya (foreign matter lodged in the body), is the most difficult of all surgical operations, inasmuch as actual contact or actual manipulation is the only means accessible to a surgeon in the region of the pelvic cavity, the spleen, the liver, the intestines and the uterus. All surgical acts in respect of the foetus or the enceinte, such as lifting up, drawing down, changing of postures (version), excision, incision, the cutting of limbs and section, pressure, the straightening and the perforating of the abdomen, could not be done otherwise than by actual contact of the hand, which may sometimes prove fatal to the foetus or to the enciente. Hence the king should be first informed (as success in these cases is often uncertain) and all acts should be performed with the greatest care and coolness.

We have stated before that the foetus is generally presented in cases of difficult labour in eight different postures or forms. The obstruction of the child in the passage of parturition (Garbha-Sanga) may be effected in three different ways, owing to its head, shoulders or hips being presented in a wrong way and held fast in the passage. Every care should be taken and no pains spared to bring a child alive into the world, which is not already dead in the womb. The sacred verses (Mantras), possessing of the virtue of bringing out the foetus, should be recited in the hearing of the enciente in the case of a dhap. XV.] CHlklTSA STHANAM. 4O5 failure in the first attempts at effecting parturition. The mantras are as follows. 2.