The Sushruta Samhita — trans. Bhishagratna

Of the sixteen vessels (eight on each side) of the Hanus (Jaws), the two Siras about each of the joint of the jaw-bones should never be opened. 22.

Of the thirty-six* vessels in the tongue, sixteen are situated in the under-surface of that organ and twenty in the upper surface ; of these the two speech-carrying and the two taste-carrying ones should be held unfit for venesection. Of the twenty-four vessels in the nose, the four adjacent to the nose proper and the one running into the soft palate should be held unfit for similar purposes. Of the thirty-eight vessels in the two eyes, the one situated at each Apanga should not be opened. Of the ten vessels in the two ears, the soundcarrying one in either ear should not be opened. Of the sixty vessels of the nose and eyes coursing through the region of the forehead, the four vessels adjacent to the sculp proper and the Avarta-Marma should be held unfit for opening or bleeding. One vessel (Sird) in each of the two Avartas and the one in the Sthapani-marma should not be opened (on any account). Of the ten vessels in the temple, the one about each temple-joint should be held unfit for opening or bleeding. Of the twelve vessels in the head, the one

*Gayi asserts that there are eight each of the Vayu-carrying, Pitta- Carrying, Kapha-carrying and blood-carrying S'iras in the region of the neck, thus making a total of 32 in place of 36 of the text.

He also holds that there are 28 in place of 36 S'irds in the tongue, 16 in place of 24 in the nose, 24 in place of 38 in the eyes, 16 in place of 10 in the ears and 8 in place of 10 in the temple. In the counting of the S'iras situate in the other parts of the body, he, however, does not differ fiom the text.

Chap. Vlt] SARIRA STHANAM. TQ;

in each of the two Utkshepa-Marmas, one in each of the (five) Simanta-Marmas and one in the Adhipati-Marma, should be held unfit for the purpose. No incision or opening should be made into any of these fifty vessels situated in the region above the clavicles. 23-31.

Memorable verses :— As the stem and leaves etc, of a lotus plant, originated from its bulb, spread over the whole surface of a pool or tank (lit : water), so the vessels emanating from the umbilicus of a man spread over his whole organism. 32.

Thus ends the seventh Chapter of the S'arira Slhanam in the Sus ruta Samhila which treats of the description and classification of S'iras (vessels).

CHAPTER VIII.

32.

Thus ends the seventh Chapter of the S'arira Slhanam in the Sus ruta Samhila which treats of the description and classification of S'iras (vessels).

CHAPTER VIII.

Now we shall discourse on the Sariram which treats of the method of Venesection etc. (^ira-Vyadha-

Vidhi-^ariram). i

Persons unfit for Venesection:— The

vessel or vessels (Sira) of an infant, an old man, a perched man, one fatigued and emaciated with endocarditis (Kshata-kshina), a person of timid or coward disposition, a person used up with excessive drinking or sexual enjoyments or tired with the troubles of long journey, an intoxicated person, a patient who has been treated with purgatives, emetics or with Anub^isana and Asthdpana measures (enemas), a man who has passed a sleepless night, an impotent (Kliva) or emaciated person, an enceinte, or one afflicted with cough, asthma, high fever, phthisis convulsions, paralysis, thirst, epilepsy, or effects of fasting, should not be pierced or opened. Incisions should not be made into those veins (Siras) which are not fit for opening, or into the fit ones, if invisible ; it should be the same with those which cannot be properly ligatured or even if ligatured cannot be raised up. 2.

Diseases which are amenable to acts of venesection have been described before (Sonita-Varnaniya-Adhydya). Venesection may be performed in the said diseases as well as in those which have not been enumerated in connection with them and also in other cases whether suppurated or unsuppurated, if such a proceeding is deemed necessary and after the application of Sneha and Sveda. Venesection should be made even in the cases declared unfit for it (such as in an infant etc.) in cases of

Chap. VIII.] SARIRA STHANAM. 1 99

blood-poisoning (such as snake-bite etc.) and in fatal diseases (Vidradhi etc.). 3-4.

Preliminary rules : —The patient should be

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blood-poisoning (such as snake-bite etc.) and in fatal diseases (Vidradhi etc.). 3-4.

Preliminary rules : —The patient should be duly fomented i^Sveda) atid anointed (Sneha) with oily preparations. A liquid* food or diet consisting of articles which are antidotal to the bodily principles (Doshas) which engendered the disease or Yavagu (gruel) should be given to him at first. Then at the proper season (i.e., not in the rainy or winter season etc.) the patient should be brought near the surgeon and made to sit or lie down and the part to be incised upon should be bound, neither too loosely {e.g., in the extremities etc.) nor too tightly (^.^.,in the head etc.), with any of the accessories, such as cloth, linen, skin, the inner fibres of a bark, creepers etc., so as not to create any pain or agitation in his mind. Then the vein should be duly opened with proper instrument (and with a careful regard to the situation of any local Marma). 5

IVletrical text : —Venesection should not be performed in an extremely cold or hot, cloudy or windy day. It is forbidden to open a vein without necessity or in a healthy person, or in a disease in which such as a proceeding is absolutely prohibited. 6.

The Yantra-Vidhi :— The patient whose vein is to be operated upon should be seated on a stool to the height of an Aratni (distance of the elbow from the tip of the small finger) with his face turned towards the sun. He should keep his legs in a drawn up or contracted posture resting his elbows (Kurpara) on his knee-joints and the hands with his two thumbs closed in his fists placed on (the upper ends of; his Manyas (sterno mastoid muscles), Then having cast the binding

* A liquid food is recommended for the purpose of liquefying the blood so as to bleed easily. . . -

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