The Sushruta Samhita — trans. Bhishagratna

[Chap. VIII, SARIRA STHANAM,p. 203 would b2 described under the treatment of that disease. In Vata-rogas, such as Kroshtuka-s'irah (Synovites), maimedness (Pangu) and lameness (Khanja\ the Siia (vein) of the Jangha (lower leg-calf), four fingers above the Gulpha, should be opened. In cases of Apachi (scrofula), the vein should be opened simultaneously with the appearance of the disease two fingers below the Indravasti-marma. In a case of Gridhrasi (sciatica), the vein should be opened four fingers above or below the Jdnu (knee-joint). In a case of goitre, the veins attached to the roots of the Uru (thighs) should be opened. The instructions regarding the opening of a vein in one leg shall hold good in the case of that in the other, as well as in cases of those situated in the two upper extremities (hands), but the speciality is that in a case of enlarged spleen, the vein near the Kurparasandhi (elbow-joint) of the left hand or that inside the fourth and the fifth fingers should be opened. Similarly in a case of Yakriddalyodara or Kaphodara, the corresponding vein in the right hand should be opened. Several authorities advise the opening of the same vein in cases of cough and asthma* due to the action of the deranged Kapha. 27-35.

In a case of Vis'vachi, the same argument holds good (four fingers above or below the Kurpara-sandhi) as in a case of Gridhrasi. In a case of Pravdhikd (diarrhoea) attended with Sula (colic), the vein within two fingers width around of the Pelvis (Sroni) should be opened. The vein of the penis should be opened in a case of Parikartikd (D.R.-ParivartikA), Upadansa, Suka-dosha and seminal disorders. The vein on either side ofp. 204 the scrotum should be opened in a case of hydrocele (Mutra-Vriddhi). 36-39.

* Gayi holds that in cases of asthma and cough venesection should be had recourse to only when they are in a mild form.

p. 204

the scrotum should be opened in a case of hydrocele (Mutra-Vriddhi). 36-39.

The veui four fingers below the navel and on the left side of the Sevani (suture) should be opened in a case of Dakodara (ascites). In a case of internal abscess and colic in the sides (Pleurodynia), the vein in the region between the breast and the left armpit should be opened. Several authorities assert that in a case of Avavahuka and Vahusosha (atrophy of the hand), the vein between the Amsas (shoulders) should be opened. In a case of Tritiyaka (Tertian) fever^ the vein inside the Trika-Sandhi should be opened. In a case of Chaturthaka fever, a vein jo hied with either side of and below the shoulder-joint should be opened. In a case of Apasmara, the middle vein adjacent to the joint of the jaw-bones (Hanu-Sandhi) should be opened. In a case of insanity and hysteria* (Apasmara), the vein between the temple and the edge of the sculp or those in the Apanga (tips of the eyes), the forehead or the chest should be opened. In cases of the diseases of the tongue and the teeth, the veins on the under-surface (Adho-Jihva) of the tongue should be opened. In the case of a disease of the palate, the local vein should be opened. In diseases of the ears and specially in a case of inflammatory ear-ache (Karna-Sula), the vein along the region above the ears should be opened. In diseases of the nose and specially in a case of the loss of the smelling faculty, the vein at the tip of the nose should be opened. In cases of eye-diseases, such as

* Dallana, however, differs here from the text. He says, on the authority of Vagbhata, that the opening of a vein between the temple and the edgt of the sculp or those in the Apanga, the forehead and the chest should te recommended in cases of insanity only, and not in the case of of .^pas^mdra as well (as in the text).

Chap. VIII.] SARIRA STHANAxM. 205

Timira (blindness), Akshipdka (ophthalmia) etc., as well as In diseases of the head and in Adhimantha, the veins about the nose, the forehead and the Apdnga (the outer canthus of the eyes), should be opened. 40-51.

Defective Venesection :— Now we shall

40-51.

Defective Venesection :— Now we shall

describe the twenty kinds of defects relating to an opened vein (Dushta-vyadhana;. They are as follows : — Durviddha, Atividdha, Kunchita, Pichchita, Kuttita, Aprasrutd, AtyudirnA, Ante-abhihata, Parisushka, Kunita, Vepita, Anutthita-viddhd, Sastrahata, Tiryagviddhd, Apavlddlia, Avy^dhyd, Vidrutd, Dhenukd, Punhpunarviddha and Marmaviddha, i.e., incised about the Sira-marma, the Sn^yu-marma, the Asthi-marma and the Sandhi-marma. 52-53.

Their definitions :— The vein in which an act of venesection is unattended with a satisfactory outflow of blood owing to its being incised with an extremely slender instrument and is marked by an extremely painful swelling in consequence thereof, is called Durviddhat (badly incised). The vein in which the incision becomes excessive and no blood comes out properly or enters an internal channel owing to the largeness of the incision, is called Atividdha^ (over-incised). An opened vein in which the incision has been made in a curving manner and is attended with the foregoing results, is called Kunchitai (crooked or contracted). An incised vein presenting a flattened or thrashed appearance on account of its being opened with a blunt knife (Kantha-Sastra) is called Pichchitai (thrashed). The vein at the sides of which incisions have been successively made, instead of in its body, is called Kuttitat (lacerated). An incised vein, unattended with any bleeding owing to the patient's fright, coldness or loss of consciousness, is called Aprasrulai (unbleeding).

2o6 THE SUSHRUTA SAMHITA. [Chap. VIII.