The Sushruta Samhita — trans. Bhishagratna

Surgical instruments should be used in connec-

* Hot gargles are recommended in cases of ulcers of the deranged Vayu and Kapha while cold ones in cases of ulcers of the aggravated Pitta and blood.

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tion with an ulcer which is deep-seated but provided with a narrow orifice and which is due to the penetration of a Salya (shaft) and which could not be removed with the hand alone. 109-111.

The diet of an ulcer-patient should in all cases be made to consist of food which is light in quantity as well a? in quality, demulcent, heat-making (in potency) and possessed of appetising properties* Protective rites should be performed for the safety of an ulcer-patient from the influences of malignant stars and spirits with the major and the minor duties (Yama and Niyama) enjoined to be practised on his behalf. 112-113.

The causes of ulcers are sixf ; their seats in the body number eight| in all ; the features which characterise them are five $. The medicinal measures and remedies in respect of ulcers are sixty Ij in number. And these ulcers are curable with the help or co-operation of the four necessary factors (the physician, the medicines, the nurse and the patient). 114.

The comparatively smaller number of drugs which I have mentioned (under the heads of Ropana, Sodhana, etc., in the present chapter) from fear of prolixity, may be increased in combination with other drugs or substances of similar virtue, (digestionary transformation and potency, etc.) without any apprehension t The six causes of an ulcer are Vayu, Pitta, Kapha, Sannipdta, S'onita aud Agantu.

* See Chap. XIX.— Sutra-Sthanam.

t The eight seats of an ulcer are Tvak, Mansa, S'ira, Snayu, Sandhi, Asthi, Koshlha and Marma.

§ The five symptoms of an ulcer are due to Vata, Pitta, Kapha, Sannipata and Agantu. The symptoms due to S'onita being identical with those due to Pitta, are not separately counted.

II The sixty medicinal measures and remedies are those describee^ before in the present chapter.

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The symptoms due to S'onita being identical with those due to Pitta, are not separately counted.

II The sixty medicinal measures and remedies are those describee^ before in the present chapter.

p. 264

of doing any mischief thereby. Recipes consisting of rare or a large number of drugs or ingredients, should be made up with as many of them as would be available in the absence of all of them, as mentioned in the present work. A drug belonging to any particular Gana or group if separately described as non-efficacious to any specific disease, should be omitted whereas a drug not belonging to a group may be added to it if it is elsewhere laid down as positively beneficial thereto. 11 5-1 17.

Upadrava : — The distressing supervening symptoms which are found to attend a case of ulcer, are quite different from those of an ulcer-patient. Those which confine themselves solely to the ulcer are five in all — smell, colour, etc., and those which are exclusively manifest in the patient are fever, diarrhoea, hiccup, vomiting, fainting fits, aversion to food, cough, difficult breathing, indigestion and thirst. The medical treatment of ulcers though described in detail in the present chapter, will be further dealt with in the next chapter on Sadyo-Vrana. 118-120.

Thus ends the first Chapter of the Chikitsita-Sthanam in the Sus'ruta
Samhita which deals with the treatment of the two kinds of ulcer.

CHAPTEK II.

Now we shall discourse on the medical treatment of recent or traumatic wounds or sores (SadyOVrana-

Chikitsa). i,

Metrical Texts; -The holy Dhanvantari, the foremost of the pious and the greatest of all discoursers, thus discoursed to his disciple Susruta, the son of Visvdmitra. 2.

i,

Metrical Texts; -The holy Dhanvantari, the foremost of the pious and the greatest of all discoursers, thus discoursed to his disciple Susruta, the son of Visvdmitra. 2.

Different Shapes Of Sores :— I shall describe the shapes of the various kinds of Vrana (sores or wounds) caused by weapons of variously shaped edges in the different parts of the human body. Traumatic ulcers have a variety of shapes. Some of these are elongated, others are rectangular, or triangular, or circular, while some are crescent shaped, or extended, or have a zigzag shape, and some are hollow in the middle like a saucer, and lastly some have she shapes of a barley corn (bulged out at the middle). An abscess or a swelling, due to the several Doshas and which spontaneouly bursts out, may assume any of the aforesaid forms, while the one effected by a surgeon's knife should never have a distorted or an improper shape. A surgeon thoroughly familiar with the shapes of ulcers is never puzzled at the sight of one of a terrible and distorted shape. 3 — 5.

Physicians of yore have grouped these variously shaped traumatic ulcers under six broad sub-heads, such as the Chhinna (cut), Bhinna (punctured or perforated), Viddha (pierced), Kshata (contused), Pichchita (crushed), and the Ghrishta (mangled or lacerated) according to their common features and I shall describe their symptoms. 6.

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266 THK SUSHRUTA SAMIIITA. [Chap. II.