An English Translation of the Sushruta Samhita, Vol. I: Sutrasthanam — trans. Kaviraj Kunja Lal Bhishagratna (1907)

eight forms of operations may be attended with dangers of four different kinds such as those arising from an insufficient or over performance, or from the slanting or oblique deviation (of the knife or the instrument), or from an act of self-injury on the part of the physician.

A physician ( surgeon ; making a wrong operation on the body of his patient either through mistake, or through the want of necessary skill or knowledge, or out of greed, fear, nervousness or haste, or in consequence of being spurned or abused, should be condemned as the direct cause of many new and unforeseen maladies. A patient, with any instinct of self-preservation, would do well to keep aloof from such a ph\sician, or from one who makes a wrong or injudicious application of the cautery, and should shun his presence just as he would shun a conflagration or a cup of fatal poison.

On the other hand, a surgical operation, carried to excess, (or a surgical instrument inserted deeper than what is necessary , is attended with the danger of

244 THE SUSHRUTA SAiMHlTA. L Chap. xxv.

cutting or destroying a vein, ligament, bone, joint, or any vital part of the body. ' A surgical operation by an ignorant surgeon brings about, in most cases, the instantaneous death of the patient, or consigns him to the pangs of a life-long death.

The symptoms which generally manifest themselves in connection with the injudicious hurting of any of the five vital parts or principles of the body (such as the joints, bones, veins, ligaments, etc.) are vertigo, delirium, loss of bodily functions, semi-insensibility ( comatose state), incapacity of supporting oneself, cessation of mental functions, heat, fainting, looseness of the limbs, difficult respiration, excruciating pain or pain peculiar to the deranged Vayu, secretion of blood or a thin watery secretion like the washings of meat from the injured part, or the organ, with coma or inoperativeness of all the senses. A vein* iShira) any wa}' severed or injured is attended with a copious flow (haemorrhage of deep red blood, resembling the hue of the cochineal insect, from the ulcer ; and the deranged local Vayu readil}' exhibits all its essential characteristics, and ushers in diseases which have been enumerated under that head in the chapter on the description of blood.)

Similarly, an injured ligament gives rise to a crookedness or bending of, as well as to a gone feeling in the

* Other than ihc one silualcd in any of the abovesaid vital parts of the body.

Chap. XXV. ] SUTRASIHA'NAM. 245

injured limb or organ, attended with pain and loss of function, and the incidental ulcer takes a long time to heal.

An abnormal increase in the local swelling, together with an excruciating pain, loss ol strength, breaking pain in the joints, and in-operativeness of the affected part, mark the wounding of a flexible or immovable joint. Similarly, in the case where a bone is hurt or injured in the course of a surgical operation, the patient is tormented with indescribable pain, da}' and night, and finds no comfort in any position whatsoever. Pain and swelling specifically mark the affected locality, and thirst and inertness of the limbs add to the list of his sufferings.

A case of any injured Sira-Marma ( vital venal or arterial combination or plexus exhibits the same symptoms which characterise the hurting of a single vein, as previously described. Loss of actual perception (anaesthesia^ and a yellowish colour of the skin mark the case where the injury is confined to the vital principle of the flesh.

A patient, who is discreet, and is not in a special hurry to end his earthly sojourn, would do well to shun the presence of a bungling, unskilful surgeon, who can not even keep himself unhurt in the course of a surgical operation.

p. 246

The evils, which attend the obhque insertion of a surgical instrument, have been described before ; and accordingly care should be taken not to leave any room for the occurence of those evils in connection with a surgical operation.