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

The patient, who may mistrust his own parents, sons and relations, should repose an implicit faith in his own physician, and put his own life into his hands without the least apprehension of danger ; hence a ph5'sician should protect his patient as his own begotten child. A surgical case may yield to a single incision, or may require two, three, four or more than that number to effect a cure. By doing good to humanity with his professional skill, a physician achieves glory, and acquires the plaudits of the good and the wise in this life, and shall live in Paradise in the next.

Thus ends the twenly-fiflh Chapter of the Sulrasthimim in the Sushruta Samhita which tieats of the eight forms of Surgical operations.

CHAPTER XXVI.

Now we shall discourse on the Chapter which treats of the exploration of splinters lost or deep-seated in the organism (Pranashta-Shalya-Vijna'niya'- madhysryam).

Definition : — The term Shalyam is derived from the root "Shala" or Shvala" (to go swiftly) joined to the Unadi affix "Yat." Shalyas may be divided into two kinds according as they are extrinsic Agantuka) or idiopathic (Sharira) in their origin.

A Shalyam usually serves to act as an impeding or obstructing agent to the entire organism, and, hence, the science which deals with its nature and characteristics is called the Shalya-Shastram (Surgery). An idiopathic (Sharira) Shalyam may be either a hair, nail, embohsed blood (Dhatus)*, etc., excrements (Mala), or deranged humours of the body (Dosha), while an extrinsic Shal3'am should be regarded as one which afflicts the body and is originated from a source other than any of the preceding ones, including particles of iron and bone, stems of grass, scrapings of bamboo, and bits of horns, etc. But an Agantuka (extrinsic) Shalyam specifically denotes an article of iron, inasmuch as it

* Embolism and Thrombosis have been included within Shalyam by the Ayurvedic Pathologists.

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ITHE SUSHRUTA SAMHITA. 1 Chap xxvi.

pre-eminently sqvvqs the purpose of killing and is the most irresistible of all metals. Since any amount of sharpness can be imparted to the point of an article made of iron and since it can be easily discharged from a distance, iron is the metal exclusively chosen in the construction of darts or arrows.

Classification of Shafts : — Arrows (Shara) may be divided into two classes according as they are feathered or unfeathered ; and their barbs are usually constructed in the shape of trees, leaves, flowers, or fruits, or are made to resemble the mouths of birds and wild and ferocious animals.

Flights of arrows: — The flights or directions of an arrow (Shalyam) may be divided into five different kinds, such as the upward, the downward, the backward (coming from the back), the oblique and the straight. Either through its diminished momentum, or through any external resistance, an arrow may drop down and penetrate into the skin, arteries, or any internal channel of the body, or into any bone or its cavity, causing a wound or an ulcer (Vrana) at the spot of its penetration.

Symptoms : — Now hear me describe the symptoms which are exhibited in connection with an arrowwound (Shalya*-Vrana). These symptoms may bep. 249 grouped under two sub-heads, such as the specific and the general. The general characteristics are as follows : — The ulcer, which is marked by pain and swelling and presents a raised or bloated aspect like a water bubble, assumes a dark brown hue and appears soft to the touch. The seat of the ulcer is seen to be studded over with pustular eruptions and a constant bleeding sets in from its inside. The specific symptoms, which mark a Shalyam lodged in the skin, are the hardness and extended character of the local swelling and the darkness (discolouring) of its skin.

* An arrow or an iron barb, from "Shala" to kill.

In a case where the arrow Shalyam) is lodged in the flesh, the swelling increases in size and the incidental ulcer refuses to be healed and cannot bear the least pressure. Suppuration sets in and the ulcer is characterised by a sort of sucking pain.*