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

A loose, unbarbed arrow, lodged in a wound with a broad mouth and lying in an Anuloma direction, should be withdrawn by applying a magnet to its end. A shaft of grief, driven into the heart by any of the multifarious emotional causes, should be removed by exhilaration and merry-making.

A shaft (Shalyam), whether large or small, may be withdrawn from its place in either of the two ways known as the Anuloma and Pratiloma. The Anuloma consists in withdrawing a Shalyam through a way other than that of its penetration, while the contrary is called the Pratiloma.

A Shalyam lodged in a place lying close to the spot of its penetration (Arvacheenam) should be extracted through the wav bv which it has entered

Chap. XXVII. ] SUTRASTHANAM.

p. 259

(Pratiloma). On the other hand, a shaft or Shalyam, piercing deep into any part of the body, but not coming out by the other side (Par^cheenam), should be drawn out through a way other than that of its penetration (Anuloma).

A shaft, piercing deep into any part of the body so as to reach the other side of the wounded hmb or part, (but not cutting out clean through it owing to the diminution of its original momentum), and remaining protruded in the heaved up flesh, should be extracted through a channel other than that by which it has originally penetrated (Anuloma), and by stirring or striking it with the hand or a hammer. The heaved up flesh should be opened with an incision, when found possible of being so opened, and the embedded Shalyam should be drawn out by stirring or striking it with the hand as laid down before.

A Shalyam, lodged in any soft part of the abdomen, chest, arm-pits, inguinal regions or ribs, should not be cut open or struck with hammer, but should be tried to be removed with the hands through the wa)- of its penetration (Pratiloma), in failure whereof the Shalyam should be extracted with surgical appliances (Shastra) or any other surgical instruments ( Yantras),

Authoritative Verse on the Subject : — A patient, fainting away (during the course of such a surgical operation), should be enlivened by

26o THR SUSHRUTA SAMHITA. : Chap. XXVli.

dashing cold water over his face. He should be solaced with many a hopeful and cheering word, and a nourishing diet such as, milk, etc. should be given him, and his vital parts should be protected.

Then having extracted the Shalyam, the incidental wound or ulcer, the blood having been wiped of, should be fomented with lieat or by apph'ing warm clarified butter to its surface in the event of it being found fit to be so treated i.e., 'devoid of pain and unattended with further bleeding). Cauterisation should be resorted to where the condition of the wound would indicate such a measure. After tliat, the wound should be plastered (Pradeha) with honey and clarified butter, and bandaged with a piece of clean linen ; and directions as to the diet and nursing of the patient should be given (as previously laid down).

A Shalyam, lodged in a vein or a ligament (Snayu), should be extracted with the help of a probe. The shaft (Shalyam), lodged in the body and lying buried under the incidental swelling, should be extracted hy firmly tying blades of Kuslia grass around its body. A shaft (Shalyam;, lodged in a spot situated anywhere close to the heart, should be withdrawn by the way by which it has entered ; and the patient should be enlivened with sprat's of cold water, etc. during the operation.

Chap. XXVII. ] SUTRASTHA'N'AM. 261

A Shalyam, lodged in any other part of the body and that is difficult to extract, and that produces pain and local inflammation, should be removed by cutting the part open. In the case of a shaft 1 Shalyam) which has pierced into the cavity of a bone, the surgeon should firmly press the affected bone with his legs, and pull out the embedded shaft with all his might by gripping it with a surgical instrument, in failure whereof a strong man should be asked to firmly catch hold of the patient, and the Shalyam should be pulled out with the help of a gripping surgical instrument as before.