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

Strong wine should be given to the patient, or he should be slapped on the shoulders, so as to cause him to suddenly start in a case where a morsel of food would be found to have obstructed and stuck fast in his gullet. A tight gripe about the throat of a person with a creeper, rope or the arm of an antagonist, tends to enrage the local (Kapham), which obstructs the cavity of the passage (Srota) producing salivation, foaming at the mouth and loss of consciousness. The remedy in such cases consists in lubricating and diaphorising the body of the patient with oil and heat, and in administering strong errhines (Shiro-Virechanam), and the juice or extract of meat which is possessed of the virtue of subduing the deranged Vayu.

Authoritative Verses on the Subject:— An intelligent physician should remove a Shalvam with due regard to its shape, location and the adaptability of the different types of surgical instruments to the case under treatment. A physician should exercise his own discretion in extracting feathered shafts (Shalyas) from their seats of lodgment, as well as those that are difficult of extraction.

A physician is at liberty to exercise his own skill and wisdom, and to devise his own original means for

Chap. XXVII. ] SUTR.ASTHA'NAM. 265

the extraction of a Shalyam with the help of any surgical instruments when the abovesaid measures would prove abortive. A Shalyam, not removed from the bod}'- and left in its place of lodgment, brings on swelling, suppuration, mortification of the affected part, and a sort of excruciating pain, and may ultimately lead to death. Hence a physician should spare no pain to extract a Shalyam from its seat of lodgment.

Thus ends the twenty-seventh Chapter of ihe Sutraslh^nain in the Sushruta SamhitS, which treats of extraction nf Shalvam.

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CHAPTER XXVIII.

Now we shall discourse on the Chapter, which deals with the fa\ourable or unfavourable prognosis of an ulcer. ( Viparitarviparita - Vrana - Vijna^niya - madhyaryam ).

IVIetrical Text :— Certain fatal or unfavourable symptoms (Arishtas)* unmistakably presage the death of an ulcer-patient, as a flower, smoke and cloud respectively herald a fruit, fire and rain. In most cases, the ignorant cannot interpret aright these fatal symptoms owing to their extremely subtile nature, or out of ignorance or stupidity, or because such symptoms are very closely followed by the death of the patient.

These fatal indications serve as sure precursors of death in a patient, unless warded off by the blessings of hoi}' Brahmanas, who are free from low desires or animal propensities, and are also accustomed to practise the Yo^a and other religious penances ; or death may be averted with the help of men who are initiated into the mystery of concocting life-giving elixirs (Rasayanam".

* The symptoms which are developed by the deranj^ed bodily humours in the organism of a man at a time when they have passed beyond all medical cure, and when the body serves as a mere passive back-ground for those phenomena, awaiting its impending dissolution, are called Ariahtas,

Chap. XXVIII. ] SUTRASTHANAM. 267

Man}'' such indications do not prove instantly fatal but bring on death in course of time, just as diseases, supposed b}' some to be due to the influence of malignant planets, take time before they become patent out of their incubative stages. An attempt to cure a doomed patient is only repaid by failure and the ridicule of the world, and hence an intelligent physician should make it worth his while to carefully observe and study these fatal indications. A contrariety of the natural smell, colour, taste, (sensation, sound, touch, etc.) of an ulcer indicates a near and fatal termination of the disease.

An ulcer emits a pungent, sharp, or fishy smell under the respective influences of the deranged Vayu, Pittam and Kapham. An ulcer, deranged by the action of the vitiated blood, emits a smell like that of iron (Loha-gandhi), while one, originated through the concerted action of the deranged humours, emits a smell characterised by the distinctive features of each of them. On the other hand, an ulcer, due to the joint action '^of the deranged Vayu and 'Pittam), emits a smell like that of fried paddy ; one, due to the action of the deranged Vayu and Kapham, emits a smell like that of linseed oil ; whereas one, brought about by the action of the deranged Pittam and Kapham, smells like sesamum oil. All those odours, marked by a somewhat fishy character, should be deemed the natural odours of ulcers, and any other smell should be held as a contrary or unnatural one.

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