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

Of the abovesaid instruments the Mandalagram and the Karapatram should be 'used in incising and scraping. The Vriddhipatram, the Nakhasastram, the Mudrik^, the Utpalapatram, and the Arddhadharam, should be employed in incising f Chhedanam ) and excising (Bhedanani) ; and the Kushapatram, the Shuchi, the Atemukham, the Shararimukham, the Trikurchakam and the Antarmukham should be made use of in exudating or secreting (Visravanam.i The Kutharika, the Vrihimukham, the Ara, the Vetasapatram and the Suchi (needle) should be used in puncturing. The Vadisha and the Danta-Shanku should be used in extracting sohd bodies. The Eshani 1 probe or director) in probing or searching the course or direction of the pus (in a suppurated part), and the Suchi (needle; should be used in suturing. Thus we have explained the eight different functions ol the instruments in connection with surgical operations.

The kutharika (small, blunt axe) measures seven lingers and a half in liic handle, the blade is half a finger in width and is blunted like the tooth of'a cow. The Vrihimukham measures six fingers in its entire length and its top is like that of a Vrihi seed, and the edge is cut into small thornlike projections. The Ar5 resembles the awl of a cobbler and measures ten fingers in its entire length, the blade is wide as the seed of a sesamum and has the girth of a Durva (grass) stem. The Vetasapatram (knife) resembles the leaf of a Vetasa plant. The blade is four fingers in length, one finger in width, and is keenly edged, the handle measuring four fingers in length. The Vadisha is shaped like a modern fishing hook. The Danta-shanku (pincers for extracting teeth) somewhat resembles the Vrihimukham in shape. The face of an Eshani (probe) is like that of a Gandupada (earth-worm). 9

p. 66

No^v we shall deal with the mode ol handling the abovesaid instruments. — The Vriddhipatram and other instruments for excising (Bhedanam; should be caught hold of at a part between the blade and the handle. In acts of scraping the Vriddhipatram and the MandaUgram should be handled with the palm of the hand slightly turned up. The instruments for secreting should be caught hold of at the roots of their blades at the time of using them, while in the case of a king, an old man, a timid or a delicate person, a child, a woman and specially in the case of a prince of the royal blood, the Trikurchakam should be used when any secreting or exudating operation would be necessary. The handle of a Vrihimukham should be kept concealed within the palm of the hand and the blade should be caught hold of with the thumb and the index finger (Pradeshini). The Kuth^rika should be first supported on the left hand and then struck with the thumb and third finger of the right. The Ara, the Karapatram and the Eshani, should be caught hold of at their roots. The rest of the surgical instruments should be grappled according to requirements.

The abovesaid instruments are shaped like things which their very names imply, as ha^^e been already described. The Nakashastram and the Eshani measure eight fingers in length. The Suchi (needle)

Chap. VIII. ] SUTRASTHA'NAM. 67

shall be described later un. The top-ends of the Vadisha and the Danta-Shankhu pental pincers'; are a little bent down and their faces are made to resemble sharp thorns, or the newly sprouted leaves of a barley plant. The top-end of an Eshani closely resembles the mouth of an earth-worm. Tlie lenj^th of a Mudrika should be made equal to that of the top phalanges of the index finger 'of a man of avera'ge height.) A Shararimukham measures ten fingers in length. The rest of the instruments are mostly made to measure six fingers in length.

Commendable features in a Surgical instrument : —Instruments that are fitted with handles of easy grip and are made of good and pure iron, well shaped, sharp, and are set with edges that are not jagged and end in well formed points or tops, should be deemed as the best of their kind.

Curvature, bluntness ( Kuntha— lit :— incapable of cutting hair , unequal sharpness of the edge, roughedgedness, over- thickness, over-thinness, over-lengthiness, and over-shortness are the defective traits in a surgical instrument. Those possessed of contrary features should be used. But a Karapatram set with a very rough (dentated) edge may be used for the purpose of sawing the bones.

A surgical instrument meant *'or excision 'Bhedanann should be set with an edge as thin as that of a Musura

68 THE SUSHRUTA SAMHITA'. [ Chap. VIII.

pulse 'lentil seed , while an instrument used in scraping should be set with an edge half as thin as that of the former. An instrument used either in connection with the measures of secretion or cutting by uplifting (Vyadhanam) should be set with an edge as fine as the human hair, while an instrument of incision should have an edge half as thin as that of the former.