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

Now you may ask the question how can an acid subst'ance, which is fiery in its virtue and heat-making in its potency, tend to subdue the effects of an alkali which is possessed of similar virtues and properties, instead of augmenting them, as can naturally be apprehended ? Well my child, the question can be fairly answered by stating, that substances of all tastes enter into the composition of an alkali except the acid one. The pungent (Katu : taste is the principal taste of an alkali, while the saline :Lavana forms its minor or accessory flavour LAnurasa). Xow this saline taste in conjunction with the acid one renounces its extremely sharp or irritating property and is thus transformed into one of sweetness or of soothing virtue. Hence it is that an acid taste tends to alla)^ the burning incidental to an application of alkali (potential caustic) in the same way as water tends to put out fire.

An operation of perfect cauterisation with an alkaline application brings about an amelioration of the disease, or the disease is entirely subdued, accompanied by

86 THE SUSHRUTA SAMHITA'. [ Chap. XI.

Hghtne^ss of the limbs and absence of secretion from the affected part ; while an insufficient burning [of the part] is generally attended by symptoms of aggravation of the malad}' and also gives rise to local pain, itching and numbness, [On tire other hand], excessive burning [of the part] with an alkaline preparation may ha^'e a fatal termination, and is attended by such symptoms as burning, suppuration, redness, secretion in and from the seat of affeqtion. A feeling of languor and fatigue comes upon the patient accompanied with thirst, swooning and an aching sensation. An ulcer incidental to a burn by an alkali should be treated with a special eye to the nature of the disease and the deranged bodily humour specifically involved in the case.

A weak person, an infant, an aged person, a man of timid disposition, a patient suff'ering from abdominal dropsy with general anasarca or from haemoptysis, a pregnant woman, a woman in her menses, a person suffering from an attack of high fever or urethral discharges, or emaciated with chronic inflammation of the lungs, or a person subjected to fits of fainting or abnormal thirst, or a person suffering from virile impotency, or whose testes ha^'e become deranged either upwards or downwards, or a woman suffering from retro\'ersion or introversion of the uterus or prolapsus of the vagina, should be deemed

p. 87

unfit for being cauterised with alkalis. Moreover their application is. not to be sanctioned over the veins, nerves, joints, gristles or tender bones or cartilages, sutures, arteries, throat, umbilicus, genitals, regions of Srotas (external channels), parts covered over with a thin layer of flesh, inside the nails and other vulnerable parts of the body, nor in diseases of the eyes, excepting those which affect the eyelids.

Alkalis fail to produce any beneficial effect in a patient suffering from oedema of the limbs, or suffering from bone- ache, or laid up with a disease affecting the joints or the heart, or in a person of impaired appetite who has lost all relish for food, even when their use is otherwise indicated.

Authoritative verse on the subject : An Alkali adnn'nistered by an ignorant phvsician is to be dreaded more than poison, fire, blows with a weapon, thunder-bolts, or death itself ; while in the hand of an intelligent physician it is potent enougli to speedily subdue all serious diseases in which its use is indicated.

Thus ends the eleventh Chapter of the Suliasthanam in the Siishiuta Samhita which treats of the Pharmacv of AlkaHs.

C H A PT E'R XII.

Now we shall discuss the Chapter which treats of cauteries and the rules to be observed in their use

(Agni-Karma-Vidhimadhyayam).

A fire (cautery ) is better than an Alkali as far as its healing property is concerned. A disease burnt with fire, is cured for good and knows no recrudescence ; and diseases which ordinarily baffle the skill of a surgeon or a physician, and never prove themselves amenable to medicinal or surgical remedies, are found to yield to fire I cauterisation .