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

Thus ends the twelfth Chapter of the SutrasthSnam in the Sushruta Samhit^ which treats of Cauteries and the rules to be observed in their use.

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CHAPTER XIII.

Now we shall discuss the Chapter which treats of leeches and of how and which to use (Jalaukarvacharraniyamadhyaryam).

Leeches should be applied where the patient would be found to be old or imbecile, or a woman, or an infant, or a person of an extremely timid disposition, or a person of a delicate constitution, and as such is not fit to be surgically operated upon, since this mode of bleeding is the gentlest that can be possibly devised. The blood vitiated by the deranged wind (Vayu\ bile (Pittam), and phlegm (Kapham) should be respectively sucked through a horn^ by leeches and a gourd appliance (Alavu-Yantra) or with whichsoever of them is available at the time, irrespective of the cause of such vitiation, whenever such bleeding or sucking would be found to be imperatively necessary.

Authoritative verses on the subject : — A CO whom is described in the Shastras as of a hot or heat making potency, and as possessed of a slightly cooling (Snigdha) or soothing (Madhura) property. Accordingly it should be used in sucking the blood vitiated through the action of the deranged bodily wind. Leeches, which are born in water, are possessed of Madhura (sweet or soothing) properties, and hence they

Chap. XIII.] SUTRASTHANAM. 9^

should be used in sucking the blood vitiated throoigh a deranged condition of the bile (Pittam\ The gourd (Alavu) is pungent, parching and irritating in its potency and should be therefore used in sucking the blood vitiated through the action of the deranged phlegm (Kapham).

Mode of application :— The part from which the blood is to be sucked should be first scarified or slightly cut in two or three places, and then the mouth or the open end, of the horn, covered with a thin piece of muslin tied round its edges should be placed over it and sucked with the mouth through the aperture at its tip or top- end, or with a gourd appliance equipped with a lighted lamp placed in its inside.

The term Jalauka (leeches) may be etymologically interpreted to mean creatures whose life (Ayu) or whose longevity is in, or depends upon, water, whereas the derivative meaning of the term Jalauka (leeches) is based upon the fact of their dwelling ("Oka"— dwelling place) in water (Jalam). Leeches may be divided into twelve distinct species of which six are venomous, and six non-venomous. The six venomous species are named Krishna, Karvura, Alagarda, Indrayudha, Sdmudrik^ and Gochandana. The leeches of the first-named species (Krishna) are marked by thick heads, and of a colour resembling powdered lampblack. The leeches of the Karvura type have extended or lOO THE SUSHRUTA SAMHITA. [Chap. XIIl.

elongated bodies like the Varmifishes, and are indented and thick at the waist. The Alagarda leeches are hairy, thick and round at the sides, and black at the mouth. The leeches of the Indrayudha species are marked on the surface with up-pointed rainbow coloured lines. The skins of the Samudrikas are blackish yellow, dotted over with white spots of a variety of shapes. Leeches which are provided with narrow mouths and are marked by bifurcating line at the bottom like the scrotal sac of a bull are called Gochandanas.

A person bitten by any of the abovesaid venomous leeches has an irresistble inclination to scratch the seat of the bite which is marked by a considerable swelling. Fever, with burning, retching, drowsiness and delirium supervenes and ultimately the patient loses all consciousness. The remedy consists in the administration of an anti-toxic medicine known as Mahagada, as snuffs, potions and unguents, etc. A bite by an Indrayudha usually proves fatal. Venomous leeches, as well as cures for their bites, have thus been described.

The non-venomous species include Kapilas, Pingalas, Shankhamukhis, Musikas, Pundarimukhis and Saravikas. The Kapilas are coloured like Manah-Shila ( realgar ) at the sides, and their backs are tinged with a glossy hue like that of a Mudga pulse. The Pingalas have a reddish colour, are round in shape and

Chap. XIII. ] SUTRASTHANAAI. loi

capable of speedy locomotion. The Shankhamuldiis are marked by a blackish red hue like that of the liver, are provided with sharp elongated moutlis, and are capable of sucking blood with the greatest swiftness. The Musikas are coloured like the common blind moles, and emit a fetid smell from their bodies. The Pundarimukhas are coloured like the IMudga pulse and are so called from the fact of the resemblance of their mouths to the full-blown lotus hhes TPimdarikas). The Saravikas have cold bodies marked with impressions like lotus leaves and measure eighteen fingers' width in length, and they should be employed in sucking blood from the affected parts of lower animals. This exhausts the list of non-venomous leeches.