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

Authoritative verse on the subject : — Blood-letting surgically performed on a fatigued or exhausted subject, or on a person in a swoon, or anyway poisoned or intoxicated, or on a person suffering from extreme constipation of the bowels accompanied by suppression of the flatus i Vayu) and urine, or on a person of timid disposition, or on one overcome with sleep, is marked by the absence of any outflow of blood.

The vitiated blood, failing to find out an outlet, gives rise to itching, swelling, redness, burning, suppuration and pain in the part (to which it is confined). On the contrary, blood-letting performed on the body of a person excessively diaphorised or heated, or by an ignorant or inexperienced surgeon, or with an injudiciously deep incision, is attended with haemorrhage, which may be followed by such dreadful results as Shirobhitapa or violent headache, blindness or loss of sight (Timria, Adhimantham (ophthalmia^ loss of vital principles of the body (Dhatu-Kshaya), convulsions, paralysis (Ekanga Vikara), Hemiplegia (Pakshaghata), thirst, a burning sensation, hic-cough, cough, asthma, jaundice and even death.

Chap. XIV. ] SUTRASTHANAM. n^

Authoritative verses on the subject : — Therefore blood-Jetting should be performed on a patient not in an extremly hot or cold season, neither on one who is too much heated or improperly diaphorised (before the act). The patient should be given gruel ( Yavagu) before the operation. A spontaneous cessation of red flow would indicate that there has been a free discharge of blood. » An act of complete and successful blood-letting is followed b}' a feeling of lightness and alleviation of pain in the affected part, by an abatement of the disease, and a general sense of cheerfulness.

A person, accustomed to blood letting, enjoys a kind of immunity from all types of skin diseases, sarcomata, aneurism, oedema, and diseases brought about by a vitiated condition of the blood such as, Ovarian tumour, Carbuncle, Erysipelas, etc.

A plaster composed of Ela, Shitashiva, Kustha, Tagara, Patha, Agaradhuma, Bhadradaru, Vidanga, Chitraka, Trikatus, Ankura, Haridra, Arka, and Naktamala, or three, or four, or as many of them as are available, pasted together and soaked in mustard oil saturated with common salt, should be rubbed over the mouth of the incision. By this means the blood will fully come out. In a case of excessive flow or hcemorrhage, the mouth of the incision should be gently rubbed with a composition consisting of the powders of Lodhra,

Il6 THE SUSHRUTA SAMHITA. [ Chap. Xiv.

Priyangii, Madhiika, Pattanga, Gairika, Sarjarasa, Rasanjana, Shalmali flowers, Shankha, Shukti, Masha, Yava and Godhuma, and firmly pressed with the tips of the fingers. As an alternative, the mouth of the incision should be gently rubbed with the powdered barks of Sdla, Sarja, Arjuna, Arimeda, Mesha-shringi, and Dhanvana, or the edges of the wound should be lightly dusted with the burnt ashes of a silk cord (a piece of silk rolled up in the form of a cord}, and firmly pressed with the tips of the fingers ; or the mouth of the wound should be lightly touched with the powders of Laksha and Samudra-phena, and its edges should be similarly pressed together as above. Then the wound should be firmly tied up (with a piece of silk or linen; plastered over with a paste of the substances mentioned in connection with the bandaging of ulcers (Vrana). The patient should be kept in a cool room, covered over with a wet sheet and constantly soothed with sprays of cold water. A medicinal plaster of a cooling virtue and a course of cooling diet should be prescribed for him. The wound should be cauterised with fire or an alkali, or the vein should be again opened at a point a little below the seat of the first incision in case where the abovesaid measures should have failed to check the flow of blood. The -patient should be made to drink a decoction compound of drugs of the Kakolyadi group, sweetened with sugar or honey ; and his ordinary' drink should consist of the

[Chap. XIV. ] SUTRASTHANAM. II7 blood of the Ena or common deer, or of a sheep, hare, or buffalo. A diet composed of boiled rice, soaked in or saturated with clarified butter, should be prescribed, and the complications should be subdued according to the nature of the deranged bodily humours respectively involved therein.