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

process known as the Vallikarna is indicated in cases where the lobes are short, thin and unequal. The adhesion known as the Yasthi Kama is indicated in cases where the thin and severed ear-lobes are run across with veins and made of knotty or nodular flesh. The case in which the ear-lobe, being permeated with a little quantity of blood, is fleshless and ends in a narrow tip or end, furnishes the occasion for Kakusthakapaii.

The five abovesaid adhesions, if followed by swelling, inflammation, suppuration and redness of the affected part and found to be secreting a sort of slimy pus or studded over with pustular eruptions, may be apprehended as not to be attended with success.

Authoritative verses on the subject : — The exact middle point of the external ear should be pierced (with a knife^ and the severed parts should be pulled down and elongated in the case where both the parts of a bifurcated ear-lobe would be found to have been entirely lost or eaten away. In the case where the posterior one of the two bifurcated parts would be found to be longer or more elongated, the adhesion should be effected on the anterior side ; whereas the contrary should be the case where the anterior one would appear to be more elongated. Only the remaining one of the two bifurcated parts of an ear-lobe would be pierced, cut in two and adhesioned on the top,

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in the case where the other part would be found to be gone. A surgeon well-versed in the knowledge of surgery ''Sh^stras should slice off a patch of living flesh from the cheek of a person devoid of ear-lobes in a manner so as to have one of its ends attached to its former seat (cheek). Then the part, where the artificial ear-lobe is to be made, should be slightly scarified (with a knife), and the living flesh, full of blood'and sliced off as previously directed, should be adhesioned to it (so as to resemble a natural ear-lobe in shape).

A surgeon, wishing to effect any sort of adhesion other than those described before, should first collect the articles enumerated in the chapter on Preliminary Measures to Surgical Operations, together with milk, water, Dh^ny^mla (fermented rice boilings), Suramanda (transparent surface-part of wine) and powders of earthen vessel. Then the hair of the patient, whether male or female, should be gathered and tied up in a knot, and the patient should be given a light food (so as to keep up his strength without hampering his digestion) ; after which his friends and relations should be asked to hold him firm. Then having ascertained the particular nature of adhesion to be effected in the case, the smgeon should examine the local blood by incising, excising, scarifying or puncturing the affected lobes as found necessary, and determine whether the same is pure or vitiated. Then having

I_|8 THE SUSHRUTA SAMHITA'. [ Chap. XVI.

washed the blood with Dhanyamla and tepid water, if found vitiated through the action of the deranged (V^yu), or with milk and cold water in the event of the same being contaminated by the deranged Pittam, or with Suramanda and warm water in the case of its being vitiated by the action of the disordered Kapham, the surgeon shall bring about the adhesion by again scarifying the affected parts of the ear, so as not to leave the adhesioned parts elevated (raised), unequal and short. Of course the adhesion should be effected with the blood being still left in the parts that had been scraped. Then having anointed them with honey and clarified butter, they should be covered with cotton and linen, and tied with strings of thread, neither too loose nor too tight, and dusted over with powders of baked clay. Then directions should be given as regards the diet and nursing of the patient, who may be as well treated with the regimen laid down in the chapter on Dvi-vraniyam.

Authoritative verses on the subject : — Tlie patient should be careful not to disturb the bandage and avoid physical exercise, over- eating, sexual intercourse, exposure to, or basking in, the glare of fire, fatiguing talk, and sleep by day. For three consecutive days the ulcer should be anointed with unboiled oil ; and cotton soaked in the same substance should be placed over it, which is to be altered, each third day, till healing.

Chap. XVI.] SUTRASTHANAM. 14^