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

The incidental ulcer should not be tried to be healed up as long as the local blood (blood in the ulcer) is not fully purified ; or so long as there is haemorrhage from the seat of the affection or the local blood continues feeble. An ulcer, adhesioned with the least of the Vayu-vitiated blood continuing in its inside, will spontaneously burst or break open afresh. It will be again attended with pain, -burning, redness and suppuration in the event of its being closed with a little quantity of Pitta-deranged blood incarcerated in its inside. Adhesioned even with a little quantity of Kapha fouled blood in its cavity an ulcer is marked by itching and numbness. An ulcer adhesioned with the continuance of an active haemorrhage from its inside is marked by a brown or blackish yellow swelling. An ulcer, adhesioned at a time when the local blood, though otherwise good or pure, has been thinned or weakened through excessive bleeding, is followed by a corresponding emaciation (thinness) of the adhesioned part. The lobule of the ear thus adhesioned should be gradually pulled down and elongated after the complete healing of the local ulcer and the subsidence of its concomitant symptoms, and after the cicatrix has assumed the colour of the skin of the surrounding part. Otherwise the adhesioned part may be characterised by pain, swelling, inflammation, burning and suppuration, or the adhesion may again fall off. An adhesioned ear-lobe, unI50

THE SUSHRUTA SAMHITA. [ Chap. XVI.

accompanied by any of the distressing or unfavourable symptoms, should be gradually elongated by rubbing it with an unguent composed of the milk, fat, and marrow of any such animals and birds as the Godha, the Pratudas, the Vishkiras, the Anupas, or the Audakas as would be available, and clarified butter and the oil expressed out of the seeds of white mustard, boiled with the decoction or Kvatha of Arka, Alarka, VaU, AtivaU, Anant^, Apamarga, Ashvagandh^, V.idarigandha, Kshira-Shukla, Jalashuka and the drugs forming the group known as the Madhura, which should be previously prepared and carefully stowed in a covered receptacle.

IVIetrical texts :— Then the above medicinal unguent should be applied or rubbed over the lobe of the affected ear, whereby all the disturbing or unfavourable symptoms would be subsided, thus favouring its firm and steady growth. Similarly a plaster composed of Yava, Ashvagandh^, Yashtyahva, and Tila, pasted together might be rubbed over the affected ear-lobe with advantage. Oil prepared and boiled with the essence of Shatavari, and Ashvagandh^, or Payasya, Eranda, Jivana and milk increases the growth of an ear-lobe. The lobe of an ear, which refuses to grow in size in spite of being fomented and lubricated as above indicated^ should be scarified with slight longitudinal incisions on its anterior side (that is on the side nearest to the cheeks)

Chap. XVI. ] SUTRASTHANAM. I^l

and not on the posterior one, as such a procedure might be attended with dreadful results.

An ear-lobe should not be tried to be elongated just after the adhesion of its two severed parts, inasmuch as the centre of the adhesion, still being raw, might cause them to fall off again. Thus an ear-lobe under the circumstance should be gradually elongated, only when it would be found to be marked by the growth of hair on its surface, and the hole or the perforation has assumed a circular look, and the adhesion has become firmly effected, well-dried, painless, even and level in its entire length.

The modes of bringing about an adhesion of the two severed parts of an e;f\-lobe are innumerable ; and a skilled and experienced surgeon should determine the shape and nature of each according to the exigencies of a particular case.*

* Additional Text :— O Sushrula, again I shall deal with diseases which affect the lobule of an ear under the circumstance described above The deranged bodily Vdyu, Pittam and Kaphani, either jointly or severally, give rise to several types of diseases which affect the lobule of an ear. The deranged V^yu produces numbness and an erysipelatous swelling and ulcer about the affected ear-lobe, while an erysipelatous ulcer in the locality accompanied by swelling, burning, suppuration, etc., should be ascribed to the action of the deranged Pittam. Heaviness, numbness and swelling of the ear-lobe accompanied by constant itching in the affected locality mark the action of the deranged Kapham. The medical treatment in these cases consists in effecting a subsidence of the particular deranged humour by means of diaphoresis, lubrication, Parishekas (medicated plasters) or blood-letting as the case may be. These measures should be moderately applied and a nutritive and invigorating food should be pres1^2 THE SUSHRUTA SAMHITA. [Chap. XVI.