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

A bandage should be tied in any of the three ways of Gadha, Sama and Shithila fastenings according to the shape and seat of the ulcer.* A tight bandage (Gadha- Vandha) should be tied round the buttocks, round the sides, round the arm-pits, round the inguinal regions, round the breast or round the head. A bandage of the Sama pattern should be fastened round the ears, round the extremities (hands

* Additional text : — A bandage, tightly tied round an ulcerated or affected part of the body without causing any pain or discomfort to the patient, is called a GAdha-Vandha, while the one which is loosely bound is called Shithila, the one neither too tight nor too loose being called a SamaV'andha. 22

p. 170

THE SUSHRUTA SAMHITA. [Chap. XVIII, and legs), round the face, round the throat, round the lips, round the penis, round the scrotum, round the back, round the belly and the chest. A loose bandaging (Shithila-Vandha) should be the rule in the region of the eyes and locations of important joints or unions.

An ulcer, brought about or characterised b)^ the symptoms of the deranged Pittam and occurring at a place where a tight bandaging is indicated, should be fastened with one of the Sama-Vandha class, and with a Shithila bandage where one of the Sama type would be indicated ; whereas it should not be bandaged at all in the event of a loose bandage (Shithila-Vandha) being indicated. The same rule should be observed in the case of an ulcer caused through a diseased or contaminated state of the blood. Similarl}'', in the case of an ulcer produced through a deranged condition of the Kapha m, a loose bandaging, otherwise enjoined to be adopted, should be substituted for one of the same pattern. A tight bandage should give place to a lighter one under the same circumstances, and such a procedure should be deemed as holding good even in the case of an ulcer caused by the action of the deranged Vayu.

In summer and autumn, the bandage of an ulcer, due to the vitiated blood or Pittam, should be changed twice a day ; while the one tied round an ulcer of the deranged Vayu or Kapham, should be changed on eachp. 171 third day in spring and Hemanta. Similarly, an ulcer, marked by the action of the deranged Vayu, should be bandaged twice a day. " Thou shalt exercise thy own discretion, and vary or adopt the preceding rules of bandaging according to the exigencies of each case."

A medicated lint fails to have any efficacy but rather tends to augment the local pain and swelling where a bandage, enjoined to be loosely bound, or bound up with moderate and uniform steadiness (Sama-Vandha), is replaced by a tight or deep fastened one (GadhaVandha,. A loose bandage, injudiciously used in a case where a tight or a moderately firm bandage should have been used, would cause the medicine to fall off from the lint and give rise to the consequent friction and laceration of the edges of the ulcer. Similarly, a moderately firm and steady bandage (Sama-Vandha; fastened in a case where a light or loose bandage should have been used, would fail to produce any effect. A proper bandage would lead to the subsidence of pain, and the softening of the edges of the ulcer, thus bringing about a purification of the local blood.

Evils of non- bandaging :~An ulcer, left uncovered and untied with a suitable bandage, is soon assailed by gnats and flies. It is moistened by sweat and cold wind, etc. and stands in danger of being irritated by deposits of many foreign matters

172 THE SUSHRUTA SAMHITA. [ Chap. XVIII.

such as> the particles of bone, dust, weeds, etc. Moreover, a constant exposure to heat or cold brings on varied pains, the ulcer develops into one of a malignant type, and the applied medicinal plasters are dried, encrusted and speedily fall off.

IVIetrical Texts :— A smashed, lacerated, fractured, dislocated, displaced bone, or a vein or a ligament similarly jeopardised, may be soon healed or set right with the help of a surgical bandage. The patient is enabled by such a means to lie down, or stand up or move about with ease. And an increased facility of rest or movement leads to speedy healing.