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

Cases where bandaging is prohibited : —Ulcers should not be bandaged at all that are due to the deranged condition of blood or Pittam, or to the effects of a blow or of any imbibed poison, and characterised by a sucking, burning pain, redness, or suppuration, as well as those which are incidental to burns, or to the applications of actual or potential cauteries marked by a sloughing or phagedenic character.

Metrical Texts :— An ulcer due to a scald in a leper or a carbuncle in a diabetic patient (Pidaka) as well as a fleshy condylomata due to a bite from a venomous rat, or any other poisonous ulcer should not be bandaged at all. The same rule should be observed

* Different reading :— Pricking, burning pain.

Chap. XVIII.] SUTRASTHANAM. 1 73

in the case of a dreadful suppuration about the anus, or in that of a sloughing ulcej. An intelligent physician, familiar with the specific features of ulcers, should observe the shape of the one under treatment, and prognosticate the result from its seat or locality and the nature of the deranged bodily humours involved in the case. The season of the year in which an ulcer is first seen to appear also determines the nature of the pfognosis.

Bandages may be tied up either from above, below, or from the sides of a diseased locality. Now I shall fully describe the process of bandaging an ulcer.* First the Kavalika or tow should be thickly laid over the seat of the ulcer and after that a piece of soft and unshrivelled linen should be placed upon it, and the bandage should be loosely or tightly tied up according to the directions laid down before.*

The lint and the (inserted) medicine should not be over-lubricated and must not be inordinately oily in asmuch as such a lint or medicine would give rise to the formation of excessive and abnormal slimy mucous in the ulcer. On the other hand, an extremely dry lint would set up friction and laceration of the edges of the ulcer, like the one wrongly or improperly inserted

* Several authorities such as GayadAsa, Brahmadeva, etc. hold this portion of the text to be an interpolation. Both Dallana and ChakrapSni have included it within their commentaries with nearly the same remark.

p. 174

into its cavity, causing numbness, excessive exudation and unevenness of its surface. A lint, properly saturated with a medicinal plaster and rightly inserted into the cavity of an ulcer, leads to its speedy healing. All secreting measures in connection with an ulcer should be continued or stopped according to its condition, whereby the nature and shape of the bandage should be determined as well. An ulcer, due either to the deranged condition of blood or the Pittam, should be dressed and bandaged once a day which may be extended to a number of times in the case of an ulcer brought about by the deranged Kapham and Vayu. The pus or the local morbid matter should be secreted by pressing the base or the bottom of an ulcer and b}- gently moving the hand along it in a contrary' direction (down, upward ; and all bandages around joints and Gudasandhis) should be duly tied up.

The rules laid down under the head of adhesioning the parts of a bifurcated ear-lobe would hold good in a case of severed lips as well. The measures amply discussed in the present Chapter should be extended by means of inference, analogy and judgment to apply mutatis mutandis to the bandaging of a fractured or dislocated bone.

An ulcer, properly bandaged, has a greater chance of not being affected by lying down, sitting up, or any other movement of the patient, nor by the joltingsChap. XVIII. ] SUTRASTHA'NAM. 1 7^ of a conveyance he may ride or be carried in. An ulcer affecting a vein or a ligament or the skin (superficial) or the flesh or the bones cannot be healed without bandaging it. An ulcer situated in any of the internal chambers (cavities) of the bod}', or occurring at any junction of the limbs or organs, etc. or having its seat in a bone and whether of a deep, superficial, malignant, or corrosive character, cannot be brought to a successful termination without the lielp of a bandage.

Thus ends the eighteenth Chapter of the Sutrasth^nam in the Siishruta Samhita which treats of the dressing and bandaging of ulcers.

CHAPTER XIX. Now we shall discuss the Chapter which treats of the management or nursing of a patient with an ulcer etc. (Vranito-pa^saniya-madhyaryam).

First of all a suitable chamber should be sought and selected for a patient, suffering from an ulcer. It should be roomy and spacious and situated in a commendable site.

IVIetrical Text :— Diseases, which are physical, mental or traumatic in their origin, can never attack a person who dwells in a clean and spacious chamber, protected from excessive heat, and strong gusts of wind.