An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)

* The practice, in this case, is to add twelve Seers (three prastha measures) of water to the Prastha measure of milk at the time of cooking.

p. 400

the right hand (instead of the left hand) should be opened in this case. 18.

IVIetrical Text : —After slightly bending down the wrist (of the left hand;, the vein in connection with the thumb of the left hand should be cauterized with a (burning) Sara for the purpose of giving relief in a case of enlarged spleen. 19.

Treatment of Vaddha-gudodara, etc. : - In cases of the Vaddha-guda (Entertis) and the Parisraivi types of Udara, the patient should be first treated with emulsive measures and fomentations and then anointed with a sneha. Then an incision should be made on the left side of the abdomen below the umbilicus and four fingers to the left of the line of hair which stretches downward from the navel. The intestine to the length of four fingers should be gently drawn out ; any stone, any dry hardened substance (Scybalum ?), or any hair found stiffing to the intestine should be carefully examined and removed. Then the intestine should be moistened with honey and clarified butter. It should then be gently replaced in its original position and the mouth of the incision in the abdomen should be sewn up. 20,

Treatment of Parisravi-Udara : -In

cases of the Parisravi type of Udara, the obstructing matter should be similarly removed (from the intestines), as in the preceding case, and the secreting intestine should be purified. The (two ends of the severed intestines should be firmly pressed and adhered together and large black ants should be applied to these spots to grip them flistly with their claws. Then the bodies of the ants having their heads firmly adhering to the spots, as directed, should be severed and the intestines should be gently reintroduced into their original

Chap. XIV.] CHIKITSA STHANAM. 4OI

position (with the severed heads of the ants adhering to the ends of the incision) and sutured up, as in the preceding case. A union or adhesion of the incidental wound should then be duly effected. The <^eam should now be plastered with black earth mixed with Yashtimadhu and duly bandaged. The surgeon should cause the patient to be removed to a chamber protected from the wind and give him the necessary instructions. The patient should be made to sit in a vessel full of oil or clarified butter and his diet should consist only of milk. 21.

Treatment of Udakodara :— A patient

afflicted with Jalodara (ascites) shovild be first anointed with medicated oils, possessed of Vdyu-subduing virtues, and fomented with hot water. Then his friends and relatives should be asked to hold him firmly by his arm-pits, when the surgeon would make a puncture with a surgical instrument, known as the Vrihi-mukha, on the left side of the abdomen below the umbilicus, to the breadth of the thumb in depth and at a distance of four fingers to the left of the dividing line of hairs in the abdomen. Simultaneously with that, a metal tube or a bird's quill, open at both ends, should be introduced through the passage of the puncture to allow the morbific fluids (Doshodoka\ accumulated in the abdomen, to ooze out. And then having removed the tube or the quill, the puncture should be lubricated with oil and Saindhava salt and bandaged in the manner described in connection with the bandaging of ulcers.

The entire quantity of the morbific fluid should not be allowed to ooze out in a single day, inasmuch as thirst, fever, aching of the limbs, dysentery, dyspnoea and a burning of the feet (Pada-daha) might supervene in consequence, or as it might lead to a fresh accumulationp. 51p. 402 of matter in the abdomen, in the event of the patient being of a weak coustitution. Hence it should be gradually tapped at intervals of three, four, five, six, eight, ten, twelve, or of even sixteen days. After the complete outflow of the fluid, the abdomen should be firmly tied with a piece of flannel, silk-cloth or leather, inasmuch as this .would prevent its flatulent distention.

Diet: — For six months the patient should take his food only with milk or with the soup (Rasa) of Jdngala animals.