An English Translation of the Sushruta Samhita (Bhishagratna ed.)

Their definitions :— The vein in which an act of venesection is unattended with a satisfactory outflow of blood owing to its being incised with an extremely slender instrument and is marked by an extremely painful swelling in consequence thereof, is called Durviddhat (badly incised). The vein in which the incision becomes excessive and no blood comes out properly or enters an internal channel owing to the largeness of the incision, is called Atividdha^ (over-in- cised). An opened vein in which the incision has been made in a curving manner and is attended with the fore- going results, is called Kunchitai (crooked or contracted). An incised vein presenting a flattened or thrashed ap- pearance on account of its being opened with a blunt knife (Kantha-Sastra) is called Pichchitai (thrashed). The vein at the sides of which incisions have been successively made, instead of in its body, is called Kuttitat (lacerated). An incised vein, unattended with any bleeding owing to the patient's fright, coldness or loss of consciousness, is called Aprasrulai (unbleeding).

2o6 THE SUSHRUTA SAMHITA. [Chap. VIII.

A vein with a large incision in its body made with a sharp and flat-edged instrument, is called Atyudirnat (improperly wide-incised). An opened vein in which blood oozes out in small quantity is called Ante- abhihatat (struck in the interior). An opened vein in an anaemic patient (marked by a total absence of bleeding and) stuffed with Vayu (lit., as if the flow has been dried up by the Vayu), is called Paris'ashkaL (dried up). A vein opened but to a quarter part of the proper length and attended with a scanty outflow of blood, is called Kunitai (partially incised). A vein which trembles owing to its being bandaged at a wrong place and from which blood does not flow out in consequence, is called VepitaL (quivering i. A vein incised without being previously properly raised up and attended with a similar result (ie., absence of blood), is called Auutthita-viddha^. A vein cut into two and attended with excessive bleeding and inoperativeness of the organ is called Sastrahata' (knife-cut). A vein incised with an instrument applied slantingly and (consequently) not fully opened, is called Tiryagf-viddha' (obliquely incised), A vein incised several times and (every time) with an improper instrument, is called Apaviddhat (wrongly incised) A vein unfit for opening {i,e., whose opening has been forbidden in the Sastras\ is called Avyskdhyai (unfit for opening), A vein opened carelessly and hastily is called Vidrutai (erratic). A vein bleeding continuously owing to its being repeatedly pressed and successively opened, is called Dhenuksi. A vein variously cut owing to its being pierced into the same part with an extremely slender-pointed instru- ment, is called Panah-punarvidahsi (repeatedly incised). If a vein in the Sn^yu-marmas, the Asthi-marmas, the SirA-marmas or the Sandhi-marmas be opened, it is

Chap. Vllt.] SARtRA STIIANAM. 20/

called Marma-viddhai and in such cases severe pain,
emaciation (Sosha) deformity or (even) death may be
the result. 54.

Memorable Verses : —Practice (even) docs

not give the necessary skill in surgical operation of the
veins etc., as they are naturally unsteady and changing
like fishes. Hence a vein should be opened with the
greatest care. An opening into the body, made by an
ignorant and unskilful surgeon, is attended with the
aforesaid dangers and many other distresshig symptoms.
An act of venesection, properly performed, gives more
speedy relief than that derived from the application of
medicated oil &c., or of plaster as well. Venesection
(bleeding) properly performed is half of the treatment
described in surgery like the application of Vasti-
karmas (enematic measures) in therapeutics. 55.

A man medically anointed (Sneha-karma), diapho- rised (Sveda\ vomited (Vamana), purged (Virechana), or treated with both the Vasti-karmas (Anuvasana and Asthdpana) or bled shall forego anger, physical labour, sexual intercourse, sleep in the day time, excessive talking, physical exercises, riding or driving etc., sitting on his haunches, frequent ramblings, exposure to cold, winds and the sun, hardly digestible, uncongenial and incompatible food until the strength is perfectly restored or, according to some authorities, for a month. These subjects will be fully dealt with later on Aturopa- drava-chikitsa, ch. — 39). 56.

Memorable Verses :— The vitiated blood

incarcerated in any part of the body should be abstract-
ed therefrom by scarifying it, by cupping it with a
Sira (pipe), a horn, a gourd, or leeches, or by the opening
of a vein respectively, according to the density of the
blood. (Others assert that) leeches should be applied in

208 THE SUSHRUTA SAMHITA. [Chap. Vlll.

the case of the (vitiated) blood being confined deep
into the body, scarification with a surgical instrument
should be made in the case of clotted blood, with a pipe
in the case of extensive vitiation of the blood through-
out the body and with a horn or a gourd in the
case of the deranged blood having been seated in the
skin. 57-58.

Thus ends the eighth Chapter of the S'arira Sihanam in the Sus'ruta Samhita which treats of venesection.

Now we shall discourse on the Sctriram which treats of the description of the arteries, nerves and ducts, etc.*

(Dhamani-Vyakarana-^ariram). r.

There are twenty-four Uhamanies (ducts) in all, and
all of them have their origins in the naval region
(which includes the whole abdominal region*|-). Several
authorities assert that no arbitrary distinctions should
be made among the Siras (veins), Dhaman is (arteries),
and the Srotas, (channels), since Dhamanis and Srotas
are but different modifications of one original kind
of Sira (vessels). But this opinion is not a sound one
inasmuch as they have got different natures, origins
and functions and as being described so in the Ayurveda.
But owing to their adjacent positions, the existence
of several authoritative dicta (Apta-vak) regarding the
oneness of their character, similarity of their functions,
and the minute nature of their shape, they appear to
be homologous in their action, even amidst the real
diversities in their work and office. 2.

Of the twenty-four Dhamanis, which (originally)
have their roots in the naval region (Nabhi), ten
have upward course, ten have downward course, and
four flow laterally or transversely. 3.

Functions of the up-coursing Dha- manis:— The ten up-coursing Dhamanis (nerves)

* Sans. Dhama— to be filled with air, so called from the fact of their being distended with air after death.

t So far, as in foetal' life, allantoic arteries and ihe unbilical veins subserve the purposes of nutrition, excretion, etc , and reflects the rudi- mentary vascular system.

210 THE SUSHRUtA SAMHITA. [Chap. IX.

perform such specific functions of the body, as sound, touch, taste, sight, smell, inspiration, sighing, yawning, sneezing, laughter, speech, and weeping, etc., and tend to maintain the integrity of the body. These Dhamanis, reaching the heart, respectively ramify themselves into three branches, thus making thirty (ramifications in all). Ten of these serve the following purposes, viz , two serve as the channels of the bodily Vayu, two of the Pitta, two of the Kapha, two of the blood, and two of the Rasa (lymph chyle). Eight of the remaining ones (twenty), serve the following functions, viz.^ two of them cany sound, two sight or colour, two smell, and two taste. Moreover a man speaks with the help of another two, makes sound with the help of another couple, sleeps through the instrumentality of another pair (couple), and wakes up with the help of another couple. Two of the Dhamanis (ducts) carry the fluid of lachry- mation, two of them (ducts), attached to the breasts of a woman, cany milk of her breasts, which, coursing through the breast of a man, convey his seminal fluid. Thus we have described the thirty Dhamanis with their ramifications. These sustain and maintain the integrity (of the limbs and members of the body) above the (line of) umbilicus, such as the Udara, the sides, the back, the chest, the neck, the shoulders and the arms. 4.

IVIcmorabIcVcrSe:—Theup-coursing Dhama- nis duly perform the offices stated above. Now I shall describe the specific functions, etc., {i.e,, nature, office, and situations, etc.,) of the down-coursing ones. 5.

Functions of the down -coursing

Dhamanis : — The down-coursing Dhamanis res-
pectively form the channels for the downward conveyance
of Vayu (flatus), urine, stool, semen, and catamenial

Chap. IX.] SARIRA STHANAM. 211

fluid, etc. These Dhamanis reaching down into the PittAsaya (receptacle of the Pitta) separate the serum prepared out of the food and drink through the agency of the local heat (and pitta), and carry it to the remotest parts of the organism maintaining their healthy moisture, supplying them with the necessary principles of nutrition and (ultimately) conveying them to the up- coursing and lateral Dhamanis, in order to be conveyed to the parts traversed by them respectively. Thus they indirectly serve to supply the heart with its quota of healthy Rasa (serus fluid), if not in a direct way. Moreover they tend to separate the efifetematter (urine, stool and sweat) from the fully transformed lymph-chyle in the abdomen, the stomach and the small intestines (Amds'aya and Pakvas'aya). Each of the down-coursing Dhamanis is found to ramify into three branches at a place midway between the Amas'aya (stomach) and the Pakvds'aya (intestines). Thus they number thirty in all. The functions of the ten out of these (thirty vessels) are as follows, viz., two serve to carry Vdyu, two Pitta, two Kapha, two blood, and two Rasa (lymph-chyle). Two of these Dhamanis, running into the intestines, carry the food, another two carry the Toya* (watery) part, another two, running into the bladder, serve to carry out the urine (from the bladder), another two carry the semen, and another two serve as the channels of transmission and emission of the same fluid and serve to carry the ovarian discharge in women. The two Dhamanis, attached to the large intestine (Sthulantra), serve as the channels of faecal matter, while the remaining eight convey perspiration to the lateral-coursing Dhamanis, Thus we have finished describing these thirty Dhamanis with their ramifications. These sustain and maintain the * Xhi,s watery p^rt reaching the bladder is tKansformed into urine,

212 THE SUSHRUTA SAMHITA. [Chap. IX.

integrity of the parts of the body below the naval region, such as the Pakvasaya (Intestine), the waist, the organic principles of stool and urine, the organs of generation, the anus, the bladder, and the lower limbs of the body (Sakthi) (according to their utility in the physical economy of the organism). 6.

Memorable Verse ;— These down-coursing

Dhamanis perform the afore-said functions. Now I shall describe the specific functions {i.e., nature, office, and situations, etc.,) of the lateral-coursing Dhamanis. 7.

Functions of the lateral-coursing*

Dhamanis: — The four lateral-coursing Dhamanis,
gradually ramifying themselves into hundreds and
thousands of branches, simply baffle counting. The
net-work of these Dhamanis spreads over the whole
orgnism and maintain its integrity. Their exterior
orifices are attached to the roots of hairs (pores of the
skin) through which they convey the perspiration and
the Rasa (serum), thus supplying the body, both inter-
nally and externally, with the soothing nutritions
(moisture of healthy lymph-chyle). The effects and
potencies of the articles of anointment, sprinkling,
immersion, and plasters, enter through these orifices
into the internal organism through the agency of the
heat in the skin, and sensations of a pleasant or
painful contact are experienced through their instru-:
mentality. Thus we have finished describing the four
lateral-coursing Dhamanis with their ramifications
throughout the whole organism. 8.

Memorable Verses :— The Dhamanis have
got pores in their sides through which they carry
the Rasa (lymph-chyle) throughout the organism, like
the filaments and fibres of water-lily and lotus. The.'^e
Phan\anis furnish the self-conscious Ego, confined in

Chap. IX.] SARIRA STHANAM. 21 3

the material body, which is the resultant of the combi-
nation of the five material elements, with a distinct
sensation* peculiar to each of the five sense-organsf
and break up the combination (of the five material
elements) at the time of death. 9 — 10.

Now we shall describe the symptoms produced by a
Srota (duct or channel) pierced at its root or starting
point. The ducts or channels respectively conveying
the life, the food, the water, (the organic principle of)
the Rasa (serum), the blood, the muscles, the fat,
the urine, the stool, the semen, and the cata-
menial blood, naturally fall within the scope of
Surgery (Salya-tantra). Several authorities assert that
the Srotas (vessels) are innumerable]:, and perform
different functions in their different aspects.

The two Srotas (channels) of Prana (bronchi) have their roots in the heart and the Rasa-carrying Dhama- nis (pulmonary arteries). An injury to any of these Srotas (vessels) produces groaning, bending down of the body, loss of consciousness (Moha), illusion, and shivering, or may ultimately prove fatal. The food- carrying Srotas (^Esophagus) have their roots in the Amasaya (stomach) and in the food-carrying Dhamanis (intestines). An injury to or piercing of such a duct (Srota), gives rise to tympanites, colic pain, aversion to food, vomiting, thirst, blindness or darkness of vision, or may even end in death. There are two water-carrying (Udaka-vaha) ducts or channels which have their roots in the palate and the Kloma^ and a pie-cing of any

* Hearing, touch, smell, taste, and sight.