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

• This explanation is given on the authority of old Vagabhata. Dallana, however, explains the verse in a different way. He explains it to mean two different preparations of milk— one with Yashti-madhu and mixed with sugar and castor oil as a Prakshepa and the other with Gokshura and mixed with Laksha and castor oil as a Prakshepa.

A third in'erprctation would make three preparations of milk prepared separately with Yashti-madhu, Laksha and Gok&hura — sugar and castor oil being mixed in the first (as Prakshepa) and castor oil alone in the second and third.

A fourth preparation would be to prepare the milk separately wiih Yasbtimadhu, Laksha and Gokshura as in the preceding case— without the Addition of castor oil (as Prakshepa),

272 THE SUSHRUTA SAMHITA. [C^ap. II.

Emesis is beneficial in the case where the blood
would be found to be confined in the Am as ay a
(stomach). Purgatives should unhesitatingly be pre-
scribed where the blood would be found to have been
lodged in the Pakvas'aya (intestines) and Asthapana
measures without oil should be employed with hot,
purifying i^Sodhana) substances (such as the cow-urine,
etc.) The patient should be made to drink a Yavagu
(gruel) with Saindhava salt and his diet should consist
of boiled rice mixed with the soup of barley, Kola and
Kulalttha pulse divested of oil. 35-36.

In a case of a perforation or piercing of any of the
bodily Koshthas attended with excessive haemorrhage
or bleeding, the patient should be caused to drink (a
potion of animal) blood and such a case marked by the
passage of stool, urine, etc., through their proper channels
of outlet and by the absence of fever and tympanites
and other dangerous symptoms, (Upadrava), may end
in the ultimate recovery of the patient. 37-38.

In a case of a perforation of the Koshtha (abdomen)
where the intestines have protruded or bulged out in an
untorn condition, they should be gently re-introduced
into the cavity and placed in their original position,
and not otherwise. According to others, however,
large black ants should be applied even to the perforat-
ed intestines in such a case and their bodies should be
separated from their heads after they had firmly bitten
the perforated parts with their claws. After that the
intestines with the heads of the ants attached to them
should be gently pushed back into the cavity and re-
instated in their original situation therein. The bulged
out intestines should be rinsed with grass, blood and
dust, washed with milk and lubricated with clari-
fied butter and gently re-introduced into the cavity of

Chap. II.] CHIKiTSA StHANAM. ^^^

■ the abdomen with the hand with its finger nails cleanly
paired. The dried intestines should be washed with milk
and lubricated with clarified butter before introducing
it into their former and natural place in the abdo-
men. 39-41.

In a case where the intestines could be but partially
introduced, the three following measures should be
adopted. The interior of the throat of the patient
should be gently rubbed with a finger [and the urging
for vomiting thus engendered, would help the full
introduction of the intestines into the abdominal cavity].
As an alternative, he should be enlivened with sprays
of cold water ; or he should be caught hold of by his
hands and lifted up into the air with the help of strong
attendants and shaken in a manner that would bring
about a complete introduction of the intestines into
the natural position in the abdominal cavity. They
should be so introduced as to press upon their specific
(Maladhara) Kald (facia). 42-43.

In a case where the re-introduction of the intes- tines into the abdominal cavity would be found to be difficult owing to the narrowness or largeness of the orifice of the wound, it should be extended or widened with a small or slight incisiona ccording to requirements, and the intestines re-introduced into their proper place. The orifice or mouth of the wound should be forthwith carefully sutured as soon as the intestines would be found to have been introduced into their right place. Intestines dislodged from their proper seat, or not intro- duced into their correct position, or coiled up into a lump bring on death. 44-46.

Subsequent Treatment : -[After the full

and correct introduction of the intestines] the wound should be bandaged with a piece of silk-cloth saturated

274 TtiE SUSHRUTA SAMHITA. [Chap. it.

with clarified butter, and the patient should be given a draught of tepid clarified butter (D. R. tepid milk) with castor oil for an easy passage of the stool and downward coursing of the Vdyu (spontaneous emission of the flatus). Then, for its healing up (Ropana), a medicated oil, pre- pared with the bark of the Asvakarnay Dhava, S'dlmali, Mesha'S'ringi, S'allaki^ Arjuna^ Viddri, and Kshiri trees and Vald roots should be applied to the wound. For a year the patient should live a life of strictest conticence and forego all kinds of physical exercise. 47 — 48.

The legs and the eyes of the patient should be
washed and sprinkled with water in the event of the
bursting out of the testicles which should be intro-
duced into their proper place within the scrotum, and
sewn up in the manner of a Tunna-sevani (raised seam).
The scrotum should be bandaged in the shape of a
Grophansb-Vandha and a restraining apparatus (Ghatta-
Yantra) placed round the waist of the patient (to
guard it against its oscillations or hanging down). The
wound should not be lubricated with any kind of
oil or Ghrita inasmuch as it would make the wound
moist and slimy. The wound should be healed with a
medicated oil prepared with Kdldmisdri, Aguru^ Eld,
Jdti flower, Chandana, Padmaka, Manahs'ild, Devaddru,
Amrita and sulphate of copper (pounded together). 49-50.

A plug of hair should be inserted into a wound on
the head, after having extracted the foreign matter
therefrom, with a view to arrest the exuding of the
brain matter (Mastulunga) which invariably proves fatal
to the patient through the aggravation of the deranged
Vayii in consequence thereof. The hairs of the plug
should be taken out one by one as the healing process
progresses (granulation). An oleaginous medicated plug
or lint should be inserted into a wound on any other

Chap. II.] CHIKITSA STHANAM. 275

part of the body, which should be treated with the
measures and remedial agents laid down in connection
with a traumatic ulcer after having first allowed the
vitiated blood to escape. 51-52.

The medicated oil known as the Chakra-taila*
should be poured (frequently applied) by means of a
slender pipe into an ulcer (wound) which is deep-seated
but narrow-mouthed, after first letting out the vitiated
bloodf. An oil duly prepared and boiled with Samangd,
Haridtd, Padmdy TriiargaX Tuttha, Vidanga, Katuka,
Pathydy Guduchi and Karanja acts as a good healing
(Ropana) agent (in these cases). The use of an oil
prepared with Tdlis'a, Padmaka, Mdnsi, Harenu^ Aguru^
Chandana^ and the two kinds of Haridrd, Padma-vijuy
Us'ira and Yashti-madhu acts as a good healing remedy
in cases of traumatic ulcers. 53-55-

A cut wound (Kshata) should be treated with its
own specific measures and remedies, while a bruised
one (Pichchita) should be treated (to all intents and
purposes) as a case of Bhagna (bone-fracture). The first
treatment of a mangled or contused wound (G-hrishta)
is to extinguish pain, after which it should be dusted
with the powder of proper medicinal drugs (such as
S'dla, Sarja, Arjuna, etc.). 56' 57.

In the case of a dislocation of any part of the body,
caused by a fall (from a tree), or in the event of having
been run over or trampled down (Mathita — by a carriage
or by a beast), or of being wounded (by a blow, etc.),

* The oil just pressed out of an old oil-miil or squeezed out of the chips of wood belonging to an old one, in the manner of the Anutaila to be described hereafter, is called the Ohakra-taxla

t The vitiated blood should first be lei out for fear of putrefaction of the ulcer.

:;: Triphala, Trikatu and Trimada are called Trivarga.

276 THE SUSHRUTA SAMHITA. [Chap. II.

the patient should be kept immersed in a large tank
(Droni) of oil and the diet should consist of the soup or
essence (Rasa) of meat. A man fatigued (from the
labours of a journey), or hurt at any of the Marmas,
should be likewise treated with the preceding
measures. 58.

Oil or clarified butter should be always administered
as drinks, washes or external healing applications for an
ulcer-patient with a due regard to his temperament and
the nature of the season. Medicated Ghritas, yet to be
mentioned in connection with the medical treatment of
a Pittaja abscess, should be used as well in the case of
a traumatic ulcer (according to its respective indica-
tions). A physician should wash a traumatic ulcer
attended with an aching pain either with a Vala-oil or
tepid clarified butter (according to the nature of the
season and the temperament of the patient).* 59 — 61.

An oil codk^dvilthSamangd^Rajani, Padmd{fih.-krg{),
Pathyd, sulphate of copper, Suvarchald, Pad^naka,
Lodhra, Yashti-madhuka, Vidanga, Harenuka, Tdlisa-
patra^ Nalada (fatdmdnsi), (red) Chandana, Padma-
kes'ara^ Manjishthd, Usira^ Ldkshd, and the tender
leaves of Kshiri trees, Piydla seeds, raw and tender
Tinduka fruit, or with as many of them as would be
available, should be regarded as a good healing remedy
in respect of all non- malignant traumatic sores or ulcers.
Applications of astringent, sweet, cooling and oily
medicines should be used for a week in a case of a
traumatic ulcer (Sadyo-vrana), after which those men-
tioned before, in the Chapter of Divraniya, should be
adopted. 62—63.

* With oil in autumn and in the case of a patient of Rakta-pitta temperament, and wi»h Vala-oil in winter and in the case of one of a Vata- kapha temperament.

Chap. II.] CHIKITSA STHANAM. 277

Treatment of Dushta-Vrana:— In the

case of a malignant ulcer (Dushta-Vrana) emetics, errhines, purgatives, Asthapana, fasting, specific sorts of diet (composed of bitter, pungent and astringent things) and blood-letting, should be prescribed (accord- ing to the requirements of each case). The ulcer or sore should be washed with the decoctions of the drugs of both the Aragvadhddi and the Surasddi ganas, and an oil cooked with a decoction of the said drugs should be applied to the wound for |the purification (Sodhana) thereof. As an alternative, an oil boiled and prepared in an alkaline water or solution (four times that of oil) with a Kalka of alkaline subs- tances (such as Ghantdparuli, Palas'a, etc.) should be used for that end. Oil cooked with Dravanti (Satamuli, according to certain authorities, Mushika- parni according to others), Chiravilva^ Dantiy Chit- raka, Prithvikd Nimba-leaves , Kdsisa^ Tuttha^ Trivrit, Tejovaii, Nili (indigo), the two kinds of Haridrd, Saindhava salt, Tila, Bhumi-Kadamba^ Suvahd, S'ukd- khyd, Ldngaldkvd, Naipdli^ Jdlini, Madayanti^ Mrigddani, Sudhd^ Murvd, Arka, Kitdri, Haritdla^ and Karanja, or with as many of them as would be available, should be used for the purification (of a malig- nant sore or ulcer). If found applicable, a medicated Ghrita prepared and cooked with the foregoing drugs and substances as Kalka should be used for the same purpose. In the case of a malignant ulcer, due to the aggravated Vayu, the purifying remedy should consist of a Kalka of Saindhava salt, Trivrit and castor leaves. In the case of a (malignant) Pittaja sore, the remedy should consist of a Kalka of Trivrit, Haridrd, Yashti- madhu and Tila. In the case of a malignant ulcer, caused by the aggravated Kapha, the purifying remedial

278 THE SUSHRUTA SAMHITA. [Chap. II.

agent should consist of Tila, Tejohvd, Danti, Svarjikd
and Chitraka roots. An ulcer brought on owing to the
presence of the virus of Meha or Kushtha in the system,
measures and remedies mentioned under the treatment
of Dushta-vrana should be adopted and used. 64 — 68.

The recognised school of physicians, which recognises
these six types of traumatic sores, does not add to the
list, herein mentioned, other types of ulcers, whereas
vain pedagogues try to swell it with a larger number of
types by adding connotative prefixes and suffixes to the
names of the aforesaid six. It is mere vain-gloriousness
on their part to say so, since all the other types that
they can devise are but single instances and can be made
to fall under one of these six general heads. Hence
there should be only six kinds (of traumatic sores) and
not more. 69.

Thus ends the second Chapter of the Chikitsita Sthanam of the Sus'ruta Samhita which deals with the treatment of Sadyo-vrana (traumatic sores).

Now we shall discourse on the medical treatments of fractures and dislocations (BhagTiaS). i.