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AN ENGLISH TRANSLATION
OF

THE SUSHRUTA SAMHITA


WITH
A FULL AND COMPREHENSIVE INTRODUCTION, ADDITIONAL TEXTS, DIFFERENT READINGS, NOTES, COMPARATIVE VIEWS, INDEX, GLOSSARY AND PLATES

IN

THREE VOLUMES

EDITED BY

KAVIRAJ KUNJALAL BHISHAGRATNA,


Vol.

m.r.a.s.

II.

NIDANA-STIIANA, S'ARIRA-STMANA, CIIIKITv^ITA^ .STIIANA AND KALArA-STIIANA.

CALCUTTA:
PUBLISHED BY THE AUTHOR,
NO.
10,

KASHI GROSE'S LANE


I9II

AH

Rights Reserved,

PRINTED BY

M.

25,

BHATTACHARYYA, AT THE BHARAT MIHIR PRESS, ROY BAG AN STREET, CALCUTTA.

MAY 3

?oni

PREFACE.

It

is

with

mingled feelings of pain

and

we now place before the public the Second Volume of our English Translation of the Susruta Samhita. The arduous task of compleasure that
piling

a connected and succint history of any


whatever,
of
the

Hindu System requires greater leisure and more of Medicine extensive reading than we can lay any prepart

ancient

tension

to.

Years of patient study and constant


with

discourse

our

sainted

preceptor the

late

lamented Mahamahopadhyaya Kaviraj Dwaraka

Nath Sen, Kaviratna,


golden'' chain
.

that refulgent link of the

of
us,

the

Dhanvan^aric succession,

have enabled

however, to grasp the leading

facts, and during' thje.Iast few years we have worked contihutrusly^^n-moments snatched from

the

practice of an anxious profession that


respite, to
It

knows

no

arrange these facts

in their

present
the sad
this

form.

breaks our heart to record

departure of our venerable

Acharyya from

sublunary sphere to a land 'from whose bourne

no traveller
It is

e'er returns.'*

hardly necessary for us to reply to those

critics

who, through their ignorance of the original

L^e.^^

2
in

Sanskrit
as an

works, persist

describing

empirical

system destitute
in

Ayurveda of Anatomy,
meet

Physiology or Pathology
It

any

scientific sense.

behoves

us,

however,

in this preface to

some of the charges which have been brought


against us.

Exception has been taken to our not including


in

the

opening stanza the usual invocation


Self (for a successful completion
it

to the

Supreme
all

of the work) although

has found

its

way

into

almost

the printed editions of the the

work
the

extant.

Now

stanza referred to finds no place in

the various

manuscript copies of
in

original

work which are

our possession,

or on which

we have been
was
in
first

able to lay our hands.

The work
Madhuwas only
it

put into print by the late Dr.

sudan Gupta and we believe that


this

printed
in
it

edition

that

the

benedictory

address

question appeared

for the first time,

and that

has since crept,

by the process of

circulation,

into subsequent printed editions.

In this opinion
that in

we

are supported by the

fact,

none of the various commentaries and annotations on the Susruta Samhita is any mention

made

of the line in question, whereas,

had

it

been

the opening stanza of the original work,


certainly
at

it

would
notice

have received

at least a passing

the hands of the commentators, however easy


it

or simple

might have been.


himself,

Further,
it

were

it

composed by Susruta

would not have

been
the

in the

form

in

which we

find

it

in the printed

editions.

The
like,

ancient

sages

used

invariably
"^r^^''

auspicious

expression "^^Tci:'^ or

and the

when commencing
their

a work and

never invoked any particular deity for a happy


termination
of
undertaking."^
to

These are
omit
the

the reasons which have led us

passage

in

our present translation.

Another objection raised by a certain section


of the
all

community
to

is

that

we should
the

not have

at

undertaken

translate

work
is

into the

English

language.

Their contention

that the

Ayurveda,
Eternal

being

an integral portion of
should,

the

Vedas,

on
at

no

account,

be

rendered into a Mlechchha Bhdshd and thus


accessible
to

made

the

public

large,

irrespective

of caste or creed.

Such an
latitudes
lines.

objection, at this time of the day,

is,

to say the least,

most puerile

Truth

is

truth,

and

and longitudes are not

its

boundary

lated

The Vedas themselves have been transTo keep into many European languages.
privileged
classes

the truths promulgated by our ancient sages confined within the coterie of the

and thus

to deprive

the educated public of the

Thus

asTTUmr^:" Charaka Samhita.


Sutra.
>^'W

'a)
(/;)

"^ram'f fi^^^f^ffl^T'^z^Ts

*'^^T^

^Ti^Mm:"

Kanada Vaiseshika Sutra

(^)

"^^T^ ^^fsr^T^T" Vedanta

benefit

of

such
In

truths

would certainly be

sacrilege.

giving preference to

English as
actuated

the

medium
It

of translation

we have been

by more reasons than one.


cannot be gainsaid that English has

now

become almost the


and
a

lingua franca of the world,

to disseminate the ancient

wisdom of India

throughout the world,

we

could not have selected

medium

better than the English language.


this,

Besides

we have been

actuated by the

hope of drawing the direct attention of our benign Government to the


scientific

value

of our

system of Medicine by
procedure.

the

adoption of such a

Here we must not stop without expressing


our sincere and hearty thanks to our learned and

valued friends

Kaviraj Jogindranath Sen, M.A.,

Vidyabhusana, Kaviraj Jnanendranath Sen, B.A.,


Kaviratna and Professor

Satyendranath

Sen,

M. A., Vidyavagisa, who have rendered us material


help in the publication of this volume.
freely

We

must

admit that but

for the active

and continued

co-operation of the

could

not

have brought

above-named gentlemen we out this volume so

promptly and successfully.

Our thanks

are also

due

to Dr. S. Sanyal, to

B.Sc, L.M.S.

for his

kind
for

help,

Dr.

S.

N. Goswami, B.A., L.M.S.

his kindly supplying us with materials for writing

the

Introduction,

and

to

our readers

for their

kind encouragement

In

conclusion,

we implore our
in the

readers

to

excuse the errors of

omission and commission


execution
of such a
is

which are inevitable

huge work,
profession

more

especially

when

the author

encumbered with the responsible duties of


involving,

his

as

they do, the

life

and

death of persons entrusted to his care.

10,

KASHI GHOSHE'S LANE,^ Calcutta. I


'

KuNJA LaL BhISHAGRATNA.

November^ igii,

INTRODUCTION.
In the introduction of the
is not Encyclopaedia of ancient medical
first

volume of our translation

of the Susruta-Samhita we have attempt-

Ayurveda

ed to place before the public a correct


interpretation of
.,^,

an

Vayu,

_,.

Pitta

and Kapha,
of

Mse on

Biology!''^^^'

^^^

^^^^^^^

so-called
it

humours

the

body* and
that our

is

a great pleasure to us,

pronouncement has been very kindly accepted.


of the

In

the

introduction

present volume we would draw the


is

attention of the readers to the fact that Ayurveda


all

not

at

an encyclopaedic work,
*

an
known
as

Encyclopaedia of the Indian


as

Berdoe says

: "What
all

is

the

Humoral Pathology formed


Dogmatics.

the

most essential part of

the

system of the
caused

Humoral
Hip-

Pathology explains

diseases

by the mixture of the four


water.
it.

cardinal humours, viz., the blood, bile,

mucus or phlegm and


these humours.
is

pocrates

first
is

leaned

towards

it,

but

it

was Plato who devoloped

The

stomach

the

common

source of

all

When

diseases

develop, they attract humours.

The

source of the bile

the liver, of the

mufcus the head, of the water the spleen.

Bile causes catarrhs and rheu-

matism, dropsy depends on the spleen."

Be
logy
this

it

observed

that

among

the

humours of Hippocrates there


Physiology and

is

no

place for Vata although in point of fact both his


are
to

Patho-

be traced to
is

the "Tri-dhatu" of Ayurveda.

The

secret of

anomaly

that the theory of

Vata was found


to
its

to be a complicated
its

one

and Hipprocates, not being able


it

comprehend
stead, his

original import, left

out and cautiously introduced, in


find

own

theory of "water".
;

Sowe

"Humoral Pathology
It is
)

is

not of Indian origin

neither

it is

the

same which the Indian Rishis of Rigveda developed under the name of
Tri-dhatu."
(

simply an imitation of Susruta

who

introduced blood

[<!) ci-M<j^'i

^s the fourth factor in the genesis of diseases.

Bui the bor-

rower, in his interpretation of Susruta, had

made

a mess of

it.

He

retain-

ed blood,

but

substituted

"water"

in place of

Vkta, the most important

of the three, for reasons best

known

to

him.

il

INTRODUCTION.
Medicine
in
all
its

system of

departments,

but

it

is

the

Science of Life entire.

Though

it

is

customary and convenient to group apart


as are

such phenomena
are exhibited by

termed

mental and such of them as

men

in society,
it

under the heads of Psychothem,

logy and

Sociology, yet

must be allowed that there are no


Nature,

absolute demarcations

in

corresponding

to

and so
are

in the entire

Science of Life, psychology and sociology


with

inseparably

linked

Anatomy and
Hygiene

Physiology, nay,
all

more,

with

Pathology and

and above

with

Treatment.

In short the Biological Sciences must deal with


are

whatever

phenomena
in

manifested
placed.

by living matter
(

in
)

whatever condition
well as Life

it is

Life in health
therefore,
fall

^^5:

as

disease

( ^:?irTf: ),

within the
in Society

scope of Biology even


(

life

exhibited
it.

by man

f%cTTf%cf

is

not exempted from

f^cnficf ^Ji -^'MM^i^^f

f%mf%cT^
11

^^^
Ayurveda,
entire
^

era

^5r^?TT#V.

^ ^'^

'^T^,

#^r^T, x^ ^'^m
^^

In calling Ayurveda, therefore, the entire Science of Life,

Science

the of

"^^

^'^

"^ ^"'^^^

of

our

own,

but

we
and

rely

^"^ prejudice solely on


these,

facts
will

and

figures,

when
same

closely studied,

lead

any one

to

arrive at

the

conclusion,
as
Ill

not

unlike
of

our

own and

to interpret
all

Ayurveda
we
will

collection
firs':

Biological
for

Sciences in

departments.

the

place,

the guidance of our readers,


itself is

mention that the name Ayurveda

a strong evidence

Negative Evidences thereof:


I.

in favour of its ^r t -^^ o

Of Life.
(\^q

ji Secondly,

being called the Science n c we will refer to

The Name

it-

arrangement of the subject-matter


the

in
larly

Sarira-sthana

which
of the

is

popu-

belived to be

the anatomical

portion

book, as

tending
II.

to
.

the
.

same conclusion.
.

In
.,

The arrange-

..

ment of the subject-matters.

this

section,

chapters
of

on

....

Midwifery
follow

^nd Management

Infants

close to the heels of those on Anatomy and Physiology, and

INTRODUCTION.
these
latter

iH

again

are

immediately
intermixture
is

preceded

by chapters

on Psychology.

This

certainly an

anomaly

and can
elucidated

in

no wise be
these

satisfactorily

explained
truths

unless

we

have to look upon

as

general
of

of
truths

Biology,
exclu-

by the Introduction

special

sively collected
4j<[Mlci f*f
i

from the science of medicine


call
it

fviw^rrf^^

^^T^

To.

Descriptive
is

Anatomy

or Physiology,

in the

modern sense of the term


of Descrip-

simply ridiculous.

The
and
in
is

absence of any reference to brain

Want
tive

Anatomy and

spinal cord, to pancreas f ^


>

and

heart,

Physiology in the
Ithlnaitself^-^"^^"
dency.

book of Anatomy and Physiology


in the

unpardonable and

Sarira-sthana

we
Moreover,
Kirke's
in

feel

this

absence almost to despon-

western

medical science, Grey's Anafor

tony and

Physiology,

instance, in

their

bulk,

exceeds, each,
to

more than

a thousand of pages
less

and

to present

the

public,

under the same name

than half a dozen


is

of pages, as

the result of

Indian wisdom,
is

certainly a very
to inspire

miserable

contrast

a contrast that
at least

calculated

no admiration,

but, on the contrary, to

generate in scientific
all

minds an universal apathy,


is

an apathy towards

that

connected with the system of Indian Medicine.


Rishis from
all,

In order

to save our venerable

this disastrous plight,

we
but

announce here
of

foremost of

that

our

beloved Science
work,

Ayurveda

is

by no means an

Encyclopaedic

distinctly possesses every


^'''^''"

characteristic

ces^'*''' I The definition

that

"^a^^s

the

Science

of

Biology.
indicates

The
that

very
it

name
actually

Ayurvada
a

Same

as Life as

is

science of

Ayus

same
In
masterly

sense

as

Mr.

Herbert Spencer

understands by his remarkable definition of Life.


liis

classification

Mr.
first

Herbert Spencer has,


place to

in his Biology, given, indeed,

the

Anatomy and

Physiology, but

still it

is

divested of any elaborate chapters

dealing with the subjects.

IV

INTRODUCTION.
In
the

science
its

of Life a short reference to the structures


is

of the
its

body or

functions
if

quite

sufficient

to

illustrate

principles,

and

we

fail

to find therein

any discourse on
still

the

descriptive
is

Anatomy and Physiology, we


fate

consider

that there

nothing amiss.
of

But unfortunately the

Ayurveda
it

is

otherwise.

Though
simple,

the

very

name

indicates that
for its

is

Biology pure and


in

still it is

denounced

dificiencies

Anatomy
of

and Physiology, and doomed


Sanskrit

for ever.

words are notorious

for

their

confusion

meanings, but, as regards Ayurveda there exists no difference


of opinion,
at
least,

so far
in

as

the

first

word
it is

is

concerned.

Ayus
they

is

Ayus everywhere
not put
but,

Ayurveda and
any

the only fault

our venerable Rishis may be reasonably charged with, that


did

themselves

into

great

trouble

to

explain

Ayus,

on the contrary,
to

unlike scientific men,


significance

misspent their energy

ascertain

the
is

of the

insignificant portion of Ayurveda, that

the meanings of the

root "F/^a" in the light of

Grammar.
these

The

scientific ear, ever unsatisfied with

grammativalue

cal eruditions, has ultimately

thrust an Encyclopaedic

upon what
there
is

is

properly speaking, a book of Biology.


difference between

Of

course,

marked

the

two.

An
truths

ordinary
of
life,

treatise

on

Biology deals

with

the

general

and does not


concerned,

represent, by

way

of illustrations, all

its

special
is

truths, nor their practical sides,

but so

far

as

Ayurveda

the

general truths of Biology are thrown into the


special truths, gleaned

background and the

exclusively

from

the science of medicine, are given great prominence (fir^^irf^

^T^
as a

^^^f^cnf'T

),

so

much

so,

that

it

is

now regarded

system

of

Medicine and Surgery which has neither

Biology,
is

nor Anatomy, nor Physiology, nor Pathology

but
in

a systematised

Empiricism or Quackery.

This

is

certainly

a great

misfortune.

Apart from the name, the arrangement

of the subject, to which

we have

just

referred,

at

least,

the section of Sarira-sthana (the falsely so-called

Anatomy

of

INTRODUCTION.
the Hindus),

V
its

is

a direct contradiction to

bieng considered

as an Encyclopaedic work.

The

existence of the chapters on


in

midwifery and management of infants

the same, following


as

immediately the chapters on


additional

Anatomy, serves
It
is

strong

evidence

thereof.

an

anomaly no doubt,
the
section
of

that Midwifery has been

offered

place in
j

Anatomy, but the confusion does not


Reasons for
in cor-

porating Midwifery
into this Anatomical section.

get at

all

,,

t j confounded,

-r if

j. we are led to
i

believe
of

that

the science of generation ^ race


(if

superior

we

are at

all

permitted to use the term) forms, indeed, an important depart-

ment of Practical Biology.

From whatever standpoint we look


find there are

to the question,

we
in

grounds to lead any one to pronounce


to

our

favour and

come

to

the

conclusion at

which we
facts,

now

venture to arrive.

Besides these
cite

two important

we now
Internal evidence.
our view.
of the

the following passage as


i

^ j r . a strong mternal evidence in favour

of

Maharshi Punarvasu,
structures of the
is

after giving us a short table

principal
this

even

reference

considered
'^^

human body, remarks that by many as superfluous,

Reasons for omitting

Descriptive

S'"^' ^^^^ ^" acquaintance with the molecular construction of an


''^

organism
as a reliable

is

quite

sufficient to help us

guide to treatment.
referred to
is

The passage

quoted below

Biology
if

Now we
and
the
that

ask the reader


hilt,

if

this

is

not a sufficient evidence,


is

proving to the

that

Ayurveda

nothing but

we run no

risk of
is

committing a grave omission


wholesale dispensed with
this

chapter on

Anatomy

from

Ayurveda.
that

For the improvement of

awkward position
no Anatomy
he has very wisely

in the section of
is

Anatomy
that
is

there should be
as

^-Ihe entire credit

due to Susruta,
a

made

the

suggestion,

knowledge of the anatomical


far

structures of the

body

of great value, at least so

as

it

VI

INTRODUCTION.

helps the Surgeons and the Surgeons only in their operations.*

But so

far as

Biology

is

concerned

with

medicine,

Susruta

does not forget to lay particular


the

stress

on the knowledge of

molecular construction
actually

of

the

body.

The
this
still

following

memorable passages

preached by

renowned
as

Surgeon, some three hundred centuries ago,

stands

model from which modern Science, even


vancement, can draw inspirations.

in its present ad-

He

says
I.

T ^^^l^T

5^'

tf

\^cPH\

f%H*.

^^cTT'^it ^^'^'T^T^'giT'^^ff fen:

II

IT<5m^ f% ^^

^RRTcT^^^
That
is,

^
is

?^ ^Ml^^ Wtrl
'5TTf%^Tii[
II

the

protean work of the protoplasm in which the


the

great Self resides cannot be detected by

body's eye

to

know
eye.

its

work, mind's eye

necessary, along with the body's

For acquiring

efificiency in

Surgery alone, the dissection

* Susruta
that
it is

recommends
can

dissection on dead

human

bodies and suggests

only required of those

who
it.

will practise surgery

and that students


dissection

of medicine
living

do without

Herophilus

practised

on

bodies and

with the object of practising

medicine successfully,
influence

but

it

soon

fell

into disrepute

and did not

at

all

the art

of

Medicine.!

He was condemmed
all

even by his

own
of

pupil Philinus of cos

who

declared that

the
in

Anatomy
the least

his vivisecting master


in

had taught him


patients.

had not helped

him

the

cure

his

Such

indeed was the fate of vivisection for which Europe

But Susruta's, Avagharskana


perfect

is

now takes pride. now considered by many as the only


It
is

mode
of

of dissection that

ever known.

with the help of

this

method

dissection

the layers of epidermis and dermis could be

discovered and blood-vessels with their minute branches could be counted


to

be as many as

thirty millions.

Not only
still

this,

but also in the opinion of

several

European savants, Susruta

stands as a model

of surgery and

European surgery has borrowed many things from Susruta and has yet

many

things to learn.

INTRODUCTION.
of

Vll

dead

body

(not

of

living

body
^^^

as

proclaimed by
into view

Herophilus), nay,

the Avagharshana which brings


^^^
.,

The
of

knowledge

^^^^^^ ^

epidermis and
,.
,

the

the Molecular Construction of the body is all that is

dermis, the
,
,

number and branches


and nerves
,

of
-,

blood-vessels

that

lie

embedon

wanted.
Professor

^^^
Michael

j^

muscles, etc

is

only
his
all

necessary.
article

Foster's

remarks

in

Physiology in the Encyclopedia Britannica, to


are
just
in

appearnces,

the

same

line, if

not identical with our extract,


in the future,
infer-

when he
is

says **that the

problem of Physiology,
arriving

largely

concerned
the

in
eye,

by

experiment and

ence,

by

mind's

and not

by the body's eye alone,


be

assisted,
at a

as that

may

be,

by lenses yet to

introduced

knowledge of the molecular construction of the protean


;

protoplasm

of the laws

according
to

to
it

which

it

is
;

built

up

and the laws according


laws

which
clear

breaks

down

for these

when ascertained
short
is is

will

up the mysteries of the

protean work which the protoplasm does."


Ijo

the knowledge of the molecular construction of

the body

just the thing with

which Biology

is

concerned,

and such
in

the

unanimous verdict both


the

in the East as well as in the

the

West, in

most ancient and

most modern

Sciences of the world.

Now,

if

the 'knowledge of the molecular

construction of the protoplasm, of the laws according to which


it is

built up,

and the laws according


our Ayurveda

to

which

it

breaks down,'

is all

that

is

necessary for an accurate knowledge of


is

Anatomy

and

Physiology,

pre-eminently the Science

we want.

The

following extracts,

from Charaka Samhita, are cited

here to prove that

we

are quite justified in our contention.

2.

^fl?:^icrTt

^ % ^%^^5mt fir^^

That

is,

the

body

is

said to be numberless, because

composed of molecules and these no body can count them

are

up.

Vlll

INTRODUCTION.
their union, they build

By

up the body,
viz.,

and

this

union

is

governed

by three Laws,

the Laws

of Vayu,

Karma and
and

Swabhava (which
Laws,
the
Z^.,

are almost equivalent to the three Biological

the law of heredity, the law of external relations

law

of

molecular motion caused by Ethereal vibrations

compared with which nerve-impulses


are grosser

akin to electric force,


far
is

and coarser shocks).

So

we think we have
not defective,
if it

proved

that

Ayurveda, as a Biology

contains no descriptive
in the
Its

same sense
is

as

Anatomy and Physiology descriptive Grey's Anatomy or Kirke's Physiology is.


its

Histiology
is

molecular;

Pathology

is

molecular

its

Molecular in every sense is the Biology of the Hindus. Virtually speaking, Ayurveda is
Physiology
molecular.

our Science of Life, and we

will

presently

shew

that

Lije

and Ayus

are identical.

breaking

The continuous adjustment of molecules, their successive down and building up within an organised living
its identity, is

body, without destroying

the definition of

Ayus

as suggested by Maharshi Punarvasu.

He

says

In
slight

another place
modification

the
in

same

definition

is

repeated with a

and

this

he enumerates ^TTT^ff^:,
distinctive
to this

(consciousness) as the most

^^^'^^^^^^

of'Ayu.
?t^:

characteristic of ^I'wj.
definition,

According

re'er

to

aifl^f^^r^imMT: and %i^Tgan organised living body f^^: and '^ig^^: are
;

identical with processes of

breaking

down and
identity.

building up of

the organism without

destroying
is

its

The

idea of

continuous adjustment

included also in these two words.

So we

find,

the definition oiAyus^ as sugessted by Punarvasu,

includes

The same

as Life,
^ilr

more than what is proposed in . tt j u t t -x Mr. Herbert c Spencer's definition oi Ltfe.


x/r
..

>

/-

The words

and

eftf%?TiT,

as explained

by the great annotator


the

Chakrapani, represent two more distinct phases of Life,

INRODUCTION.
first

IX

bearing

upon the

cistence

in

the system of a preven the second


,

tivefactor of

comprehensive than Life Mr. as defined by Herbert Spencer.

More

PO''"g
adjit

...
^^

putrefaction,

the

agent or agenr.
relations

hat

the internal

catttouche?, which

professor

Foster speaks of as "contiuously passing from protop

protoplasm and compared/ith

which the nervous

^
em
for-

^ Prof.

Michael

(whih are perhaps electrical in


^

Foster on the Theory of Sensation.


plained

are rosser

and coarser shocks.


viz.,

^^-^^^^ ep'ahei,

"^^lf^/' as

by Chakrapani

t^I^?^ mWT*[ ^TT^fw^' furnishes us\^

with a clue to determine wat

Ayus

^[^:

actually means.

Our

Sacred

Upanishads now come


='"d '"
,

J
are

Upa^n'fste

""-^^ "' '^"f


place

"^g: flTC" ie

"' '" 'he first Ayu and Prana


"?[:

one and the same prinole.


,

In the second place,

im:

^ ^:", i.e Prana and Vdy are identical. In the third place, '% 1^ ^^?i ^fTT^n^'n'RT:",?'.^., Vayu is not unlike Ether.
In the fourth place,
'^T3

^-^^t w",

i.e,^

the primitive fluid


viz.,

^according to Lord Kelvin)^ divided into two parts,

without motion, another


place,

edued with motion.


everything
in
this

In the

"^4f%5in^if\
this

/>.,

world
pi

waves of

Ether enduecwith motion.

In the sixth
is

"^rg^
name

^*^:" "^gx^
;

t%,

W m^g",

ie.,

Vayu

the univei-.^.

in the Phjical world it is known by the in the Liing world it is called under a Vayu different name and that nam is Prana (mw.) From the above short tab we come to know that the

store of energy

of

agent that adjusts the internl


is

relations to external relations,


is

Ayus and

that

Ayus

is

Liftand that Life


is

motion of the

great etherial fluid which

kown
is
.

in Sanskrit as ^'is"

and that
i

*'^T^^

the
,

sum
,

of
j

all
.

the various

The same as
fined

pri-

mitive fluid as de-

energie biological and abiological

by

Lord

Kelvin.

which nder the name of heat,

5 electricy or consciousness, etc., manifest

light, I

themselves both in the Physiil as well as in the Metaphysical

X
world,

INTRODUCTION.

and

that

Prana

(vm',) is

another

name

of the same force


divides
itself

that, in acting

on an aggregated
viz.y

living

body,

into five distinct forces,

Prdna, Apdna^ Samdna, Uddna^


(

and Vydna, and subserves the functions of correlation


and sustentation
(

^rgt

f^

and controls oxidation (^^).


adjust,
like the

So

Prana continuously helps to

main-spring of a

watch, the internal relations to the external relations.

We

are

indebted to the master mind of Sankara


"^

for his able exposi-

tion of the functions of this main-spring,

vJyu a5dlth7r.

^^at
as

is,

of the etherial vibrations (mgiiro:)


into

transformed

the

vital force

in
it

an organised body.
in his

We

quote below

what he says about

celeberated commentary on the Vedanta Darsana.


-s

The five divisions of V^yu in its action on a living aggregate.


That
is,

'H^*

^^
,

^^"^

^^^

^fc^^w

^ w^w^ ^ ^ fw-^
,

^'^

_-.

'^

cf^T^^

_c
STTST^

^fI

the primitive

fluid that

is

endued with motion


five divisions, viz

in its

evolution of Life gets knotted into

Prdna,

Apdna, Samdna, Uddna and Vydna, and this acting on any aggregated living matter is called Prana. So what we call Prana is not the Vayu itself, but a particular mode of its
motion.

Hence

the question of identity and non-identity

is

a of

matter of choice.
the
(as a

Shortly
is

speaking,
the

this

is

the Biology
into

Hindus.

This too

sum and substance


Physiology

which
itself.

department of Biology),

unfolds

This too evidently serves as the line of

Biology forms the

demarcation between

^TfT^:

and

^'.^j:,

^^fl'n^T^evllopel
as so much collateral branches.

f^: -^ ^fwj.
Health and
r^,^^^^^^^^
Disease,

From

this

too

Hygiene

and

Psychology and Sociology


fact.

have

all

their origin

and

start.

In

Biology forms the basis

upon

which the great edifice of the Indian Medical Science, as


a collateral branch, has been developed.

Conclusion.
there in the Ayurveda

^j^g
;

general truths of Biology a e

all

but the

special truths from medicine

INTRODUCTION.

XI

have been given so great a prominence that the real character


of the

formed into a Science of Medicine.

*******
book
has been over-shadowed and
it

has been trans-

With a view
an
idea

to

convey to

the

minds of our readers


Medical Science
Science of

of the

different

branches of the

which developed as a'collateral branch of


Life,

this great

we would here touch upon


had formed
its

a few of

them

in passing.

Magnetism
Masnetism.

way

into the therapeutics of

the ancient Hindus and animal magne.

tism was very

extensively

practised
in

in

India long before they were recognised by

Mesmer

Germany
good

and subsequently by John Elliotson

in

England.
Science
of the
in

The Indian

writers

on

Medical

old days have described

length the
waters of

medicinal properties of
the principal rivers, lakes, water-falls

the

and mineral springs of


their

the country that were


tive

known

at

the time and

respecthat

curative
flesh
is

powers as applied to various ailments


heir
to.

human
the
it

This goes a

long
in

way

to establish

fact

that

Hydropathy was known


in the

India long before

was even dreamt of

Western world.
from time immemorial had
of

The

ancient

Hindu

sages

been
assage.
to practising

cognizant

the

benefits

of

massage
them.

and
it

shampooing and
is

taken

Whereas,

but of
to

late

that the

advantages of these methods have

begun
it

be appreciated
hesitates

by the Western Medical School and


to

no longer

acknowledge them

as efficacious therapeutic agents.

The

Science of begetting healthy and beautiful children,

which
Genesiology.
tion

... m
is

just beginning to receive atten-

other countries

was not unhis

known

to

the ancient
laid

Hindus, and

Manu
life

in

Mdnavastill

dharma-Sdstra has
form an
section of
integral

down

special injunctions

which

part

of the domestic

of the orthodox

the

community.

As

a matter

of fact, they

knew

Xll

INTRODUCTION.
mental impressions of the parents
exercise
at

that

the time of confuture destiny

ception

great

influence

over the

of the child in embryo.

Thus we read
distance,
loves ardently

in the Sastras

"A

woman^ though

at

conceives

child

of

the shape of the person

she

and thinks of

at the time.

Just as a tree that

grows

is

not different from the parent tree whether

we

plant
child

a branch or

sow a seed, so the main


the
features

features of the

partake of
slight

of

its

father,

though there might be

changes due
subtle

to the soil."

The
the
objects
is

soul co-operates with the

Manas
time.

(the

mind)

mind co-operates with


3

the senses
little

the senses perceive

all this

takes place in

or

no

The above
us.
?

the

connection
is

between

the

soul

and objects around

What
fore,

there

which the mind

cannot comprehend
it.

There-

wherever the mind enters, the soul follows


soul

"The
requires
latter.

being subtle, whenever


effort of

it

enters another soul,

some time and an

the

mind

to

know

the

The

soul,

which intensely meditates on an


object.'' etc, etc.

object,

assumes the shape of that


In a

book entitled Bhoja-Prabandha being


of the anecdotes

a collection

realating to the reign

Anaesthetics.
there
tion
fering
is

^^

^^^^.^

p^^.^^

^^

Pandita

Ballala

narrated

the detail

of

an interesting surgical operasuf-

which had been performed on the Raja, who was


from an
excruciating
at

pain

in

the

head.

All
of,

the

medical aid obtaining


in vain

the

same time was availed


critical

but

and

his

condition

became quite

when two
examining

brother

physicians
in.

accidentally

arrived in
after

Dhar, who were

duly called
the

These
that

physicians,

carefully

patient,

held

unless

surgically

treated

no

relief

could possibly be afforded to the Royal patient. Accordingly they administered an anaesthetic called Sammohini with
*
F/V/.?-Baraha
1-3.

Mihir's

Brihat Samhil^ Book,

II.

Chapter Ixxv-

Verses

INTRODUCTION.
a

XUl

view

to

render

him

insensible

and, they

when completely,
trephined his skull,

under the influence of the drug,

lemoved

the malignant

portion

of the brain, the actual seat

of the complaint,

closed

and stitched up the opening and

applied a healing balm to the wound.


tered
a
restoration

Then
to

they administhe
felt

known
(as

as

Sanjivani

patient,

who,
ease.

thereupon,

regained

consciousness
narrated by
of

This
in

incident
his

and Thakur Saheb


of

quite at
0/

Gondal
goes to

Short History
that

Aryan Medical Science)

prove

the attendant physician

Buddha,

is

likewise recorded to have practised cranial surgery greatest success.

writh the

Instances of successful cases of

abdominal

section are also not rare.

Thus

it

will

appear that the ancient


surgical operations

Indians knew

and successfully practised


now-a-days as
Tiie

which

are regarded

the

greatest triumphs of
in the

modern

surgery.

purpose of chloroform
to

palmy
but

days of yore was used


there
is

be

served by
to

Sammohini,

hardly

a drug

known
at

modern Pharmacopaeias,
certainly lessens the

corresponding

whith

Sanjivani which
present

chances of deatlis
anaesthetics.

that

sometimes occur under


..

Let them, who allege that the Hiudu system of the healing Art
is

unscientific,

now pause and

reflect ere

they

make
can a

such an unwarranted and irresponsible assertion.

How
veins

system which contains so accurate an account of the unions of

bones
arteries,

and ligaments, anastomoses


etc
,

of nerves,

and

and which assures the world of the existence of


a half

three crores

and

of veins
figures

and

arteries

in

the

human
mathe-

body giving

facts

and

thereof

with

such
?

matical precision, be regarded as being unscientific


It
is

certainly an undeniable fact that

one

of the colossal
is

achievements

of

modern Western Medical Science


point
at

its

Anatomy; but
issec xon.

the

issue

is

whether the process of

laying

open the structures of the


lancets,
a
fact
is

body

with the
For,
is
it

at all

satisfactory

method.

not

that the finest

and the

XIV

INTRODUCTION.
if

minutest arteries of the skin are never disclosed,


is

the scalpel
at

used

so recklessly
to

to

remove the skin

all

once and

not allowed

go deeper into the muscles

to expose the
i

minute branches of blood vessels and nerves that may happe


to
lie

embedded

therein ?

But, on the contrary, look


for

at

the

process

promulgated by Susruta
!

demonstrating practical

Anatomy Its originality and perfection beats hollow all the known methods, although it was discovered in almost the The process prescribed by the Hindu pre-historic age.
system
is

as follows
it

Cover a dead
edge
out
of of
carefully,

body
and

with
a

Kusa

grass

and place
three

at

the
it

the water of

rivulet.

After

days take
succsesive

gradually

take off

the

layers

the

epidermis

and dermis and


it

of the muscles beneath by gently and lightly rubbing

over

with

soft

brush.

Thus the
this

smallest

and

the

thinnest

arteries,

which have by
existence
are

time

swelled

and obtained a

distinct

made

palpable

everywhere even to

the minutest.

The process is termed, as we have pointed before, Avagharshana by Susruta. The Western method might be an
^ easier

and a

more off-hand one, but by no means

precise.

Though
Avagharshana.
blind to
it

the merit of discovering this


is

mode
It is

^^ dissection
call

due

to Susruta,

we

are all
!

and

Hippocrates the father of Medicine

generally believed

that with a view to further his researches


it is

and perfect
work

his

knowledge,

Hippocrates who inaugurated

the system of dissection of dead the


secretly.

human
that
it

bodies

and he did
a century

Credulous people may lend a willing ear


is,

to such assertions but the fact


later

was not
to

till

that

Hirophilus

openly

resorted

dissection

of
in

human

bodies

and thereby earned an

undying fame

Europe, obliterating Susruta's name


speaking, he
figured
in

for ever,

though, virtually

(Susruta)

was the pioneer of dissection and

the

world

more than

millenium before the

advent of Hippocrates and over eleven centuries prior to tb$


age of Herophilus^

INTRODUCTION.
It

XV
place here to mention
,

would not, perhaps,


Dr. A. F. R. Hoernle,

be out of
,

that

in his recent publication

M. A F. R. S C. I. E., Ph. D., on Hindu Osteology, has proved it


and what a mine
!

to the hilt,

how

systematic, scientific, unerring and exact were


of

the researches of the ancient Hindus

resplendent truths lay imbedded in

them

We,

in

our Intro-

duction of the

first

volume

of

this

work, have tried to prove

how

very superb, salutary and supremely happy was the theory

of Vayu, Pitta,

and Kapha promulgated by


to the

we have

incidentally

Susruta. There mentioned that the Science of Embryo-

logy was not

unknown
in the

Hindu

sages.

In

the present

volume we mean to prove to a point that the main principles


promulgated

Anatomy, the Physiology and the Pathoto

logy of Susruta yield in no way


subjects

the

principles

on those

included

by the modern
the other hand,

Western Scientists and


affirm that in the

investigators.

On

we boldly

theories

propounded by Susruta some two thousand


lies a

years

back there

fund of truths which might well throw a flood

of li^ht on the field of labour of the

modern

scientific

the West.
(causing to

For

is

it

not a

fact that the theories of

men of Vamana

eject

the
the

contents of the stomach

by mouth),

Virechana (causing
(causing

evacuation of the intestines), Nasya

to inhale through the nose), Anuvdsana and Asthdfana which, in ancient India, had earned the appellation of Pancha-Karma, and had gained universal prevalence, and were

extensively

practised
late,

by oriental physicians

from time im-

memorial, have, of
of the

been hailed by the medical authorities

day as the most approved and commended

mode

of

treatment.
Sceptics

who

care nor to

examine and weigh


system
is

solid facts,

bluntly

allege

that

the

Ayurvedic
observation

not

based
all

upon
true
logy,

experiment
Science,

and

the
its

keystone of

and such being the case


Therapeutics
as

Anatomy, Physioerroneous.

Pathology and
cruel

are
it is,

all

The
un-

suggestion,

and baseless

originally

emanated

from an

eminent Indian physician

who has earned an

XVI

INTRODUCTION.
reputation by
writing a Treatise on
(the

enviable

Medica.
so

He

says

Hindu Materia
is

*'It

Ayurvedic system)
observation

built not

much upon experiment and

as

upon an
But such

erroneous system of Pathology and Therapeutics.*'

an expression would not stand the

light of day.

Indeed

none but the

ancient

Hindu

sages did set a high value on

experiment and observation, and where they did not

claim
that

some

occult knowledge or intuition,


all their

it is

upon these two

they mainly based

knowledge.

The Materia Medica


Its description

of the

Hindus

is

really a

marvel.
to the
articles

of the

properties of drugs belonging

animal, vegetable and mineral kingdoms, and of the


of food essential
its

to the

maintenance of health and strength,

selection of the specific dietaries and elimination of what

are

prohibited
correct.

in particular

ailments

are every

day

being

found

The European
corroborative

preparations of Indian drugs


thereof.

and

diets

are

evidence

The

theory

adopted by the ancient Hindus as the basis of their investigation


is

that

every

substance,

whether regitable or animal,

possesses five properties namely,

Rasa, Guna, Viryya, Vipaka


reveal,

and Prabhava which lenses alone cannot


eye
after

nor the body's


rats

observation and experiment

made upon

and

rabbits.

And
both

those

who have

opportunities of studying and

practising
assert

the Eastern

and Western

Medical Science

that the ancient Medical Science of the

Hindus once
in

reached the highest standard of excellence

and perfection

Materia Medica, Therapeutics and Hygiene and was simply


unrivalled and unapproachable, as
it

blended Philosophy with


eye.
facts

Science the mind's eye with the body's

dispassionate

examination of these
will
it

(and such as

can be multiplied to any extent),


reader that Ayurveda, as

convince

an impartial

we

find
if

described in Charaka
in

Samhita and Susrula Samhita,


fairness

approached

spirit

of

and enquiry,
marvellous
of

might

reveal

the germs of not a few

of the

achievement of

the
afford

present
to

age in the
assiduous

domain

Medical Science

and

the

INTRODUCTION.
Student
a
vast

XVll

scope

and varied materials

for

comparision

between the Eastern and the


material

Western systems,

and render

help

in

improving

upon the one with the aid of

the other, and this to the benefit of the suffering humanity at


large.

Lastly

it

is

our prayer, that

if

Western Medical Science


benefited
it

was ever anywise, directly or


ancient

indirectly,

by the

Medical

Science

of

the

Hindus,

is

but

meet
all

and

fair

that the former should

come forward
and
that as

to
it

render
is

possible aid to her parent Science,

almost

dying

now
its

for

want of aid and succour we look hopefully to

our present

benign

Government

in

whose power

lies

the

means of

complete regeneration.

PLATE

No.

I.

Vital points

(Marmas)

in the

arm

Vital points

(Marmas)

in the

arm

(inner side).

(ouVer side).

'J" indicates the points recognised in Juijutsu.

See Chapter VI, S'arira-S'thana.

PLATIO No

If.

Vital points

(Marmas)

in the leg

'

Vital points

(Marmas)

in the

back

(outer side).
j

of the thigh

and the

leg.

**J" indicates the points recognised in Juijutsu.

See Chapter VI, S'arira-Sthana,

CONTENTg.
NIDANA STHANA.
(Sect/on on Pathology).

CHAPTPR
in its

I.

Diseases of the Nervous System, etc : The action of the V.-tyu normal state. The Prana V^yu The Udana Vdyu The Samana V^yu The Vy^na V^yu The Apana Vdyu. Descriptions of the nature

of the diseases When they are localised in the different parts of the system. Pathology of Vatta-rakta premonitory symptoms prognosis. Spasms Convulsions Epilepsy without Convulsions Epilepsy with Torticollis. Prognosis. Wry-neck or Convulsions. Hemiplegia Premonitory Symptoms Facial Paralysis Prognosis. Sciatica. Erb's Paralysis. Synovitis of the Knee-joints. Lameness. V^ta-Kantaka. Pada-D^ha Pada-Harsha. Ams'a-s'oshaka. Ear-ache. Deafness. Nasal voice. Indistinct Speech. Tuni Prati-tuni. Tympanites. VataIts
Its
Its Its

Its

shthili, Pratyashthila.

..

...

...

Pages 117.

CHAPTER II. Classifications Patholog>'Premonitory Symptoms. HsemorrhoidS VatajaType Pittaja Type Kaphaja Type Raktaja Type Sannipataja Type Congenital Type. Figwarts or condylomatous growths about the
:

genitals. Prognosis.

.,'.

...

...

...

1824.

CHAPTER
Leading Indications.

III.

Premonitory Symptoms. S'leshmaja As'mari Pittaja As'mariVataja As'mari. Seminal Concretions. Supervening Symptoms.^ Situation of the BladtJrinary Calculii ; General Etiology.
der*- How stones are formed in the Bladder.
...
...

25 30'

CHAPTER
Fistula-in-ano
cand

IV.

Symptoms. Derivation

Fistular Ulcers : Classifications Premonitory of the term Bhagandara.Vataja Type Pittaja

Type Kaphaja Type Sannipatika Type Traumatic Type S'ata-ponaka Type Ushtra-griva Type Parisravi Type S'ambukavarta Tppe Unmargi

Type. Fistulous Pustules. Prognosis.

...

...

3i~34'

CHAPTER
/Etiology

V.

Cutaneous Affections in general: Premonitory Symptoms

Kapdla Kushtha (Macula). KakanakaPundarikaDadru (ring-worm) Sthularushka Eka-Kushtha Ichthyosis)- Charma-dala (Hypertrophy of the skin) Visarpa-Kushtha Parisarpa-Kushtha Sidhma Vicharchika
(

Classifications.

Aruna-Kushtha Audumbara
(Keloid) Pama

Rishya-jihva

(Psoriasis) Vip^dikaKitima

(Eczema) Kachchhu
cause
of

Rakasa

(Dry

Erythema)

Kilasa. Congenital
...

Kushtha.

Prognosis.

How

Kushtha becomes contageous.


...

Some
...

other contagious

diseases enumerated.

35

42'

CHAPTER
toms.

VI.

meha Pishta-meha Sandra-meha S'ukra-meha. Names and Symptoms of Pittaj a Meha Nila-Meha Haridra-meha Amla-meha Ksh^ra-Meha Manjishtha-meha Rakta-meha. Names and Symptoms of Vsttaja Meha Sarpir-mcha Vasa-meha Kshaudra-meha Hasti-meha. Supervening Symptoms. Kaphaja Types Pittaja Types Vataja Types. Abscesses. due Prameha. Prognosis. Carbuncles. Pimples. Pustules,

etc.,

Diseases of the Urinary tracts : Pathology Premonitory SympKaphaja Type Pittaja Type Vataja General characteristics. Type. Names and Symptoms of Kaphaja Meha Sura-meha Lavana-

to

Symptoms

of

Madhu -Meha.

..

...

...

...

4349.

CHAPTER Vn.
Dropsy
tredisposing

with an abnormal condition of the abdomen:

Classifications.

causes. Premonitory

Symptoms.Vataja,

Pittaja

and

Enlargement of the Spleen and the Liver with dropsy of the AMomen. Vaddha-gudodara Parisrdvi-Udara. Jalodara (Ascites). General Characterstics of Dropsy. Prognosis. 50
Kaphaja Types. Tridoshaja Type.
54.

Ill

CHAPTER

VIII.

False Presentations and Difficult Labour -.Causes. Definition.

Classifications

and

Symptoms.

Abortion. Miscarriage. Prognosis.

Csesarian Section.

5560.

CHAPTER
Vidradhi
Pittaja

IX
and
Classification Vataja,

(Abscess,

etc.)

'

Definition

Types Sdnnipdtika Type Traumatic Type Ivaktaja Type Incurable type of External Abscess. Internal Abscesses Their Incurable localities. Differentiating diagnosis of Gulma and Vidradhi.
and Kaphaja

Type

...

.-.

.-.

61

66,

CHAPTER
of women

X.

Erysipelas, Sinus and Diseases affecting the

Definition of Erysipelas Vataja, Pittaja and Kaphaja Types Sannipatika Type Kshataja Type. Prognosis. Nsidi-Vrana (Sinus). ClassificationVataja, Kaphaja and Pittaja Types Dvandvaja and
Tri-doshaja

mammary glands

Types S'alyaja
Its

Type. Stana-roga. Breast-milk Its


traits.
...

character
of

normal and abnormal


...

Stana- Vidradhi
...

(Inflammation
...

mammary

glands).

67

71.

CHAPTER
Glands, Scrofula,

XI.

Tumours

and Goitre : Dosha-origened Glands

Sirdja gland (aneurysm or Varicose Veins). Apachi (Scrofula* etc.) Its symptoms. Tumour Its symptoms Blood-origined Tumour. MamsaArvuda. Prognosis. Adhyarvuda. Dvirarvuda. Cause of not being
its

suppurated. Definition

of

Goitre Its
...

specific

Symptoms Vataja
...
...

Goitre Kaphaja Goitre


Goitre.
...

Medoja

Goitre. Prognosis. General shape of


...

7378.

CHAPTER
ginital organ)

XII.

Hydrocele, Hernia, Scrotal Tumours,


and
Premonitory Symptoms of Vriddhi.
Vriddhi

Upadamsa

(disease of the

and Elephantiasis: Classification of Vriddhi

Definition

Inguinj^I

Symptoms

of Dosha-origined

Vriddhi. Medoja

Raktaja

Vriddhi Hydrocele.

IV

Hernia. Upadams'a Symptoms

of.

different

Dosha-origined types
Elephantiasis.

of

UpadamSf'a.r Raktaja Upadams'a.-Definition of


a,ncl

Causes
79

Symptoms

of different kinds of Elephantiasis.


...

Prognosis
...

of Elephan...

tiasis.

Localisation of Elephantiasis.

84.

CHAPTER
l^iseases

XIII.
of Kshudra-Roga (minor

known by
Names

ailrnents): The

?ind

the general Symptoms

name

of the diseases included therein.

^jagallika Yava-prakhya

Andhalaji Vivrita KachchhapikaValmika

^indra-vriddha Panasikd Pashana-Gardabha- Jala-Gaiddabha KakshaVishphota Agni-Rohini Chippa Kunakha Anus'ayi Vidarikd S'arkardrbuda Pama Vicharchikd Rakasa Pdda-ddrika Kadara
Alasa
etc.

Indra-lupta (Alopecia) DarunakaArumshika Palita Masurika Tila-kalaka NyachchhaCharma-kilaVyanga Parivartika Avapatika Niruddha-Prakas'a Niiuddhat-guda Ahi-putana Vrishana'

^achchh^ Guda-Bhrams'au

..

":.

'\, :,:'

...

8593.

CHAPTER
' Sukdi-dbSh,a:--^Its

XIV.
of
...

classification. Symptoms
..'
...

different

Types.

iProgonsis.

...

.94

9^.

CHAPTER XV.
Fracture and Dislocation, etc -.Their Causes. General
of Sandhi-mukta (Dislocation).
features

Diagnostic Symptons of Dislocation. TWfferent -kinds of Kanda-bhagna (Fracture) General, symptoms of Kanda'bhagna. Curable and incurable Types, 97 ioq.
... ...
...

CHAPTER
Mukha-Roga
general).*

XVI.
the
cavity of

(Diseases

which

affect

the

mouth

in

General Classification and Localisation. Diseases of the lips. Dosha-origined Types. Raktaja Type Mangsaja Type Medoja Type Diseases of the roots of the teeth. Their Names and specific Symptoms.Danta-Nstdi
(Sinus at therootof
a,

tooth). Diseases of the tooth

proper. -^Their Names and specific Symptoms. Diseases of the tongue Their Names and specific Symptoms^ Diseases of the Palate Their

Js^mes and

specific

Symptoms. Diseases

of the

Throat and Larnyx

Their Names and specific Symptoms. The


in the entire cavity.

different
...

Kinds and Symp...

toms of Rohini, Diseases

loi

III.

End

of the contents of Sutra-stlisina.

SARIRA STHANA.
(Section on Anatomy).

CHAl TER
The Science of Being in General
first

1.

-.The Twenty -four Tattwas or

Principles.

ThePurusha or the Primordial Being or the Self-conscious


Traits of Commonalty
and Diversity.

Reality.The Prakriti or the External Nature personified or the non*


conscious
the

Eternity

Comparison of
in
five

Philosophy of A'yurveda with that of Samkhya as well as with the


branches of Philosophy.

other
the

Prakriti
...

and Purusha how understood


(mind).

A'yurveda

Different
...

kinds of
specific

Manas

The

Primary

Elements of Creation
in creation.
...

Their

function Their mutual co-operation


... ...

113

121.

CHAPTER

II.

Purification of Semen and Cataminal fluid etc. : Derangement of Semen. Specific treatment. Derangement of Cataminal fluid.
Specific treatment.

Traits of pure and healthy Semen and Cataminal Menorrhagia. Amenorrhoea. Their treatment. Regimen to be observed during Menses. Conduct of husband during the period. Prohibited period. Conception Subsequent Conduct. Causes of Colours the child. About twins Causes of the child being of Defective Organ
different
in;

fluid,

Fecundation without sexual intercourse Causes of Deformity

in the child

State of the Foetus

Its activity

while in the

womb.

...

122133,

CHAPTER
Pregnancy, etc : Combination
Matter. Factors which determine Sex.
of

III. Self

with

the

Impregnated

Signs

of

Period and Signs of Menstruation. Pregnancy. Prohibited conducts during Gestation. Develop-

VI

ment of the

Foetus.

Longings and

its

effects

during pregnancy. Develop-

ment of the Foetus from the Sixth

to the

Eighth month.

Different

opinions on th3 formation of the Foetal body.

Time of Delivery. The solution


...

Factors respectively supplied by the Paternal and Maternal Elements, etc.

External Signs of Male, Female and

Twin

conception.

134143.

CHAPTER
The development of Factors
Factors which
principles

IV.

in the
its

womb

as

well

as

the

contribute to the growths of


folds

different bodily organs


foetus.

and

: Different
their

of skin over the

Kalas and
discharged.

varieties.

Seat

of the semen.

The definition of Why and how semen


is

Placenta. Formation of different limbs and organs of the Heart and action. Effects of dayFoetal body. Sleep and sleep. Somnolence. Effect of Sleep on an Enciente woman Gnawing. The temperaments. Symptoms of Vataja, Pittaja and Kafaja temperaDvandvaja and Sannnipatika temperaments. Sattvika, ments - Symptoms
its effect.

its

of

Rajasika and Tamasika features.

...

...

...

144

158.

CHAPTER

V.

The Anatomy of the Human body : Definition of foetus. Enumeration of the dfferent Limbs and Membeis of body. Their Numbers

The
or

Cavities or Viscera.

Cluster.

Sevani
kinds
of

Channels. Kandara.
Sutures.

or

Asthi-Sanghdta. Simanta. Bones


theif

^Jala

or Plexuses.

Kurcha
of

the four Extremeties.


Different

Bones of the Trunk. Bones


Bones

above the Cavicles

and

situation

Sandhi

or Joints.
Clavicles.

Joints of the four Extremities,

Sandhis

of the

Koshtha and

Their forms,

The Snayu or Ligaments. Their Number and Situations. Muscles. Muscles in the extremities in the Koshtha Of the Head and Neck. Extra Muscles in Women. The Vaginal Canal The Uterus The Womb. Superiority of Surgery Preparations of dead body Mode of dissection. 156 172.
distinctions

and

locations,

...

..

CHAPTER

VI.

The Marmas or Vital parts of the body: Classifications of Marmas Their different Numbers. Their Locations. Their Names and
Distributions.

The

Different opinions

the Thorax,

etc.

Heads of Marmas. Qualitative Classes. Marmas of the Extremities. Marmas of Marmas in ihe Back. Marmas in the Clavicular region.
different

on Marmas.

vJheir specific Symptoms when

injured.

...

...

173

i^d.

Vll

CHAPTER
The Description and
System:
Siras.

VII.

Classification of Sirsi or the

Vascular

Their Numbers and action. Names and Classification of the principal Their specific Locations. The Pitta, Kapha, Vayu and Rakta-carrying S:r4s. Specific Colours of Sir^s. The specific Sirds not to be punctured. Siras of the four Extremeties, Trunk and the region above the Clavicles and their 191 197.
roots.
...
...

...

CHAPTER
The method of Venesection
Preliminary Rules.
:

VIII.
unfit for

Persons

Venesection

The Jantra-Vidhi or how the patient should be placed in cas3s of Venesection. Venesection in the Extremeties. Venesection on the parts of the body. Proper and Defective Venesection Classidiff'erent

fication

and definition of Defective Venesection.

...

...

198

208.

CHAPTER
and Number of Dhamanis.

IX.

The Description of the Arteries, Nerves and Ducts : Region

Functions
...

of

the

up-coursing Dhamanis.

Functions of the down-coursing Dhamanis. - Functions of the lateral coursing Dhamanis.

The Situation of the


at the roots.

S rotas and the


...

specific
...

Symptoms
209

when

pierce

215.

CHAPTER
Nursing and Manigement,
day of
conception
till

X.

etc-

of Pregnant
rules.

Women from

the

parturition :-- General

Sign Preliminary Measures. --Post-parturient Measures. Children. Treatment of the Mother Makkalla pain Natal Rites. Diet and treatment. Management of the Child. Lactation. Selection of of Breast-milk. Treatment of Wet-nurses. Wet-nurses. Examination, Infantile Diseases and their Diagonosis Treatment of Infants. Nursing of child. Symptoms when malignant the child."Eductation and Marriage. Defective Pregnancy Symptoms and Medical treatment. Miscarriage treatment. Manageduring the period of Gestation.

Especial Regimen of imminent Parturition Effects of

premature

Urging

for

its

etc.

I ifantetc.

ile Elixirs.

stars,

strike

Its

Its

riient

of Pregnancy and special Recipe for Pregnant


...

Women
..

according to

months of Gestation.

...

...

216

238.

nd

of the contents of

l^airira Stha^na.

Vin

CHIKITSITA STHANA.
(Section on THERArEUTics).

CHAPTER
Classification of Ulcers.
specific

I.

The two kinds of inflamed Ulcers: The

Causes,
ulcers.

Symptoms and
General and

Idiopathic and

Traumatic

toms of Blood-origined
tics.

Symp Symptoms of Suddha Vrana. TherapeuThe sixty different Factors of medical treatment of Upadrava
Symptoms. Symptoms of
ulcers.

different

Dosha-origined ulcers.

ulcers.
...

or the Supervening

Symptoms

of ulcers.

...

269

264.

CHAPTER
Different
specific

n.
or Sores

The medicxl treatment of Traumatic Wounds


Shapes and Classifications of Sores.

Their definitionsTheir
.

Wounds.

Symptoms Their treatment. Treatment of Cuts or Incised Treatment of Excised Wounds. Treatment of Viscera when perforated. Subsequent treatment. Treatment of Diabetic Ulcers. Treatment of Ulcers due to Kushtha or malignant Ulcers. 265 278.
...

CHAPTER
The
Symptoms
of incurable fractures.

HI.

medical treatment of Fractures and Dislocations :


lir.\bs.

Bandage. Diet. Defective Bandaging Prrgnosis. Treatment of fractures in particular Gandha-Taila. Suppuration of fractured Bones Symptoms of Complete
Washing.
union of fractured Joints.
...

...

...

279

288.

CHAPTER
The medical treatment
-! Nervous affection of the

IV.

of Vatta-Vystdhi or

Nervous disorders :

Nervous affections of the Pakvas'ayg. S'alvana-upanaha. General Measures beneficial to Vata-Vyadhi. The Tilvaka-Ghrita. The Anu-Taila. The S'ata-paka and Sahasra-paka Taila. The Patra-lavana. The Kanda or Sneha-lavana. The KalyanakaA'mas'aya
lavana.
...

<

289296.

IX

CHAPTER
Vata-Rakta.
Its

V.
of of

The medical treatment of Maha^-Vata-Vysidhi : Causes

definition Premonitory symptoms Specific features Vata-Rakta Prognosis. Preliminary remedial measures. Plasters
Treatment of Vata-Rakta with a preponderance of different Doshas.
five

etc.

Pradehas Guda-IIaritaki and

Pippali-Vardhamana Yogas.

Regimen of conduct.
Ghrita.

The

Medical Treatment

The Diet. of Apatanaka. Traivrita

Treatment

Treatment of Manya-stambha. Treatment of Ardita. Kshira-Taila. Hingvadi-vati. Symptoms and Treatment of UruTympanites stambha. Therapeutic properties of Guggulu. 297 315.

Treatment
of
etc.

of Pakshaghata.

Apatantraka.

...

...

CHAPTER

VI.

The medical treatment of Ars'as (Haemorrhoids) : General remedial measures. Application of Kshara (Alkali). Symptoms of
satisfactory, excessive

and defective Cauterisation. Diet


piles.

Plasters. Treatment of Internal Bhallataka-yoga. Other forms of


conduct.
...

Rectal Speculum. Dantyarishta. Abhayarishta. Bhallataka-yoga. Regimen of diet and


...

...

...

...

316-328,

CHAPTER
Different

VII.

The medical treatment of Asmari (Urinary Calculus, etc) :


modes of treatment
in

As'mari.

Treatment

of Vataja,

Pittaja

and Kaphaja As'mari. Alkaline treatments. Modes of Surgical operations.

Prognosis. Lithotomic
tomic operations,

operations.

Post-surgical
...

measures.

Surgical
329-337,

treatment in Seminal Concretions.


...

Diet. Parts to be
...

guarded in Litho...

CHAPTER
Classification.

VIH.
etc)

The medical treatment of Bhagandara (Fistula-in-ano,

Different Forms and Names of incision. Treatment of Ushtra-griva. Treatment of Parisravi. Bhagandara in infants Treatment. Treatment of traumatic type. Treatment of Tri-doshaja type. Syandana Taila. Description of instrument. Regimen of 338-345.
General
treatment.

Specific

measures.

diet.

...

...

...

CHAPTER
The medical treatment
general):

IX.

of Kushtha (Cutaneous Affections in

Pathology. Conduct of diet and regimen. Regulation of diet and conduct. Preliminary treatment. Treatment of Doshaja types. Alkaline Maha-tikta Ghrita. Tikta-Sarpih. Medicinal Nila-Ghrita. Maha-nila Ghrita. Treatment ment. Treatment of by Bleeding, Emetics and Purgatives. Vajraka Taila. Maha-Vajraka Taila. Treatment by Khadira. Diet. 346-361.
plasters.
treatS'vitra.
...

...

...

CHAPTER
Affections). Mantha-Kal pas.
(Wine)

X.

The medical treatment of Mahat-Kushtha (Major Cutaneous


and
Powders.

Mahaushadha
parations.

Diet. Medicated Arishtas, Asavas, Suras Medicinal Ayas-kriti. Aushadha Ayas-kriti. Ayas-kriti. Khadira preparations. ...Khadira-Sara pre...
...

...

...

362-371.

CHAPTER
tracts):

XI.
(Diseases of the

The medical treatment of Prameha

Urinary

Two-fold

Classifications,

Causes
diet.

and Symptoms. Forbidden

Preliminary treatment. The Specific treatment of Kaphaja Meha Specific treatment of Pittaja Meha. Specific treatment of Vataja Meha. Palli Mode of ative measures Medicinal Arishtas, Asavas, Yavagus,
articles of food
five

and drink. ^Articles of

medicinal remedies.

etc.

treat-

ing a poor Prameha-patient.

..

...

...

...

372-378,

CHAPTER

XII.
(the Abscesses or

The medical treatment of Prameha-Pidaksi


Eruptions which mark the sequel of a case of Prameha)

: Curable

cases of
for-

Treatment. Dhanvantara-Ghrita.- Fomentations bidden in cases of Madhu-meha. S'ala-saradi Avaleha. Navaya.sa Churna. Loharishta. Traits of cure. 379-385,
Prameha- Pidaka.
...

...

...

CHAPTER
properties and use. ^-The

XIII.
origin,

The medical treatment of Madhu-meha :~S'ila-jatu Its

Makshika-Kalpa.The Tuvaraka-Kalpa. 286-391.

CHAPTER
condition of the

XIV.
with an abnormal

The medical treatment of XJdara (Dropsy


Abdomen)
:

Symptoms of curable and incurable types. Diet of forbidden. Treatment of Vataja, Pittaja and Kaphaja types. Treatment of Dushyodara. Genera] treatment of Udara. Haritaki Ghrita. Maha-vriksha Ghrita. Chavy a Ghrita. Anaha-Vartis. Treatarticles

ment of Plihodara. Shat-palaka Ghrita. Treatment by Venesection.


Treatment of Baddha-Gudodara. Treatment of Parisravi Udara. Treat-

ment of Udakodara. Treatment by tapping,

Diet.

..,

392-403.

CHAPTER
The medical treatment
presentation
of

XV.
(Difficult

of

Mudha-Garbha
Labour)
:

and mal-

Varieties of MudhaGarbha. Incantations. Postures of the Foetus. Operations involving destruction of the Foetus. Craniotomy. After-measures. Diet and men of conduct. The Bala Taila. The Bala-Kalpa. 404-411.
the Foetus

and

Difficult

regi-

...

CHAPTER
Classifications.

XVI.

The medical treatment of Vidradhi (Abscesses) and Tumours:


Karanjadya Ghrita.
Treatment of

Treatment of Vdtaja, Pittaja and Kaphaja Vidradhi. Treatment of traumatic and blood-origined types. internal Vidradhi. Treatment of Vidradhi. Treatment of
... ... ...
...

Majja-jata Vidradhi.

412-417.

CHAPTER
of the
types of
*.

XVII.

The medical treatment of Erysipelas etc., Sinus and Diseases Mammary Glands Classifications of curable and incurable
Visarpa
(Sinus).

(Erysipelas) Treatment of Vataja and Pittaja Visarpa.

Gauryadi Ghrita.

Vrana
(Sinus).

Treatment of Kaphaja Visarpa. Treatment of NaCdiKaphaja and S'alyaja N^di Treatment of Vataja,
Pittaja,

Alkaline

treatment Treatment

by

Plug-stick

Bhallatakadya
...

Taila Treatment of Stana-RogaPurification of breast-milk Surgical


treatment of Stana-Roga.
...

...

...

418-426.

CHAPTER

XVIII.

The medical treatment of Granthi (Glandular Swellings), Apachi (Scarvi), Arvuda (Tumour) and Gala-ganda (Goitre) : General

Xll

Kaphaja and Medoja GrantM Treatment of Vataja, Medical treatment of ApacM- Surgical treatment of Apachi. Kaphaja and Medoja types of Arvuda Treatment of Vataja, Arvuda (Tumour), Gala-ganda Treatment of Vataja, Kaphaja and
treatment of
Pittaja,

Granthi.

Pittaja,

Medoja types of Gala-ganda

(Goitre).

...

...

...

427-438.

CHAPTER
Tumour,
etc.),

XIX.
(Hernia,
Plydrocele, Scrotal

Ihe medical treatment of Vriddhi

Upadamsa

(Diseases of the Genital Organ) and S'lipada

(Elephantiasis) -.Treatment

of

Vataja,

Pittaja,

Raktaja,

Kaphaja,

Medoja and Mutraja Vriddhi- Treatment of Antra-Vriddhi. ment of Upadams'a General treatment Treatment of Vataja,

TreatPittaja,

Kaphaja,

Tridoshaja and

Raktaja types of

Upadams'a.

Treatment
...

of

Slipada

General treatment Treatment types of S'lipada Alkaline remedies.


...

of Vataja, Pittaja and Kaphaja


...

439

449.

CHAPTER XX
The medical treatment of Kshudra-Roga
Treatment of Aja-gallika and Yava-prakhya. Treatment of S'arkararvuda,
etc.

(Minor Ailments)

Treatment of Vivrita, Treatment of Pada-dari, Treatetc.


etc. etc.

Treatment of Baldness and Alopecia, Treatment of Darunaka, Treatment of Jatu-mani, etc Treatment of Yuvana-pidaka Treatment of the Retroflexion of the Prepuce. Treatment of the Constriction or Stricture of the Urethra surgical treatment.
ment of Alasa and Kadara.
etc.

Its

Treatment of the Stricture of the Anus,


putana and the Prolapsus of the Anus.

etc.

Treatment of
...

Valmika, Ahi...

450-458.

CHAPTER

XXI.

The medical treatment of the Sores on the Penis produced by the ^Uka -.The specific treatment of the different types of S'ukadosha

General treatment. Prognosis.

...

...

...

459-461.

CHAPTER
Treatment of Vataja,
Pittaja,

XXII.
Medoja types of Oshtha-

The medical treatment of the Affections of the Mouth :


Kaphaja and

Xlll

kopa Treatment of the diseases of the Danta-mula. Treatment of Danta-Veshta etc. Paridara S'aushira Upakus'a Danta-Vaidarbha
Adhimamsa.
different

types

Treatment of Danta-nadi. Treatment of the diseases of the of Tooth. proper. Treatment of Tongue-diseaseS
and Kaphaja types of
of

Treatment of Valaja, Pittnja


Treatment of the
Throat-diseases.
different

tongue-diseases

type;:

Tatiu-gata diseases
Pittaja,

Treatment
...

of

Treatment of Vataja, types of Rohini. Treatment of the different Mukha-Roga. Incurable types of Mukha-Rcga.

Kaphaja and Raktaja


Sarva-sara 462-474.

types of the
...

CHAPTER
general

XXIII.
(Swellings). Classifications of

The medical treatment of Sopha


S'opha

Its

causes.

The
...

specific

symptoms of Dosha-origined

Symptom of Vishaja S'opha Complications Prognosis. The Special treatment of the different types of S'opha. General remedies.
types of S'opha.

Diet.

...

...

...

...

475-477.

CHAPTER
Tooth-brushing

XXIV.
is

The Rules of Hygiene and the Prophilactic Measures :

Cases where tooth-brushing forbidden. Eye and Mouth Colly rium. S'iro'bhyanga. Combing. Anointing. Parisheka. Affusion. Effusion. Anointments. Prohibitions of Anointments, Physical Exercise. Rubbing and Friction. Massage. Bathing. Prohibition of Bathing. Anulepana. A'lepa. Food. Pravata and ISivata. vSleep General Rules of Conduct. Rules Drinking Water, Curd (Dadhi)When and How to be taken. Women to Evil
washing.
etc.

for

etc.

unfit

visit.

Effects of the foregoing Abuses.

...

...

480-502.

CHAPTER XXV.
The medical treatment of a Variety of Diseases : Diseases
the Ear-lobes Classification

of

Causes and Symptoms General treatment Specific treatment. Treatment of Palita. Treatment of Vyanga,
etc.

503-504.

XIV

CHAPTER
Virile
:

XXVI.

ing the Strength and the The medical treatment for inc Power of weak persons Definition of Vaji-Karana Means of
six
etc.

Causes and Symptoms of the P'orms of Sexual incapacity. 510-514. Incurable types. Remedies Utkarika Pupalika. Cakes
Vaji-karana.

CHAPTER

XXVII.

The Recipes and Modes of using Elixirs and Rejuvenators : The Human Organism Which will make it invulnerable to the inroads of

any Disease and Decay.

and Physical maladies.


kalpa.

Time of using Rasayana. Rasayana Mental Vidanga-Rasayana Vidanga-kalpa. Kas'maryafor

Varahi-kalpa

Bala-kalpa. Ati-bala, Use of S'ana

Naga-bala,
...

Vidari and S'atavari-kalpa.


...
...

(-seeds).

515-521.

CHAPTER
The
Elixirs
of

XXVIII.
tend to improve the
to

and Remedial Agents which


the
Life
:

Memory and
Duration

invigorate

Mental Faculties as well as

increase

the

S'vetavalguja -RasayanaKrishnavalgujaRasayana Manduka-parni-Rasayana Brahmi-Rasayana Brahmi-Ghrita Vacha-Rasayana S'ata-paka-Vacha-Ghrita. Measures for prolonging Uses of Gold. 522-523.
Human
life.
...

...

...

...

CHAPTER
innate morbific tendencies and decays
:

XXIX.
which
arrest

The Restorative and the Constructive Agents


using the Soma.

Classifications of Soma. Mode of


Conduct
after taking

Therapeutic
criptions

effects.

Regimen of Diet and Distinctive, features


Habitats.
...
...

of the Soma-plants
...

Soma. Their des530-538.

Its

Their

...

CHAPTPR XXX.
The Tonic Remedies which remove Mental and Physical
Distress
drugs.

the use of Rasayna. Names of the healing Persons Regimen of Diet and Conduct Dosage The Mode of Mode of Culling the above Differentiating Therapeutic the Oshadhis. drugs. Their Habitats. The common Habitat of
:

unfit for

their use.

effects,

traits.

all

539-545'

XV

CHAPTER
The medicinal uses of Sneha,
of

XXXI.
etc,
uses.

: Classifications

of

Measures of The Kashaya-paka-Kalpa. The Sncha-p^ka-Kalpa. Alternative


Description

Sneha

specific

drugs.

Sneha The

methods.

Application of Sneha according to specific Dosha and Season.

Degrees of

Cooking a Sneha Distinctive

traits

of the complete cooking of a Sneha.

Process of Internal Use of Sneha

The Dosage.
of

The Specific Uses of Clarified butter Evil Effects of over-dosage Sadyah-Sneha. Forbidden cases
Eff'ects

Sneha-pana.-Good

of Sneha-pana.

...

...

546-557.

CHAPTER XXXn.
The medical treatment by measures of Sveda
Diaphoretic measures
etc.):

(Fomentations,

fect

Classifications of Sveda. Specific Applications. Effects of Sveda. Prohibited cases of Sveda. Symptoms of perbe followed and imperfect Sveda. Measures Sveda. 558-564.
Its

to

after

CHAPTER XXXni.
tives

The Distresses which prove amenable to the use of Purgaand Emetics Importance of Purgatives and Emetics. Mode of
:

application of Emetics.

tion.

Symptoms of excessive, satisfactory and deficient Effects of satisfactory Emetics. Cases where Emesis forbidrecommended. Mode of administering den. Cases where Emesis Purgatives. Classifications of Koshtha. Diet. Benefits of proper PurgaPersons who should not be purged. Persons who should be purged. Necessity of applying Sneha before Ithe administration of Purgative or
Emetics.
is

is

Emetic.

...

...

...

...

...

565-589-

CHAPTER XXXIV.
The treatment of the Disorders resulting from an
Injudici-

ous Use of Emetics or Purgatives : Their Classes. Cau.ses and treatEvils of an Unpurged Residue of a Purgative or Emetic. ment. Evils of a

Digested Purgative,
Doshas.

Flatulent

Evils of Colic. Partial -and


etc.

insufficient or excessive expulsion of the

Deficient

Medication (Ayoga).

Over-drugging with purgatives,


excessive
to

etc.

(Ati-yoga).

Vomiting or excessive Purging

be known.

Flatulent distention of

Haemorrhage (Jivadana).

due

to

^Jiva-s'onita,

how

the

Abdomen (Adhmana). Cutting

XVI

(Pravahika).

Dysenteric stools (Parisrava). Diarrhoea Anus, Overwhahiiing the heart. Retention (Vibandha) of stool and urine. 577 589.
pain
in

the

etc.

flatus,

...

...

...

...

CHAPTER XXXV.
The Dimensions and Classifications of a Netra and a Vasti with their therapentic applications -.The importance of Vasti-

The application of Vasti in different diseases. Dimensions of the Materials of the Pipe. Construction of the Vasti. Classifications of the Vasti. Nomenclature of the Vasti. Application of Niruha-Vasti and Asthapana-Vasti. Their therapeutic Effects The different Defects of a
Karma.
Pipe.
Vasti.
...

...

...

...

...

590598

CHAPTER XXXVI.
The medical treatment of the mishaps which are consequent on the Injudicious Application of the Pipe and the Vasti :
Remedies
for the injudicious application

of the
its

Pipe.

Disorders

resulting
resulting

from a defective Vasti (bladder) and

contents.

Disorders
for the

from the defective Position of the Patient.


of the defective
position of Niraha-Vasti

Remedies
...

Complications
for

and Sneha- Vasti.

Intervals
...

the application of Purgative,


Vasti.
...
...

Emetic,
...

Asthapana-Vasti and Anuvasana599

607.

CHAPTER
Process of Anuvasana-Vasti
Oils and Snehas.

XXXVII.
preparing several medicated

The treatment with Anuvatsana-Vasti and Uttara-Vasti: The

The process of

The Symptoms of excessive, and application of Anuvasana-Vasti. Diet the application of Distresses from Injudicious a Vasti. The Successive Actions of a Application of Sneha-Vasti. Specific Symptoms Their remedies. a Male and Uttara-Vastis Dimensions of the Pipe of the Vasti Mode of application. Vaginal Uttara-Vasti. Diseases a Female Uttara-Vasti. 608 626, amenable
Proper
time for the application of Sneha-Vasti.
insufficient,

mode

of applying a

Sneha-Vasti.

satisfactory

after

Vasti.

for

for

patient.

to

...

...

...

...

XVll

CHAPTER
:

XXXVIII.

The mode of applying, as well as the treatment with a


The mode of Preparing a Vasti. The mode of ApplyNirudha-Vasti Symptoms of a satisfactory application of a Vasti. Subsequent Drugs to b^ used in a Niruha-Vasti. The Formula of treatment and Diet The process of preparation. The Dvadasa-Prasriti. a Niruha-Vasti.
ing a Vasti.

Classifications of Vastis according to the range


cations. Corrective

of their therapeutic appli-

Vastis. Lekhana- Vasti. Vaji-Karana- Vasti. Vrim Pichchhila- Vasti. Grdhi-Vasti. Sneha-Vasti. Utkles'anaVasti. Dosha-hara-Vasti. Soothing Vasti. Yukta-ratha-Vasti. Siddhathe composition of Vastis in cases Vasti. Must^dika-Vasti. Variations of persons of different Temperaments. Nomenclature of different Vastis Specific Uses. 637 646. and

hana-Vasti.

in

.their

...

...

...

CHAPTER XXXIX.
The treatment of distressing Symptoms which are manifested in a patient The quantity of diet to be taken after the exhibition
:

of a Niruha-Vasti.

Internal

application

of Sneha after Blood-letting.

Preparations of different diets.

and

Diet to be taken according to the Dosha to the Strength of the patient. Regimen of conduct. Articles of
diet.

647652.

CHAPTER
(Fumes),

XL.

The treatment which consists in employing the Dhuma Nasya (Snuffs) and Kavala (Gargles) ; Classifications of
ot different Dhuma- Varti. Formation of the Pipe used Mode of inhalation of different Dhumas Prohibitive cases Dhuma-pana (Smoking) The therapeutic of Dhumaeffects

Dhuma Materials
in

Dhuma-Pana
of

Time

Pana Mode
clature of the

Smoking. Snuffs and Errhines (Nasya)The Nomenterm "Nasya" Classifications of Nasya S'iro-Virechana Its
of

application Dosage of Sneha-Nasya Effects of proper, excessive and


cient application

defi-

of a Sneha-Nasya

Avapida-Nasya Forbidden

cases.

Prati-marsha Nasya when to be used- Its effects. Specific use of SnehaNasya. Kavala-graha (Gargles) Classification Mode of application

Their

uses Kavala

and Gandusha

distinguished

How

long

Kavala
excessive

Symptoms Gargling. Prati-sarana


should be retained

of satisfactory,

deficient

and
...

Its classification

and

effects.

653

671.

End

of the Contents of the Chikitsita Sthatna.

KALPASTHANA.
(Section on Toxicology).

CHAPTER
Poison
:

I.

The mode of Preserving Food and Drink from the

effects of

The necessary qualifications of a Superintendent of the Royal Kitchen The necessary features of a Royal Kitchen. Characteristic features of a Poisoner. Indications of poisoned food and drink, General treatment. The mode of preparing Soup, 673 684.
etc.

etc.

...

...

CHAPTER
The Indications
Poisons
:

ir.

(Effects,
Its

Nature

and Operations) of Sthavara

Sthavara Poison source. Names of the different Vegetable Effects of poison on the Human organism. Effects of Bulb-poisons Specific properties and actions of Bulb-poisons Definition of Dushi-visha Symptoms of weak and slow poisoning Derivative
and Mineral poisons.

meaning of Dushi-visha
Poisoning

Symptoms
...

of the different stages of

Sthavara

The
...

medical treatment.

Koshatakyadi-Yavagu Ajeya-Ghrila
... ...

Vishari Agada. Treatment of the supervening Symptoms of Poisoning.


Prognosis.
...

685

694.

CHAPTER
The Subject of
Water.
(the nature, virtue,

ni.
etc.

of)

Animal Foisons :
oi

Different locations Characteristic

features

and
its

purifications

poisoned

internally.

purification. Mythological Poisons in the Atmosphere and origin of Poison. Properties of Poison Nature and Location of Snakepoison General treatment of poisoning Symptoms of taking poison Prognosis. Fatal 695 702.
bites.
... ... ...

CHAPTER
The
tions of Snakes

IV.

Specific Features of the Poison of a Snake-bite

: ClasificaSymptoms
the

Classifications of
amongst Snakes.

Snake-bites

Their

specific

Characteristic features of the


different Castes

different

species of Snakes.

Features of

Particular Habits of the

different kinds of

Snakes.

Names of the

different species

of Darvi-kara Snakes

Names

of

XIX
the different species of Mandali

Snakes Names

of the different species of

Names of the different species of Nirvisha Snakes Names and Origin of the different species of Vaikaranja Snakes Sub-families of the Vaikaranja Snakes. Characteristic features of Male and Female Snakes Features of Iheir bites General and specific symptoms of a bite by a DarviRajim^n Snakes
kara

Snake Specific symptoms


bite
different

of

bite

by a Mandali Snake Specific

symptoms of a
Snakes of
of poisoning

by a Rdjimdn Snake
Sexes and Ages,
etc.

Specific

symptoms of

bites

by

Symptoms

of the different stages


stages

from the bites of a Darvi-kara Snake

poisoning from the bite of a Mandali Snake

Different Different stages of


of
...

of

poisoning

from the bites of a Rajiman Snake. The Vegdtitara


Stages.

(or the intervening)

Different

Stages of

poisoning in cases

Lower Animals.
...

Different stages of poisoning in cases of Birds.

703

714.

CHAPTER
of

V.
treatment

The medical treatment of Snake-bites : General


Snake-bites.

Mantras
of

(Incantations)

Blood-letting

in

Snake-bites

Specific treatement of the bite by a

Hooded

(Darvi-kara) Snake, a Mandail

Snake and a Rajiman Snake.


Snake-bites.

Centra-indication to blood-letting in cases of


etc., to

Dosage

Collyrium,

be resorted to in cases of
in cases of

different Beasts

and Birds. General dosage of medicines

Snake-

bites

Specific treatment of
Doshas due

poisoning according to the Physical

Sympfoms
for

Specific treatment of
the aggravated
of

the different Supervening


to

Poison

Symptoms. Remedy Medical treatment of persons made


Poisoned

unconscious from the effects of a Fall or Suspended Animation. --Symptoms

wounds from Poisoned Darts,

etc.

Agadas Mahagada Ajitagada Tarkshya'gada Rishabhdgada Sanjivana Agada Darvi-kara- Rajila-visha-hara-Agada Mandali-visha-hara AgadaVams'a-tvagadi Agada Pancha-s'irisha Agada Sarva-Kamika Agada Ekasara Agada. ... ... 71^ 727.
Recipe of different

Treatment of a

Wound-

CHAPTER
Cases Symptoms
of
:

VI.

Different Varieties of Rats General Rat-poisoning Rat-poisoning Specific symptoms and treatment of Ratpoisoning General treatment. Causes of Rabies Symptoms of Hydro-

of

phobiaPrognosis.
bites

Symptoms

of Jala-trasa Its treatment Treatment of


teeth

by rabid-dogs

Treatment of

and nail-scratching.

728

736.

XX

CHAPTER

VII.

Treatment with the Sounds of a (medicated) Drum, etc., possessed of Anti-venomous Virtues Ksharagada Its Uses and
:

Tharap^utic
Agad-x

Effects

Rules

Kaiyinaka-Ghri'.a Amrita-Ghrita ~ Maha-sugandhi of Diet and Conduct. Symptoms of Elimination of Poison.


737741-

CHAPTER
On insects,
Insect-bites,
Insects
i.e.,

VIII.

etc-

the measures, etc. to be adopted in cases of The Germination and Classification of Insects

of Vataja,

Pittaja,

Kaphaja

and Sannipatika

temperaments.

class of Insects

their Bites The Kanabha class of Insects The Gaudheyaka S'ata-padi Manduka (Frogs) Pipilika (Ants) Makshika (Stinging Flies) Mas'akas (Mosquitoes). Incurable classes Treatment of a bite by strong and acute- poisoned Insects Recipes of Remedies in different cases. Origin and Classification of Scorpions Specific and

Symptoms of

traits

characteristics of

Mild -poisoned Scorpions, Madhya-visha Scorpions and

Development of Luta-poison
its

Treatment of Scorpion-bites. Spider-bites. Potency Location. Characteristics of seat in the body of a Spider Mythological Account Poison according to of the Origin of LutSu. The different names of Spiders and the general Symptoms of their Bodies Specific Symptoms of Spider-bites and their Treatment General Remedies Specific symptoms of the Incurable cases of Spider-bites Their treatment. Surgical Treatment Treatment of Ulcers incidental to the Bites by Insects or Snakes. 742 762.
Tikshna-visha

Scorpions

Its

...

...

End

of the Contents of the

Kalpa

Sthaina.

THE

SUSHRUTA SAMHITA
NIDANA STHANAM.

CHAPTER
Now wc
shall

I.

discourse

on the

Vatavyadhlthe
feet

(diseases of the nervous system)

Nidaaam*.
clasped
of

Metrical text: Having


the

holy

Dhanvantari,

who had
pitcher

arisen out

of

the
his

primordial ocean with the


head, and

of ambrosia
all
:

on

who was
of

the foremost of

Sus'hruta interrogated
the

him as follows
all

"Tell me,0 thou,


force),

knowers of

truth,

foremost

discoursers,

about the different

locations

and functions of the bodily Vayu (nerve


its

both

in
it

normal and
its

agitated conditions, (as well as

when

changes

natural seat through a

concourse of

disturbing or aggravating causes).

Instruct

mc on
its

the

nature of distempers, which


condition."
2.

result

from

deranged

The holy Dhanvantari, the


as follows:

greatest

of

all

healers,

having listened to the foregoing words of Sus'hruta, replied

This
which

vital
is

Vayu

(nerve force), which courses


in its

through the
*

body,

self-begotten
translated

origin,
is

and
to

The term Nidanam,


factors,

usually

as Pathology,

meant

include

fall

within the respective provinces of Pathology,


well.
xli.

/Etiology,

functions of

Symptomology and Pathognomy as Vayu see Introduction vol. I. pp.

For the meaning and


xlii.

2
is

TH SUSHRUTA SAMHITA.

[Chap.

I.

regarded as identical with the divine energy of eternal


(God),
its
is

life

Inasmuch as

it is

unconditional and absolute


eternal
(like

in

actions
subtile
It

and

effects,

and
the

self-origined,

and

and all-pervading
is

sky and the

atoms).

the primary factor, which determines the

principle of cause
things,

and

effect

in

all

forms of created
It
is

whether mobile or immobile.


fact of its

so called

(Vdyu) from the


origin

coursing (skr.
It
all

Va to move)

throughout the universe.

determines the growth,

and disintegration of
it

animated organisms, and


of
all

as such,

receives

the

homage

created

beings.

Although

invisible in itself, yet its


is

works are patent or


dry and piercing, and

manifest. It

cold, light, mobile,

follows a transverse course.

It is characterised by the two attributes (proper-scnsibles or Gunas) of sound and touch. It abounds in the fundamental quality of Rajas

(principle of cohesion

and action),

is

of inconceivable

prowess, propels

all

the deranged or obstructing prinicples


is

(Doshas)

in

the organism, (or in other words,

primarily

concerned with the deranged principles of the body

which are pathogenic


in its action,

in their actions).

It is

instantaneous

and radiates
currents.
intestinal

or courses through the organIt

ism

in constant in

has

its

primary

field

of

action

the

tract

(Pakvadhana) and the


state,
it is

rectum (Guda).
factor, which, (In

In

Its

deranged

the principal

combination with the deranged PIttam


the
root

and Kapham),

lies at

of

all

diseases,

and
3.

Is

accordingly termed the king of diseases (Rogarat).

of State Now, hear me


:

The action

Vayu

in its

normal

describe the

symptoms, which

it mark the Vayu, The Vdyu, in its normal

as

courses

through the organism.

or undisturbed condition, main-

tains a state of equilibrium

between the different Doshas


;

and the root principles of the body (Dhatu)

it

further

Chap.

I.]

NIDANA STHANAM.

tends to

maintain uniform state in the metabolism of

the body, (protoplasmic,

Agni*) and helps the organs

of sense-perception in discharging their specific functions.

The bodily Vayu,


grouped under
difference in
its

like

the

Pittam

in

the

organism,

is

five different

subheads according to the


is

functions and locations, and

classified

as

the

Prana,
five

These

Udana, Samana, Vyana and Apana.f classes of Vayu, located in their specific
towards the integration and main-

regions,

contribute

tenance of the body.

Vayu, that courses


is

The Prana Vayu : The


(governs)the cavity of the mouth, |
function being to force

in
its

called the Prdna,

down

the food into the cavity of

the stomach, and to assist the different vitalising principles


of the

body (such

as the internal heat or fire


life,

etc.) in dis-

charging their functions in


I

and

to contribute to the

general sustenance of the body.


this particular

deranged condition of
is

kind of

Vayu
:

(Pnina)

usually followed

by

hic-cough, dyspnoea and other kindred distempers. 7.

The Udana Vayu The most Important of the


vital
is

Vayus, which courses (sends

its

vibrations) upward,
etc.

called the

Udana.
it

It

produces speech, song,

In

its

deranged state

brings on diseases which are speci8.

fically

confined to regions lying above the clavicles.

The Samana Vayu : The


'courses in (governs) the
* See

Samana Vayu
in

stomach (Amashaya) and


p.p.

the

Introduction Vol.

I.

XLVIII XLIX Mahamahopadhyaya


Agni as digestive heat (/athardgni).

Dvarka Natha Kavlratna


t

interprets this

The Prana Vayu is identical with the energy of the nerve centre in the medulla the Udana with that of the one which is situated in the speech centre. The Samana is same as the energy of the epigastric plexus, the Udana is same as the energy of the Motor-Sensory Nerves, and the Apana is identical with the force of the Hypogastric plexus, X The field of its action includes the regions of the heart, throat, bead
;

and the nose.

"4

THE SUSITRUTA SAMHITA.


Its

tChap.

1.

region of intestines (Pakvdshaya).


digesting the

functions consist in
in

chyme brought down


from

into the intestines

unison with the digestive ferment (Agni),


in disintegrating its essence
its

and
or

especially

refuse

excreted
of the

matter.

deranged or aggravated
causes
9.

condition

Samana Vayu
digestion, etc.

dysentery, Gulma,

and impaired
as the
its

The Vyana Vayu : The


Vyana
functions consist
in

Vayu known

courses (acts) through the whole organism, and

sending the lymph chyle,


in

etc. all

through the body and

helping the out-flow of

blood

(Asrik^ and perspiration.

Five kinds of muscular moveof the


is

ments* are ascribed to the action


a deranged

Vyana V^yu,

condition

of which

generally attended

with diseases which are not confined to any particular


region,

member,

or organ of the body, but are


as, fever, etc),

found to
ro.

affect the

whole organism (such


the

The Apana Vayu : The


Apana
foetus

Vayu known
of
in

as the

acts

in

lower

region

the

intestines

(Pakvadhana).

Its functions consist

bearing

down

the

and the

faeces

and

in

evacuating the urine, semen

and catamenial blood. An enraged condition of this Yiyu tends to bring on serious diseases, which are peculiar to
the

urinary bladder and the distal portion of the large

intestine

(Guda).

An

aggravated

condition of both the

Vyana and Apana Vayus may produce Prameha and


disorders
of

the

seminal
five vital
life.

fluid,

while a
leads to

simultaneous
a sure and

excitement of the

Vayus
11-12.

speedy termination of

Now we
Vayus
*

shall describe the nature of diseases, brought

about by the

localization

of the

variously aggravated

in the different parts of the


flexion, lowering

body.
ancj

In
lifting

the cavity
up or
lateral

Such as expansion,

down

thrusting of any part of the body.

Chap.

I.]

NIDANA STIIANAM.
Stomach (Amashaya) the deranged or
at

of

the

aggrafits,

vated
thirst

Vayu

gives rise to vomiting, vertigo, epileptic

and pain

the

sides

(Pars'va

Sula)

and about
intestines
rise

the region of the heart (Hridgraha).

In

the

(Pakvashaya) the enraged or disturbed Vayu gives


to a

rumbling

in the intestines, a piercing

pain about the

region of the

umbilicus, scanty

and

stool,

or their entire

and painful urination suppression (Andha), and pain

about the region of the coccyx (Trika). 13


ly,
it

5.

Similar-

incarcerated in the sense-organs, such as the cars, etc.

tends to deprive them


.skin

of their

respective faculties.

In the

(lymph chyle) it produces a discolouring of the


in the

complexion, parchedness and twitching


causes

skin,

and
a

complete local
piercing

anaesthesia, giving
in

rise to

tingling,

pain

the

skin,

which spontanefissures.

ously bursts, or becomes marked with cracks and


Similarly,

the

aggravated

Vayu

interfering

with the
flesh,
it

principle of blood gives rise to

ulcers.

In the

produces painful nodes and tumours (Granthi), while in


the principle of fat
it

brings on almost painless tumours

(Granthi) unattended with


cerated in the veins

any kind
it

of ulcer.

Incar-

&c. (Sira)

produces a stiffening or
;

painful contraction, or a varicose or neuralgic condition


in a

ligament (Sndyu),

it

produces numbness (anaesthesia),


;

palsy, aching pain


it

and convulsive jerks


it

in a

long joint,

tends to deprive
painful

of

its

contractibility

and produces
affected

inflammatory swelling
it

(about the

part).

In the bones

produces a wasting (atrophy) of

the bones which crack and begin to spontaneously burst,

attended

with the characteristic bone-ache.


life,

Again
it

in

that important principle of

the marrow,

tends to
all

dry

it

up and produces a

sort of pain,

extending
a

over

the body which


in the principle

knows no respite or abatement. of semen it tends to produce

Similarly,
scanty,

6
defective,

THE SUSHRUTA SAMHITA.


or excessive

[Chap.

I,

emission of that vital


i6

fluid, or

complete stoppage thereof.

23.
and agitated,
over the
affects

The Vayu,
succession

thus

disturbed

in

the

lower and

the upper extremities of the


all

body, and the head, or extends


deranges
all its

root-principles (Dhatu).

body and The symptoms,


(Akshepa),

which mark such conditions of the body, are numbness


(paralysis), convulsive contortions of the limbs

anaesthesia,

and various kinds of pain(Sula),and swelling

(Sop ha) of the body. The deranged Vdyu, having entered the natural seats of the Pittam or

Kapham, develops
of

symptoms, which are peculiar to


gives rise to

either

them, and

numerous

diseases.

24

25.
and
loss of conscious-

The symptoms, which characterise the union of the deranged Vayu with the Pittam (in its particular seat)
are a burning sensation, heat, thirst,
ness, in addition to the

symptoms

of the Vataja

disease

so generated

in

that particular part of the body, while

a similar unison with the


swelling

Kapham
in

develops coldness,
part).

and heaviness (o( the affected

The
and

disturbed or agitated

Vayu
a

unison with the principle


(pins

of blood gives

rise

to

sort of pricking pain

needles in the affected locality), which can not bear the


least touch, or
is

marked by complete
to

anaesthesia,

and

symptoms,
in its train.

peculiar

the

deranged Pittam, follow


body,

26

28.
etc. in
is

Vomiting, and a burning sensation,

the

mark

the instance

when

the Prana
;

Vayu

surcharged
lassitude,

(Avrita) with the

Pittam

while weakness,

somnolence
plexion
(

and a general discolouring of the comR.,

D.

loss

of

taste)

characterise

a case

when

it is

surcharged with the

deranged

Kapham

burning sensation in the body, loss of consciousness or


epileptic
fits,

and a sense of giddiness (vertigo) and

Chap.

I.]

NIDANA STllANAM.

physical

languor are the indications, which distinguish


of the

a case

Udana Vayu being surcharged with


a stoppage
or

the

Pittam

while

absence of perspiration,

appearance of goose-flesh on the skin, impaired digestion,

coldness and

numbness of
of the

the

affected

part

characterise

case

same being surcharged with

the

Kapham.

2932.
and
epileptic
fits

Copious flow of perspiration, heat with a burning


sensation in the body,
indicate a case

when

the
;

Samana Vayu has become


while a copious flow of
stool

united

with the
urine,

Pittam

and

and

an excess of mucous secretion (Kapham) from the nose


(fluent coryza) etc.
it

and horripilation mark a

case,

where

has become saturated with the

Kapham.
a
case

33

34.
when
the

Heat and a burning sensation


and a profuse
mcnorrhagia

in the affected part

mark

Apana Vayu becomes surcharged with


as a sense of heaviness in the a case

the Pittam, where-

lower limbs characterises

when

it

becomes overcharged with the Kapham.

3536. [Symptoms such as,] burning and jerking in the limbs, and a sense of physical languor become manifest
in the

event of the

Vyana Vayu

being surcharged

with
stiff-

the Pittam, while a general heaviness of the limbs,

ness or

numbness of the

bone-joints,

and an incapability
being surcharged

of locomotion

indicate the fact of

its

with the

Kapham. 3738.

The Nidanam
An
course,

of Vsita

Raktam :
sexual
inter-

over-indulgence in grief, excessive


inordinate
physical
exercise,

drinking

large

quantities of wine, observance of a regimen of diet

and
imconor

conduct

in a particular
it,

season of the year which

is

proper to

use of articles of food which are not

genial to one's

own temperament and an improper

THE SUSHRUTA SAMHITA.


(as

[Chap.

I.

baneful use of such oleaginous substances


fied

oil,

clari-

butter etc.) are the factors, which vitiate in

common
foregoing

the

blood

and
in

Pittam of a person.
vitiate

The

causes especially tend to

or

agitate

the

Vayu
or
in

and blood

persons

of delicate

constitutions,

corpulent persons, or in those


perfect continence.

who

observe

a form

of

39.

The
sive

vital

Vayu becomes enraged


horses,

or agitated

by exces-

riding on

camels or elephants, or through


etc.,

the lifting or carrying of great weights,

or by an in-

ordinate indulgence in things which are possessed of the


specific

virtue

of
the

enraging or

aggravating

that

vital

principle.

On

other hand, an over-indulgence in

such articles of food as are heat-making in their potency,


or a surfeit of edibles largely

composed of
as a large

sharp, acid or

alkaline substances,

as well

consumption of
tends to
vitiate

potherbs

etc.,

or an exposure to

heat

the blood of the organism,

and which, on account of such

contamination, tends to speedily obstruct the passage of


the fleet-coursing
course, Ibecomes

Vayu. The Vayu, thus impeded in its more and more agitated each moment,
of the term

and
way.

is

prone to speedily agitate the blood in a similar

The antecedence

"Vata" or "Va}^u"
is

in the

nomenclature of the disease (Vata-Rakta)


bringing about the malady, although
concert
40.

owing

to the precedence accorded to the action of the

deranged
it

Vayu
this

in

effects

In

with

the

vitiated

blood

of

the

organism.

Similarly, the disease brought about by the

agitated

Pittam, in conjunction with the vitiated or agitated blood,


is

called the Pitta- Raktam, while

the

one incidental

to

the

combination of
is

the

deranged

Kapham
In a

with
case

the vitiated blood


of

called

Kapha-E/aktam.

Vata-Raktam,

the legs, or the lower extremities

can

Chap.

I.]

NIDANA STHANAM.

not bear the least touch (Hyperaesthesia) and a sort of


pricking, piercing pain (pins and needles)
in
is

experienced
withered
or

those

regions.

The
all

legs

become

atrophied
of Pitta
soft

and lose

sensibility

to touch.

In a case
red, hot,

Rakt am,

the legs

become extremely
case of

and swollen, characterised by a sort of indescribable


In
a

burning sensation.
legs

Kapha-Raktam,

the

become swollen and numbed. The swelling assumes a whitish hue and feels cold to the touch, and is accompanied by excessive itching. In the Sannipatika
or Tridoshaja form of

Dushta-Rakfcam, the
41

legs exhibit
to
all

symptoms, which are respectively peculiar


three preceding types.

the

43.
:

Premonitory Symptoms
tive stage of the disease the

In

the incuba-

legs

perspire

and become
local perspira-

cold
tion

and flabby, or (on the contrary\ the


is

stopped and the legs become hot and hard.


is

More-

over, a pricking pain

experienced

in

the affected parts

which are marked by complete anaesthesia, heaviness, or


heat,

and discolouring of the skin.


affects

The
in

disease creeps

in either
first

from the lower extremities, or


the

some

cases,
all

upper ones and gradually extends

over the body like an enraged rat-poison.

Prognosis
skin
joint

The form of the disease

in

which the

of the part lying between the instep

and the knee-

becomes abraded or spontaneously bursts open, exuding pus and blood, attended with loss of strength
(Prana) and flesh, curvature of the fingers, and eruptions
of nodules, should be case of

regarded

as

incurable

while a

one year's standing admits only of palliative


44.

measures.

The enraged or agitated Vayu, while coursing swiftly through the Dhamanis (nerve.s) of the body, shakes it in
quick
succession,

and

disease,

(exhibiting

such

10

THE SUSHRUTA SAMHITA.


as shaking or convulsive jerks),
is

[Chap.

I.

symptoms
which
is

originated

called

form of the disease,


ground,
at

Akshepaka* in which the patient


is

(spasms, convulsions).
falls

The
the

to

intervals,

without convulsions).

ApataLnaka (Epilepsy aggravated or agitated Vayu, The


called
entire

charged with an abnormal quantity of Kapham, sometimes affects and stuffs the

nervous system, and


is

gives rise to a form of disease,

which

called

Dandaiit

pataiaakaTnt (Epilepsy with convulsions), inasmuch as


deprives the

body

of its

power of movement and flexibility,


(Danda).
to

making

it stiff

and

rigid like a rod

45

46.
is
;

The
its

disease

but

rarely

yields

medicine and,

cured in rare instances only with the greatest difficulty


characteristic

symptom

being a paralysis of the jawdifficult.

bone, which makes deglutition extremely


disease
in

The
like

which the enraged Vayu bends the body

a bow

is

called

Dhanushtambha

(Tetanus).

The

disease

admiits of being divided into

ingly as the

two distinct types accordbody of the patient is curved internally


extended,
lit
:

(Antaraiyama, lit: inwardly or forwardly


emprosthotonos), or externally (Vahirakyatma,

exin

tended or bent on the back, resting on his heels and


occiput

Opisthotonos).
patient
suffers

When

the extremely enraged

and powerful bodily Vayu (nerve-force), accumulated


*

The

from vanishings

(idniyale)

and

loss of

con-

sciousness through

the instrumentality
is

of the enraged

and aggravated

Vayu, hence the disease

so

named

Gayaddsa.
unison

t Jejjada holds that the enraged Vayu, in

with

the

deranged

Kapham,
coldness,

gives

rise

to another kind of convulsions (Akshepaka) which he


exhibits

has denominated as Danda-patanakh which,


swelling

such

symptoms
its

as

and heaviness of the body on account of

being

brought about by a concerted action of the deranged Pittam and Kapham.


Several
authorities aver that there are four distinct types of

Akshepakah,

such as Danda-patanakh, Anlarayamah,


of traumatic (Abhighataja) origin.

Vahirayamah, and Akshepakh

Chap.

I.]

NIDANA STHANAM.
abdomen,

II

the regions of the fingers, Insteps,

chest, heart

and throat, forcibly draws


the

in the local

ligaments (Snayu),

body becomes contracted and bent forward, bringing about a curvature of the inner trunk. The disease
in

this

form

is

called

The movements become fixed in


paralysed,
(at

of the

Antarayatma Dhanushtambha. eyes become impossible, which


;

their sockets

the jaw-bones

become

the sides

are

broken, and the patient ejects


of)

intervals

quantities

slimy mucous (Kapham).

These
the

are

the

features

which

mark

the

first

type

(Antarayama Dhanushtambha).

On

the contrary,
In

when

same enraged Vayu, centred or lodged


violently, the

ligaments

which traverse the posterior side of the body, attracts

them

body
and
Is

is

naturally bent backward.

The
the

patient
chest,

experiences a sort of
waist
thighs,

breaking pain

at

(which are

ultimately

broken).

The
47

disease

called Vahiratyatma,

and should
medicinal

be looked
treatment.

upon as beyond the

pale of

all

50.

in

Four types of Akshepaka are usually- recognised practice such as, the (i) one incidental to the
action
(2),

concerted

of

the

enraged

bodily

Vayu and
Pittam,
(3),

Kapham
of

the one brought about

through the union

the

enraged

Vayu with

the deranged

the one due to the single action


(4)

of

the

agitated
injuiy

Vayu

and the one due to any external

or blow

(Abhighataja).*

An

attack of Apatdnkah due to excessive


abortion
or
is

haemorrhage, or following closely upon an

miscarriage at pregnancy (difficult labour), or which


Incidental to

an external blow or injury (traumatic),


51

should be regarded as Incurable.


*

52.

Brahma Deva designated


Akshepakah,

the four types of the disease, as Apatanakah,

Samsrishta
(traumatic).

simple

Akshepakah

and

the

Abhighataja

il;2

THE SUSHRUTA SAMHITA.


The
disease, in

[Chap.

I.

which the extremely agitated Vayu (Dhamanis) which spread either


body, whether in
or lateral direction,

affects the nerve chains

in

the

left

or

in the right side of the

the upward,

making them and in which the joints of the other side of the body become useless and inoperative, is called physicians. Pakshfiighstta (Hemiplegia) by eminent The patient, the whole or half of whose body has
downward,
lax and
vigourless,

become (almost) inoperative and

lost all sensibility,

but

who
falls

retains his consciousness so

long as there remains

the least vestige of vitality in the affected part, suddenly

down and

expires.

53

54.

ProgTIOSis:-A
plegia),

case

of

Pakshaghata
the

(Hemi-

brought about through the single action of the

enraged or agitated

Vayu

of

body, can be cured

only with the greatest care and


the
in

difficulty.

case

of

same

disease,

engendered by the aggravated Vayu


deranged Pittam or Kapham,
It

conjunction

with the

proves amenable to medicine (Sadhya).


curable
ciples

becomes

in-

when caused through

the waste of the root prin55.

(Dhatu) of the body.

Apatantrakah
aggravated
principles)
tacle in the

(Convulsions)

: The

Vayu,
and

(by

its

specifically
its

exciting factors

and dislodged from

natural seat or recep-

body

in

consequence thereof, courses upwards


in the regions

and

finds

lodgment
It

of the head, heart and


parts

temples.
convulsive

presses

upon those

and gives

rise to

movements

of hands and

legs, or at

times

bends them down.

Symptoms : The
closely
shut,

patient

lies

with his eyes

or stares with

a sort of fixed or vacant

gaze,

the

eyes
all

remaining fixed or immovable.


perception,
or

The

patient loses

and groans.
of

Respiration

becomes

difficult,

symptoms

temporary asphyxia

Chap.

I.]

NIDANA STHANAM.
set In.

and unconsciousness
condition
of of

Consciousness and a normal


the

the

organism return with

passage

the

enraged
the

Vayu from
patient

the

heart,

while on the

other hand

relapses

into

unconsciousness

simultaneously with the envelopment of the heart


that
is

with

enraged and Kapha-e^aturated Vayu.

This disease
to

called

Apatantrakah and
enraged
56.

is

ascribed

the

action

of

the

Vayu

surcharged with the deranged

Kapham.

IVIanyastambha: The
with
the

local

Vayu, agitated

through such causes as sleep in the day time, reclining

neck on an uneven place or pillow, gazing


length of
time,

upward

for a considerable

or

looking

aside in a contorted way,

and enveloped
disease

in the

deranged

Kapham,

gives rise to

the

known
57.

as

Manya-

stambha (wry neck or

torticollis).

Arditam
old

(Facial Paralysis)

:~*P regnant women,


to fall

mothers immediately after parturition (Sutika), infants,

and enfeebled persons are most prone


It

victims

to this disease*.

has been also

excessive haemorrhage or loss of

known to result from blood. The local Vayu,

extremely enraged or aggravated by continuous talking


in

an extremely loud voice, chewing of hard substances,

loud laughter, yawning, carrying extremely heavy loads,

and lying down


finds

in

an uneven position on the ground,


regions of the head, nose, upper
lip,

lodgment
forehead

in the

chin,

and the

joints (inner cornea) of the eye,

and produces the disease called Arditam by distorting


the face.

Symptoms
shakes
*
;

The

neck

and half of the


is lost,

face

longitudinally suffer distortion and are bent.

The head
and
th^.

the power of articulating speech


portion of the text included within asterisks

The

has been

reject

by Jejjadacharyya as spurious.

14

THE SUSHRUTA SAMHITA.


The
teeth

[Chap.

I.

eyes are distorted Into a variety of shapes.


of the neck and the chin, as well
affected side

portions

as

the

on the

become

painful.

Premonitory Symptoms : The


generally

disease

commences
a pricking

with

shivering,

horripilation,

cloudiness of vision, upcoursing of the bodily


anaesthesia,

Vayu and
locality,

pain

in

the

affected

numbness

or paralysis of the jaw-bone, or of the cervical

muscles of the neck.

Physicians,
it

conversant with the


paralysis).
in

Etiology of

diseases, call

Arditam (Facial

Prognosis : A case of Arditam, appearing

an ex-

tremely enfeebled or emaciated patient, or exhibiting


such symptoms as a winkless vision, inarticulate speech

which hardly seems to come out of the


years' standing, should be

throat, excessive

palsy of the face, as well as the one of more than

three

Gridhras'i

(Sciatica):

deemed as incurable. 58. The disease in which

the

two great nerve-trunks (Kandara), which emanating from


below the lower extremity of the thigh reach down to
the bottom of the insteps and toes, and

become

stuffed or

pressed with the enraged Vayu, thus depriving the lower


extremities
Gridhras'i.

of
59.

their

power of locomotion,

is

called

ViS'vachi
The
disease in

(Erbe's paralysis or Bracial neuralgia):


affecting

which the enraged Vayu

the

nerve-trunks (Kandara) which run

to the tips of fingers

behind the roots of the upper arms, making them


[capable
of

movement and depriving them


is

of their
60.

)wer of flexion or expansion

called Vis'vachi*

KrOShtukaS'irsha
Ints)
:

(Synovitis

of
in

the

knee-

An
the
it

extrimely painful swelling


aforesaid nerve of a
it

the kneeis

When
:ted to

sirgle

arm

is

afTecld the disease

alone, while

attacks the both

when both

their nerves are

Chap.

I.]

NIDANA STHANAM.
is

1$ action
called

joints,

which

originated through the concerted

of the deranged

Vayu and
from the

the vitiated
fact

blood

is

Kroshtukas'irsha

of

its

resembling the
6i,

head of a jackal (Kroshtuka)

in shape.

Khan ja (Lameness): The


the
waist.

disease proceeds from

drawing up of the nerve trunks (Kandara) of a leg by the deranged Vayu lying about the region of the

When
is

both the legs are similarly affected, the

patient

called a

starting for a

Pangu. He, whose legs tremble before walk and who afterwards manages to go
called a

on limping
bone-joints

is

Kalaya Khanja one


62
6^.
:

in

whom

the

become

loose.

local Vdyu, enraged by making a false step on an uneven ground, finds lodgment in the region of the ankle (Khudaka, instep

Vata Kantaka -The

according

to

others), thus

giving

rise

to

a disease
sensation
local

which

is

called

Vata Kantaka.
the
feet

The burning

in the soles of

caused

by the enraged

Vayu,
blood,
afflict

in
is

conjunction with the deranged


called

Pittam and

Pada-daha, which

is

generally seen to
the legs
are

persons of pedestrian habits.


all

When
and a

deprived of
pain
is

sensibility of touch,

sort of tingling

experienced in them
is

which

is termed Padaharsha, it due to the deranged action of the Vayu and

Kapham.
dries
joints
is

The

disease in which the enraged local

Vayu

up the normal

Kapham

lying about the

shoulder-

called Ansa-s'hoshaka.

The form

in

which the

aggravated local Viiyu contracts the nerves of the arms


is

called

Avavahuka*.

6467.
(deafness)

Vad hiry ay am
only
*

: The
either
of

disease

occurs
or
sur-

when

the deranged
is

Vayu,

singly
the the

The Ansa-shosha
is

due

to the single action

enraged

Vayu,

while Ava-vahuka

due

to the

concerted

action of

deranged Vayu

and Kapharo,

THE SUSHRUTA SAMHITA.


stuffs

[Chap.

charged with the Kapham,


channels (Srota) of the
ears.

the sound-carrymg

68.

Kama
sort

S'ulam: The

disease

in

which

the

deranged Vayu causing a piercing pain


of

in the

regions of
rise

the cheekbones, head, temples and neck, gives

to

aching pain in the tympanum,

is

called Karna-

s'ulam

(otitis).

The

local

Vayu, deranged and saturated

with the

Kapham

stuffing the nerves

(Dhamani) which
(in

conduct of the sound of speech, produces complete

some

cases partial) loss

of

the

power of speech

eg.

Muka

(dumbness

Minmina
69

(nasal voice) and

Gad-gada

(indistinct speech).

70
(rising

sort of pain,

which

from the bowels or the


rise

urinary bladder and

ranging downward) gives

to

a bursting sensation in the regions of the anus and


genitals,
is

the

called

Tuni, whereas the one, rising upward

from the preceding parts and extending up to the region


of the
intestines,
is

called

Prati-tuni.

distension

of the

abdomen
is

(Udara), attended with the incarceration


its

of flatus (Vayu) and an intense pain and rumbling in


inside,

called

Adhmsinam (Tympanites). When


is

it first

affects the

stomach fAmasaya) and


Praty^dhmaiinam.

unattended with an

oppressive feeling about the heart and pain at the sides'


it is

called

The Vayu

saturated with

the

deranged

Kapham

causes the preceding type

of

distemper.

7174.
fixed
or

knotty stone-like tumour (Granthi) of considermobile, and appearing

able density, whether

below the umbilicus, and having an elevated shape which is always found to be extended in an upward direction, is
called

a VatabSthilSb, (which) as

its

name

implies,

is

due

to the action of the local

deranged Vayu.

The tumour,

thus formed, obstructs the emission of flatus and impedes


the evacuation
of faeces.

tumour of similar shape,

Chap.

I.]

NIDANA STilANAM.

I^

appearing laterally or across the region of the abdomen


(Jathara)

and obstructing the passage of


(Vata)
the
is

stool,

urine
^6.
Subhruta

and

flatus

called a Pratyashthila'.
Chapter of the Nidana Sthanam
the

75
in the

Thus ends
system.

first

Samhita, which treats of

Nidanam

of

the diseases of

the nervous

CHAPTEE
Now Ars'aS
(i)

11.

we

shall

discourse
i.

on the

Nidanam
classes viz

of

(Haemorrhoids},

Haemorrhoids

may

be divided into six


of the

(iv)

Vdtaja (due to the action

deranged Vayu\
(iii)

(ii)

Pittaja (due to the action of deranged Pittam),


to the action of deranged

Kaphaja (due

Kapham),
blood),

Raktaja (due to the action

of

the

vitiated

(v)

Samiipdtaja (due to the concerted action of the deranged

Vayu, Pittam and

Kapham and (vi) Sahaja PathoIOg^y The deranged Vayu,


i

(congenital).

Pittam,

etc.

enraged by their specific aggravating causes, or by such


acts or conduct as partaking of

food

composed of

in-

compatible substances, eating before the previous meal


has been digested, inordinate sexual intercourse, sitting on
the haunches, excessive riding, and the voluntary suppression of

any natural urging of the body,

either severally

or

in

combination of two or three Doshas, or vitiating

the blood of a person,

food and drink &c.,


seats
in the

who observes no moderation in become dislodged from their natural

(expansion
principle)]

body [according to the law of Prasaranam and change of place by a deranged organic and are carried down through the large
therein,

intestine

(Pradhana Dhamani) into the descending colon


give rise to growths of

and

getting lodged

polypi or fleshy condylomata,

which are known as piles. These growths chiefly appear in persons suffering from
impaired digestion
(Agni), and

gain

in

size

through

friction

of clay or stone, or

weeds, wood, lumps by contact with cold water. 3. The lower end of the large intestine, which passes

with the wearing apparel,

into the flexure of the rectum

and measures four and

Chap.

II

NIDANA STHANAM.
in length, is

I9

half

fingers

called

the

Gudam

(lit
is

the

channel of fecal matter), the interior of which

provided with three spiral grooves. Each of these grooves


or ring-like muscles
are
lie

a finger
as

and a
out-flow,

half

apart,

and

respectively

known

Pravdhini,

Visarjani
defecation

and and

Samvarani, or the grooves of


closure

of

the

anus (sphincter

ani), covering a space of

four fingers
finger's

and having
4.

laterally

an elevation of one
grooves are like the

width.

Metrical Texts : These


the other, coloured like the

involuted indentures of a conch shell, situated one above


palate

of

an elephant.
as

A
it

part of the channel, half a finger's width in length


is

usually measured from the


is

outer

hairy orifice of the


5

rectum,

called the anus (Gudoushtha).

6.

The

first

of the aforesaid grooves or rings

lies

about

a finger's width apart from the orifice of the anus.

Premonitory Symptoms :~A


for food, a tardy

non-relish

and

difficult digestion of

food (brought

into
in

the stomach), acid eructations, a sense of weakness

the thighs, a rumbling sound in the intestines, emacia-

tion of the body, frequent eructations, swellings

around
cutting

the

eyes, a croaking
in

sound

in the

intestines,

pain

the

rectum (Guda), apparent indications of an

attack of phthisis, jaundice, dysentery, cough, dyspnoea,


vertigo,

somnolence, excessive
(Indriya),

sleep,

weakness of the

organs

advent of this
with
its

which predict the disease, and which become more marked


are

indications

progress.

7.

The Vataja Type : Piles,


of the aggravated

due to the action


the

Vayu, arc non-exuding, rose-coloured,

and uneven
flowers
in

in their surface.

They resemble

Kadamba

structure

pointed like

and are either tubular or sharpa needle, sometimes assumino- the shape of

20

THE SUSHRUTA SAMHITA.


The

[Chap.

II.

the wild Tundikeri flower.


patient
of this type

stool of a hsemorrhold

becomes excessively hard, and can

be evacuated only in a sitting posture, with the greatest pain and


difficulty.

An

excruciating
of

pain

is

experisides,

enced

in

the

regions

the

waist,

back,

anus, umbilicus and the genitals.

Symptoms

peculiar

to Gulma, Ashthila, enlarged spleen and abdominal dropsy add to the distress of the patient, whose skin, nails, eyes, teeth, face, urine and stool also assume a

dark black colour.

8.

The

Pittaja

Type : Piles,

brought

on

through the action of the deranged Pittam, are slender,


blue-topped, shifting in their nature, yellowish
in

their

hue, or are coloured like shreds of liver, resembling in

shape the tongue of the Suka bird.


middle, like barley grains,
leeches
stool
is

They

are thick

at

or

resemble the mouth of

and secrete a sort of slimy exudation. The marked with blood, and the patient complains of
sensation
(in

a painful, burning

the

rectum) at the

time of defecation.
thirst,

Fever, with a burning sensation and


fits,

and epileptic

supervene.

The

skin,

nails,

eyes, face, teeth, stool,

and urine of the patient assume

a yellow hue.

9.

The Kaphaja Type : Piles, due to the action


of

the

deranged

Kapham, become

white,

are

sunk

about their roots, and are hard, round and glossy.

They
cow or
These

assume a greyish hue and resemble the


the
piles

teats of a
fruit.

stones

of

the Karira, or of a Panasa

do not

burst,

nor do they exude any sort of secretion.

The

patient feels an irresistible tendency to scratch the

excrescences.

and are

become copious in quantity charged with mucous (Sleshm^), resembling


stools

The

the washings of meat.


(Sita-jvara),

Indigestion, fever with shivering

and heaviness of the

head and

oedema

Chap.

II.]

NIDANA STHANAM.

21

with a non-relish for

food are the symptoms which beof

come manifest with the progress


patient also

the

disease.

The

skin, finger nails, eyes, teeth, face, sLool

and urine of the


(haemorrhoids),

assume a white colour.


in the vitiated

lO.

The Raktaja Type


having their origin
of the colour
of

:- Piles

condition of the blood

resemble the sprouts of the Vata tree in shape and are


of
red
coral,

or

the

seeds
all

(dark

red)

Gunja
are

berry.

They
the

exhibit

the

symptoms,
in
rise

which
Pressed

peculiar to the Pittaja type of this disease.

hard

by

constricted

fi-eces

their to

passage through the anus, they suddenly give

hcxmorrhage of
characteristic

vitiated (venous) blood,

and symptoms
are

of

excessive

bleeding

found

to

supervene,

il.

The Sannipata Type


haemorrhoids

:-

in

case

of

due

to

the

concerted

action

of the

deranged

Vayu,
12.

Pittam

and

Kapham,

symptoms

characteristic of each of these types manifest themselves


in unison.

The Congenital Type :Congenital hemorrhoids


the

(Sahaja Arsas) are usually ascribed to defects


one's

in

semen and ovum of

parents and should be

medicinally treated with an eye to the special deranged

Doshas involved
are hardly visible
faces

in the case.

The

polypi

(in this

type)

and are rough and yellowish, with their

turned

inward.

They

are extremely painful.

person suffering from this type of piles gets thinner and


thinner every day and eats but very
(Sird)
little.

Large veins

appear on the surface of the body.

The

patient

becomes

irritable, the semen decreases in quantity, making the procreation of a small number of children possible only by him. The voice becomes feeble, the

digestion

is

impaired, and disorders affecting

the

head

22
nose,
ears

THE SUSIIRUTA SAMHITA.


and
All

Chap.

II.

eyes

follow.

croaking

sound

is

heard in the intestines, attended with a rumbling

in the

abdomen.

relish

for

food vanishes and the region

of the heart seems to be

smeared with a kind of sticky


13.

paste (of mucous), etc.

Auhoritativc verse on the subject :

qualified physician should undertake the medical treat-

ment
outer

of

haemorrhoids which occur cither about the

or the middle groove of the rectum, (in as

much

as

they prove amenable to medicine).


ing about the innermost
ring
or

polypus,

appear-

groove of the rectum,

should be treated without holding out any definite hope


of cure to the patient.
14.

Ling'ars'aS
Vayu
etc.,

(Fig warts or condylomatous growths

about the genitals):


finding

The

deranged and aggravated


in

lodgment

the

genitals,

vitiate

the local iiesh and blood, giving rise to an itching sensation in the affected localities.

The

parts

become

ulcerat-

ed (through constant scratching) and the ulcers become

studded with sprout-like vegetations offlesh(warts),which

exude a kind of slimy, bloody discharge. These growths, or excrescences generally appear on the inner margin, or
on the surface of the glans penis,
slender vegetations
of skin,
in

the

form of

soft,

resembling the hairs of a

small brush (Kurchaka).

These vegetations ultimately

tend to destroy the penis and the reproductive faculty


of the patient.

Bhagars'aS : The
body, lodged
to

deranged Vayu

etc.

of the

in the vaginal region of a

woman,

gives rise

similar

crops of soft polypi in the passage.


isolated at the outset,

They

may crop up may assume

and (by coalescing) the shape of a mushroom, or an umbrella,

secreting a flow of slimy, foul-smelling blood.

The deranged Vayu,

etc.

may

further

take

an

Cbap.

II.]

MDANA STHANAM.

^3

upward course, and finding a lodgment In the ears, nose, mouth and eyes may produce similar warts in those Warts, which crop up inside the cavities of localities.
the ears,

may

bring on earache, dumbness, and afoul dis-

charge from those organs, while those (cysts) cropping up


in

the

eyes will obstruct the

movement

of the eye-lids,

giving rise to pain and a local secretion and

ultimately
in the

destroy the eye-sight.


nostrils

Similarly,

such growths

produce catarrh, excessive sneezing, shortness


nasal
as Futinasya.
lips,

of breath, headache,

known

speech and the complaint Such vegetations cropping up in

and about the


mouth, they

palate or the larynx, tend to

make

the

speech confused and indistinct.

When

appearing

in the

impair the faculty of taste, and diseases


the

which
cited

affect

cavity of the n^outh follow.

Vyana Vayu,
a

united with the aggravated

The exKapham,

produces
skin

kind of hard papillomatous growths on the

(about the anus) which are called the Charmakilas

(papillomata).* 15.

Authoritative verses on the subject

These Charmakilas
Kapham
come
the

may

be attended

with a kind of

pricking pain through an excess of the deranged Vdyu,

whereas those which have their origin


(lymphatics) assume

in the

deranged

a knotty shape and be-

same colour as the surrounding skin. On other hand, they become dry, black or white, and
of the

extremely hard through an exuberance of the deranged


local blood

and Fittam.

16.

The symptoms
general

of polypi, appearing in the neighbourin full, while

hood of the anus, have been described


characteristics

the

of

those,

which

are

found to

crop up around the genitals, have been briefly discoursed


*

According
b dy.

to others,

Charmakilas may crop up on the skin of any

part of the

^4
upon.

THE SUSMRUTA SAMHITA.

[Chap.

II.

An
of

intelligent

physician

should

ponder over
in

the two groups of

symptoms while engaged

treating

case

piles.

case of piles exhibiting


is

symptoms
the
piles

peculiar to

the

two deranged Doshas

called

Samsargajam.
arc

Six distinct types of bio-Doshaja


17.

known

in practice.*

Prognosis : A
(with
ed,
its

case of piles

due to the conpartially develop-

certed action of the three deranged


characteristic

Doshas of the body,


Cases, which

symptoms) but

may

be temporarily checked (Yapya).

are of

more than a

year's standing, as well as those in

which the hciemorrhoids are due to the concerted action of the two Doshas (Samsargaja), or are situated in the
middle groove of the rectum,
the greatest
difficulty.

may
of
.

be
the

cured

but with
or

Cases
types

Sannipatika
be given

congenital
incurable.
is

(Sahaja)

should
in a

up as

The Apana Vayu,


is

person whose rectum


tries to pass out

overrun with such polypus growths,


driven back

through the anus, but


obstructed
in
its

upward, being

passage by the vegetations, and then


thus

mixes with
functioned)
*

his
fire

Vyana Vayu,

imparing (the
18-19.
of the

five-

(Pittam) in his body.


one
(2)

Such

as (i) the

due

to

the

concerted action

deranged
derange-

Pittam and Kapham,

the one incidental to the simultaneous

Kapham, (3) the one brought about through the disordered condition of the Vayu and blood, (4) the one due to the combination of the deranged Pittam and Kapham, (5) the one produced
ment
of the

Vayu and

the

by the concerted action of the deranged Pittam and blood,

(6) the

one

which

results

from

the

combined action of the deranged

Kapham

and blood.

Thus ends

the second Chapter of the

Nidanasth^nam
piles.

in

the

Sus'ruta

Samhita which deals with the Nidanam of

CHAPTER
Now we
shall discourse
calculi).
I.

III.

on the

Nidanam

of

As'

mari
The

(urinary

disease admits of being divided into four


the

several

types, such as the Vdtaja, the Pittaja,

Kaphaja and

the Sukraja (Seminal)

concretions.

preponderance of the deranged


stood
as

An exuberance or Kapham should be underall

the
2.

underlying

cause of

invasions of this

disease.

General aBtioIOgy : The Kaphah


who
neglects
of
to cleanse
his

of a

man,

(Samsodhana)
is

the

internal

channels

organism, or

in the habit of

taking

unwholesome food, enraged and aggravated by


exciting
causes,
is

its

own
rise

carried

into the

urinary bladder.

Here
to the

it

becomes saturated with the

urine,

and gives

formation of concretions or gravels

in its cavity. 3,

Premonitory Symptoms: An
in urination,

aching

pain in the bladder, with a non-relish for food, difficulty

an excruciating pain

in the

scrotum, penis,

and the neck of the bladder,


lassitude,

febrile
in

symptoms, physical
the urine are the
in

and a goat-like smell


indicate
the

symptoms, which
the bladder.
4.

formation of gravel

Metrical Text ; The


ed
in a particular case

deranged Doshas involvtheir


specific

respectively impart

and determine the character of the accompanying pain. The urine becomes thick, turbid,
colour to the urine,

and vitiated with the action of the aggravated Doshas, and micturition becomes extremely painful. 5.

Leading Indications : A
ciating pain
is

sort

of excru-

experienced either about the umbilicus,


or at the

or

in

the

bladder,

median rape of the

26

THE SUSHRUTA SAMHITA.

[Chap. III.

perineum, or about the penis, during micturition when


gravel
is

forming

in

the
its

bladder.
out-flow, or

The

urine

is

stopped at intervals in

becomes charged
like

with blood, or flows

out twisted

and scattered
a

spray, leaving a sediment of clear, sandy, red


particles of stone,
colour.
at the

or yellow
in

which resembles
is

Gomedha gem

Moreover a pain

experienced in the bladder

time of running or jumping or in swimming, or


6.

while riding on horseback, or after a long journey.

The ^leshmas'mari: Stone


ginated through the action of
the

or gravel,

ori-

deranged Kapham,

saturated with an excessive quantity of that

Dosha by

the

constant

ingestion

of

phlegm-generating (Sleshlower orifice of

mala) substances, increases

in size at the

the bladder and ultimately obstructs the passage of the


urine.

The

pressure and recoil of that incarcerated fluid


rise to

on the walls of the urinary badder gives


crushing, bursting, pricking pain in

a kind of

that

organ,

which

becomes cold and heavy. A Kapha-origined stone or gravel is white and glossy, attains to a large size, to
that of a hen's egg, and
flower.

has the colour of the

Madhuka

This type

is

called S'leshmas'mari.

7.

The
the

Pittaja

As'mari : The

Kapham

charged (dried) with the deranged Pittam becomes hard

(condensed) and large in the aforesaid way, and lying at

mouth of the bladder obstructs the passage of the The bladder, on account of the flowing back of urine.
obstructed
urine
into
its

the

cavity,

seems as
fire,

if it

has

been exposed to the heat of

an adjacent

boiling

with the energy of an alkaline solution.


sucking, drawing and burning pain
organ.
is

kind of

experienced in the

marked by symptoms which characterise Ushna-v^ta (stricture). The concretion is found to be of a reddish, yellowish
This type of
As'mari
is

further

Chap. III.]

NIDANA STHANAM.
fruit,

2;
or
it

black colour like the stone of the Bhalldtaka


is

coloured
8.

like

honey.

This type

is

called

Pittaja

As'mari.

The Vatas'mari : The


acquires hardness and gains
lying
at the
in

deranged

Kapham

(mucus) inordinately saturated with the bodily Vdyu,


dimensions, and these

mouth of the bladder obstructs the passage of the urine. The incarcerated fluid causes extreme pain in the organ. The patient constantly under severe
pain gnashes his teeth or presses his umbilical region,
or rubs his
penis,

or

fingers

his

rectum
is

(Pdyu) and
experienced

loudly screams.
in

burning sensation
urination, belching

the

penis,

and

and defecation

become
type of

difficult

and painful.*
to

The

concretions in this

As'mari are found

be of a dusky colour,

rough, uneven in shape, hard, facetted and

nodular like
9.

Kadamva

flower. This type

is

called Vdtas'mari.

Infants are

more

susceptible to

an attack of any of

the three preceding types

are fond of

of As'mari, inasmuch as they day sleep or of food composed of both wholeingredients, and are in the habit

some and unwholesome

of eating before the digestion of a

previous meal, or of
In
in

taking heavy, sweet, emollient and demulcent food.


children the bladder
is

of diminished size

and poor
the

muscular structure.
possibility of the

These

facts contribute to

easy

organ being

grappled (with a surgical


extracted
10.

instrument)

and of the stone being

with

the greatest ease in cases of infantile As'mari.

The ^UkraS'mari
abrupt stoppage of a sexual

Sukras'maris
adults

or seminal
to

concretions are usually formed in

owing

the

germination of semen in their organisms.


act,

sudden or
coition

or
its

excessive

tends to dislodge the semen from


* Stool

natural receptacle
straining.

and urine can be voided only with the greatest

2^
in the

THE SUSHRUTA SAMHITA.


body.

[Chap. III.

The

fluid thus dislodged,

but not emitted,


fluid

finds a

wrong passage.

The Vayu

gathers up the
it

(semen), thus led astray, and

deposits

(in a

round or

oval shape) at a place lying about

the junction of the

penis

and the scrotum and dries up the humidity with


it is

which

charged.

The

matter, thus formed, condensed,

and hardened, is called the seminal stone (Sukrds'mari), which then obstructs the passage of the urine, giving
rise

to

pain

in the

bladder,

painful

micturition,

and

swellino;

of the scrotum.
its seat^'.

The stone vanishes under


-12.

pressure in

ii

Authoritative verses on the subject


:

Concretions, sands and sediments found

to be

Bhashma-meha are but the modifications, or attendant symptoms of a case of The same group of stone in the bladder (Asmari). symptoms and the same kind of pain are exhibited and
deposited in the urine in a case of

experienced in a
case

case

of

gravel
in

{S'arkard) as
bladder.

in

of stone (Asmari)

the

The
in

local

Vayu

coursing
of

in

its

natural

direction

helps the disthe

charge

calculi

(Asmari)

with the urine


in

event of they being extremely attenuated


Particles

structure.

of

a stone broken
{S'arkard).

by the Vayu are

called

urinary calculi
recfion,

pain about the cardiac


the thiojhs,

a sense of weakness and lassitude in


in

a griping pain

the

regions of the spleen and liver

(Kukshi-sula), a shivering sensation, thirst, hiccough or


eructations,

darkness

or

sallowness

of

complexion,

weakness, emaciation with a non-relish for food


*

and

We

can not but contemplate with admiration the

fact

that Sushruta

was aware of the formation of seminal or spermatic concretions in the seminal vesicles through degenerative changes of spermatozoa and other
secretions

and

their

subsequent calcification as lately discovered by the

savants of the "Wesi.

Translator

Chap.

III.]

NIDANA STIIANAM.
digestion
in

29

impaired
manifest
obstructed detected
lassitude,

are

the

symptoms

which
channel

are

gravel-patient.

gravel

{S'arkard)
is

at

the

mouth

of

the urinary
:

by the following indications


emaciation, cachectic
the

viz.,

weakness,

condition of the body,


(Kukshi-s'ula),

pain

over

hepatic

region

non-relish for food,

sallowness
thirst,
13.

of complexion, hot and

high coloured urine,

pressing pain at the

cardiac

region and vomiting.

The bladder
rounded on
This organ
its

is

situated

in

the pelvic cavity, surloin (Kati),

different sides

by the back,

umbilicus, scrotum,
is

rectum (Guda), groins and penis.


with a single
aperture
or

provided
with
its

opening and
nets of

lies

mouth downward, covered with


ligaments (Snayu), in the
is

nerves (Sira) and


a
;

shape of
structure
is

gourd.

The organ
its

extremely thin

in
it

and thus situated within the pelvic cavity,

connected, through

mouth

or external orifice, with


It is

the rectum, the penis, and the testes.

also

known
of
vital

by the name of Maladhara (the receptacle of impure


matter) and forms (one of) the primaiy seats

energy (Prana)*.

The urinary ducts


it

(ureters) pass close

by

the

large

intestines (Pakvas'aya)

and

constantly

replenish the bladder and keep

moist with that waste


as
rivers

product of the system

in

the

same manner

carry their contributions of water into the ocean. These passages or ducts (which are two) are found to

take

their

origin

from

hundreds

of

branches (or
visible

mouths tubuli
structures

uriniferi),

which are not

to

the

naked eyes, on account of their extremely attenuated


and carry, whether
the
in a state

of

sleep

or

wakening,
*

urine

from

below the region of the


which means that an injury
fatal result.

The

text

has Prdndyatanam^

to the

urinary bladder

may be attended with

30
stomach-f-

THE SUSHRUTA SAMHITA.


(Amasaya)
into the bladder keeping

t^hap.

III.

it

filled

with this important fluid of the body, just as a newpitcher,


is filled

immersed up to its neck in a vessel full of water, by transudation through its lateral pores. 14. In the same way the Vayu, Kapham and Pittam are
into the bladder (through their
in

carried

respective ducts

or channels), and
rise to the

unison with the retained urine, give


the

formation of stone, on account of


produced.

slimy
in

character of the deposit


the

Stone

is

formed

same way

in the

bladder as sediments are ultimately

deposited from clear and transparent water at the bottom


of a

new

pitcher which

contains

it.

As

the wind

and

lightning jointly

condense

the

rainwater into
(heat) jointly
in the

hailstones, so the bodily

Vayu and Pittam


of the
it

contribute

to

the

condensation

Kapham
its

bladder and

transform

into stone.

The Vayu in the downward direction,


emission of urine
it
;

bladder,

coursing in
full

natural

helps

the

and

complete

while coursing in a contrary direction,


various

gives

rise

to

forms of

maladies such
;

as,

Prameha, strangury, as well as seminal disorders in short, it produces any urinary trouble to which the
bladder
t

may

be subjected.

15.

From

the kidneys.

Thus ends
Samhita which

the

third Chapter of the

Nidana Sthanam

in the

Sushruta

treats of the

Nidanam

of urinary calculi.

CHAPTER

IV.

Now we shall discourse on the Nidatnam of Bhag^ancla.ram (fistula m ano and fistular ulcers), i.
The deranged Vayu,
(a simultaneous

Pittam,

Kaphah and Sannipatah


etc.)

derangement of the three bodily Doshas)


give
rise

and extraneous causes (such as a blow


to the types of

Bhagandaram known
Samvukdvarta
the so

as

Sataponaka,

Ushtragriva,

Parisrdvi,
is

and
that

Unmargi.
it

The

disease

named from

fact

bursts

the rectum, the perineum, the

bladder and

the

place

adjoning to them (thus setting up a mutual communication between them).

The
as

pustules,
in

which appear
their

in this

regions

are

called

Pidakds

unsuppurated
are

stage, while they are called


in

Bhagandaram when they

a stage

of

suppuration.

pain about the sacral

bone and an itching about the anus, accompanied by a


swelling

and burning sensation, are the premonitory


of this disease.
2.

symptoms

The ^ataponakah Type : The


excited, condensed, of

Vayu,

and rendered motionless by a course


gives
rise

unwholesome
or

food,

to

pustule within

one

two

fingers'

length from the

rectum

(anal

region,

Guda), by vitiating the flesh (areolar tissue)


locality).
It

and blood (of the


colour and
is

assumes a vermilion

characterised
If

by a variety of pricking,
its

piercing pain.

neglected at the outset, the pustule runs

into suppuration.

Owing

to

vicinity to the bladder,

the abscess or the suppurated pustule

exudes a kind of

slimy secretion and becomes


of small sieve-like holes,

covered with hundreds

through which a constant frothy

discharge

is

secreted in large quantities.


if it is

The

ulcer, thus

formed, seerns as

being thrashed with a rod, pierced

32

THE SUSHRUTA SAMHITA.

CChap. IV.

with a sharp instrument, cut with a knife, and pricked by


needles.
jets

The

region of the anus cracks and bursts, and


fecal

of urine,

matter,

flatus

(Vata) and semen

are emitted through these sieve-like holes.


of
fistula
is

This type
fistula

called

Sataponakah

(Sieve-like

in ano).

3.

The Ushtra-grivah Type: -The


Pittam, carried

enraged

down by

the

Vayu

(into the rectum) finds


rise to a small, raised,
in

lodgmeit

therein,

and there gives

red pustule, which

resembles the neck of a camel

shape, and

is

characterised
etc.

by a varied kind of pain,

such as sucking

at the beginning, runs into suppuration.

The pustule, not medicinally treated The incidental


being burnt with
fire

ulcer seems as

if it is

or alkali, and

emits a hot, fetid discharge.


fecal matter

Jets of urine, flatus (Vata),


in

and semen flow out of the ulcer


called Ushtragrivah.

the

event of
remedies.

it

not being healed up with

proper medicinal
4.

This type

is

The Parisravi Type: The


carried

enraged Kaphah,

down by

the

Vayu

(into the rectum)

and lodged
pains,
etc.

therein, gives rise to a white, hard, itching pustule in that


locality, characterised
If neglected at the

by a variety of itching
it

outset,

soon

runs

into

suppura-

tion.

The
fluid.

incidental ulcer becomes hard


itching
,

and swollen,
and semen
it

marked by excessive
slimy

and a constant secretion of


in

Jets of urine, fecal matter, flatus

are emitted through the

ulcer

the

event of
is

not

being well cared for at the outset.


Parisravi.
5.

This type

called

The ^amvukavartah Type : The


and Kapham,
size
is

en-

raged Vayu, in conjunction with the aggravated Pittam


carried down, and
finds

lodgment

(in

the region of the rectum), giving rise to a pustule of the


of the
first

toe,

and characterised by a piercing

Chap. IV.]

NIDANA STHANAM.
etc.

33

pain,

and burning, itching sensations


the
outset,

Such a

pustule,

neglected at
incidental

speedily suppurates, and

the

ulcer

exudes secretions of diverse colours,


a
in

characterised
revolves

by

kind
the

of

whirling
of

pain,

which

about,

direction

the

involuted

indentures (within
are

the grooves of the rectum) such as

found

within the body of a river or fresh water

mollusc.

This

is

called

Samvukavartah.

6.

The Unmargi Type : Particles


tonous person,

of

bones,

eaten with (cooked) meat by an imprudent, greedy, glut-

may

be carried

constipated stool by the

down with the hard and Apana Vdyu (into the rectum),
of the anus, or
their
in the

thus scratching or abrading the margin

burrowing into the rectum


evacuated
in

event of

being

improper directions through (transverse or

horizontal postures).

The
as

scratch or abrasion

is

soon
with

transformed into a fetid

and putrid
a
plot

ulcer, infested

worms
will

and

parasites,

of

miry

ground

soon

similar

swarm with a spontaneous germination of These worms and parasites eat away parasites.
of,

the sides
anus,

or largely burrow into, the


fecal matter,

region
flatus

of the

and

jets of urine,

and

(VayuJ

are found

to

gush out of these


is

holes.
7.

This type of

Bhagandaram

called

Unmargi.

Authoritative verses on
ject: A
pustule, appearing about

the subof

the region

the

anus and characterised

by a
is

slight pain

and swelling,
nature
{i.e.,

and spontaneously
from a

subsiding,
of

should be regarded as a
quite
different

simple pustule, which


fistula

in

ano, which has contrary features


to

invariably found

be attended with a violent pain

and

swelling

etc.,

and takes a long time

to

heal).

Fistula-pustule

crops up within a space of two


the

fingers'

width of

Pdyu proper

(distal

end of the
5

34
rectum),
is

THE SUSHRUTA SAMHITA.


sunk
at
its

[Chap. IV.

root,

and attended with pain


itching

and

febrile

symptoms.
after

Pain,

and

burning

sensations are experienced


in a carriage, or

about the anus after a ride

defecation.
in the

The anus becomes


premonitory stages

swollen,
of

and the waist painful Bhagandaram. 89. Prognosis : Almost

all

the
to

types

of

this

disease

(Fistula

in

anoj

yield

medicine
are

after

prolonged course of
except the
incurable.
Thus ends

treatment, and

hard to cure,

Sannipatah
10.

and traumatic ones, which are

ihe fourth

Chapter of the Nidana Sthanam in the Sushrula

Samhila, which treats of the

Nidanam

of Fistula in

ano (Bhagandaram).

CHAPTER
Now we
shall discourse

V.

on the Nidatnam of
i.

Kushof

tham
nial

(cutaneous affections in general),


diet

Improper
improper,

or

conduct; especially ingestion


indigestible,

unwholesome,
;

or

incongeintercourse

food

physical

exercise
of

or

sexual

immediately after partaking


tance, or
after

any

oleaginous subs-

vomiting
the

constant use of milk in comof

bination
or

with

meat
;

any

domestic,

aquatic

amphibious
vomiting

animal
;

exposure to heat
for
etc.

an and repression of any natural urging are the factors which tend to derange

a cold

water bath after

and aggravate the fundamental principle of Vayu in a The enraged or aggravated Vayu, in combinaperson. tion with the agitated Pittam and Kapham, enters into
the
vessels

or

ducts fSira),

which transversely spread

over the surface of the body.


deposits the Pittam

Thus the enraged Vayu

and Kapham on the skin through the


body.

medium

of their

channels and spreads them over the

entire surface of the

The

regions of

the

skin

in

which the aforesaid morbific diatheses are

deposited

become marked with


bific

circular rings or patches.

The mor-

diatheses (Doshas), thus lodged in the skin, continue

to

aggravate, and having

been neglected at the outset,

tend to enter into the deeper tissues and thus contaminate


the fundamental principles (Dhatus) of the body.
2.

Premonitory Symptoms A
:

roughness
in

of the skin,

sudden horripilation, an itching sensation

the surface of the body, excess or absence of perspiration,


anaethesia of the parts, a black colour of the blood,

and

a rapid growth and expansion of

the body) are the


tory stages of

any ulcer (appearing on symptoms which mark the premoniKushtham. 3.

36

THE SUSHRUTA SAMHITA.

tChap. V.

group of Kushtham,

Classification : [Diseases, falling under the may be divided into two broad
and Kshudra
first

subdivisions], viz., Mahdktishthas (major)

{minor) Kushthas, the

consisting of

seven,

and the
Aruna,

second of eleven different types, aggregating eighteen


in
all.

The Mahakushthas

are classified

as,

Audumvara,Rishya-Jihva, Kapala, Kakanaka, Pundarika, and Dadru. The minor or Kshudra-kushthas (Lichen and Dermatitis) are Sthularushkam, Mahakushtham, Ekakushtham, Charmadalam, Visarpah, Parisarpah, Sidhma,
Vicharchika, Kitima,
of

Pama, and Rakasa.

All the types

Kushtham, whether major or minor, involve the action

of the deranged Vdyu, Pittam or

Kapham, and are connected with the presence of parasites in those localities *
The preponderance
of
in

(Dosha)
as
its

any

case of

any particular morbific diathesis Kushtham should be looked upon

originating
is

cause.

The

type,

known

as

Aruna
;

Kushtha,

due to the action of the preponderant Vayu

Audumvara, together with Rishya-Jihva, Kapala and Kakanaka, to a preponderance of the deranged Pittam while Pundarika and Dadru owe their origin to an excess of the deranged Kapham. These types of major or minor Kushthas are successively more extensive in
;

their

action

and more incurable on account of

their

respectively invading a greater

number

of

the

bodily

elements (Dhatus).

6.
owes
its

Mahakushthas :Aruna-kushtha
origin
slightly

to

an exuberance of the deranged Vayu.


thin

It is

vermilion-coloured,

and spreading

in its

* Certain

authorities

hold that,

all

types of

Kushtham (cutaneous
avers that, the

affections) to be of parasitic origin.

The Garuda Puranani

parasites,

which

infest the external principles of the

body, are the primary


shlemshajd

causes

of

cutaneous

Sif^eclionsA'iishtAaika'heiavoniafy'dk

v6hyasambhavdli,

Ch.

CLXIXV.

4.

Chap, v.]

KlDANA STHAKAM.

37

nature.

sort of pricking, piercing pain (is experienced


locality)

in the affected

which
as

loses

all

sensibility
is

to

the touch.

The type known


like

Audumbara
Pittam.

coloured

and shaped

a ripe or

mature

and has
called

its

origin in the

deranged

Audumbara fruit The type

Rishyajihva is rough and resembles the tongue The type of a Rishya (Deer) in shape and colour. known as Kapaila (Macula cserula^) resembles a black
(deep

type

is

The Katkanaka Kharpara ( baked clay ). characterised by a dark red and black colour
blue)

like the seed

of

the Guiija berry.


is

sort

of sucking
affected

and burning
locality in
all

pain

experienced

in

the
of

the four preceding


the

types

the

disease

which are the outcome of

deranged
if

Pittam.

The
fire,

whole diseased surface seems as

burning with

and emitting hot fumes.


origin

They

are

speedy

in

their

and rapidly
soon

suppurate
infested

and break.

All

these

types

become

with parasites.

These
7.

are the general features of these forms of Kushthas.

Pundarika: The
of a
(full

patches resemble the petals


in colour,

blown) lotus

flower

(Ringworm)

assumes

the colour

ffaint

blue)

and Dadru of an

Atasi flower, or of copper.


nature and are found
to

They

are spreading in their

be

overspread

with pustules.
raised, circular,

Both the Dadru and Pundarika types are


time to be fully patent.
teristics of

and characterised by itching and take a considerable These are the general charac8.

Dadru and Pundarika.

Kshudra Kushthas :We


cribe
(the features of the diseases

shall

now

des-

known as) Kshudraknshthas (M. Text): The type known as Sthula'rushka


appears about the joints.
base,
is

It is

extremely thick at
is

its

cured with the greatest difficulty, and

strewn

over with hard pustules (Arungshi).

In the type

known

3^
as of

THE SUSHRUTA SAMHITA.


Mahatkushtham
which

[Chap. V.

the skin contracts, and with the


is felt

bursting of the skin (a piercing pain


ted part),

in the affec-

loses all sensibility to the touch,

accomIn

panied by a general sense of lassitude in the limbs.


the

Ekakushtham

(Ichthyosis) type
It is incurable.

the skin assumes a

reddish black colour.


as

In the form

known

Charmadalam (Hypertrophy
is

of the skin) a burning,

sucking, drawing pain

experienced in the palms of the


of the feet which

hands and

in the

soles

become
disease,
of)

cha-

racterised with
affects
in

an itching sensation.
the
(organic

The
all

which
skin,

succession
flesh,

principles

blood and

and speedily extends

over the body,

like Erysipelas,

and

is

attended with a burning sensation

fVidaha), restlessness, suppuration

and a piercing pain


fits), is

and

loss of consciousness (epileptic

called

Visarpa

Kushtham.
is

The form

in

which a

number

of exuding

pustules gradually extend over the surface


called
is

of the

body

which
called

Parisarpa Kushtham. The type of the disease white and thin, and is characterised by itching
(in the

and does not create any disturbance

patient),
is

is

Sidhma (Maculae
restrict itself

atrophicae). This

form

generally

found to

to

the

upper part of the body.

Vicharchika (Psoriasis) is characterised by excessive pain and itching and gives rise to extremely dry crack-like
marks on the body [hands and
feet].

The same form


itching,

of

malady attended with


Vipatdikat.

pain,

burning and

and

restricting itself solely to the lower extremities, is

called
(a

The type

in

which the eruptions exude


circular,
is

kind of slimy secretion) and which are


excessively itching, glossy

thick,
called

and black-coloured

Kitima (Keloid tumours). Small pustules or pimples secretion and characterised by an itching, burning appearing on the surface of the body are called Fakma The preceding kinds of pimples attended (Eczema).

Chap, v.]

NIDANA STHANAM.
vesicles,

39
are

with burning

are

called

Kachchus and
legs,

found to be chiefly confined to the


buttocks.

hands and
pimples
all

sort

of

dry and

non-exuding

characterised by excessive itching and appearing

over the body,

is

called

Rakasai (dry Erythema). 9-10.

The forms known as Sthularushka, Sidhma, Rakasa, Mah^kushtham and Ekakushtham should be considered Parisarpa-kushas offspring of the deranged Kapham. tham alone is due to the action of the deranged Vayu, while the remaining types (of minor Kushtham) owe
their origin to the action of the

deranged Pittam.

ii.
is

Kilasam

The

disease

known
It

as

Kilasam

but another form of Kushtham.


three types according as
it

may

be divided into

is

brought about through

the action of the deranged

Vayu,

Pittam or Kapham.
is

The
is

difference

between Kilisam and Kushtham


itself

that

the former confines

only to theTvaka (the skin)and


of

marked by the absence

any

secretion.*

case of
is

Kilasam caused by the action of the deranged Vdyu


circular, vermilion-coloured

and rough to the touch. The


off scales of

affected part

when rubbed peals

morbid

skin.

case

of Kilasam, due to the action of the deranged


is

Pittam,

of a lotus flower (in shape

marked by eruptions, resembling the petals and colour), and are attended
sensation.
In

with an

extremely burning

the

type

originated through the action of the deranged


the affected part (skin) assumes

Kapham,

glossy, white colour,

becomes thick and

is

marked by an

itching sensation.

The form
become
*

in

which the eruptions or patches extend and


soles

confluent, invading even the

of the

feet,

case of

Kushtham has
it

its

primary seat

ir\

the blood and skin (of the


of

patient), in

which

lies

confined during the


secretes the
it*

period

incubation,
secretion

after

which

it

attacks the skin and

characteristic

of the

deranged Dosha involved in

40

THE SUSHRUTA SAMHITA.

[Chap. V.

the palms of the hands and the region of the anus, and in

which the

local

regarded as

assume a red colour should be A case of Kilasham, which is incurable.


hairs

the outcome of a burn (cicatrix) should


sidered as incurable.
12.

be likewise con-

A
skin,

preponderance of the deranged


(leprosy)
is

Vayu

in a case of

Kushtham
local

indicated

by a contraction of the
flow of
perspiration,
in the affected part,

anaesthesia, a copious

swelling,

and piercing or cutting pain

together with a

deformity of the limbs and hoarseness.


case

Similarly, an excess of the deranged Pittam in a

of

Kushtham, should be presumed from the suppuration of


the affected part, from the breaking
of the
local

skin,

from the falling

off of the

fingers,

from the sinking of

the nose and ears, from the redness of the eyes and from the germination of parasites in the incidental ulcer.
excessive action of the deranged

An

Kapham,

in

a case of

Kushtham, gives
of the affected

rise to itching, discolouring

and swelling

part which becomes heavy and exudes

the characteristic secretion.

Kakanam, which
the
patient, are

Pundarika and are due to the germinal defect of


types,

The

incurable,

inasmuch as

they involve

(according
three
outset.

to

Dallana)

the

concerted action of the

simultaneously
1

deranged Doshas from the very

Memorial verses :-~As a


course
of time, has driven
its

tree,

full

grown

in the

roots,

which derive their


deeper
disease
so
this

nourishment from the rain water, deeper and


into the successive strata

of the

soil,

(Kushtham),

first

affecting

and confining

itself to

the

upper layers of the skin, will invade the deeper

tissues
until al-

and organs
most
all

etc.

of the patient,

if

unchecked

the fundamental principles or elements

Dhdtus
14.

are attacked

by

its

virus in the course of time.

Chap, v.]

NibANA STHANAM.
of a case of

4t

The symptoms

Kushtham

confined only

to the serous (Tvaka) fluid of the skin are the loss of the

perception of touch, a scanty perspiration, itching and discoloration

and roughness of the affected

part.

The sympis

toms which manifest themselves


fined to the blood are

when

the disease

con-

complete anaesthesia, horripilation,

absence of perspiration, itching and excessive accumulation of pus in the

affected parts.
flesh

The symptoms

of

Kushtham
of

affecting only the

are thickness of the

patches, dryness of the mouth, roughness

and hardness

the

patches which become

covered with pustular

eruptions and vesicles, and an excruciating pricking pain


in,

and numbness

of,

the affected

part.

The symptoms
fat

of

(Kushtham) invading the principle of


and
a breaking of the

only are a
in the

fetid smell

and an excessive accumulation of pus


skin,

affected part

exposing deep

gashing wounds which soon become infested with para-

The body seems as if covered with a plaster. Symptoms of (Kushtham) affecting only the bones and the marrow are a sinking (lit: breaking) of the nose, a
sites.

redness of the eyes, loss of voice and


of parasites in the incidental ulcers.

the

germination
of the

Symptoms

disease restricting itself only to


are a crippled
state

the principle of

semen

of the hands

and distortion of the


spreading of
the pre-

limbs, loss
ulcers

of the
all

power of locomotion,

and

the other

symptoms

peculiar to

ceding types of the disease.

15 20.

child,

which

is

the offspring of the contaminated


its

semen and ovum of


should

parents afflicted with Kushtham,


as

be likewise

regarded
case

Kushthi.

21.

Prognosis: A
in a

of

Kushtham appearing
of his orga-

person

of prudence

and discretion and confined

only to the serum (Tvaka), flesh and blood

nism should be regarded as curable.

palliative treat-

42

THE SUSHRUTA SAMHlTA.


is

[Chap. V.

ment

the

only remedy

in cases

where the disease


fat
;

is

found to invade the principle of

whereas a case

where the poison


up as incurable.

is

found to have penetrated into

any of the remaining organic principles should be given


22,

Wise men hold that, for killing a Brahmana, or a woman, or one of his own relations, for theft, as well as for
doing acts of impiety, a
this foul disease by

man is sometimes cursed with way of divine retribution. The disease


in his

reattacks
his

man even
it.

next rebirth in the event of

Uncured Kushtham (leprosy) is the most painful, and most troublesome of all diseases. 23 24. A Kushthi (leper), getting rid of this foul malady by observing the proper regimen of diet and conduct and by practising expiatory penances and by resorting to
dying with

proper medicinal measures, gets an elevated status after


death.
25.
is

Kushtham (Leprosy)
the

a highly contagious disease

communicated through sexual intercourse with a leper (Kushthi), or by his touch or breath, or through partaking of the same bed, and eating and drinking out of the same vessel with him, or
contagion

being

usually

through using

the

wearing

apparel,

unguents

and
fever,

garlands of flowers previously used by a person afflicted

with this dreadful disease.

Kushtham

(Leprosy),

pulmonaiy consumption, ophthalmia and other Aupasargika disease (incidental to the influences of malignant
planets or due to the
effects

of impious
to another.

deeds) are
26.

communicated from one person


Thus ends
Samhila which
the
fifih

Chipter of the Nidanaslhanam in the Sushruta

treats of the

Nidanam

of cutaneous affections (Kushtham).

CHAPTEE
Now we
It

VI.

shall discourse

on the Nidanam of
i.

Pra-

meha (diseases
may
the
is

of the urinary tracts),

be prognosticated that an

idle

man, who

indulges in day sleep, or follows


in

sedentary pursuits or

habit

of taking

sweet liquids, or cold and


ere long fall

fat-making or emollient food, will


victim to this disease.
:

an easy

2.

Pathology The

bodily principles

of Vdyu,

Pittam and Kaphah of such a person get mixed with


improperly formed chyle of the organism. Thus deranged,
they carry

down through
of the of the bladder,

the

urinary ducts the defind

ranged

fat, etc.*

body and

lodgment

at

the

mouth (neck)
(generic)

whence they are emitted

through the urethra -t",

causing diseases,
3

known by

the

name

of

Prameha.

Premonitory
sensation in the
the
of
feet,

symptoms: -A

burning

palms of the hands and of the soles of


sweetness and whiteness of
thirst,

a skin

heaviness of the body, coldness or sliminess

the

and limbs,

the urine,

somnolence, lassitude,

a bad-smelling

breath, a shortness of breath, slimy

mucous deposit on the


and an
are
4.

tongue, palate, pharyx and teeth, clotted hair


ordinate growth
indications which

in-

of

the

finger

and toe

nails

the

mark the advent

of the disease.

General Characteristics: A
of cloudy

copious flow

or turbid urine characterises all the types of

the disease,

which,

together with the

abscesses

and

eruptions (Pidaka)
*

which mark
in

its

sequel, should be
virus
or

The

particle

"cha"

the

text denotes other

morbific

matter.

Dallana.
therein according to others.

Remain incarcerated

44
regarded as

THE SUSHRUTA SAMHITA.


involving
the

[Chap. VI.

concerted action of the de5.

ranged Doshas (Vayu, Pittam and Kaphah).

The Kaphaja Types

Cases

of Prameha,

which are caused by an exuberance of the deranged Kapham, may be grouped under ten subheads such as,
Udaka-meha, Ikshu-meha, Sura-meJia, Sikata-meha, S'anai-meha, Lavana-meha, Pishta-meha, Scindra-meha, S'uk-

ra-meha and Phena-meha.


curable, inasmuch

The

ten aforesaid

types are

as the medicines

which tend to remedy


the disease,

the deranged

Kapham

(Dosha), the cause of

prove also
(flesh,

remedial to the other principles of the body


etc.)

marrow, blood, semen


6.

deranged (Dushya)
types, which are

from the same causes.

The Pittaja Types The


:

brought about through an exuberance of the deranged


Pittam, are

named
all

as Nila-meha,

Haridrd-meha, Amla-

meha, KsJiara-meha, ManjisJitha-ineha^ and S'onita-meha,


Palliation
is

that

can

be effected

in

these

types,

which tend to correct the deranged Pittam, which has brought on the disease, fail
inasmuch
exert
as the medicines to

similar

virtues
it.

on the organic principles


7.

(Dushyas) deranged by

The Vataja Types : The


which
are

types of

Prameha

produced by an aggravated condition of


are divided into four subgroups, such as

the bodily

Vayu

Sarpi-ineha, Vasd-meha,

Kshoudra-meha and Hasti-ineha.


restore the fleet-coursing,

These should be regarded as most incurable inasmuch as

no kind of medicine can


diving
{ie.

deep

invading the bones and the marrow) Vayu,

which

at the
state

same time
8.

also

augments the Pittam,


in
its

to its

normal

and thus advances (unchecked)

work

of disintegration.

The deranged Kaphah, in conjunction with the (morbid) Pittam, Vayu and fat, gives rise to all Kaphaja

Chap. VI.

NIDANA STHANAM.
The deranged Pittam,
fat
in

45
conjunc-

types

of Prameha.

tion with the deranged Vayu, blood,

and

Kapham,
marrow

produces the Pittaja ones


unison with the deranged

while the deranged Vayu, in


Pittam,
the
fat,

Kapham,

and

Vasa

(myosin), engenders
9.

types of Vataja

Prameha.

Symptoms
the
least

of

Kaphaja
water-like and
of

IVIehas
is

-The

urine* of a person suffering from

an attack of Udakapassed without


the
It

meha becomes white and


pain.

In

case

Ikshumeha
The

urine
the

resembles the expressed juice of sugarcane.


colour of wine
case of
to
in

has

a case of Surameha.
is

urine in a
is

Sikatameha
a

passed

with pain and


fine

found

leave

sediment of extremely
{Sikatas). In
a
case
in

and sand-like
the

concretions
urine gushes

of

Sanaimeha
and
is

out at intervals

jets

charged

with a slimy mucous (kaphah).

The

urine

in a case of

Lavauameha becomes limpid


a saline taste.

(non-viscid) and acquires


at

There
a
case

is

horripilation

the

time of
the

micturition
urine

in

of

Pishtameha

(Chyluria),

resembling a stream of

water, charged

with a

solution of pasted rice

(Pishtam).
urine
of

In
thick

case

of

Sandrameha, the
while
in

becomes
found to
case

and

turbid,

case

Sukrameha
is

the urine

resembles semen (or the


:

urine
In

be

charged with semen

Madhaba).
means
to

of

Tl e

Sanskrit

term

Meha

literally

micturate.

The

verbal

noun Mehanam
urethral
fact

signifies utination as well as the act of passing

any morbid

secretion.
its

Hence

the

urine in most

of these cases denotes the

of

being charged with pus or any other

morbid secretion of the


etc.,

urinary

oigans such as Ojah (albumen), marrow,

which imparts

tluir

characteristic colours to the fluid, clature


of

fact

which determines the nomenits

the

disease

and forms the keynote of

diagnosis

in

the

Ayurveda. Ed.

46

THE SUSHRUTA SAMHITA.

[Chap.

I.

Phenamelia the patient passes frothy urine


jets.

in

broken

lo.

Symptoms of
shall

Pittaja

Mehas : Now

we

describe

the characteristic features

of the types

of Prameha, which are due to the action of the deranged

Pittam.

The

urine

in

case of

frothy, transparent

and

bluish.

Nilameha becomes The urine in a case of


yellow
like

Haridrameha
(Haridra) and

becomes
is

deep

turmeric

passed with a burning pain.

The
and

urine in a case of
smell.

Amlameha
filtered

acquires an acid taste

The
urine

urine in a case of Kshairameha* resembles

an alkaline solution

(through a piece of linen).

The

in

case of

washing of the Manjistha, while


the urine
is

MaDJisthameha resembles the in a case of Raktameha,


^or

found to be of blood-colour
1 1
.

charged with

blood - Madhava).

Symptoms of Vataja-IVIehas
Prameha, which
deranged Vayu.
are
In

: Now we

shall describe the characteristics of the different types of

due
a

to

an

exuberance of the
the

case of Sarpimeha,

urine

looks like a stream of clarified butter, while in

one of

Vasatmeha
of

it

resembles the washings of Vasa.


the

In a case

Kshaudrameha,
a

urine

looks
of

like

honey and

acquires

a sweet taste.

In

one

Hastimsha, the

patient passes

copious

quantity of urine, like an

excited elephant, at a time, and in one unbroken stream,


(the organ

becoming steady immediately


I2.

after

the act

of micturition).

Supervening"
growth of

symptoms

: The
flies,

fact

of

the urine being assailed by a swarm of

lassitude,

flesh (obesity), catarrh, looseness of the limbs, a


a distinct alkaline taste, smell, colour and touch.

* The urine acquires (Madhaba Nidanam).

f Charaka has included

it

within Kshaudra

Meha and Madhu Me

a.

Chap. VI.]

NIDANA STHANAM.

47

non-relish for food, Indigestion, expectoration of mucous,

vomiting, excessive sleep, cough and laboured breathing


(Svasa) are the

supervening

traits

(Upadrava) of the
in

Kaphaja Prameha.
pricking (veda)

piercing

pain

the

testes, a

pain in

the

bladder,

a shooting
heart,
for
is

pain
acid
food,

(Tuda)

in the penis, a griping

pain at the
a

eructations,

fever,

dysentery,
if

non-relish

vomiting, a sensation as
fumes,
epileptic

the entire
in

body

emitting
thirst,

a
fits,

burning

sensation

the

skin,

insomnia, jaundice (Pandu) and a yellow


stool

colour of the

and urine
at
all

are

the

supervening

symptoms which mark the Pittaja types of Prameha.

An

oppressive feeling
for

the

heart (Hridgraha), eager

longings

foods
fits

of

tastes,

insomnia, numbness

of the body,

of shivering, colic pain

and constipation

of the bowels
specifically

are the

supervening symptoms, which


types.

mark the Vataja


the

Thus we
13-16.

have

described

nature

of the twenty

different types of

Meha with
The
cles,

their supervening evils as well.

ten

different types of

pimples, pustules etc.)

Pidaka (abscess, carbunare found to crop up on the

bodies of patients, suffering from Prameha, and abounding


in fat

and Vasa, and whose fundamental principles have


the

been affected by
the

simultaneous

derangement
are

of
as

Vayu, Pittam and Kapham.

They

named

Siravikat, Sarshapika,

Kachchapika;

Jaiini,

Vinat^,

Putrini, Masurika, Alaji, Vids^rika and Vidradhikab. \7

at

IVIctrical Texts the margin and dipped


in its

An
is

abscess

which

is

raised

in its centre, so as to

resemble

an Indian saucer
les or

shape

called Saravik^.

Pimp-

pustules
are

of the shape

and

size of

white mustard

seeds
(the

called

Sarshapikat.

An

abscess, resembling

back

of) a tortoise in
is

shape and

attended with a
wise.

burning sensation,

called

Kachchapika by the

48

THE SUSHRUTA SAMHITA.

[C^i^P-

^^

An

abscess studded with slender vegetations of flesh and


is

attended with an intolerable burning sensation


Jg^lini.

called

large

blue-coloured

abscess

(carbuncle)

appearing on the back or the abdomen, and exuding a


slimy secretion and attended with a deep-seated pain
called
is

Vinatat

thin and extensive abscess (studded


is

withslender pustules D.R.)

called Putrini. Pimples to

the size of lentil seeds are called Masurika.

dreadful

abscess which

is

of a red

and white
is

colour, studded over

with

blisters or

exuding vesicles

called Alaji.

hard
is

and round abscess as large as a


called Vidai'ikat. called

(full-grown) gourd

An
of

abscess of the

Vidradhi type

is

Vidradhika (carbuncle) by the wise.


its

An

incidental

abscess in a case

having
as that

origin in the

Prameha should be regarded as same morbific principle (Dosha)


18-28.

which has produced the disease (Prameha)


:

Prognosis
or at

Pidaka,or an abscess, appearing

about the region of the heart, anus, head, shoulder, back

any of the

vital joints

(Marma)

of the body, and

attended with other supervening symptoms producing

extreme
a
all

prostration

[impaired

digestion
as

D."

R.]

in

the patient
case
the

should

be

abandoned

incurable.

In

of Vataja

meha, the deranged Vayu presses


of the

fundamental principles out of the body through

the urethra and rages rampant in the lower part

body, united with the deranged

fat,

Hence a
abscess),

case
is

of

Vataja meha, (or


29-30.

marrow and Vasa. its accompanying

held as incurable.

A person in whom the premonitory symptoms (Purvarupam of Prameha) have appeared and who passes
a
little

larger quantity of urine


as
all

than

usual,
it.

should

be

considered
afflicted

already

afflicted

with

person

with

of the

disease

or half of the premonitory symptoms and passing a copious quantity of urine

Chap. VI.

NIDANA STHANAM.
as

49

should be considered

one suffering from an attack


with deep-seated absces-

ofPrameha.

31

32.
afflicted

A
ses

Prameha patient

and other distressing symptoms, which are usually

found to supervene in the disease, should be pronounced as suffering from

Madhumeha and adjudged


sit

incurable.

Madhumeha

patient seeks a halting place while walk-

ing,

wants a place to

on while halting,
if

lies

down
33

if

he
34.

finds a sitting place,

and sleeps

he

lies

down.

As
(bluish

five

mixed

colours such as grey, brown, Kapila

yellow),

Kapota
in

(blackish

grey),

Mechaka
(such as

(light-green)
five

may

be produced by combination of the


definite proportions

primary colours
green,

white,

black, yellow

and

red), so

a diversity of

causes, through the relative

preponderance of the partiof the

cular

kinds of food, and of the deranged Doshas, root


(Dhatu) and excretions

principles

body (Mala),
35.

may be attributed to the origin of Prameha. IVIemorial verses : All types


not properly
treated

of Prameha,
the outset,

and attended to
into

at

may
types,

ultimately

develop

those

of

Madhumeha
:

which are incurable.


(Acute Infective)

36

For English equivalents of the


Cystitis

of urine

Prameha compare Frequent, painful micturition, small quantity voided with pain and urgency. Urine slightly acid or alkaline
different types of
in

reaction, cloudy, containing blood corpuscles.

Cystitis (Chronic Infective)


rigor.

Great and
offensive
Infective)

frequent pain, in the

lumbar region,

Urine

thick,
Urinein

and alkaline, containing ropy mucous and blood. Cystitis (Non-

Symptoms like
cloudy
with

those of

acute

inflammatory type.
is

acid

and

mucous.

Blood

generally

present

considerable quantity.

Neuralgia of the bladder, compare


Hoematuria,

Albuminuria,
Pyuria,

Albumosuria,

Hoemoglobinuria,

Peptonuria,

Spermatorrhoea and Diabetes, Proteuria and Polyuria.

Thus ends the

sixth

Chapter of the Nidana Sthanam

in the

Sushruta

Samhit^, which treats of the

Nidanam

of Prameha.

QS

CHAPTER
Now we
shall discourse

YII.

on the Nidainam of
royal

Udara
i.

(dropsy with an abnormal condition of the abdomen),

Metrical Text : The


tari,

sage Dhanvan-

the

foremost

of

all

pious
of

men
the

who
of

equalled
thus
to

in

splendour and glory the lord

celestials,

blissfully discoursed

on

the

Niddnam
2.

Udara

Susruta, the son of the holy

Vis'vamitra,

who devoutly
divided

approached him for that purpose.

Classification

This disease may be

into eight different types, of

which four are produced

by the several actions of the three deranged Doshas of Of the rethe body and their concerted action as well. types, two being known as Plihodara (including maining
Yakritodara), and Vaddha-Gudodara (tympanites due to
the
constriction
or

of the

anus),

the

seventh Agantuka

(traumatic

of

extraneous
proper).
3.

origin),

and the eighth


deranged

Dakodara (Ascites

Predisposing
addicted
of
to

Causes : The
of taking
food,

Doshas of a person of extremely impaired digestion,


the

habit
putrid

unwholesome

food, or

eating

dry,

or of violating the rules of

conduct to be observed in connection with oleaginous

measures

etc.,*

are aggravated

and

find

lodgment

in the

abdomen.
nal

Thus appearing
all its

in the

shape of an abdomi-

tumour (Gulma), they give

rise to this dreadful disease,

attended with

characteristic

symptoms. The lymph


food getj
it

chyle formed out of the assimilated

vitiated,

and, impelled
*

by the aggravated Vdyu,


erpitic,

percolates

These include purgative,

A'stha'panam and Anuva'sapann

p(iej^su|re,

thp. VII.]

NIDANA STHANAM.
in the

Jt

through the peritoneum


of oil or clarified butter

kept

in.

same manner as a quantity a new, earthen pot will


its sides.

transude through the pores of


distends the skin (Tvak)

It

thus gradually

of the

abdomen.
in

The

process

becomes general

all

through the abdominal


is

region and

the disease (Udara)

produced

consequence. 4

Premonitory sypmtoms : The

5.

precursory

symptoms of the disease and appetite, emaciation


appearance of veins on
closely

are loss of strength, complexion

of the muscles of the

abdomen,
pain

its

surface, acid reaction of food


its

following

upon

digestion

(Viddha\

in the bladder,

and swelling of the lower extremities.


whether
his

The

patient cannot ascertain


6.

meal has been

digested or not.

The Vataja, Pittaja, and Kaphaja Types A case of Udara in which the abdomen en:

larges

on

its

sides

and

posterior

part,

and

is

over-

spread with nets of black veins should be ascribed to the


action of the deranged Vdyu.
of the stool

A pain (Sula),

suppression

and urine (Andha) and a cutting and piercing


this Va'taja

pain and flatulent rumbling in the intestines are the symp-

toms which likewise characterise


Udara.

form of

A sucking pain

in the

abdomen, thirst, fever with


of which yellow
nails,

a burning sensation, yellow colour of the swollen skin of


the

abdomen, on the surface


colour of the

veins

appear, yellow
urine

eyes,

face, stool

and

and the rapid increase of the dropsical


of the Pittaja Udara.
is

swelling, are

the

characteristics

In a case of

Kaphaja type the dropsical swelling


and

cold to the touch

becomes

overspread
,

with

white-coloured, veins.

The abdomen seems heavy hard, glossy and is extremely distended. The swelling slowly increases, and the fingernails and face of the patient become white, and he
complains of a general
lassitude. 7

9.

52

THE SUSHRDTA SAMHITA.

tChap. VIl.

The TridOShaja Type : Evil-natured


men
or lovers sometimes)

wo-

(with a view to win the affections of their husbands

mix with

their food

and drink such


urine,

refuse matters of their bodies as nails, hair, faeces,

catamenial blood

etc.

(which are supposed to be possessed

of talismanic virtues).

The

three

Doshas

of the body, vitia-

ted by such food or drink, or through imbibing

any sort of

chemical poison (Gara) administered by one's enemy, or

by taking poisonous waters, or Dushi-Visha (slow poison whose active properties have been destroyed by fire or
any antipoisonous medicine),
give
rise to

will vitiate the blood

and

a kind of dreadful dropsical swelling


specific

of the

abdomen, marked by the


of

them

The

disease

is

symptoms of each aggravated in cold and cloudy


is

days and a burning sensation


the

felt

(in

the

inside

of

abdomen\

The
is

patient becomes pale, yellow and

emaciated, and

afflicted

with thirst and dryness


at short intervals.

in the

mouth, and loses consciousness


disease
is

This
lo.

also

known

as the dreadful

Dushyodaram.

Plihodaram. (Spleen
men)
:

with dropsy of the abdo-

-Now hear me describe the


is

symptoms of Plihoof a person, derang-

daram. The blood and the

Kapham

ed and aggravated through the ingestion


gogic food, or of those which

of

phlegma-

followed by an acid

digestionary reaction (Viddha), often enlarge the spleen,

(which gives
disease
is

rise to

a swelling of the abdomen).

This

called

Plihodara by the experts.


its

Plihodaram
characteristic

protrudes on theleft sideof the abdomen,

symptoms being

lassitude,

low

fever,

impaired digestion,
distress-

loss of strength, jaundice,

weakness, and other

ing symptoms peculiar to the deranged Pittam and Kapham. A similar enlargement of the liver through similar causes on the right side of the abdomen is
called Jakriddfitly udarani.
1 1

1 2.

Chap. Vll.]

NIDANA

SfHAJSTAM.

^3
fecal matter,
etc.

Vaddha-gUdOdaram* : The
body,
lies

mixed with the deranged Vayu, Pittam


stuffed
in

of the
in-

the

rectum of a person whose

testines have been stuffed with slimy food

(as pot herbs)

or with stones

and hair

(enteritis).

They

give

rise

to

a sort of abdominal dropsy by swelling the part between the heart

and the umbilicus which is called Vaddha Gudodaram. Scanty stools are evacuated with the great-

est pain

and

difficulty

and the patient vomits a pefecal

culiar

kind of matter with a distinctly


?).

smell

(scyabalous

13.
:

Parisravi-Udaram Now
the causes
is

hear

and symptoms of the type of

me describe Udaram which


down with
intes-

called

Parisratvi-udaram.
(such

Thorny
etc.),

or sharp-pointed

substances

as

fish-bones

carried

the food in a slanting

way from

the

stomach into the

abdomen, sometimes scratch or burrow into the


tines.

Causes other than the preceding ones, (such as

a long

yawn

or over-eating

etc.)

may

contribute

to the

perforation

of the intestines, giving rise to

a copious

flow of a watery exudation


of the anus

which constantly oozes out


umbilicus.

and

to a distension of the lower part of the


,

abdomen

situated below the


is

This

is

called

Parisravy udaram which


a burning sensation.
14.
:

marked by a cutting pain and


hear

Dakodaram Now
causes and

me

describe

the

symptoms of the type known as Dakodaram (ascites). The drinking of cold water immediately after the application of an Aunvdsanam or Asthapanam enema, or closely following upon the exhibition of any
purgative or emetic medicine, or just after the taking
a

of

medicated

oil

or clarified butter,

etc.

tends to derange
to the

* Dropsical swelling of the


triction of the

abdomen with tympanites due


intestinal obstruction.

cons-

rectum known as

54

THE SUSHRUTA SAMHITA.

'

[Chap. VII.

the water-carrying channels of the body.

The same
etc. in

result

may

be produced by the drinkmg of

oil,

inordi-

nate quantities

The

water,

by percolating or transudchannels, as
before
des-

ing through the walls of these


cribed,

inordinately

enlarges

the abdomen, which


is

be-

comes glossy on the surface and


bloated

full

of water,
like

being
a
fullit

rounded about the umbilicus and raised


water-drum.

The

simile

is

complete as

fluctuates under pressure, oscillates,


liar

and makes a pecu15.

sound

like a

water-drum under percussion.

Distension of the stomach, incapacity of locomotion,

weakness,

impaired digestion, cedematous swelling of


looseness
in

the limbs, a general sense of lassitude and

the limbs, suppression of flatus and stool,

and a burning

sensation

and

thirst are
its

among

the general characteris16.

tics of the disease in

various forms.
cases of

Prognosis

All

Udaram

after

the

lapse of considerable time develop into those of

ascites,

and a case arriving at such a stage should be given up as


incurable.

16

17.

Thus ends

the seventh Chapter of the


treats of the

Nidana Slhanam
Udaram.

in the Sub'ruta

Samhita which

Nidanam

of

CHAPTER Vm.
Now we shall discourse on the Nidanam of IVlUClhagarbham (false presentations and difficult
labour),
i.
:

Causes of lYIudha-garbham
intercourse during pregnancy, riding on

-Sexual
etc.,

horseback,

or in
fall,

any

sort of conveyance, a long walk, a false step, a

pressure on the

lying

womb, running, a blow, sitting or down on an uneven ground, or in an uneven


fasting,

posture,

voluntary

repression

of

any

natural
bitter,

urging

of

the body,

partaking of extremely

pungent, parchifying
tities

articles,

eating in inordinate quansubstances,

of

Sakas

and alkaline

dysentery
in

(Atisdra),

use of emetics or purgatives,

swinging

swing or hammock, indigestion, and use of medicines which induce the labour pain or bring about abortions,

and such
fixture.

like causes tend to expel the faetus from its These causes tend to sever the child from the uterine wall with its placental attachment owing to a

kind of Abhighatam (uterine contraction) just as a blow


tends to sever a fruit from
its

pedicel.

2.

Definition: The
dislodged from
the
uterus,
its

faetus,

thus

severed

and

seat, excites

peristalsis

not only in

but

induces

sort

of constant, spasmodic

contraction

of the intestinal

cavities (Koshthas), pro-

ducing pain
thus

in the liver, spleen, etc.

The Apana Vayu,

obstructed

through

the

spasmodic contraction
pain
in

of her abdomen, produces

any of the following sympin

toms,
in

viz.

a sort of spasmodic

the sides,

or

the

neck of the bladder, or

the or

pelvic cavity,

or

in the

abdomen, or

in the vagina,

Andha (tympof urine,

anites

with

obstruction,

etc,)

or

retention

^6

THE SUSHRUTA SAMHITA.


the faetus,
case
in
if

tChap. VIII.

and destroys
bleeding.

immature, attended with


continues
to

In

the

faetus

develop

and
to

is

brought
vaginal
the

an inverted posture at the entrance

the
if

canal,

and

is

impacted

at that

place,

or

Apana Vdyu
faetus
is

gets

disordered
of the

and consesame,
3.

quently cannot help the expulsion

such

an obstructed

called

Mudhagarbhah.

of

Classification Mudha-garbha may

and Symptoms: -Cases


be roughly divided
Kilah,
the
into

four

different classes such as, the

Pratikhurah,
sort

the

Vijakah and the Parighah.


in

The
its

of false
its

presentation

which the

child

comes with

hands,

legs and head turned upward and with

back firmly

obstructed
or a kila,
is

at

the

entrance to the vagina, like a stake

called Kilah.

The
and

sort of presentation,

in

which the
out,

hands,
its

feet

head of the child come


at

with
is

body impacted

the

entrance to the
in

vagina,

called

Prathikhurah. The type

which only

hand and the head of the child come out (with the rest of its body obstructed at the same The type in which the place), is called the Vijakah.
a single
child

remains obstructing the head of the passage in


is

a horizontal position, like a bolt,


Certain
authorities

called the

Parighah.
to

aver that, these are the only four

kinds of Mudhagarbha.

But we can not subscribe

the opinion (which recognises only four kinds


presentations),

of false

inasmuch as the deranged Vayu (Apana)


fsetus

can present the


at

in

various

different

postures

the

head of the vaginal canal.


first

Sometimes, the two


it

thighs of the child are

presented, and sometimes


flexed
up.

comes with a single


child

leg

Sometimes the

comes
up, so

with

its

body, bent double, and thighs


breech
is

drawn

that only
child
is

obliquely presented.

Sometimes the

presepted, impacted at the head

Chap. VIII.]

NIDANA STHANAM.
its chest,

57

of the

passage with
is

or sides, or back.
its

Someits

times the child


resting

presented with
the

arm around

head,
first.

on the side, and

hand coming out

Sometimes only the two hands are first presented, the head leaning on one side; sometimes the two hands, legs
and the head of the
impacted
at
child, the rest

of the

the
is

exit in a doubled up posture.

body being Some-

times one leg


at

presented, the other thigh being impacted


I

the

passage (Payu).
sorts

have briefly described these


of

eight

of

presentation

which

the last two

are

irremediable.
if

The

rest

should

be given up as

hopeless
cations

these are attended with the following compli-

viz.,

deranged sense-perception of the mother,


of the
repro-

convulsions, displacement or contraction

ductive organ (yoni) a peculiar pain like the after-pain of


child birth, cough, difficult respiration, or vertigo. 4.

lYIemorial verses : As
is

fruit, fully

matured,
to

naturally

severed from

its

pedicel and

falls

the

ground and
the
foetus

not otherwise,
to
its

so

the cord, which binds


is

maternal part,

severed in

course
(

of time^
this

and the child comes out of the uterus


).

into

world of action

On

the

other hand, as a

fruit,

worm-eaten or shaken by the wind or a blow, untimely


falls to

the ground, so will a foetus be expelled out of

its

mother's

womb,

before

its

time.

For four months


remains
or
in

after the date

of fecundation, the

faetus

liquid

state,

and hence

its

destruction

coming
In the

out of the

womb
fifth

goes by the

name

of abortion.

course of the

gain in
at

and sixth months the limbs of the foetus firmness and density, and hence, its coming out
is

such a time

called miscarriage.
;

5-7.

Prognosis
her

The enceinte who violently


(at

tosses

head

in

agony

the time

of parturition)

and

the surface

of

whose body becomes

cold, compelling

58

THE SUSHRUTA SAMHITA.


forego
all

[Chap.

VIH.

her to

natural

modesty,

and whose sides


of large

and

abdomen
veins,

are

covered

with nets
dies

blue-

coloured

invariably

with

the

dead child
in the

locked in her

womb.

The death
or of

of the

foetus

womb may

be ascertained by the absence of movements

of the foetus (in the

womb)

any pain of

child-birth,

by a brown or yellow complexion of the enceinta, cadeverous smell in her breath, and colic pain in the abdomen

and

its

distension owing to the continuance of the swollen

and decomposed

child in the womb. 8-9. The death of a child in the womb may result from some emotional disturbance of its mother, (such as caused by bereavement or by loss of fortune during

pregnancy)

while an

external blow

or

injury

(to the

womb)

or

any serious disease of the mother may


like result.

also

produce the

child,

moving

in the

womb

of a dead mother,
etc.)

who had just expired (from

convulsions

during parturition at term, like a goat (Vastamara)

should be removed immediately by the Surgeon from the

womb

(by Caesarean Section)

;*

as a delay

in extract-

ing the child


*

may

leads to

its

death,

io-:i.

Csecsarean Section means incision of the uterus through the abdomi-

nal walls and extrication of the foetus therefrom.

Operation like this upon

a dead subject requires no


the

skill

of a

surgeon.

Any one can do


modern
times,
foetus

it

without
the

help of any
life is

anatomical

knowledge.

In

when

mother's

in peril,

and the expulsion of the

becomes nearly

impossible,

by the natural passage,


canal or in the

owing

to

an existenee of deformity
of the foetus,

either in the parturient


to save both

forms and structures

mother and child

this operation is principally

undertaken.

The evidence
in passages like

of similar attempts,
just

in

ancient India,

is

found

recorded

what we have
subjects,

translated
is

and that the operation was


it.

practised on living

there

not the least doubt about


it is

This

custom

is still

preserved in Central Africa, and

possible that the

Egyp-

tians like

Hindu philosophy and

religion learnt this also


p.

from the Hindus.

"Felkin," says "Baas in his History of Medicine

70 "saw a case of the

Csesarean operation in Central Africa performed by a man.

At one stroke

Chap. VlII.]

NIDANA STHANAM.
bladder
is

^9
the dead
child
lies

Additional Text : The


like a

is

ruptured,

weight upon the placenta and

pressed upward on the spleen, liver


is

and

gall bladder.

The mother
in

shivers and

oppressed with tremor,

dryness of the
a

tongue,
smell

dyspnoea

and perspiration.
in

She complains of
danger of imminent
the death of the

cadaverous

her breath and stands


a

death.
child
in

By

these

symptoms

physician
is

shall

know

the

womb.

This portion

partly

recognised by Brahmadeva

and

is

totally rejected

by Jejjadacharya as spurious.

an incision was made through both the abdominal walls and the uterus.

The opening
tant

in

the

latter

organ

was then enlarged, the hemorrhage

checked by the actual cautery,

and the child removed.

While an

assis-

compressed the abdomen, the operator then removed the placenta.


bleeding from the abdominal walls

The

was then checked.

No

sutures

were placed on the walls of the uterus but the abdominal parietes were
fastened together by seven figure-of-eight
iron needles
sutures,

formed with polished


dressed with a

and threads of bark.


from various
roots,

The wound was then


the

paste prepared

woman

placed quietly upon her

abdomen,

in order to favour
finished.

perfect drainage,
It

and the task of the African


first

Spencer "Wells was


half unconscious
patient

appears that the patient was

rendered

with banana wine.


well.

One hour

after the operation the

was doing

And

her temperature never


the eleventh day the

rose above loi F.

nor her pulse above 108.


healed, and the

On

wound was completely


reminded of the opera-

woman
this

apparently as well as usual."

W^hen we read

evidence of Felkin, we are


our

tive steps as described in

own
to

ancient book of Surgery from which

modern surgeons have been able


It is

borrow the operation of rhinoplasty.


the

a great pity

that while

in Africa

same practice

is still

retained

intact,

we

in India

by spurious attempts and disgraceful contortions, subsand dismal knowledge of grammar and rhetoric

titutions of false readings


try to

prove in the face of strong evidence that in ancient India Coesarean

Section was attempted only on cases where one "might not perspire."
If

we

take f%qfligi: in the sense of "a

danger" and not exactly in the sense of "a

woman whose life is in great woman who is dead" as recom-

mended by Dalian
meaning
if

instead of ^^^f^ a

and Arundutta (and which might have been the word like o^iq^ had been used in the text),
in

we
p.
is

find at

once that Weber's remark

his History of Indian Literature

270

*'that in

Surgery they

(the

Hindus) attained to high proficiency"

not based on the solitary evidence of rhinoplasty alone.

In performing obstetric operations with success examples like this are


not rare.
If the

two

different readings

2f^?Ti'i; ^"^l

^f%^i^ be taken conidea


that in ancient

jointly into consideration

we

are impressed

with

the

6o

THE SUSHRUTA SAMHITA.

tChap. VIlI.

India Csesarean operations were very frequently undertaken in cases of


puerperal eclampsia, where the mother had been in the deplorable condition of a goat suffering

from cramps and convulsions as well as in cases

of an accidental

death not unlike that


in

which

fell to
is

the lot of the poor

mother

of

him

whose name the operation

called.

^g = goat

aii?[

destroyer (See Monier William's Dictionary) hence a goat-destroyer = a


tiger or wolf) or in cases

where the presence of deformity


foetus

in the parturient

canal or of malformation of the


living
child.

prevented the natural delivery of a

The

incision

is

not

to

be made anywhere

else but exactly

in the place
knife,

where Felkin saw the


selection
of ^f^' %\\,^

illiterate

Negro

successfully apply his

the

as

suggested by some commentators

being a tempest on a tea pot especially


grave.
is

when

the

subject
site for

is

beyond the

In a living subject the selection of a

proper

the operation

of course

very

commendable.

Hence we

venture to suggest that

extraction of the living foetus from the


this part of the pelvis

womb

by making incision through

was also attempted

later on.
to

We

extract here the

two

different readings

and leave our readers


inferences.

judge whether we are

correct to

draw the above

Ed.
ch. II. slo. 53.

f^^TJ

Bdgabhata S'arira Sihanam.

Thus ends the eighth Chapter


tions.

of the

Nidana Sthanam
labour and

in

the Sus'ruta
presenta-

Samhita, which treats of Nidanam of

difficult

false

CHAPTER
Now we
shall

IX.
on
the

discourse
etc.)I.

Niddnam

of

Vidradhi
The

(abscess

blessed Dhanvantari, the honoured of the

gods,
of the

who

for the

promulgation
for

of the

knowledge
proper

Ayurveda

and

administering

medicines

(to the sick),

took his birth at Kdsi, (Benares) as a

king, thus fully discoursed on the

symptoms
2.

of Vidradhi

(abscess etc.) to his disciple, Sus'ruta.

Definition
extremely

and classification : The


and
aggravated
to

deranged

Vayu,

Pittam
vitiating

Kapham, resorting the Tvaka ( skin ), blood, (with their own specific
and
rise

the bone

and

flesh,

and
round

fat of

a person

properties),

gradually give
or

to

deep-seated,
is

painful,

extended
wise.

swelling which

called

Vidradhi by the

The

disease admits of being divided into six

types

such as

the
the

Vataja type, the Pittaja type, the Kaphaja type,

Sdnnipatika type, the Kshataja type (traumatic),


its

and the Asrija (which has

seat in the vitiated

blood).
3-4.

Now we

shall describe their specific


:

symptoms.
abscess

The Vataja Type


black or vermilion colour,
is

This

assumes a

is felt

rough to the touch and

characterised

by a

sort of excruciating pain.

The

growth and suppuration of the abscess


about
in

are

brought

a variety of

forms

(owing to the variable


in

and irregular action of the deranged Vayu inolved


these cases).
5.

The Pittaja Type : This


vara
fruit.

abscess assumes a

blackish yellow colour or one like that of a ripe


It is
is

Audum6.

attended with fever and


of rapid

a burning

sensation, and

growth and suppuration.

62

NIDANA STHANAM.

Chap. IX.

The Kaphaja Type: This


like

abscess

is

shaped

an Indian saucer (s'arava) and seems cold to the touch. It assumes a light yellow colour and is characterised

by numbness, itching and

little
is

pain.

and suppuration of

this abscess

The growth very slow. The


thin,

secretions from a Vataja

abscess

are

those from

a Pittaja type are yellow, while the exudations from a

Kaphaja abscess are white.


the Sannipatika type

J.

The Sannipatika Type: An


is

abscess
is

of

of varied colour, and

attended

with a varied sort


etc.)

of pain (sucking,

drawing, turning

and exudes secretions of various colours (white,


etc.).

yellow,
large

It is

little

raised

or

elevated at

its

top,

and irregular
or

in its

shape and does not uniformly


8.

suppurate in

all its parts.

Agantuja
or

Kshataja Type
ulcer,

:-~The

local

inherent

heat

of an

(caused by a blow or a
is

dirt) in a person, addicted to

unwholesome regimen,
rise to

augmented and conducted by the deranged V^yu and


vitiates the

blood and Pittam, thus giving


is

a kind

of abscess which

(traumatic abscess).
wise

known as Symptoms
it

the

Agantuja Vidradhi

of the Pittaja type likefever,


thirst

mark

this type of abscess

and

and a
9.

burning sensation attend

from the very beginning.

The Raktaja Type: This


a black or

abscess assumes

tawny

colour, covered with a large

number

of black vesicles, and

fever

and an intolerable burning


the

and pain attended with


the Pittaja type,
It
is

all

symptoms

peculiar tOj

mark

the present form of

the disease.

called Raktaja Vidradhi.

Of

external Vidradhis

or abscesses, those

of the Sannipatika type should

be

regarded as incurable.

10

11.

Antara-Vidradhi : Now

we

shall describe

the characteristic features of internal abscesses

(Antara-

[Chap. IX.

THE SUSHRUTA SAMHITA


The Vdyu, Pittam and Kaphah
eating

6$

VidradhI).

of the body,

deranged through
of food

heavy,

incompatible and in-

congenial (to the physical


articles

or of dry,

temperament of the eater) putrid and decomposed sub-

stances, or

exercise,

by excessive coition and fatiguing physical or by voluntary repression of any natural

urging of the body or through the eating of food which


is

followed

by an acid

reaction,

either

severally

or

collectively give rise

to a tumour-like (Gulma), raised,

or elevated abscess in the interior of the organism, which


is

often felt to be shaped like an ant-hill.

12-13.

Localities
seated at the
umbilicus, or in
regions), or
heart,

: They mouth (neck)

are

generally found

to be

of the bladder, or about the

the

sides,

or in the

Kukshi (inguinal
liver,

on the Vrikkas, or on the

or in
in

the

or

on the Kloma, or on the spleen, or


several

the

rectum.

Their general characteristics are identical with


types
of

those

of the

external abscess.

The

symptoms

of their

suppurated or unsuppurated stages


in the

should be determined

light

of the chapter on

Amapakvaishanyiam (Ch XVII

Sutra.). 14-15.
:

Their specific
me
ent
in

symptoms -Now
specifically

hear
these

describe the

symptoms which
organism.
is

mark

internal abscesses according


j

to their

seats in the differ-

regions
the

of the

An

abscess appearing

rectum (Guda)
(

marked by the suppression


it

of the flatus
to

Vata).

Seated in the bladder,

gives rise

difficulty

of urination

and scantiness
it

of

urine.

Appearing about the umbilicus


tines.

produces a distressing
(Atopa)
in the intesit

hic-cough and a rumbling sound

Seated

in either of the sides

(Kukshi)

tends to

aggravate
ing
in the

inordinately the vayu of the body.

Appearextreme

inguinal region

it

gives rise

to an

catching pain at the

back and waiyt.

Sea^ted in either

64
of the

NIDANA STHANAM

[Chap. IX.

Vrikkas it brings about a contraction of the sides. Appearing on the spleen, it produces symptoms of
and obstructed respiration.
to an excruciating

difficult
it

gives rise

Seated on the heart and piercing pain within


all

its

cavity and a drawing pain (Graha) extending

over
its

the

body (D. R.

cough).

Seated in the Liver


are
thirst

characteristic

indications

and

difficult

breathing (D. R.
chable thirst
the
is

hic-cough) whereas a sort of


the

unquenseat on

symptom which marks


abscess

its

Kloma.
part

16-17.
:

Prognosis
vital

An

appearing

on

any
be

(Marma)

of the

organism, whether large

or small in size, suppurated or unsuppurated, should

deemed

as

extremely hard to cure.

Discharge from an

abscess formed in the region of the organism above the

umbilicus and (spontaneously bursting), will

flow out

through the mouth whereas similar secretions from down


the umbilical

region

of (the abdomen), naturally find


fissure of

an outlet
in

through the
the

the anus.
etc.)

The
a

case

which

secretions

(pus

find

down-

ward channel and outlet may end in recovery of the patient; whereas the one in which the secretions take an
upward course
invariably
the

proves

fatal.

An
an

incision
internal

made by surgeon from

outside

into

abscess, other than the one

situated on the heart, or on

the bladder or on the umbilicus


successful, but the one, seated

may

occasionally, prove

on any of the preceding


etc.)

vulnerable visceras (heart, bladder

of the

body and

surgically opened invariably ends in death.

18-19.

woman, who has miscarried


the

or has

been even

safely delivered of a child at term,

may

be afflicted with
injudi-

a dreadful abscess in
cious

event of her taking

and unhwholesome food after parturition. The" ?ibscess in such a case, which is attended with extreme

Chap. IX.]

NIDANA STHANAM.
(Ddhajvara)
origin to
,

65
considered
as;

hyper-pyrexia

should

be

having had

its

the

vitiated

blood (Raktaja

Vidradhi) accumuVated in

the

organism.

The

abscess,,

which appears
a safely

Kukshi (in the iliac region) of delivered woman owing to the presence of the
in

the

unexpelled
birth,

blood-clots

in

those
as

regions
a
is

after

child-

should be also diagnosed

case
called

of Raktaja

abscess.

The unexpelled
if

blood

Makkalla*

Such an abscess,
is

not absorbed

in the

course of a week,

sure to suppurate.

20

21.

Differentiating diagnosis of

Gulma
how
is

and Vidradhi* : Now


Vidradhi (internal abscess).
it

shall discuss the featuresi

which distinguish a Gulma (internal tumour) from a


It

may

be asked,

that

Gulma, (internal tumour)

though caused by,

and involving the co-operation of the same deranged

Doshas

as an internal abscess, does nut suppurate, while


?

the latter (Vidradhi) does run to suppuration

2223.. though

The answer
(internal

is

that a

Gulma

(internal tumour),

caused by the same deranged Doshas


abscess),

as

a Vidradhi

does

not resort to any deranged


blood,
etc.,

organic matter, such as flesh,

while, on the

contrary, in a case of Vidradhi,

the diseased" flesh and

blood
an

of a

locality are in

themselves transformed into

abscess.

An

internal

water bubble floating


*

tumour (Gulma) is like a and moving about within a cavity


does
in

Gulma according
where
it

to Sus'ruta

not suppurate, but the term


Giil

*'Api" (also)
as
in the case

contemplates instances
has got

which a
the-

ma

rinay

suppurate

its basis in

deranged

flesK eVcr' of the

locality.

Charaka

asserts that

retarded

digestion" of the inges.ted -food


pain,

followed by digestionary acid

reaction, colic

insomnia with fever

and a non- relish

for food

and a sense of oppcessiohi


set

toms which indicate that suppuration Has


that
it

in a

etc. ar thei sympGulma, and be adVises


'

(Gulma) should be treated^wixlrpouUices,

etc.

66
of the

THE SUSHRUTA SAMHITA.


body
it is

[Chap.

IX.

etc.

without any

fixed

root

of

its

own.

Hence,
because

that a
all.

Gulma

(internal

tumour) does not

suppurate at
it

Suppuration
contains

sets in in

an abscess only

largely

flesh

and blood unlike a


is

Gulma

(internal

tumour) which

not formed of any

such organic matter, and depends only on the aggravated

Doshas giving birth


suppurate at
all.

to

it.

Hence, a Gulma does not


case
of

24.

Incurable Types : A
abscess

an internal
bladder
or

suppurating

about

the

heart,

umbilicus as well as one of the Tridosha type (appearing


in

curable.

any part of the organism) should be given up as inThe abscess in which the marrow suppurates
becomes
fatal.

(generally)

The suppurating
affects

process in

an internal abscess, which generally


lying bone,
is

the

under-

sometimes found to
failing

affect the

marrow.

The suppurated marrow,


account
of the

to

find

an outlet on

compactness of the

local flesh

and bone,
localit}^

produces a sort of burning sensation in the

which consumes the body


disease

like

a blazing
like

fire.

The
dirt,

confined

to

the

bone,

piercing

torments the patient for a considerable length of time.

An

incision

(made into the affected bone)


of a
fat-like, glossy,
in

is

followed

by the
thick

secretion
pus.

white, cold

and
an

Men,
Sastras,

learned

the

knowledge of the
abscess
as

Medicinal

designate
(abscess

such an
of
the

Asthighata-Vidradhi

bone)

which
is

involves all the three kinds of deranged Doshas, and

attended with various kinds of pain which mark them


respectively.

25-26.
the
Sui'rut^

Thus ends the ninth Chapter of the Nidanasthanam in 3f^nbitd which treats of the setiology of abscess.

CHAPTER
Now we
shall discourse

X.

on the Nidanam of
(sinus)

Visari.

pa

(erysipelas),

Nad!

and

Stana-roga
deranged and

(diseases affecting the

mammae

of a

woman),

Definition of Visarpa :~The


aggravated Doshas, (Vayu, Pittam and
recourse to, and
affecting the

Kapham) having
flesh

Tvaka

(Skin),

and

blood,

speedily give

rise to a sort of shifting, elevated

swelling (Sotha)
of
to

marked by the
over the body.
fact of its

characteristic

symptoms
is

any of them involved


extend
all

in the case.

This swelling tends


disease
called

The

Visarpa from the

extending or swiftly shifting


2.

character (Skr. srip -to go, to extend).

The Vataja Type : The swelling


soft

(Sotha)

is

and rough and assumes a black colour attended with aching pain in the limbs and a cutting or piercing an
pain
(all

(in

the affected locality).

It

is

further
fever.

marked by

the usual)

symptoms

of the

Vdtika

case of

which uneven flame coloured vesicles or bulbs appear on the affected part through the extreme
this type in

vitiation (of the

Vayu and Pittam)

should be given

up

as incurable.

3.

The Pittaja and Kaphaja Types :-Thc


Pittaja

Visarpa (erysipelas) rapidly extends (over the


fever, a
(of

body), attended with severe

burning sensation,
skin;.

suppuration

and

cracking

the the
case

A
this

large

number sume a
veins
the

of

vesicles

appears on
colour.

spot which asof


type,

blood-red

characterised

by the

destruction

of the local flesh and


of

owing to the excessively aggravated condition


deranged Doshas (Kaphha and
Pittam)

and a

68
collyrium-Iike

THE SUSHRUTA SAMHITA.

[Chap. X.

black colour (of the swelling), should be

regarded as incurable.
slowly and the
affected
is

The Kaphaja Visarpa extends process of suppuration is tardy. The


and excessive
:

part

becomes white, glossy and swollen, and


a slight pain
itching.
4-5.

marked by

The Sannipatika Type


the
part

-The

Visarpa of
affected
all sorts

Tridoshaja type

is

deep-seated

and the

assumes

all

colours

and

is

attended with

of pain

which are peculiar to the three aforesaid types.

The

local flesh

and veins are destroyed in the suppurating


disease and
6.

stage

of this

hence,

it

shouldbe

looked

upon

as incurable.

The Kshataja Type


wound
the
to a

(Erysipelas

due to a

or an ulcer): The

Pittam of a person with a


all

temperament marked by the extreme aggravation of


three Doshas, in conjunction

with the blood, resorts

wound* in his body and immediately gives rise to Eiysipelas (Sopha lit rash) which assumes a reddi.shbrown colour, with high fever with a burning sensation,
and suppuration
pulse.
in
its

train,

and
the

it

is

found to be
of Kulattha

covered with black


7.
:

vesicles

to

size

Prognosis
Visarpas
are

The
;

Vataja, Pittaja and

Kaphaja
indicate
or

curable

the

Sannipdtika and Khataja


of Vdtaja

ones

being incurable.
unfavourable

The symptoms, which


in

an

prognosis

case

Pittaja Erysipelas, have been

described before.

Those,

which attack the

vital parts

(Marmas) of the body, can


difficulty.i*
8.

be cured only with the greatest


*

Or through

the

extreme augmentafion of

all

the

three

doshas

in

the ulcer (Sadyah-kshata-Vj ana) according to others.

Golden coloured (yellow)


is

Erysipelas due

to

the action of the

(deranged) Pittam
sydhyet.).''V>. R.

incurable

(AV/a/wa /^h-tichana-vapuicha ta^hi na

Chap. X.]

NIDANA STHANAM.

69

The N^ldi-Vrana
swelling
neglects
it

:~The

pus of an abscess or
if

burrows into the affected part


in
its

person
its

fully

suppurated stage, dubious of

being so conditioned, or not, or even neglects to open


fully

a
is

suppurated

abscess.

An
to

abscess

or swelling

called a Gati

Vrana owing
a
large

an

excessive

infiltration

of pus,

and

it is

also called a

presence of
its

N^di-vrana owing to the number of recesses or cavil ies in


types
of Nddi-vrana

inside.

There are

five different

(sinuses) such as the Vdtaja, Fittaja,

Kaphaja, Tridoshaja

and

Salyaja.

9 10.
is

The Vataja, Kaphaja and Pittaja rough and shortTypes :~The V^fcaja SiEUS
mouthed, characterised by an aching pain
It (in its inside).

exudes a
at

sort

of frothy
is

secretion

which becomes

greater

night and

attended with an aching pain.

Thirst, lassitude, heat


locality) are the

and a piercing pain jn the affected

usual

accompaniments of the Pittaja

types. Fever

is

present from the beginning and the Sinus

exudes a large quantity of hot and yellow coloured

more by day than by night. The Kaphaja Sinus becomes hard and is characterised by 'itching and a slight pain (numbed ?). It is found to
secretion

which

is

secrete a

copious quantity of thick, shiny, white-coloured


11-13.

pus which becomes greater at night.

Dvandaja and Tridoshaja Types :


A
of

case

of

Nddi-Vrana involving the concerted action


of the

any two

deranged Doshas (Vayu,


exhibiting

Pittam
to

and Kapham) and

symptoms
one.

peculiar

both,

is

called

Dvandaja*

There are

three

Gayadasa does not read the symptoms of Dvi-doshaja


principles)

(?.<;.,

due

to

two morbific

types

of sinus

g ven

in the text

which

he has rejected as spurious

70
types of this

THE SUSHRUTA SAMHITA^


class of

[Chap. X.

disease, (such as the

Vata-pittaja,

Vhta-kaphaja

and

Pitta-kaphaja)

case

of

Na'di-

vrana, exhibiting symptoms of the three aforesaid types, and attended with fever and a burning sensation, difficult

breathing, dryness

of the

mouth and syncope,


of
this

is

called

Tridoshaja.

An

attack

type should
the

be regarded as dreadful

and

fatal,

casting around

gloom of death.
matter (such as
the

I4-I5-

The ^alyaja Nadi-Vrana : A


dirt,

foreign

bone, splinter

etc.),

lodged within

body and
etc.

invisible

to the eye, tends to burst


its

open

the skin,
tion
ised

of the locality along


rise to a

channel

of inser-

and gives

type of Sinus.

It is character-

by a constant
This type
is

pain,

and suddenly
i6.

and rapidly

exudes a sort of hot, blood-tinged, agitated, frothy secretion.

called Salyaja.

ThcStana-Roga:
as

These

may be
the

divided into

many

types as

the aforesaid

Nadi-Vrana and are


last

caused by the same exciting factors as

named
the

malady.
breast

The milk-carrying ducts remain

closed in

of a nullipera

thus barring the possibility of the


of an attack

descent of the Doshas through them and


of any disease
at

that

part

of

the

body.

On

the

contrary, such ducts in the breast

of a piimipara open

and expand of

their

own

accord,

thus

making
to

the
the

advent of diseases possible that are peculiar

mamma.

I7-I9:

The breast-milk
Rasa (lymph
chyle)

-The sweet essence

of the

drawn from the digested food courses through the whole body and is ultimately concentrated in the breast of a mother or a woman (big with child) which is called milk. 2o.

Its
lies

character : The
and
invisible

breast-milk,

like

semen,

hidden

in

the

organism, though

Chap.

NIDANA STHANAM.
it

/r

permeating

in a subtle or essential form.

The

charac-

teristic features of the

breast-milk bear analogy to those

of

semen
the

The
as

breast
sight

milk
or

is

secreted,

and

flows
in the

out at

touch,

thought of the child


is

same manner
at

the

semen

dislodged
etc.

and emitted
of a beloved

the

sight,

touch or recollection
the

woman.

As

strong and

unclouded affections of a
about the secre-

man

are the cause of the emission of semen, so the fondest

love of a

mother

for her children brings

tion of her breast-milk

Both semen and breast-milk are


21

the

product of the essence of digested food, this essence

being converted into milk in women.

22.

floats

Its abnormal and normal Traits: The milk of a mother vitiated by the deranged Vayu
of her

system has an astringent taste and

on

water

The milk

of a mother vitiated

by the deranged

Pittam has an acid and pungent taste and becomes marked with a yellow hue,* if left to float on water. The milk of a mother vitiated by the deranged Kapham in water. is thick and slimy and sinks The milk of a

mother vitiated by

the

concerted

and simultaneous
is

derangement of the three Doshas of the body


by the combination of
external blow or hurt
all

marked

the preceding symptoms.

An
pro-

too (Abhighata) sometimes


23.

duces vitiation of the mother's milk.

The milk

(of a mother),

which instantly mixes with


its

water, tastes sweet

and retains

natural

greyish

tint,

should be regarded as pure.

24.

The bodily
a

Do.shas having recourse to the breasts of


filled

woman whether

with milk or not and

vitiatinsf o

the local flesh and blood give rise to


*

mammary

diseases,

The

particle

'Cha"

in

the text indicates that the colour

may

turn

blue or pink in some cases.

72
(Stana-roga).

THE SUSHRUTA SAMHITA.


All
the
called

[Chap. X.

types
the

of

abscess

(Vidradhi)

excepting the one


types

Raktaja out of the six

desciibed before are found to attack the

mammae^
identical

and

their

symptoms should be understood


25.

as

with those of external abscesses.


Thus ends the
Samhit^ w ich
and
tenth Chapter of the

Nidaram Sthdnam

in the Su&'ruta

treats of the oetiolcgy

and symptoms of Erysipelas,

vSinus

mammary

abscesses.

CHAPTER XL
Now we
(Glands
shall discourse

on the Nid^nam of Granthi


etc.),

etc.),

Apachi (Scrofula
i.

Arvudi (Tumours)
etc.

and Gralagand a (Goitre),

The deranged and unusually aggravated Vayu


(Pittam and Kapham), by vitiating the
fat
flesh,

blood and
of the or-

mixed with the Kapham

(of

any

part

ganism), give rise to the formation


elevated swellings which are called

of round,

knotty,

Granthi (Glandular

inflammation).

2.

The Dosha-Origined Types : The swelling (Sopha)


of the Vaitatja type
if

seems as
severed

if

it

were

drawn
cut in

into

and elevated or as
cleft

or

pricked
if

with a needle,

in

two or drawn asunder or as

two or pierced.
is

The knotty growth assumes

black colour, and

rough and elongated like a bladder.


bright

On
red

bursting a granthi of this type exudes clear


blood.

The Fittaja Granthi

is

characterised by
its inside).

heat and

an excessive burning sensation (in

pain, like that of being boiled


in the inside.

by an

alkali

or

by

fire, is felt

The knotty formation assumes


is

a red or yellowish colour and exudes a flow of extremely

hot blood on bursting.


discoloured

The Kaphaja Granthi


It is

slightly

and cold to the touch.

characterised

by a

slight

pain and excessive itching,


stone.
It
is

and

feels

hard
its

and compact as a
pus

slow or tardy in

growth and exudes a secretion of thick white-coloured

when

it

bursts.

3-5.

The Medaja Type : The fat


thi is

origined

Granwith

large

and glossy and gains or


loss

loses in size
It is

the gain

or

of flesh by the patient.

marked

10

74

THE SUSHRUTA SAMHItA.


little

[Chap. Xt.

by a

pain and an excessive itching sensation

and
or

exudes a secretion of fat resembling clarified


a gruel, in colour and consistency,
paste of

butter

made

of the levigated

sesamum on

bursting.

6.
:

Si ra-Granthi (aneurism or varicose veins) The bodily Vayu in weak and enfeebled persons, deranged by over-fatiguing physical exercises, straining or
exertion
or

by

pressure,

presses on, contracts, dries or


(Sira) or

draws up the ramifications of veins


(of the affected
locality),

arteries
rise to

and speedily gives


is

raised knotty formation which

called a

Sira-Granthi,

In the event of
it

its

being shifting and slightly painful,

can

be

cured
case in

only with

the

greatest difficulty.
is

Whereas a
less, fixed,

which the knotty formation

pain-

large and situated at

any of the

vital parts
7.

of

the body (Marmas), should be deemed incurable.*

Apachi (Scrofula
accumulated
fat

etc.)

The

augmented

and

and

Kapham

give rise to string of hard

glossy, painless, nodular, or elongated granthi (swellings)

about the joints of the jawbones, at the waist,

joint,

about the tendons of the neck, about the throat or about


the region of the arm-pits.

These glands (Granthis)


fruit or the

re-

sembling the stones of the Amalaka


of
fish in

spawn

shape or like some other shape, are of the same


;

colour as the surrounding skin

and a string or a large


gradually growing
extensive
is

crop of such
called

glandular

knots,

Apachi-f- on account of the


8-9.

nature of

their growth.

* In several editions an additional line is to be found running as men well conversant with symptoms (of Gtanthis) recognise a type of Granthi due to the action of the deranged flesh and blood, which exhibits symp{Mansjtasrayam chdrvuda toms identical with those of a tumour But Jejjata has laskhanena tulyam hi drish/awaih lakshanajunih). questionable authority. rejected it as of
t These glandular formations appear about the root of the penis, about the sides, in the arm-pits and about the throat and the tendons of the neck.

Chap. XI.]

NIDANA STHANAM.

75

These knotty formations are characterised by itching

and a slight pain. Some of them spontaneously burst exuding secretions while others are observed to vanish and re-appear (in succession). Such vanishings, reappearances, or fresh formations continue for a considerable

time.

The
fat

disease undoubtedly owes

its

origin

to

the deranged

and Kapham, and


with
lO.
etc.)
:

may

only be

made

amenable

(to

medicine)

the

greatest

difficulty

lasting for years at a time.

ArVUda (tumour
of flesh
slightly painful,

The

large

vegetation

which appears at any part of the body, becomes rounded, immovable and deep-seated,
its

and has
part,

root sunk considerably deep

in the

affected

and which is due to the vitiation of the flesh and blood by the deranged and aggravated Doshas (Vayu, Pittam and Kapham) is called an Arvuda
(tumour) by the learned
physicians*.

The growth
it

of

an Arvuda
suppurates.

is

often

found to be slow, and

seldom

The
its

characteristic

symptoms
or
fat,

of an

Arvuda

which owes

origin

to

the
flesh

deranged condition of the


are

Vayu, Pittam, Kapham,


identical with those,

respectively

which mark the cases of Granthis, brought about by the same deranged principles of the
body.
II.

Raktaja Arvuda : The

deranged Doshas

(Vayu, Pittam and Kaphami) contracting, compressing


They resemble spawns of fish in shape and size and are due (o the action of the deranged Vayu, Pitiam and Kapham. The appearance ol such glands in the upper part of the body should be attributed to the aciicn of the deranged and aggravated Vayu. They are ixtremdy hard to cure

inasmuch as their growth (formation) involves the concerted of the morbific principles (Doshas) of the body. Bhoja.
Charaka,

action

who

designates

this

disease

as

Gandatncild,

describes

its

location in regions about the


*

jawbones alone.

That they having


is

vegetations (of flesh)

recourse lo the flesh, produce deep-seated the reading adopted by Gayadasa and ot>iers.

76

THE SUSHRUTA SAM HIT A.

[Chap. XI.

and drawing the vessels (Sira) and blood (of the affected partj, raise a slightly suppurated and exuding

tumour which
tubercles and
is

is

covered

with small warts and fleshy


This tumour
is

called a Raiktatrvuda.

rapid

in

its

growth and exudes a constant flow of

(vitiated) blood.

The complexion
pale

of the patient owing


evils

to depletive

actions

and other concomitant

of

haemorrhage

becomes

and

yellow.

The type
its

should be considered incurable on account of


its

having

origin in the blood.*

12

13.

IVIansarvuda :The

flesh

of

any part of the

body hurt by an external blow etc. (hurting it with a log of wood D.R.) and vitiated in consequence, gives

rise

to

a sort

of swelling

(tumour) which

is

called

Mdnsarvuda, which originates through the action of


the deranged

Vdyu.

It

is

glossy,

painless,

non-sup-

purating,

hard as a stone, immobile, and of the same


the
in

colour

as

surrounding

skin.

Such a tumour

appearing

person addicted to meat diet becomes

deep seated owing to the consequent vitiation of the


bodily flesh and soon lapses into one of an incurable
type.
14.

ProgTIOSIS : Even
types (such as the Vataja,

of

the

aforesaid

curable

etc.^,

the following

types of

Arvudam
nel or

(tumours) should be likewise regarded as incur-

able, those

which appear
,

in the cavity of

a Srota

chan-

an artery

or

any vulnerable

joint of the

body and

arc characterised

by any

sort of secretion

and also im-

movable, should be deemed incurable.

An Arvudam
is

(tumour) cropping up on one existing from before

* Although all types of Arvuda have their origin in the deranged flesh and blood, i)reponderant action of the deranged blood is found in Raktdarvuda^ while a dominant action of the deranged flesh marks the

MAmArvuda

type.

Chap. XI.

NIDANA STIIANAM.

TJ

called

as incurable.

Adhyarvudam, which should be likewise deemed A couple of contiguous Arvudam (tumours)


is

cropping up simultaneously or one after another

called

Dviarvudam, which should be held


(with one of the foregoing types).
of

as equally

incurable

An Arvuda

(tumour)
to

whatsoever type, never

suppurates

owing
fat

the

exuberance of the deranged


as
in

Kapham and

as well

consequence of the immobility, condensation and


involved in the case, or out of a specific
nature.
15-16.

compactness of the deranged Doshas (Vayu, Pittam and

Kapham
of
its

trait

own

Definition of Galaganda
deranged and aggravated Vayu
deranged and augmented
lity affects the

(Goitre;: The
fat of the loca-

in

combination with the

Kapham and

two tendons of tne neck (Manyds) and gradually gives rise to a swelling about that part of the
neck characterised by the specific symptoms of the

deranged Doshas (Vayu or Kapham) and principles


volved
(Goitre).
in

in-

the
17.

case.

The

swelling

is

called

Galganda

Symptoms
:

of the

Dosha-orig-ined
(in its inside)

Types The swelling or tumour in the Va^tajai goitre


is

characterised

by a pricking pain

marked

by the appearance of blue or dark coloured veins Sira) on its surface. It assumes a vermilion or tawny brown
hue.
in

The

goitre

course

of time,

becomes united with the and gains in size, giving


in

local

fat

rise to

sense

of burning

the throat, or
all.

is

characterised

by

the absence of

any pain at
its

to the touch, slow in

growth,

Vataja goitre is rough and never or but rarely


in

suppurates.
palate
as

A
well

sense of dryness
as

the throat and the

bad taste
swelling

in the

mouth

likewise

marks

this type.

The

in

the

Kaphaja Type
cold

assumes a large shape and becomes

hard, firm,

78

THE SUSHRUTA SAMHITA.


There
is

[Chap. XI.

and of the same colour (white).


slow in

but slight pain

and the patient feels an irresistible inclination to scratch


the part.
rare
It is
its

progress and suppuration


is felt
if

is

and tardy.

sweet taste

in the

mouth and
sort

the throat and the palate seem as


of sticky mucous.
18-20.

smeared with a

Symptoms
The
swelling
It
is

of

the IVledaja Type:


soft

glossy,

(heavy

D.R)
is

and paleis

coloured.

emits a fetid smell and

characterised by
short
at

excessive itching and an absence of pain. It


its

root and hangs

down from

the neck in the shape of a


its full

pumpkin
the top.

(Aldvu), gradually gaining

rotundity at

The

size of

the goitre

is

proportionate to the

growth or
peculiar
throat.

loss of flesh of
if it

the body.

The

face
oil

of the

patient looks as

has been anointed with


is

and a
in

rumbling sound
21.
:

constantly

heard

the

Prognosis
difficult

case

of

goitre

attended with

respiration,

a softening

of the

whole

body,
as

weakness, a nonrelish for food, loss of voice as well


the

one which

is

more than

of a year's standing should


22.

be abandoned by the physician as incurable.

Metrical Text: A
large

pendent swelling whether


shape

or

small

and occurring about the region of the


in
is

throat

and resembling the scrotum


23.
eleventh

called

a Gala-Ganda.
Thus ends
the

Chapter of

the

Niddna

Sthanam

in

the
lc.

Susruta Samhita which treats of the

Nidanam

of Granlhi, Scrofula,

CHAPTER
Now we shall discourse
(disease of
phantiasis),

XII

on the Nidanamof

(hydrocele, hernia, scrotal tumours etc),

the
I

genital

organ*,

and

Vriddhi Upaclansa Slipada (eletypes


of

Classes
Vriddhi
the

-There

are

seven

different

such as the

Vataja, Pittaja,

Kaphaja, Raktaja,

Medaja, Mutraja and the Antra-vriddhi.

Of

these both

Mutraja-vriddhi (hydrocele or extravagation

of the

urine),

and Antra-vriddhi types, though owing

their ori-

gin to the deranged condition of the bodily Vayu, have

been so named after the organic matters or anatomical


parts (urine, iliac colon etc.) involved in

them.

2.

Definition and Premonitory symp-

toms Any
:

of the

deranged Doshas (Vayu, Pittam,

etc

lying

in the

nether regions of the body

may
rise

resort

to the spermatic cords

(Dhamani) and give


(scrotal

to

swelling and inflammation

of Phalacosha (scrotal

sac)

which
in

is

called

Vriddhi
of the

tumour
the

etc.).

A
of

pain

the bladder,

scrotum, penis

and the waist (Kati)


swelling
the

incarceration

Vayu and
premonitory

scrotum,
disease.
3

are

the

symptoms

of

the

4.

The Dosha-origined Types : The


in

type

which the scrotum becomes distended with Vayu


an inflated
surface)
its

like
(its

air-drum,

marked by

roughness of

and the presence of a varied sort of Vataja


interior)

pain (in

without any apparent cause

is

called

Vataja
Pittaja

Vriddhi.

The

swollen
the

scrotum,
colour
of

of

the
ripe

Vriddhi,

assumes

8o

THE SUSHRUTA SAMHITA.


fruit and and heat
is

[Chap. XII.

Audumvara
sensation

attended with fever, a burning


the affected
part.
It
is

in

of a

marked rapid growth and speedy suppuration (of the scrotum). The swollen organ in the Kaphaja Vriddhi becomes hard and cold to the touch accompanied bylittle

pain,

and itching

(in

the

affected

part

In

the

black vesicles,

Raktaja type the swollen scrotum is covered over with of the type being all other symptoms
one.
like

identical with those of the Pittaja

In the a ripe

Medaja
fruit

type the swollen

scrotum looks
glossy

TMa
the

and becomes

soft,

and slightly

painful.

The
part.

patient feels a constant inclination to

scratch
its

The

Mutraj a- vriddhi (hydrocele) owes


its

origin

to

a habit of voluntary retention of urine,

characteristic

symptoms being

softness

and fluctuation on the surface


a skin-bladder
filled

of the swollen scrotum like

with

water, painful urination, pain in the testes

and swelling

of the scrotum.

5.

(Inguinal hernia) : The local Vayu enraged and unusually aggravated by lifting a
great load, wrestling
physical
strain

Antra-vriddhi

with a stronger person,


fall

violent
like

or

from a
the

tree

and such
regions

physical labour doubles up a part of the small intestine

and presses
which
is

it

down
in

into

inguinal

lying

there strangulated

the

form

of a

knot

(Granthi)
hernia).

known
not

as

Antra-vriddhi (inguinal
attended
to
at

The

part

properly

the

outset

descends into the scrotum which becomes ultimately elongated and intensely swollen and looks like an
inflated air-bladder.
It (hernia)

ascends upwards under


;

pressure,
free
it

making a peculiar sound, (gurgling) while let comes down and again gives rise to the swelling
This disease
6.
is

of the scrotum.

called Antra-vriddhi

and

is

incurable.

Chap. XII.]

NIDANA STHANAM.

8l

TheUpadansam: An
of
the
genital,

inflammatory swelling
or not
its
is

whether ulcerated
disease

called
to

TJpadansa*.
action

The

owes

origin

the

of the local Doshas, aggravated


intercourse,
;

and excessive sexual

by promiscuous or by entire absti-

nence in sexual matter

or

by

had observed a vow of lifelong


not long

woman, who continence or one who has


visiting a

known a man,

or one in her menses or one with

an extremely narrow or spacious vulva, or with rough or


harsh or large pubic hairs
;

or by going

unto a

woman
its

whose partturient canal


entire length
;

is

studded with hairs along


a

or by visiting

woman

not amorously
;

disposed towards the visitor and vice versa


ing a

or

by know-

woman who washes

her private parts with foul

water or neglects the cleanliness of those parts, or suffers

from any of the vaginal diseases, or one whose vagina

by going unto a woman in any of the natural fissures of her body other than the organ of or by pricking the genital with copulation (Vi-yoni)
is

naturally foul

or

finger nails, or biting

it

with the

teeth, or

through poison(penis

ous contact, or through practice

of getting the
the)
;

abnormally

elongated

by pricking
its

bristles

of

water parasite {Suka) into


*

body
to

or

by

practising
types of
entail the

Upadans'a

is

not

syphilis

whole

whole.

Certain

Upadans'a such as the Raktaja and Sannipatika types which


destruction of the organs concerned
exhibit
certain

symptoms which are


eruptions and
tertiary

common
used
the
to

to

syphilis

as

well.

The secondary

symptoms of
treat

syphilis
it

are

not

mentioned by ihe A'yurvedic Rishis who


medicines and this
fact

only
that

with
the

vegetable

intimates
syphilis

probability

secondary
efficient

and

tertiary

symptoms of
from
the

might not arise by their


beginning,

and

able
the

treatment
poison

the

very

preventing
of

the

absorption of
so

into

system.

The
taken

practice
into

ablution,

common among
the
it

the Hindus,

might

be

consideration as

one of

important
the

preventive

factors.

Maharshi Cbaraka has

comprised

within

chapter

on

'Senile

Impotency'. Ed,

g2

THE SUSHRUTA SAMHITA.

[Chap. XII.

any unnatural offence with female quadrupeds or by washing the genitals with filthy or or through neglect to wash the parts poisonous water
masturbation, or
;

after coition, or

voluntary

suppression of a natural flow

or pressure of semen or urine or through any hurt on the organ etc. The inflammation of the genital The disease called Upadans'a. thus engendered is

admits of being divided


as, the

into

five distinct

types, such

Vitaja,

Pittaja,

Kaphaja, Tridoshaja and the

Raktaja.

78.

The symptoms of
The roughness

different

Types:
cracking
etc.,
is

of the genitals, the bursting or

of the integuments of the penis and prepuce ness and swelling of the aff'ected part which

numb-

perceived

rough to the touch and the presence of a varied sort of pain peculiar to the deranged Vayu are the characteristic
indications of the Vattaja

type.

In

the

Pittaja type

fever sets in (from the very beginning), the penis

becomes
fig

swollen and assumes


(reddish-yellow),

the

colour of a

ripe

Indian

attended

with a sort of

intolerable
is

burning sensation.

The

process of suppuration

rapid

and a variety of pain peculiar to the deranged Pittam, (distinguishes it from the other forms of the disease).

The penis becomes swollen, hard and glossy in the Kaphaja type marked by itching and a variety of In the pain characteristic of the deranged Kapham.
blood-origined type (Raktaja) the organ bleeds

heavily

and

is

covered with the eruptions of large black vesicles.


thirst,

Fever,

(Sosha),

burning sensations and

other

characteristic

symptoms
is all

of the deranged Pittam are also

present. Palliation
in these cases.

that can be occasionally effected


specifically betraying to

Symptoms
the

each

of the Vataja, Pittaja

and Kaphaja types concurrently


Satnnipaitika

manifest themselves in

type of Upa-

Chap. XII.]

NIDANA STHANAM.
cracks, the ulcers or cancers

83

dansa.

The organ

become

infested with parasites to the suffering of


its

and death comes


wretched victim.

in to

put a stop

913.
which
a down-

^lipadam (Elephantiasis) :- The disease in


the deranged Vayu, Pittam and

Kapham, taking

ward course, are lodged


of time
is

in

the thighs, knee-joints, legs


feet in course

and the inguinal regions and spread to the


and gradually give
rise

to

a swelling therein,

called Siipadam.

There are three types of Slipada


deranged

severally

due to the actions of the

Vayu,

Pittam and Kapham.

14

15.

The symptoms
Types! The
touch.

of

the

different
in

swollen

parts
felt

assume a black colour

the VsLfcaja type and are

rough and uneven to the


the seat of the disease),
burst.

A
is

sort of

spasmodic pain without any apparent


in

reason

felt (at

intervals

which largely begins to crack or


type
is

The Pittaja
attended with
the

characterised

by a

little

softness and yellowish

hue (of the diseased localities) and often


fever,

and a burning sensation.

In the

Kaphaja type

affected localities

become

white, glossy, slightly

painful,

heavy, contain large nodules (Granthis) and are studded

over with crops of papillae.

16.

Prognosis

A case of elephantiasis of
is

a year's

growth as well as the one which

characterised by

excessive swelling (of the affected parts), exudation and


vegetation
of knotty excrescences resembling the
ant-hill

sumincur-

mits
able.

of an
17.

should be

given

up

as

Memorable Verses -A
:

preponderance of
three types
of the
(of

the deranged
disease,
in as

Kapham marks
much
as,

the

the heaviness and

largeness

the swelling) can


factor than

not be

brought about by any other


disease
is

Kapham. The

peculiar to countries

84
in

THE SUSHRUTA SAMHITA.


which large quantities of old
during the greater
part
the year

[Chap. XII.

rain-water
(lit.- all

remain
seasons)
in
all

stagnant
of

making
is

them damp and

humid

seasons.

18-91

The

disease

usually found to be confined to the legs


in

and hands of men but cases are on record


(Penis

which

it

has extended to the ear, nose, lips and the regions of the
eyes.

Mddhaba-Niddnam).
twelfth Chapter of ihe

20.
in the

Thus ends
Samhifa which

the

Nidanasthanam

Sus'ruta

treats of the

Nidanara of scrotal tumours, hernia, Upa-

dans'am and elephantiasis.

CHAPTER Xm.
Now
we
shall

discourse
(diseases

on

the

Kshudrarog'am
the general

which
i.

are

Nidanam of known by
into
forty-

name

of minor ailments),
are

These

diseases

generally divided
or

four distinct

varieties

types

such as

Ajagallikji,
Kachchapika,
Agni-rohini,

Yavaprakshya,
Jala-garddabha,

Andhdlaji,

Vivrit^,

Valmika, Indravriddhd, Panasikd, Pashdna-garddabha,

Kakshd,

Vishphota,

Chippam,

Arbudam,
Kadara,

Kunakha, Anusaye, Viddrikd, SarkardPam^, Vicharchikd, Rakasa, Pddadarikd,


Alasa,
Indralupta,

Darunaka,

Arunshika,

Palitam, Mas'urika, Yauvana-pidaka, Padmini-kantaka,

Yatumani, Mas'aka, Charmakila,Tilakdlaka, Nyachchya,

Vyanga,

Parivartiki,

Avapatikd,

Niruddha-prakas'a,

Niruddha-guda,
Guda-bhrans'a *
.

Ahiputanam, Vrishana-kachchu,
2.
:

and

Metrical Texts
eruptions which are
are glossy,

The

species of pimples or

shaped like the


painless
is

Mud^a
the

pulse

and

knotty and
of the

called Ajagallikai.

They
skin)

are

same colour
is

(as

surrounding

and

their origin

usually ascribed to the action

of the deranged

Kapham and Vayu.

peculiar to infants.f

The disease is Ya^vaiprakshyai : The eruptions


Irvellika,

Brahmadeva comprising Garddavika^


list

Gandhapidikd and
species.

Tilakdlaka in the

reads

it

as consisting of thirty-four different

Jejjata does not hold the four forms of disease

commencing with Garddain of

vika,
all

etc,

as inchided within the

list.

Gaydd^sa, finding them included


list

the recensions

reads Garddabhikd, etc. as included within -the


etc. as

Kshudra Roga, and Pama


Kushtham.
t

included within the

list

of

Kshudra

They

afflict

certain infants Dallana.

86

THE SUSHRUTA SAMHITA.


like the barley-corns,

CChp. XIII.

which are shaped

extremely hard,

thick at the middle, knotty and affect (lit confined to)


the flesh are called Yavaprakshya.

action of the deranged

They are due to the Vayu and Kapham. Andhail ji


eruptions

The
appear
the

dense,
in

raised, slender-topped

which
pus

circular

patches

and

exude

slight

are called Andhdlaji.

They are due to the action of deranged Vdyu and Kapham. VivritSfc: Pustules
fig.

or eruptions, which are coloured like a ripe are flat-topped and appear
intolerable burning
in

fruit

and

circular

patches with an
Vivrita
3
-

sensation, are called

They
6.

are due to the action of the deranged Pittam.

Kachchapika : A
elevated, nodular

group of

five or

six hard,
in the

eruptions (Granthis), arranged

shape
face

of a

tortoise

(which

may

appear on the surcalled

of

any part of the body), are


action
:

Kachchapikd.

They

are due to the

of the

deranged

Kapham
erupsoles,

and V4yu.

Valmika The

knotty undurated

tions (Granthis)

which gradually appear on the


regions

palms, joints, neck and on the

above clavicles

and resemble an
are
called

ant-hill in shape, slowly gaining in size

Valmika

Ulcers

attended with

pricking

pain, burning, itching sensations

and exuding mucopueruptions

rulent discharges appear around the aforesaid


(Granthis).

The disease is due to the action of the deranged Kapham, Pittam and Viyu. 7 8. Indravriddhst -Pimples or eruptions ^Pidakd)

arising (on the surface of the body), arranged in the


circular array as
in

same
the

marks the

distribution of the seed (sacks)

a lotus

flower are

called

Indravriddha'

by

The disease is caused by the action of the deranged Vdyu and Pittam. Pauasika Eruptions
physicians.
:

(Pidakd)

of a

sort

of extremely

painful

pustules

all

over

the

back

or

the

ears

which

resemble

the

Chap. XIII.]

NIDANA STHANAM.
Panasikat.

87

Kumuda
Wkyu.
of the
i:

bulb in shape, are called


action
of the

They
and

are due to the

deranged

Kapham and
on the joint

a^sha^na-Garddabha

: A

slightly painful

non-shifting hard swelling, which appears

jawbones, (Hanu-sandhi,

is

called

Pashdnaderanged
thin
is

Garddabha.
superficial

The

disease

is

the effect of the


:

Kapham and Vdyu.


swelling,

Jaila-Garddabha

and
of a

which

like

erysipelas
is

shifting or progressive character

and

further attended
is

with fever and a burning sensation and which


rarely

but

found to suppurate,
disease

is

called

Jdla-Garddabha*
deranged
Pittam.
of

The

results

from

the

Kakshai

The disease characterised by the eruptions


is

black and painful vesicles i^ShphotaJ on the back, sides,

and on the region about the arm-pits,

called

Kaksha.
of the
in

The

disease

is

likewise attributed to

the

action

aggravated

Pittam,

Vishphotaka

The
is

disease

which eruptions of burnlike

vesicles (Shphota) crop

up

on the whole surface of the body, or on that of any


particular locality, attended with fever,
called

Vish-

photaka.

The
9

disease

is

the

effect

of vitiated

blood

and Pittam.

14.

Agni-Rohinif ; Vesicles
appearance of burns and

(Shphota) having the

cropping up about the waist

*
bhil.

The

circular raised spots studded with vesicles are

called

Garddaof

They are reddish and

painful
it

and produced by the action

Vayu

and Pittam.
t
in

Gayadasa reads

so.

Dallana quotes from another Tantram that the morbific principles


the

men, aggravated through the action of

enraged and augmented


red-hot

Pittam and blood, give

rise to vesicles (blisters) like

charcoal

by

breaking open the flesh at the


fever

waist,

attended with txtreme pain,

high

and an

insufferable:

burning sensation which,if not properly remedied,


first

bring on

dtath wiihin a fortnight, or ten days of their

appearance.

These

(vesicles) are called

Vahni- Rohini.
to

And
the

again from another work


aciipn
of the

he cites that a case of

Vahm-Rohini due

deranged

88

THE SUSHRUTA SAMHITA.


bursting
the
local
flesh,
if

[Chap. XIII.

(Kakshd) by
is

and
a

which
blazing

attended with fever and a sensation as

fire is

burning in the inside


Agni-Rohini.

(of the affected part), are

called

The
It is

disease

is

caused by the

concerted action of the three deranged Doshas (Vayu,

Pittam and Kapham).

incurable and ends

in

the

death of the patient either


fifteenth

on the seventh*, tenth or


15.

day

(of

its first
:

appearance).

Chippam The
vitiating the
flesh
is

deranged Vdyu and


finger-nails,

Pittam
to

of the

give

rise

disease which

characterised
disease

suppuration.

The
nails

called

by pain, burning and Chippam, is also


Kshataroga.

denominated

Upanakha

and

Kunadry,

kham
black,

The
It

of fingers

becoming

rough,

and injured through the action of the Doshas


effect of a blow,

enraged through the


(bad
nails).
is

are called

Kunakha
:

also

called

Kulinam.

Anusayi

small swelling (on the surface of the

body) which

is

same colour (as the surrounding skin), but is deep-seated, and suppurates in its deeper strata, is called
of the

Anusayi by the physicians.


of the deranged

The

disease

is

the

effect

Kapham.

Vida(rika(

: A round
is

reddish

swelling rising either on the auxiliary or inguinal regions


in the

shape of a gourd

Viddrikandd)

known

as

Viddrika.
of
is

The

disease

the

deranged

due to the concerted action Vayu, Pittam and Kapham and


is

characterised

by

symptoms

peculiar

to

each of

them.

1619,

Kapham
*

proves

fatal

within

fortnight, that

due

to the

deranged Pittam,

within ten days, and that due to the deranged Vayu, within a week.

The

patient dies

on the seventh day

in a case of disease

marked by

the dominant Vayu, on the tenth day in a case

marked by the dominant

Pittam and on the fifteenth day in a case of dominant deranged Kapham.

Chap. XIII.]

NIDANA STHANAM.

89

^arkararbudam : The deranged


Kapham
(S'ira),

Vayu and
flesh, veins

having recourse to and affecting the

ligaments

(Snayu)

and
it

fat give rise to

a sort of

cyst (Granthi)
secretion
in

which when

bursts

exudes a copious

its

nature somewhat like honey, clarified

butter

or Vasa.

The

aforesaid

V^yu, when aggravated


flesh

through excessive secretion, dries and gathers the

up again

in the

shape of

(a large

number
is

of)

gravel-like

concretions (Sarkara)

known accordingly

as Sarkardrbu-

dam.

fetid secretion of varied colour

secreted from

the veins

(Sira) in these

Granthis which are sometimes

found to bleed suddenly.

The

three varieties of the skin

disease called Psbinat (Eczema), Vicharchikai (Psoriasis)

and Rakasat have already been discussed under the head 20-21. of Kushtham (Chapter. V.).

Padadarika : The
of extremely pedestrian
their natural

soles

and

feet of a

person

habits

serous
gives

moisture).
rise

become dry (and lose The local Vayu thus


painful
called

aggravated
(Dari
darika.
in

to parts)

peculiar

cracks

the

affected
:

which are

Pada-

Kadara

The
shape),

knotty

(Granthi),

painful,

hard growth raised at the middle or sunk at the sides,

which

exudes a secretion

and

resembles an Indian
soles

plum (Kola in
of the
vitiated

and

appearing at the

(palms according to

Bhoja)

of a person as an outcome

produced

local blood and fat by the deranged Doshas incidental to the

condition

of the

pricking of a thorn etc. or of gravel


(corns).

is

called a

Kadara
which
exuda-

Alasa

An
by

affection,

caused by contact of
toes,

poisonous mire
is

and appearing between the


pains,

characterised

burningj itching and


25.

tion, is called Alasa.

22

Indralupta:--The

deranged Vayu and Pittam


12

having recourse to the roots of the hairs bring about their

^O
gradual

THE SUSHRUtA SAMHITA.


falling
off,

[Chap. XIll.

while the
fill

deranged

blood

and

Kapham
disease
pecia).
is

of the locality

up those pores or

holes, thus

barring their

fresh

growth

and

recrudescence.

The
hairy

called Indralupta,*

Rujya
in

or Khailitya (Alo-

Dairunaka:

The
is

disease

which the

body (roots of hairs) become hard, dry and characterised by an itching sensation is called Daruparts of the

naka.

The

disease

due to the action of the deranged


Arunshikat
:

Kapham and Vdyu.


a

Ulcers (A runshi)
the
action

at-

tended with mucopurulent discharges and furnished with

number
of

of

mouths or
as

outlets
result

and appearing on the


of local
(of

scalps

men

the

of

parasites

and of the deranged blood and


are
called

Kapham
:

the locality)

Arunshika.

Palitam

The

heat and
region

Pittam of the body having recourse to the

of the head

owing

to overwork, fatigue,

and expremathe

cessive grief or anger, tend to

make
of the
is

the

hair

turely grey, and such silvering

hair (before
called

natural

period

of
:

senile

decay)
yellow

Palitam.

Masuriksi

(variola)

The

or

copper-coloured

pustules or eruptions attended with pain, fever and burn-

ing and appearing


face

all

over the body, on (the skin

of)

the

and inside the cavity of the mouth, are

called

Masurikd.

Yauvana-pidakat (Mukhadushikai) :~The


tree,

pimples like the thorns of a Salmali

which arefound

on the face of young men through the deranged condition


of the blood,

Vdyu and Kapham,


pimples
of

are

called

Yauvana:

pidaki

or

youth.
or

Padmini-Kantaka
rash-like

The
*

circular, greyish patches

eruptions

Women

are

generally

proof against this disease

owing

to

their

delicate constitution

and

to their being subjected to the

monthly discharge

of vitiated blood and at the


exercise,

same time
is

to

their

undergoing no physical
bodily

and hence there

little

chance

of

the

Pittam being

deranged and bringing on

this disease.


Chap. XIII.]

NIDANA STHANAM.

9I

Studded over with thorny papilla of the skin resembling


the thorns on the stem of the lotus are called

marked by

itching

Padmini-kantaka.

deranged condition of the

The disease is due to the Vdyu and Kapham. Yatucircular,

mani (mole)
less,

The reddish, glossy,

and pain-

congenital marks (Sahajam) or moles on the body not more elevated (than the surrounding skin) are called Yatumani. The disease is due to the deranged condition
of the blood

and Pittam.

2633.
:

IVIasaka
black

(Lichen)
pulse
of the

The

hard,

painless,
re-

and

elevated

eruptions
in

on the body (skin)


shape, caused

sembling the Mdsha


aggravated
condition

by

the

bodily

Vayu

are

called

Mas'aka
the
level

Tilakalaka:
about the
the

The
of are

black
a

painless

spots on

skin

size

sesamum

seed

and
This

with
is

skin

called

Tilakalaka.

disease

caused through the aggravated condition of

the Vayu, Pittam

and

Kapham .f

Nyachcham:

The
skin,

congenital, painless,

circular,

white or brown (Sydva) found to be restricted


of the

patches on the skin, which are

to a small or comparatively diffused area


are
called
:

Nyachcham.

Charmakila (hypertrophy

of

the skin)

The

causes

known

as

Charmakila
of the

and symptoms of the disease have been already described


Ars'a-Nidanam).

(under the head

Vyanga

The Vayu being aggravated through wrath and


fatiguing physical exercise,

over-

and surcharged with Pittam,

and suddenly appearing on the face of a person, causes thin, circular, painless and brown-coloured patches or
stains.

They

are

known by

the

name
due

of

Vyanga

34-38.
blood

According to certain authorities

it is

to the absorption of

by Vayu and Pittam.

+
is

According

to

others

the

spot

goes by the name of Nilikam^

if it

black-coloured and appears anywhere other than on the face*

92

THE SUSHRUTA SAMHITA.

[Chap. XIII.

The Parivartika : The


aggravated by
of the

vital

Vayu (Vydna)
integuments
affected

such causes as excessive

massage (masturthus

bation), pressure, or local trauma, attacks the

penis (prepuce) which being

by
and

the deranged

Vayu forms

into a knot-like structure

hangs down from the glans penis.


as

The

disease

known

due to the action of the deranged Vayu aggravated by any extraneous factor.
is

Parivartika or Phymosis

It is

marked by pain and burning sensation; and some-

times suppurates.

When

the

knotty growth becomes


it is

hard and
the

is

accompanied by

itching, then

caused by

aggravated Kapham.

39.

Avapatika :~When

the

integuments

of

the

prepuce is abnormally and forcibly turned back by such causes as coition under excitement, with a girl ^before

menstruation and before the rupture of the

hymen and

consequently with a narrow external orifice of the vagina)


or

masturbation or pressure or a blow on the penis,

or a voluntary retention o{ a flow of

semen or
called

forcible

opening of the prepuce, the disease


or

is

Avapdtikd
prepuce

paraphymosis.

Niruddha-prakatsa :-The

by the deranged Vayu entirely covers up the glans penis and thus obstructs and covers up the orifice
affected

of the urethra.
jet

In cases of partial obstruction

thin
cases

of urine

is

emitted with a slight pain.


the

In
is

of complete

closing

emission of urine
in

stopped
penis

without causing any crack or fissure


in

the glans

consequence.
is

The
to

disease

is

called Niruddha-prakds

which
pain

due

the deranged
39-41.

Vayu and

is

marked by

(in

the glans penis\

Niruddhaguda :-The
ed by
the repression

Vayu (Apana) obstructurging towards de-

of a

natural

fecation stuffs the

rectum, thus producing constriction

of

its

passage and

consequent

difficulty

of

defeca-

Chap. XIII.]

NIDANA STHANAM.
is

93
as
is

tion.

This dreadful disease


(stricture

known
sort

Niruddhaextremely
itch-like

gudam
difficult

of the

rectum) which
:

to

cure.

Ahiputana

of

eruptions appearing about the


to

anus of a child
feces

owing
conse-

a deposit of urine,

perspiration,
in

etc
part.

quent on the neglect


eruptions which are

cleansing

that

The
blood

the effects of the deranged

and

Kapham

soon assume

an

Eczematous character
spreads,

and exude a purulent discharge on account of constant


scratching.

The Eczema (Vrana; soon


obstinate
in

and

coalesces and proves very

the end.
:

The

disease

is

called Ahiputana.

Vrishana-kachchu
in

When

the

filthy

matter, deposited in the scrotal integuments

of a person
in

who

is

negligent

washing the parts or


ablutions,
rise to
is

the

habit

of taking

daily
it

moistend
itching

by the
turned
of the

local perspiration,

gives

an
is

sensation in the skin of the scrotum, which


into
parts.

speedily

running

Eczema by
is

constant scratching

The

disease

called

Vrishana-kachchu

and

is

due to the aggravated condition of the


:

Kapham

and blood. Guda-Bhransa of the anus (due to the Vayu)


called

A
in a

prolapse or falling out

weak and
ani.

lean patient
in

through straining, urging or flow of stool as


is

dysentery

Guda-Bhransa or prolapsus
the

42

45.
in

Thus ends the thirteenth Chapter of


Sus'ruta

Nidana Sthanam
of minor ailments.

the

Samhita which

treats of the

Nidanam

CHAPTER
Now we
disease
shall

XIV.

discourse

on the Nidanam of the


i.

known

as

SukadOSha.

Any of the eighteen different types of the disease may affect the genital (penis) of a man who foolishly
resorts to the practice of getting
it

abnormally elongated
(a

and

swollen by

plastering

it

with Suka

kind of

irritating

water

insect)

and not
:

in

the usual officinal way.

Classification
such
lika,

Diseases, which result from Sarshapika, Ashthimalpractices, are knonwn


as,

Grathitam, Kumbhika, Alaji, Mriditam,

SammudhaUttama,

pidaka, Avamantha, Pushkarika,

Spars'ahani,

Satoponaka, Tvakapaka, Sonitarvudam, Mansarvudam,

Mansapaka, Vidradhi and Tilakalak.

2.

Metrical Texts : The


shape and
size,

tiny herpetic eruptions

(Pidaka) which resemble the seeds of white mustard in


(and are found to crop up on the male

organ of generation) on account of a deranged condition


of the blood and

Kapham,
Suka

as the result of

an injudicious
Sarshapikai
pimples,

application

of

plasters

are

called

by

the wise.

Eruptions of

hard stone-like

(Pidaka) irregular

at their sides or edges

and which are


the use

caused by the aggravation of the local

Vayu by

of a plaster of the poisonous Suka, are called Ashthilika'.

The knotty Granthis


to
its

(nodules)

on the penis owing


with the
bristles of
is

being frequently stuffed


insect are called

Suka

Grathitam.
or

This type

caused

by the deranged action of the Kapham.


resembling the stone
seed

A
is

black wart
fruit

of a jambolin

in

shape

is

called

Kumbhikai.

This type

due to the
3

deranged condition of the blood and Pittam.

5.

Chap. XIV.]

NIJDANA STHANAM.
(incidental to an injudicious
penis) exhibits

95
application

An Alaji
of
identical with
in

Suka on the

symptoms, which are

those
vi).

manifested

by a case of

Alaji

Prameha

(Ch.

wart (papilloma) attended

with swelling of the part and caused by the aggravated

Vayu on
(on

the hard and inflamed


urethra)
is

penis causing

pressure

the

called

Mriditam.

The

pustule or
its

eruption appearing on the penis on account of

being
of the

extremely pressed by the hand


hairs

i^for

the insertion
is

of the

Suka)
the

in its

dorsum

called

Sammudha-

pidaka^.

(It is

outcome of the aggravated Vayu*).

large

number

of elongated pustules on the penis (in-

cidental to an application of

Suka

to

the

part)
is

which
called

burst at the middle, causing pain

and shivering,

Avamantha
The

(epithelioma ^

6 10.

type of the disease is marked by the eruptions of small pimples around the principal

Pushkarika
its

one

The type has

origin in the deranged


is

condition

of the

blood and Pittam, and

so called from the part

of the excrescenses being arranged in rings or circles like

the petals of a lotus flower in shape.


thesia (of the affected organ)

A
is

complete anes-

owing

to the vitiated blood


called Spars'a-

by the injudicious application of a Suka


haini.

Pustules
of the

appearing on the penis


local blood

through the

vitiation

and Pittam by such con-

stant applications are called Uttamsi.

suppuration of

the prepuce under the circumstance

is

called

Tvakapaikh.
the
affected

There
organ.

is

fever with a burning sensation in

The

disease

is

due to the vitiated condition


11- 15.
is

of the blood and Pittam.

The type

of the disease in which the penis


vesicles

marked

by the eruption of black

and

is

covered over

with a large number of red


According
to

pimples or pustules with


Vayu and
blood.

Dallana

it is

due

to the action of

g6

THE SUSHRUTA SAMHITA.

tChap. XIV.

an excruciating pain in the ulcerated region of the organ


IS

called

Sonitafcrvudam.

The

vegetation

of a

fleshy-

tumour on the penis


insect into
its

(incidental to a

blow on the organ


hairs

to alleviate the pain of inserting the

of the

Suka
sup-

body),

is

called MsinsaLrvudam.

puration as well as sloughing of the penis attended with


different kinds

of pain

which severally mark the de-

ranged
paHia.

This type

Vayu, Pittam and Kapham is called Ma'nsais caused by the concerted action

of the deranged Vayu, Pittam and

Kapham.

15-18.

The

specific

symptoms

of a

Tridoshaja Vidradhi
the one which affects

as described before (Chap.ix.)

mark

the penis

(owing to an

injudicious application of the

highly poisonous
disease
is

irritant

Suka

to the organs)

The

called

puration

A process of general supVidradhi. and sloughing of the organ marks the type
species.

which

is

produced by the application of a black Suka or


called Tilakailaka,

one of a variegated coloured insect of the same

The type
as

is

and should be regarded


enumerated
malig-

Tridoshaja one.

19-21.
:

ProgTIOSiS

Of the above

nant diseases of the penis, those known as Mansarvuda,

Mansapaka, Vidradhi and Tilakalak shoulda be deemed


as incurable.
Thus ends
the

22.
fourteenth Chapter

of the Nidana

Sthanam

in

the

Sus'ruta Samhita which treats of

Nidanam

of different types of S'ukadohsa.

CHAPTER XV.
Now we shall discourse on the Nidanam of Bhagf-^ na.m (fractures and dislocations etc. of bones), i
Various kinds of fracture
variety of causes,

may

be caused from a
fall,

such as by a

pressure,

blow,
etc.

violent jerking or

by the

bites of ferocious

beasts

These cases
divisions

may
as.

be grouped under the two main sub-

such

Sandhi-Muktam

(dislocation)
2.

and

Ka^nda-Bhagnam

(fracture of a kanda).

Cases of Sandhi-muktam (dislocation)


into six different types, such
lishtanty Vivartitam,

may be

divided
Visf-

as

the

Utplishtam,

Adhak-Kshiptam, Ati-kshiptam and

Tiryak-kshiptam.

General features of a dislocation :^


Incapability of extension, flexion,

movement, circum-

duction and
of the natural

rotation (immobility, considered in respect

movements

of the joint), of the dislocated


painful
to

limb,

which becomes

extremely

and cannot

bear the least touch.

These are said


4.

be the general

symptoms

of a dislocation.

Diagnostic
tion
:

symptoms

of a dislocaby two
to
articular
is

'In

case of a friction of a joint

extremeties (Utplishtam) a swelling

found

appear

on either side of the articulation attended with a variety


of pain
at

night.

little

swelling accompanied

by

a constant pain and disordered function of the dislocated

marks the case of simple-looseness (Vislishtam) of the articulation while pain and unevenness of the joint owing to the displacement of the connected bones
joint,
;

distinguish a case of

Vivartitam

(lateral displacement).

An

excruciating pain, and

looseness

of the dislocated
13

98

THE SUSHRUTA SAMHITA.

[Chap.

XV.

bone are the symptoms which characterise a case

in

which a dislodged bone


from

is

seen to drop or hang

down

In a case of abnorits joint (Adhah-kshiptam). mal projection (Ati-kshiptam), the dislocated bone is removed away from its joint which becomes extremely

painful.
is

A case of oblique dislocation

(Tiryak-kshiptam)

marked by the projection or displacement of the bone on one side accompanied by a sort of intolerable
pain.
5.

Different

kinds
Fractures

of
may

Ksinda

Bhag-

nam Now
:

we

shall describe the

Kanda-Bhagnam

(fracture etc.).
different kinds

be divided into twelve


as,

which are known

Karkatakam, AsVa-

karnam,Churnitam,Pichchitam,Asthi-chchalitam,Kanda-

bhagnam, Majjagatam, Atipdtitam, Vakram, Chchinnam,


Pdtitam and Sphutitam.
6.

General symptoms of K^nda-bhagnam A violent swelling (about the seat of fracture)


:

with throbbings or pulsations, abnormality in the position


(of the fractured
limb),

which cannot bear the

least

touch, crepitus under pressure, a looseness or dropping of the limb, the presence of a variety of pain and a sense of

discomfort in
generally

all
all

positions

are

the

indications which
7.

mark

kinds of fracture (Kanda-bhagnam).

Diagnostic

symptoms: The case where a


down
is

fractured bone, pressed or bent


extremities, bulges out
at

at its

two articular

the middle so as to resemble


called

the shape of a

knot (Granthi),
the fractured
a

Karkatam.
upward

The

case where

bone projects
into

like the ear

of
is

horse

is

called

AsVakamam.

The

fractured

bone

found to be
or

shattered

fragments

comminuted kind which can be detected both by palpation and crepitation. A smashed condition of the fractured bone marks a
in a case of the

Churnitam

Chap. XV.]

NIDANA STHANAM.
which
is

99
often

case

of the Pichcliitain kind

found to

be marked by a great swelling.


covering or skin
splintered
off
is

The

case

where the
is

of the
called

bone (periosteum)
the

cast

or

Asthi-chchallitam.
severed
is

The

case where the completely broken or

bones are

found to project through the local skin,

called Katada-

bhagnatn (compound).

The

case where a fragment


is
is

of

the fractured or broken bone

found to pierce into the


called Majjsiaugatain,

bone and dig out the marrow,


(Impacted
fracture).

The
is

case where the fractured bone

droops or hangs

down

called Ati-paititani.
its

The
is

case

where the unloosened bone (from

position)

bent

down

in

the form

of an arch

is

called

Vakram
of the

The
is

case where only one articular extremity

bone

severed
is

is

called Chhinnaoi.

slightly fractured
is

The case where the bone and pierced with a large number
an excruciating pain being
case where the bone largely
if

of holes,

called PaLtitam,

the leading indication.

The
insect

cracked and swollen becomes painful as


the bristles of a
stick fracture).

stuffed with

Suka

is

called

Sphutitam (Greencures
of the

Of the

several kinds of fracture,

are effected with extreme difficulty in

case

Churnitam, Chhinnam,
kind.
in a

Ati-patitam
or

or

Majjanugatam
occurring

case of displacement

laxation
in

child or in

an old or weak patient or

one

sufferaffec-

ing from

asthma (Svasa) or from any cutaneous


Kshata-Kshina disease
is

tion (Kushtha) or
cure.
8.

difficult

to

Memorable verses
are
to

The

following

cases

bs given

up as hopeless
be

z^/s.

fracture of the
description,

pelvic

bone (or of bones that are of

this

wherever they
pelvic joints
;

may
;

situated)

dislocation

of the

compound

fracture of the
into

thigh

bone or

of the flat bones)

fracture

small

pieces of the

lOO
frontal

THE SUSHRUTA SAMHITA.


bone or
its

[Chap.

XV.

dislocation

simple fracture of the

breast-bones, back-bone and temporal and cranial bones.


If

the dislocations
outset
is

and fractures be
if

improperly

set

from the

(Adito)* or

the

union be anyhow
9

disturbed there
If fractures

no hope
at

for recovery.

11.

happen
life

stages

of adalt

any time of the first three which has been described before

(vide Sutrasthana Chap,

XXXV.) and

if

they are set up


of being

by an
united.

able surgeon they have a great chance


12.

A
called

bending of a
its

gristle

or

cartilage

(Taruna)

is
is

fracture.

Nalaka

(long

bone)

bone
is

usually found to

be severed.

Kapatla bone
(tooth)
is

found
be

to be cracked, while a

Ruchakaf

found to

splintered
*

off.

13.
taicen

The word Adiio may be


is

into

the sense

of congenital mal-

formation which

beyond remedy.
of the particle 'cha' denotes

The presence

Valya-asthiin the Sus'ruta


fractures.

Thus ends

the fifteenth Chapter of the


treats of the

Nidana Sthanam
dislocations

amhit^ which

Nidanam

of

and

CHAPTER
Now we
lYl

XVI.
on
the

shall

discourse
(diseases
i.

Nidanam

of

Uk ha. Tog's. m
mouth

which

affect the cavity

of

the

in general),

General Classifications: Sixty


ferent

five* dif-

forms of mouth disease are known in practice.


are found to attack seven different
localities
viz.

They
the

lips,

the

gums
;

of the teeth, tongue, palate, throat

and
;

the entire cavity

of these eight are peculiar to the lips of the


;

fifteen, to the roots five

teeth;

eight

to
;

the

teeth;

to

the

tongue

nine

to the palate

seventeen to
2

the throat; and three to the entire cavity.

3.

Diseases of the lips : The eight forms which


affect the lips, are either Vataja, Pittaja,

Kaphaja, Sannior

pdtika,

Raktaja,
4.

M^ns'aja,

Medaja

Abhighdtaja

(Traumatic).

The

Vsitaja
if
it

Type: The

lips

become dry,
pulled

rough, numbed, black, extremely painful and the affected


part seems as

were smashed and

out or

cracked by the action of the aggravated Va(yu.

In

the

Pittaja type

the
(a

lips

and studded with


seed-like
lent discharge

eruptions,

become blue or yellow-coloured large number of small) mustardwhich suppurate and exude a puru-

attended with a burning sensation (in


In
the

the

locality).

Kaphaja type

the affected

lips

are covered with small eruptions,

which are of the same

colour as the surrounding part, and


or thick, cold

become slimy, heavy


is

and swollen.
feels

Pain

absent in this type

and the patient


the parts.
*

an

irresistible inclination to scratch

In the

Satnnipaitaja

type, the lips change


this.

According to others sixty-seven-^but Dalian does not support

102
colour,

THE SUSHRUTA SAMHITA.

[Chap. XVI.

becoming black, yellow, or ash-coloured (white)


and are found to be studded with various
5

at intervals

sorts of eruptions.

8.

The Raktaja type : (Produced by the vitiated


condition of the blood) the affected lips look as red as

blood and profusely bleed

and crops of date coloured (chocolate-coloured) eruptions appear on their surface. In


Maknsaja type (due to the vitiated condition of the

the

become heavy, thick and gathered up The angles of the in the form of a lump of flesh. mouth become infested with parasites which germilocal flesh), the lips

nate and spread themselves

in the affected parts.

In

the Medaja(fat-origined) type the lips


soft,

become numbed,

heavy and marked by an itching sensation.

The
looks

skin of the inflamed surface becomes glossy and


like the surface layer of clarified butter

exuding a thin
In
the

crystal-like

(transparent)

watery

discharge.
lips

Abhighaitaja (Traumatic) type, the


knotty and marked by an itching
if

become red, sensation and seem as

(pierced

into

or cut

open with an axe and (become


9

cracked and fissured).

12.

Disease of the roots of the teeth ;


Diseases which are peculiar to the roots of the teeth, are

known

as

Sitada,

Danta-pupputaka,
Paridara,

Danta-veshtaka,
Upakus'a, Dantafive sorts -of

Saushira,

Mdha-Saushira,

vaidarbha,

Vardhana, Adhimansa and the


13.

Nddi

(,sinus).

Sitada (Scurvy); The gums


bleed and
smell.

of the teeth suddenly

become putrified, black, slimy and emit a fetid They become soft and gradually slough off.
its

The
(gum

disease has
local

origin

in

the deranged

condition

of the

blood and

Kapham.

Dantapupputaka
roots

boil):

The disease in which the


is

of two

or

three teeth at a time

marked by a

violent swelling

and


Chtip.

XVI.]

NIDANA STHANAM.
Danta-pupputaka.
condition
of the

03

pain
to

is

called

The

disease

is

due

the vitiated

blood and Kapham.


in the

Danta-veshtaka:

The teeth become loose


locality.

gums,

which exude a discharge of blood and pus. This disease


is

due to the vitiated blood of the

Saushira:
is

The

disease in which an itching painful swelling appears

about the gums attended with copious flow of saliva


called

Saushira (Alveolar abscess).

It is

caused by the

deranged blood and

Kapham
in

of the locality.

Maha(loose,
putri-

Saushira
the palate
fied,

The disease

which the teeth become


or fissures, the

marked by sinuses

gums

called Mahas'aushira, the

and the whole cavity of the mouth inflamed, is outcome of the concerted action
14

of the deranged Doshas of the body.

18.

come

Paricla.ra. : The disease in which the gums beputrified, wear off and bleed is called Paridara

(bleeding

gums\

The

disease

has

its

origin

in

the

deranged condition of the blood,

Kapham and

Pittam.

Upakusa :~The

disease in which the gums become marked by a burning sensation and suppuration and the teeth become loose and shaky (in their gums) in consequence and bleed at the least shaking, is called Upakusa. There is a slight pain, and the entire cavity of the mouth becomes swollen and emits a fetid smell
;

this

disease

is

due to the
19.

vitiated

condition

of

the

blood and Pittam.

Danta-Vaidarbha : The
consequent upon the friction of the

disease which

is

gums marked by

the
(so

appearance of a violent swelling about the portion


rubbed and
in

which) the teeth beeome loose and can be


is

moved about,
the
disease

called

Danta-vaidarbha which
etc.

is

due to
:

an extraneous cause such as a blow

Vardhana

which

is

marked by the advent of an

additional

tooth (the last molar) through the action

t04

THE SUSHRUTA SAMHITA.


Vayu with
a specific

[Chap. XVI.

of the deranged

excruciating pain
the

of

its

own,

is

called

Vardhana or eruption of

Wisdom
and

The pain subsides with the cutting Adhimainsa : The disease in which a
tooth.

of the tooth.
violent

extremely painful tumour appears about the root of the


tooth,

and

is

situated in the farthest

end of the cavity of


It

the
"is

cheek-bone accompanied by a copious flow of saliva


called

Adhimansa

or

Epulis.
five

is

due
Na'di

to

the

deranged

Kapham.
the

The

sorts

of

(sinus)

which
Pittaja,

affect

roots

of the teeth (are either Vataja,

Kaphaja,

Sdnnipataja or

Abhighataja),

their

symptoms being

respectively identical with those of the

types of Nadi-vrana.

20 24.

Diseases to the teeth proper : Diseases


which are
restricted

to

the

teeth proper are

named
25.

as,

Ddlana, Krimi-dantaka, Danta-harsha, Bhanjaka, Sarkard,


Kapalika, Syiva-dantaka and Hanu-moksha.

Dalana
as
if

The disease

in

which the teeth seem


is

being

cleft

asunder with a violent pain


origin of

called

Deilana

or toothache, the

which

is

ascribed

to the action of the aggravated state of the bodily


:

Vayu.

The disease in which the teeth are Krimi-dantaka eaten into by worms, is called Krimi-dantaka (caries\

The

teeth

become

loose

and perforated by black holes


saliva.

accompanied by a copious flow of

The appear-

ance of an extremely diffused swelling (about the roots of

decayed teeth) with a sudden aggravation of the accom-

panying pain without any apparent cause


of
in
its

is

also

one

Danta-harsha which the teeth cannot bear the heat, cold or touch
specific
features.
:

The

disease
is

called Danta-harsha.
tion

It is

due to the deranged condi:

of Vdyu.
is

Bhanjaka
is

The

disease in which the

face

distorted, the teeth break,


severe,

and the accompanying

pain

is

called

Bhanjaka (degeneration of the


XV 1

Chap.

NIDANA STHANAM.

10^

teeth).

the

The disease is due to the deranged The Vayu and Kapham. Sarkaiai
:

condition of
disease,
in

which sordes, formed on the teeth and hardened (by the


action
at

of the

deranged Vayu),
of the teeth,
is

lie in

a crystallised form

the roots

called

Sarkara (Tartar).

Such deposits tend

to destroy the healthy


:

growth and

functions of the teeth. Kapalikai

The disease in which


Kapalika (calcareous
erosion into

the preceding crystallised deposits get cemented together

and afterwards separate from the teeth taking away a part


of their coating (enamel)
deposit)
is

called

which naturally makes an

and
in

destroys the teeth

Sya^va-dantaka : The disease,

which the teeth variously scorched by the action of the deranged Pittam assumes a blackish or blue colour, is

named as Syava-dantaka (black teeth). Hanu-moksha The disease in which the Vayu aggravated (by such
:

causes,

as

by loud
called

talking,

chewing of hard substances,


identical with

or immoderate yawning) produces the dislocation of the

jawbones

is

Hanu-moksha
its

It

is

Ardditam

as regards

symptoms.

Diseases of the
of diseases

26-33. tongue : The


the organ
of
three

five

kinds
the

which
of

affect

taste

are

three

sorts

Kantakas due to the


Pittaja

deranged

Doshas

(Vataja
34.

and

Kaphaja),

AUsa and
Vataja Kanloses

Upa-jihvika.

The three Kantaks : In


taka
sense

the

type
of

the

tongue

becomes

cracked,
like

the

taste

and becomes rough

a teak leaf

(giving the organ a warty appearance).

In the Pittaja

Kantaka form
sensation (of

the tongue

is

coloured yellow and studded

over with furred blood-coloured papillae with the burning

the

Pittam

in

them).

In

the

Kaphaja
in the

Kantaka type

the

tongue becomes heavy, thick and

grown over with vegetation of slender fleshy warts


14

to6

THE SOSHRUTA SAMHitA.

CChap. XVI.

shape o{ S'almali thorns. Alsbsa :- The severe inflammatory swelling about the under surface of the tongue
is

called
rise

Alasa, which
to

gives

if allowed to grow on unchecked numbness and immobility of the organ

and tends to a process of rapid suppuration at its base. The disease is caused by the deranged blood and Kapham. The Upa-jihva^ - The disease in which a
:

(cystic)

swelling

shaped

like

the

tip

of the

tongue

appears about the under-surface of that organ by raising


it

little

is

called Upa-jihvika (Ranula).

The accom-

sensations in

panying symptoms are salivation, burning and itching these are due to the the affected organ
;

35 deranged Kapham and blood (of the locality). Disease of the palate Diseases which
:

37.

are

peculiar to the part of the palate are

named
38.

Gala-s'undika,

Tundikeri, Adhrusha, Mansa-kachchapa, Arvuda, Mansasanghata,, Talu-s'osha

and Talu-pdka.

Gala-SUndika : The
swelling,

diffused

and elongated

caused by the deranged blood and


appears

Kapham,

which
goes

first

about the root of the palate and


till
it

on extending
is

looks

like

an inflated skin-

bladder

called Gala-s'undikd

(tonsilitis)

by physicians.
of

Thirst, cough, difificult breathing are

the indications

the disease.

Tundikeri

A thick swelling resembling


and suppuration
is

the fruit of the

Tundikeri plant in shape and appearing

about the root of the palate attended with a burning,


piercing
or

pricking pain

called

Tundikeri (abscess of the

numbed
the

svvelling

Adhrusha : A red, appearing about the same region, as


tonsil).

effect

of the vitiated blood of the locality, attended

with severe

fever

and pain,

is

known by
like

the

name

of

Adhrusha. Mjinsa-kachchapa: A brownish and slightly


painful

swelling

somewhat shaped
the

the back of a of the


soft

tortoise (and

appearing about

region

Chap. XVI.]

NIDANA STHANAM.
called

lo;

palate)

is

Mdnsa-kachchhapa.

The
is

disease

is,

slow

in

its

growth or development and

due to the
the region

deranged Kapham.
the petal of the lotus

Arvuda:
lily

swelling shaped like


in

and appearing

of the soft palate as an


dition

of the
is

local blood

swelling
before.
flesh

identical

outcome of the aggravated conis called Arvudam. The with the Raktarvuda described
vegetation
of morbid
soft
is

Mausa-Saiighata : A
the

at

edge

or

extremity of the

palate
called

through the action of the derani^ed

Kapham
o(

Mansa-Sanghata.
painless
fruit

It

is

painless.
to

Ta!u-piipputa:

permanent swelling

the shape
fat

the Kola

(plum) caused by the

deranged
is

and Kapham
Tdlu-pupputa.
in

at the region of the soft palate

called

Tatiu-sosha
the

: The
feels

disease a
sort

of the soft
of parched

palate

which
with

patient

sensation
in

dyspnoea and a
part
is

severe

piercing

pain

the
origin

affected
in

called T^llu-sosha,

which has
the

its

the
in

aggravated condition
concert with the

of

bodily

Vayu
sets

acting

deranged

Pittam.

Ta^lu-patka

The
called

disease in which the deranged

Pittam
soft

up a very
is

severe suppurative process in the

palate

Talu-paka,

39-47.

The diseases
larynx The
:

of
in

the throat and


are

diseases peculiar to the throat and the

larynx
the

are

seventeen
of

number and

known

as

five

types

Pohini,

Kantha-Saluka,

Adhijihva,

Valaya, Valasa, Eka-vrinda, Vrinda,


Gala-vidradhi,
Viddri.
48.

Sataghni, Gilayu,

Galaugha, Svaraghna, Mansatana. and

General features of Rohinis:-The


aggravated
in

Vayu, Pittam, Kapham,

either severally or

combination, or blood

may

affect

the

mucous

of

the throat

and give

rise to

vegetations of fleshy papillae,


lo8

THE SUSHRUTA SAMHITA.


the

[Chap. XVI.

which gradually obstruct

channel
is

of the
called

throat

and bring on death.


(Diphtheria^i.

The

disease

Rohini

49.

The V^taja Rohini :~A


tremely painful fleshy
the tongue which tend to
obstruct

vegetation of exall

Ankuras (nodules), crops up

over

the passage of the

throat and are usually accompanied

symptoms characteristic Eohini : The Ankuras (nodules) in the present type are marked by speedy growth and suppuration, and are accompanied by a burning sensation and high fever. Kaphaja Rohini The Ankuras (nodules) become
:

by other distressing of the deranged Vayu. Pittaja-

heavy,

hard

and

characterised

by

slow

suppuration
50-52.

gradually obstructing the passage of the throat.

The Sannipatika Type : Suppuration


takes place in the deeper strata of

companied by
amenable to
characteristic

all

the

membrane acdangerous symptoms peculiar to


the
of the
disease.
It
:

the three aforesaid

types

is

rarely

treatment.
of

Rakfcaja

Type

-Symptoms
in the throat,

the
fleshy

Pittaja

type of the disease are


This type

present and the


is is

outgrowth formed
with small

found to be covered
incurable.*

vesicles.

53~54
:

Kantha-^alukam
plum-stone
has

-The

disease in which a

hard rough nodular growth (Granthi) in the

shape of a
if it

crops up in the throat, which seems as


bristle of a

been stuffed with the


is

S'uka insect or

been pricked by thorns


disease
It is
is

called

Kantha-Salukam.

due to the action of the


to surgical

The deranged Kapham.


:

amenable

treatment only. Adhijihva

small swelling like the tip of the tongue caused by the


*

The

reading Sadhya (curable) which


of

is

to

be met with in the several


of the reading Asadhya

printed editions
'incurable)
is

Madhab's Nidanam

in

lieu

not to our mind correct,

Chap. XVI.]

NIDANA STHANAM.

I09

deranged blood and


is

Kapham

over the root of the tongue


as

called Adhijihva,
in.

which should be given up as soon

suppuration sets

Valaya : A

circular or ring-shaped

raised swelling obstructing or closing

up the upper end of


is

the oesophagus (structure of oesophagus)


It

called Valaya.
It is

cannot be cured and hence should be given up.


to

due

the

locality.

Valatsa

aggravated
in

Kapham in the The disease in which the unusually Vayu and Kapham give rise to a swelling
deranged action of the
:

the throat, which

is

extremely painful and causes a

difficulty of respiration,

ultimately producing symptoms


is

of

complete

asphyxia
is

called

Valasa
55

by

learned

physicians and

very

difficult to cure.

58.

Eka-vrinda and Vrinda*: The


which a
appears
circular, raised,
In

disease in

heavy and
slight

slightly soft swelling

the

throat

attended with Itching, a slightly


suppuration
is

burning sensation

and a

called

Eka-vrinda.
blood and

The disease is due to the effect of vitiated Kapham. The disease in which a round
is

elevated swelling attended with high fever and a slightly

burning sensation

formed

in the

throat

through the
is

aggravated condition of the blood

and Pittam

called
its

Vrinda.

piercing pain in the swelling

points to

Vataja origin.

5960.
:

^atagChni
concerted action

The
of the

disease

in

which, through the

deranged Vayu, Pittam and


fjagged

Kapham, a hard
brane;

throat obstructing Varti

mem-

edged

like

a Sataghni-f and densely beset with


is

fleshy excrescences
*

formed along the inner lining of


Taking Vrinda
similar
as a

The

diseases of the

throat are 17 in number.


to 18
;

separate disease they

amount

but Vrinda,

affecting

place

and being similar


is

in

appearance with but a slight distinction of symptoms,

only a particular state of Eka-vrinda, and not a separate disease.


t Sataghni
is

a kind of

weapon uged

in ancient warf?ire,

iro
that pipe
is

THE SUSHRUTA SAMHITA


denominated as Sataghni.

[Chap. XVI.

Various kinds

of pains, (characteristics of each of the deranged Vayu,

Pittam and

Kapham)
:

are

present

in

this

type which
6i.

should be necessarily considered as irremediable.

GilStyu

The
to

disease in
rise

which the aggravated


to

Kapham and
painful
in

blood give

a hard and slightly

(D.

extremely painfull glandular swelling


the
siz^ of the stone of the

the

thrviat

Amalaka
or

fruit is called

Gilayu.
is

sensation
is

as

if

a morsel

bolus of food

stuck in the throat


is

experienced which
62.

by

its

very nature

a surgical case.

Gala-vidradhi:
throat,

Thediseascin whichan exten-

sive swelling occurs along the

whole inner lining of the


action of the deranged
called Gala-vidradhi
in

owing

to the

concerted
is

Vayu, Pittam and Kapham


exhibits
all

which
of the

the features

present
:

a Vidradhi

Sanipatika type.
large

Galaugha
any

The

disease in which a

swelling

occurs in the throat so as to completely


solid or liquid food

obstruct the passage of

and also

that of
the
is

Udana-vayu (choking the pharynx, larynx and


of the esophagus), attended with a high fever

mouth

called Galaugha,

the origin

of which should be as-

cribed to the action of the deranged blood and

Kapham.

Svaraghna: -The
owing
to

disease

in

which the

patient faints

the

choking of the larynx by the deranged


stertorous breathing, hoarseis

Kapham which is marked by


ness, dryness

and paralysed condition of the throat


which has
its

called

Svaraghna

origin in the deranged

Vayu.

6365.
:

IVIanSatana

The

disease in which a pendent,

spreading and extremely painful

swelling appears in
is
is

the throat which gradually obstructs the pipe

called

Mansatana.

and by the deranged Vdyu, Pittam ^nd Kapham


It invariably proves fatal

caused

6()


Chap. XVI.]

NIDANA STHANAM.
:

til

Vidari

-The

disease In which a

copper-coloured

swelling occurs in the throat,

marked by a pricking and


flesh

burning sensation,
putrefied

and the
disease

of

the

throat

gets
is is

and sloughs

off (and
is

emits a fetid smell)

called Vidari.

The

of a Pittaja origin

and

found to attack that side of the throat on


patient
is

which the

in the habit of lying.

6^.

The disease
Cases which are found
the

in
to

the entire cavity:


invade the entire cavity of
restricted to

mouth (without being

any

particular
Pittaja,

part thereof)

may

be

either

due

to

Vataja,

Kaphaja or Raktaja type and are known by the general

name
is

Savra-Sara.
with

(i"^.

In the

Vataja type the


vesicles inside.

entire

cavity

of the

mouth
a large

studded

attended

with

pricking

sensation in their

In the Pittaja type

number

of small yellow or red-coloured vesicles attended

with a burning sensation crops up on the entire (mucous

membrane lining
of the

the cavity of the mouth. In the

Kaphaja

variety a similar crop of slightly painful, itching vesicles

same colour

as

the skin

(is

found on the entire

inner surface of the mouth.)

The blood-origined Kaktaja


;

type

is

nothing but a modification of the Pittaja one

(giving rise to similar


called

symptoms)

it

is

also

by others

Mukha-patka.

69-72.
of the

Thus ends the sixteenth Chapter

Nidana Sthanam

in the Sus'ruta

Samhita which treats of the Nidanam of the diseases of the mouth.

Here ends the Nidana Sthanam.

THE

SUSRUTA S AMHIT
SARIRA STHANAM.
(Section on Anatomy).
-.o:

CHAPTEE L
Now we
shall discourse

on the Sdriram which treats

of the science of Being in general

(Sarva-Bhuta

Chintsi ^gfriram).
The
is

i.

latent

(lit

unmanifest) supreme nature (Prakriti)


all

the

progenitor of

created

things.

She

is

self-

begotten and connotes the three fundamental or primary


virtues of Sattva, Rajas

and Tamas.

She

is

imaged or

embodied
manifest),

in

the

eightfold

categories of

Mahdn

(intellection),

Avyakta (unAhamkdra (Egoism) and

the five
is

the sole

Tanmdtras or elementals (proper sensibles) and and primary factor in working out the evo-

lution of the universe.

The one
all

absolute

and original
out

nature
of

is

the fundamental stone house of materials


self-conscious

which the bodies of

(Karma-Purusha)

working agents (agents who come into being through the


dynamical energy of
evolved in the same
fined
in

their acts or

Karmas) have been


whether confree

manner

as all water,

tank or a reservoir, or coursing

through

the channels of streams

and of mighty

rivers,

have been
2.

welled up from the one and shoreless primordial ocean.

Out

of that latent unmanifest (Avyakta)

or original
units

nature (impregnated

by the atoms or elemental


15

of

ri4

THE SUSHRUTA SAMHITA.


Purushas)
Intellection

[Chap.

I.

consciousness or

been evolved, and out of

Mahdn

egoism.

Mahdn has This Mahan or


or
as

intellection should be likewise considered

partaking
Rajas, and

of the three fundamental attributes

(Sattva,

Tamas)

of the

latent

(Avyakta) or original
its

nature.*

Ahamkara

or egoism in
as

turn

may

be grouped

under

three subheads

the Vaikdrika Taijasa (operative) or


3.

Rdjasika, and Bhutadi (illusive or Tamasika).

The

eleven organs

of cognition,

communication or
the

sense perception have emanated

from the co-operation


Taijasa

of the aforesaid Vaikarika


or Rajasa.

Ahamkara with

They

are the ears, skin, eyes,

tongue, nose,

speech, hands, genitals, anus, feet

and the mind (Manah).


five
;

Of

these foregoing organs the

first

are

intellectual

or sense

organs (Vuddhi-Indriya)

the next five being


par-

operative (Karma-Indriya\
takes
of

The mind (Manah)


both the
intellectual

the

character of
4-5.

and

operative organs alike.

The
terised

five

Tanmatras or elementals
etc.

(or the five

proper

sensibles of hearing, touch, sight, taste,

and smell) charac-

by the Nescience,

have been evolved out of the

Bhutddi
Taijasa

etc. (or Tamasa Ahamkara) concerted with the Ahamkdra through the instrumentality of the Vaikarikam. The gross or perceptible modifications of

these five
smell.

Tanmatras are sound, touch,


the

taste, sight

and
five

From

combination of the aforesaid


at a time,

Tanmdtras (Bhutadi) taken one


sively

have successuch as

emanated the
Rajas and
;

five

gross matters of space

* Sattva,

Tamas : Adhesion, cohesion and


affection, love

disintegration
;

in the Physical plane

and hate

in the

moral

emancipa.

tion, spiritual affinity

and

sin in the Psychic.

Simply phenomenal or the simple outcome of the phenomenal evolution


without being by othet specific attributes of matter and hence Skttvika or

iUuminatiDg or quasi-spiritual.

Chap,

i.]

SARIRA STHaNAM.
heat,
(fire,)

11$

ether,

air,

fluid (water),

and earth

(solid).
is

These twenty four categories combinedly


technically

form what

known

as

the

twenty

four elements
the twenty four
6.

(Tattvas).

Thus we have discoursed on

fundamental principles (Chaturvins'ati-tattvam).


Hearing, touch, sight, taste and smell

respectively

form the

subjects

of

the

five

intellectual

(Vuddhi)

organs of man, whereas the faculty of speech, handling,


pleasure, ejections or evacutation, locomotion successively

belong to the (remaining)


ones.
tion),

five

operative (Karma-Indriya)

The original nature (Avyakta), Mahan* (intellecEgoism (Aliamkara),the five sensibles (Tanmatras),
five gross

and the

material

principles
is

in

their

nascent

stage in evolution form


categories of

what

included within the eight

Nature

(Prakriti), the

remaining sixteen

categories being her modifications (Vikara),

of intellection (Mahan) and


as of

The objects Egoism (Ahamkdrd) as well the sense organs of knowledge and actions are the
themselves and in their nature.
of intellection (Buddhi)
is

material principles (Adibhautika) though they are spiritual in

The tutelary god The god Is'vara is egoism (Ahamkdra)


(Manah)
eyes
;

Brahma.

the presiding deity of the sense of


;

the

moon god
skin

is

that of the of the ears


is

mind
;

the quarters of the


is

heaven,
;

the

wind god
;

that of the
is

the sun
;

that of the
is is

the water
;

that of the taste

the earth
;

that

of

the smell

the
;

fire is

that of the speech


that of the legs
is
;

Indra

that of
that

the hands
the

Vishnu
and
7.

is

Mitra
the

is

of
of

anus

Prajapati

that

of

organs

generations.
*

Mahan, Ahamkara and the

five

Tanmatras, though but modifications


have been included within the
as they form the immediately prior

of the original

Nature in themselves,

category of Nature (Prakriti) in

asmuch

or antecedent conditions of the evolution of the

phenomenal universe.

ri6
All the

THE SUSHRUTA SAMHITA.


aforesaid

[Chap.

t.

(twenty-four)

categories
are

or of
the
are

elementals

(Chaturvinsati-Tanmdtras)
Similarly
of Prakriti

devoid
of
etc.

consciousness.

the

modifications

primal cause
all

such as the Mahat


in

bereft of consciousness

as

much

as
is

the

cause

itself,
it.

the

Avyakta or the
or

original nature

devoid of

The Purusha
and
its

the

self-conscious

subjectivity,

enters into the primal cause

(Mula-Prakriti or original
effect

Nature)

necessary

(the

evolved

out

phenomena) and makes them endued with his own The preceptors and holy essence or self-consciousness. sages explain the proposition by an analogy that as
the

milk in the breast of a mother, though unconscious

in itself, originates

and flows out


;

for

the growth and


in

sustenance of her child


of an

(as the

semen

the organism

adult male though devoid of consciousness, flows

out

during

an

act

of sexual

intercourse)
principles

so these

twenty-four

primary material
in

(elementals), to

though unconscious
towards the

themselves, tend

contribute
self or

making of the
for

self-conscious

the

universal individual (the aggregate of limited


tional
selves)

or condifinal

the

purpose of working out his


i.e.,

liberation or

emancipation

attainment of the stage of


8.

pure consciousness or perfect knowledge.

Now we
(subjective

shall describe the tracts

which the

Purusha
or

or self-conscious

reality)

and Prakriti
in

nature

(passive

non-conscious eternity) pass


those

com-

mon
other.

as
9.

well

as

wherein

they differ from each

Traits of
manifest,
eternal,

commonalty :Both the Purusha


realities,

and Prakriti are eternal


without
a

both of them are unbeginning or origin,

disembodied, without a
second,
all

pervading

and omni*

present.

Chap.

I.]

SARIRA StHANAM.
Purusha

II?

Traits of diversity : Of the


the
Prakriti,

and and

only

the

latter

is

non-conscious
qualities

possesses

the three fundamental

of Sattva,
function
as

Rajas and

Tamas.
in

Prakriti

performs the
lies

of the seed or

otherwords she
in

inherent

the

seed

or

the

primary cause

the

latter

phenomenal

evolution of the

Mahat

etc.

and contributes the maternal and birth of


universc\

element
the

in the

conception, development

primordial

cosmic matter (phenomenal

fecundated
in
its

by the Purusha (self-conscious subjectivity)


stages of evolution.
etc.
;

different

These stages are


is

called
ferent,
life.

Mahat, Ahamkara
as

and Prakriti

not indif-

the Purusha

is

to the pleasures

and misery of

But the Purusha (units or atoms of consciousness),


virtues

devoid of the threefold

of Sattva etc. are non-

concerning hence non-producing and bereft of the seedattributes

of

lying

inherent

in

all

as

the

primary
to

cause
joys

of evolution.

They
life,

are

mere witnesses
in

the
their
or-

and miseries of
though
10
is

and do not participate


the

in

enjoyment
ganism.

imprisoned

human
its

Since an effect

uniform

in virtue to

producing
Pra-

cause, the evolution ised effects or products of the


kriti

such as the Mahat,

Ahamkara

etc.

must needs par(Sattva,

take of the three fundamental

qualities

Rajas
In

and Tamas) which are predicated of the Prakriti.


other words, these

Mahat, Ahamkara,
three

etc,

are

but the

modifications
Sattva, Rajas

of the

fundamental qualities of

and Tamas. Moreover, certain authorities


are
units

hold that the Purushas

of self-consciousness,
their

possessed of the three aforesaid qualities owing to

antecedent

conditions

or

causes

(the

gross

material

universe) being permeated

with and characterised

by

them.

II.

Il8

THE SasHRUTA SAMHITA.

[Chap.

1.

IVIetrical Text (Vaidyake.) : It is asserted in the Ayurveda that it is only the gross-sighted ones and men capable of observing only the superficial
appearances,

who confound

eternal

order

or

se-

quence of things and events (Svabhd,ba), God ( Is vara) * Time (Kala), sudden and unlooked for appearances
of the

phenomena (Yadrichchha), Necessity


(Parinama) with
five different

(Niyati) and

transformation
(Prakriti).

the

original

Nature

The

forms of matter (such as


modifications
or
trans-

Ether etc

are nothing but the

formed states of the original nature and are characterised by the three universal qualities of Sattva, Rajas and

Tamas, and
same.
disease

all

created things,

whether mobile or imthe

mobile, should be considered as alike exponented by the


In
is

the

Science

of

medicine

cause of a

the one sole aim to be achieved

by means of
and
subject
further,

administering proper medicinal remedies (matter),

hence the properties of matter are the only


to be dealt with in a

fit

book on pharmacy.
prior

And
of the

because the immediately

cause

human

organism

is

a proper and

congenial

admixture of the

sperm and ovum (matter), the sense organs are the


resultants of

phenomenal

evolution of matter,
are

and the
or

objects

of sense

perception

equally

material

phenomenal
organ of his

in their nature.
:

12-14,

IVlemorable verse

-A man by a particular body perceives the same matter which


in

forms the proper object of that sense organ


as the perceiving sense organ

as

much

and the perceived sensible


cause.
in

are produced
*

by the same material


factor according to

The
order

matter,
of cosmic

The second

Sankhya,

the

evolution, which as the seed of the universe,

was hid
the

in the

burning disc
solar

of the central, primordial Sun, out of which

different

systems

have come into being.

Chap.

I.]

SARIRA STHANAM.

II9
particular sense

which

specifically forms the object of a

organ, cannot be perceived

by the

other.

We
15.

see a

flower with the eyes and not with the nose.

The Science
on the contrary
and are born

of medicine does not lay


all

down

that

the

self-conscious Selves (Kshetrajna) are


it

pervading, but

asserts that they are real

and eternal
or

in the planes of divine,

human
evil

animal
in
life.

existence according to their

good or

deeds
entities

The

existence

of these

self-conscious

can

be

ascertained duly by inference inasmuch as they are

extremely subtle in their essence.


self is

The

self-conscious
is

possessed

of infinite

consciousness,
of being

real

and
out

eternally subject to

the

process

evolved

into a finite, organic individual

through the dynamics

of the

combined sperm and ovum.


(individual)

The view

is

further

corroborated by a dictum of the Sruti which holds that

Purusha

is

nothing but a

combination of
This Purusha or

a self-conscious self and the five kinds of matter (Mahabhutas) formed into an organic body.
individual,

which
falls

is

called Individual of action

(Karmaart

Purusha),

within the scope of the science and


16

of medicine.*
*

17.

Here

lies

the difference between

Sankhya and Ayurveda. While the


the
latter

former discourses on in material character of the soul,

comin

mences

to

discuss
is

on the questions how the material environment


said to

which the soul

inhabit

is

evolved, and
is

how
is is

the inclusion

of

the spiiilual within the material organism

effected.

Hence

Sus'ruta's Physiology, like that of

Charaka,
life

in

the

strictest

sense of the

word molecular and

his

science of

an attempt

at

explanation of consciousness
agrees with the views of
Sus'ruta
is

from the

materialistic

standpoint,

which

modern western

science.

Intellect

according to

material and belongs to the same category which the


its

Sankhya

system of philosophy in
as seven.
is

explanation of evolution
to Sus'ruta, is
is

enumerates originally

The soul, accordtng


what
is

an independent existence and

often associated with

called

life.

soul,

and

it

not everywhere the same.

Where there is life, there is a The soul in Sus'cula is individual

120

THE SUSHRUTA SAMHITA.

[Chap.

I.

The attributes
vidual
enemity,
:

of

an organic indishunning of pain,

Longing

for pleasure,

energetic

undertaking of work, respiration

(Prdna\ emission of flatus (Apana), closing and opening


of the
eyelids,
intellect

(Vuddhi), sentiment (Manah),

memory, knowledge of art, perseverance, sensation and perception, are the attributes
deliberation,
discretion,

of an organic individual.

i8.

Distinctive features of the different classes of mental temperaments : An


absence of
all killing

or hostile propensities, a judicious

regimen of
in

diet,

forbearance, truthfulness, piety,

a belief

God,

spiritual

knowledge,

intellect, a

good retentive
of good

memory, comprehension, and the doing


irrespective

deeds

of

consequences, are the qualities which

grace the mind of a person of a Sa'ttvika temperament.

Feeling of

much

pain and misery, a


vanity,

roving

spirit,

non-

comprehension,
pride,

untruthfulness,

nonclemency,

an over winning confidence in one's own excel-

lence, lust,

anger and hilarity are the attributes which mark a mind of the Raijashika cast. Despondency,
disbelief
in

stupidity,

the existence of God, of intellect,


qualities
19,

impiety,

stupification

and perversity

lethargy in

action

and sleepiness are the


of a Taimasliika stamp.

which mark a

mind

distinctive traits of the five material of Elements of the world ;


The
properties of Akas'a (ether) are sound, the

The

sense of
veins,

hearing, porosity and differentia evolution of the

ligaments
Xif^^
union
^^^'.

etc. into their

characterised species (Viviktatd.)


disease

^"^ takes cognisance of sorrow,


the body
(

and death by

its

with

^t ?T^UJ^

sjfjf^C

^^^\m

giq

9gj^^
it

Hence

the living frame together with the soul that ia said to inhabit subject-matter of Ayurvedic medical treatment,

forms the

Ed.

Chap.

SARIRA STHANAM.
Vatya (etherin) are touch, the skin,
of the organism,

121
all

The

properties

functional

activities

throbbing of the

whole body (Spandana) and lightness.


of

The

properties

Tejl

(fire

or heat) are form, the eyes, colours, heat,


digestion,

illumination,

anger, generation of instanta-

neous energy and valour.

The

properties of

Apa

(water

or liquid) arc taste, the tongue, fluidity, heaviness, coldness,

olioginousncss

and

semen.

The

properties
or

or

modifications of

Prithivi (the

earth

matter

solid)

are smell, the nose,

Of
the

these the

embodiment and heaviness. 20. ether or Akasa abounds in attributes

of

Sdttvika

stamp, the

Vayu

or etherin

in

Rdjashika,
in S^ttvika

the Teja in Sattvika

and Rajashika, the water


in

and Tamashika and the earth

Tamasha

attributes. 21.

There are IVIemorable Verses : These


qualities are found to characterise

and enter intothe*suc-

cessive elements in the order of their enumeration.


specific attributes of these

The
in the

elements are manifest

substances which are respectively originated from them.

The term

Prakriti or original nature connotes the

eight
five

categories (of Avyakta,

Mahan, Ahamkara, and the

Tanmatras) and the


principles are
its

rest of the

twenty four fundamental

modifications.

The Furusha forms

the

twentyfifth principle.
ciples of

These twentyfive fundamental prin^


dealt w^ith in the present

cosmogony have been

treatise

^Salya-Tantram) as well as in the other treatise


22

(Salaky-Tantram and Sankhya Philosophy).


Thus ends the
first

23.

Chapter of the S'arira Sihananin the Sus'ruta Samhita


in general.

which deals with the science of Being

16

CHAPTER
Now we
treats
fluid

II.

shall

discourse
of

on

the

Sariiam

whicii

of
etc.

the

purification

semen

and

cataminal

(Sukra-^onita-^uddhirnama
i.
is

^ariram).

A man
seminal

incapable

ol

begetting children, whose

fluid, affected

by the aggravated Vayu, Pittam or


smell, or

Kapham, emits a cadaverous


a
clotted

has acquired
like

or shreddy
or
2.

character or which looks


thin,

putrid pus,

has become

or smells like

urine

or stool,

Deranged Semen Semen


:

vitiated

by the

deranged Vayu acquires a (reddish-black) colour and


gives rise to a pain
characterises the
(piercing
(at

and cutting

etc.)

which

Vayu

the

time of being emitted).

Similarly semen deranged by the Pittam gets a (yellowish


or bluish
etc.)

colour

and produces the


etc.)

specific

pain

(burning
(at the

and

sucking

of

the

deranged

Pittam

time of emission).

Semen

vitiated

by the action
prothe

of the

deranged

Kapham
(at

has a (white) colour and


etc.)
its

duces the pain (itching sensation

peculiar to
outflow).

deranged

Kapham
all

the
is

time of
tinged

The

semen

vitiated

by blood

with a bloody hue,

produces

kinds

of pain

peculiar to the deranged

Sonita (Pittam).

The semen
of the action

smells like a putrid corpse

and

is

emitted in large quantities.


character
to
fluid

The shreddy

or

clotted

(Granthila) should

be

ascribed

the
If

of

the

deranged
putrid

Vayu and
pus
(Puti-

Kapham.
puya).

vitiated

by the action of the deranged


it

Pittam and

Kapham
is

looks

like

Thin semen

caused by the deranged

Vayu and

Chap,

II.]

SARIRA STHANAM.

'

23

Pittam as described before.

concerted action

of the

deranged Vayu, Pittam, and


to

Kapham

causes the semen

smell

like

urine

or

fecal

matter.

Of

these,

the

cadaverously smelling, shreddy and clotted, putrid puslike

and thinned semen can be remedied and corrected


;

only with the greatest difficulty

while the one,

having

the smell of stool or urine, should be regarded as beyond


cure.

The remaining kinds

arc curable.

3.

Deranged Artavam : The


(Artavam) of a
Pittam,

catamenial

fluid

woman
or

vitiated

by the deranged Vayu,


either

Kapham,
as
unfit

blood,

severally

or

in

combination of two or more Doshas should be likewise


considered
Vitiated
for

the

purpose
exhibits

of

fecundation.
characteristic

catamenial
pain
at

fluid

the

colour and

of

the
roots).

deranged Doshas

or

blood
(of

(underlying

its

Of
is

the

several

kinds

vitiated catamenial fluids) those

which smell
is

like a putrid

corpse or fetid pus, or which


the smell of urine or fecal

clotted, or

thin, or

emits
as

matter, should be

deemed
4.

being beyond remedy, the rest being amenable.

IVIemorable Verses : The


of seminal

first

three types

derangements or defects should be corrected


physican with

by
etc*

an

intelligent
oil etc.

an application of

medicated
or

^Sneha-karma), diaphoric measures


injections ^Uttara-vasti).

uretheral

medi-

cated
of;

Ghrita

prepared with a (decoction and


flowers,

Kalka

Dhdtaki

barks should

semen em'ts a

Dddima and Arjuna be given to drink to a man whose cadaverous smell (Kunapa\ As an alterKhadira^

native, a medicated Ghrita prepared with (a decoction and levigated paste or Kalka of) the drugs forming the

S^dlasdrddi group should be given to him.


*

In a case of
Anuva-

The word " Adi

" in the text inclutles emelic>,

purgatives,

sanam and Aslhapanam meai^ures according

to their specific

Doshas.

124
clotted

THE SUSIIRUTA

SAMIIITA.

[Chap

II.

and shreddy semen (Granthi), the patient should


to drink a medicated

be

made

Ghrita prepared with a


or with an alcaline solu-

(decoction and

Kalka

of) S'athi,

tion prepared from the ashes of the burnt

P aids' ha

wood.

In

the case

of a pus-like appearance

of the fluid the

patient should

be treated with the

medicated Ghrita

prepared with (a decoction and Kalka of) the drugs included within the groups of Parushakddi and Vatddi

(Nyagrodhadi)
measures
laid

Ganas,

In
the

case

of

thin

semen,

down under

same head

before, as w^ell
to.

as those to be hereafter described should be resorted

Similarly a
coction

medicated Ghrita, prepared with


of)

(a

de-

and Kalka
or fecal
as
well

Chiti^akk roots

Ushira roots and

Hingu, should be drunk


like

in a case of the

semen smelling
of seminal

urine

matter.
in

In

all

cases

disorders

as

menstrual

anomalies, Uttara-

Vssti (uretheral or
after
oil

vaginal

injection) should

be

made

having recourse to the application

of medicated

etc.

(Sneha-karma\ purgatives, emetics, Asthapana


5

and Anuvasana measures.

12
Artava: In
Vayu,
Pittam,

Treatment
all

of derang^ed
(by
the

the four cases

when

the catamenial blood would be

found to be vitiated

deranged

Kaphah
should

or Sonita), the preliminary remedial measures of


oil etc.

the application of

purgatives

etc.

(Pancha-karma)
the

be

first

employed
be
paste
etc.),

and

then
viz.

following
of

measures

should

undertaken
of

application

Kalka,

(levigated

drugs),

Pichu (medicated
and Achamaua
treat-

plugs pecharies ment of


clots

Pathya
as

(diet)

^vashes with decoctions)

described under the


etc.

Gyonoecological
(Granthi)

cases
in

Appearance

of

of blood
fluid

place of the healthy

men-

strual

would
of P^th^,

indicate,

decoction

or a pulverised

compound

Trushuna and Vrikshaka (Kutaja).

Chap.

II.]

NIDANA STIIANAM.
Chandanam
is

125
indica-

A decoction o^ B/iadras^'rifam'^ and


ted in the case
fetid

when

the menstrual fluid would smell like

pus,

or contain marrow.

The remedies described


likewise

under the head of seminal disorders, should be


prescribed
in cases of

menstrual

anomalies caused by

the action of the deranged

Vdyu, Pittam and Kaphah


individual
case
barley,

according to the requirements of each

under

treatment.

Sdli-rice,

wine and meat


be deemed
as

with cholagogue

properties

should
13

wholesome diet

in these cases.

16.

Traits of pure and healthy

semen
which
is

and menstrual blood Semen


transparent
the smell
like
crystal,
;

fluid, glossy,
oil

sweet and
in

emits

of

honey

or like

or

honey
is

appearance
healthy.

according to others, should

be considered as

The catamenial blood (Artava) which


blood
of a
hare,

red like

the

or the washings of shellac

and leaves

no

stains

on

cloths
in

(which

may

be washed off by be considered as

simply soaking them


healthy.

water) should

1718.
(Menorrhagia) :

Asrig'dara
excessive
or
or
its its

An
the

abnormal
blood

or

discharge of the menstrual


persistence

(Artava),

long

even

after

wonted time,
properties)

appearance at a premature or unnatural period


as

(as well

contrarity

in

its

colour or

is

called

Asrigdara.

All types of the disease (Asrigdara)

are attended with an aching in the

limbs and a painful


In

flow (of

the

catamenial

fluid).

case

of excessive
as

hoemorrhage (from the

uterus),

symptoms such

weakvision,

ness, vertigo, loss of consciousness,

darkness of

or

difficult

breathing,

thirst,

burning (sensation of the

body), delirium,
*

palour,
is

somnolence and other Vataja


to

Bhadras'riyam

8'richandanam according

Dallana

or

white

Sandal \vood according Gayadasj^.

126

THE SUSHRUTA SAMHITA.


hysteria
etc.)

[Chap.

II.

troubles (convulsion,

may

set

in.

A
with

physician

should

treat

case

of

Asrigdara

measures and remedies as laid down under the head of

R^kta-pittam
patient
is

(hoemorrhage)

in

case
in

when

the

young
disease

(of sixteen years), careful

her diet,

and the
tions.

unattended

with severe

complica-

19 -2t.
:

Amcnorrhoe
menstruation
of

-In

case

of

suppression

of

(Amenorrhoe) caused by the obstruction

the

deranged
the

Doshas (Vayu and Kapham)


should
pulse,

in the
fish,

passage,

patient

be advised

to

take

Kulattha
gru
1

pulse,
Tila,

Masha
wine
curd

Kanjikam fermented sour


cow's
urine,

etc.),

(Sura),

whey, half

diluted

Takra,

and

S^uktam
before.

for

her diet.

The

symptoms and treatment


tion have been described

of thin and scanty menstruaStill

in

such a case

measures laid down for the treatment of Nashta-Rakta


(amenorrhoe)

may

be

adopted.
the

treatment described as before,

Under a course of semen or the catato their

menial blood

of a person

would be resorted
22

healthy and normal condition.

23.

A woman
forego the bed

with (healthy)
of her

catamenial

flow
first

should
three

husband during the


as

days of
colly rium.

her uncleanness,
S'le

well

as

day sleep and


nor bathe,

shall

not shed

tears

nor

smear her person (with sandal paste etc.\ nor anoint her body, nor pare her nail, nor run, nor indulge in
loud and excessive laughter and hear loud noise, nor
to
if

talk,

nor should she


herself

comb

her hiir,

nor expose

droughts, nor do any fatiguing

work

at all

because
three

woman

sleeps in the

day time (during

the

first

days of her period) her child of subsequent conception

becomes sleepy or somnolent.


collyrium along her eyelids

The woman who

applies
giv^es

(during those days),

Cliap. il.]

SARIRA STHANAM.
a

27

birth

to

blind child

by shedding

tears (during her

period) a
sight
;

woman

gives

birth to a child of defective eye-

paste etc.) a

by bathing or smearing her body (with sandal miserable one by anointing her body
;
;

a leper (Kushthi)
nails
;

by paring her
restless

nails

a child with bad


in

by running a
or tongue

one

by indulging

ex-

cessive laughter, a child

with brown (S>ava) teeth or

palate
child or

by excessive talking a garrulous


;

one of incoherent speech


;

by hearing loud
;

sounds, a deaf child

whereas
fatiguing

by

by combing her hair, a bald one exposure to the wind or by doing


the
to
first

work (during
birth
it
>.

three

days of

her

period) she gives

an

insane

child (conceived

immediately

after

Hence

these acts (day sleep etc)

arc to be avoided.

24

Regimen to be observed in her menses A woman in her menses should lie down
:

on a matress made of Kits' a blades (during the

first

three

days of her uncleanness), should take her food from, her

own blended palms or from earthen sauces, or from trays made of leaves. She shonld live on a course of Habishya
diet

and forswear during the time, even the sight of her


a

husband. After this period, on the fourth day she should


take

ceremonial

ablution,

put on
visit

new

(untorn)

garment and ornaments and then

her husband after


25.

having uttered the words of necessary benediction

period

Metrical Text : A child resembles the man whom


of her

conceived
she
first
;

after

the
after

sees

ablution on the fourth day

menses

hence she

should see none but her husband* at that time (so that
the
child

may

resemble

his

father).

After that the

priest shall
*

perform the

rites

(Garbhadhana ceremony),

In the case of the hubband being absent at the time, she should look

at the sun.

128.

THE SUSHRUTA

SAMKtlTA.

[Chap.

it.

to help the conception of a

male child and

after

the

ceremony a wise husband should observe the


rules of conduct.

following

26

27.
husbaud wishvisit

Conduct of Husband : A
ing to beget a son
for a

by

his wife, should

not

her bed

month (before the day of the next flow). Then on the fourth day of her uncleanness, he should anoint or lubricate his body with Ghrita, should partake of a food
in the

afternoon or evening composed of boiled


visit the

S^ctli rice,

milk and clarified butter, and then


wife

bed of

his

The

wife also, in her tern, should observe a similar

vow

of sexual abstinence (Brahma-charini) for a

month

before that

day on which she should anoint or lubricate


oil,

her body with


of oil

partake of food
pulse,

largely

composed

and Masha

at night.

and then meet her husband The husband then having uttered the approconfidence

priate
in

Veda Mantras and having awakened


wife,

the

should go unto her on the fourth, sixth,

eighth, tenth or

on the twelfth night of her menses


28.

for

the progenation of a male child.

IVIetrical
of these nights

Text ; A
leads
to the

visit to

the

wife

on any

continual

increase of the

wealth, progeny, and the duration of the

husband's

life.

On

the other hand, a visit

to

one's

wife

on the
to

fifth,

seventh, ninth, or eleventh

day of her flow leads

the

conception of a female child

The

thirteenth

remaining days

(till

the next

course)

are

and the condemned

as regards intercourse.

2930
going unto
to

Prohibited Period etc. : A


one's wife on the
first

day of her monthly course tends

shorten one's
diately after

life
its

and a child born of the act dies imme-

delivery.

The same
birth

result

is

produced

by a

visit
i.e.

on the secontl day, or the child dies lying-in


its
;

locm

ten days of

visit

on the third day

Chap, n.j

SARIRA STHANAM.
deformed and
short-lived.

29

leads to the child's being


child

A
lives

which

is

the fruit of a visit on the

fourth

day

long, will be well developed

and remain
in the

in the full vigour

of health.

The semen

cast

womb

of a

woman

during the continuance of her monthly

flow

does not

become fruitful because it is carried back and flows out in the same manner as a thing thrown into a stream does not go against but is carried away with the current.

Hence a husband should foreswear


wife during the
first

the

company

of his

three days of her uncleanness,

when
;

she also should observe a

vow

of sexual abstinence

the

husband should not


the twelfth

visit his

wife within the

month
nights,

'after

After the impregnation on


or four drops
(of

day of her menses). 31. any of these


the

three

following

drugs

expressed juice) of any of the such as Lakshand, Vata-S'unga!

S'ahadevd or

Vis'vadevd,
right

mixed with milk should be


of

poured into the


conception
of

nostril

the

enceinte for the

male
it

child

and care should be taken


32,

that she does

not spit

away.

lYIetrical
factors

Text : A
period
liquid

co-ordination of
(Ritu),

the

four

of

menstrual

healthy
of

womb

(Kshetra), nutrient

le.

chyle

digested food

(Ambu), healthy semen (Vija) and the proper observance


of the rules
is

necessary for the conception and developchild


just

ment
(Ritu),

of a

healthy
soil

as

the

proper season

good

(Kshetra),

water (containing nutrient


strong

matter) and
care, help

vigorous seeds (Vija) together with proper

the

germination of

and undiseased
generous,
of
its

sprouts.
is

child

which

is

the fruit of such conception

destined to be beautiful, of vigorous health,


virtuous,

long-lived,

attached

to

the
its

good

parents
tions.

and capable of discharging

parental obliga-

33.

17

130

THE SUSHRUTA SAMHItA.

[Chap. tl.

Causes of different colours of the Child: The fiery principle (Teja-dhaitu) of the
organism, which
is

the originator of
to

all

colours of the

skin (complexion), happening

mix

largely

with the

watery principle of the body at the time of conception,


serves
to

make
;

the

child

a fair
a

complexioned

one

(Gaura-varna)

mixed

with

large
it

quantity of the
chiid a

earth principle (Kshiti) of the body,

makes the
In

dark

complexioned

one

(Krishna-varna).

combiethereal

nation with a large quantity of


principles of the organism,
it

earth

and

imparts a dusky (Krishnafull

syama) complexion
serves
to

(to

the

developed

fcetus).

similar combination of watery and ethereal principles

make

the

child

dusky yellow (Gaura-syama).

Others on the contrary aver that the complexion of the


child
is

determined by the colours of the food taken


34.

by

its

mother during the period of gestation.


child
is

born blind

in

the

failure

of

the

fiery

principle

(Teja-dhatu) of the organism in reaching the


its
still
;

region of

undeveloped eyes (part


so
also

eyes would be)


(Teja-dhatu) into

a penetration
for

where the by the same


blood-shot
it

its

blood accounts

the

eyes of the

child.

Entered into the Pittam

makes

the child a yellow-pupiled one (Pingalaksha).


into
its

Entered

bodily

Kapham
its

and mixed with


eyesight.
35.

makes it a white-eyed body bodily Viyu, a child of defective


it

Memorable verses: As
densed
clarified
fire,

lump
if

of

con-

butter melts and

expands

placed by
is

the side of a

so the

ovum
in

(Artava) of a

woman

dis-

lodged and glides away


* Sus'iula's theory
is

contact with an adult male*.


occurs about
the

that

ovulation

same time as
on

menstruation

and rather

initiates the latter,


is

and the shed ova are washed

out wiih the menstrual flow, hence there

a possibility of conception

Chap.

II.]

SARIRA STHANAM.
divided
into

I31

seed

two by the deranged Vayu within

the (cavity of the) uterus (Kukshi) gives rise to the birth


of twins, conditioned
prior

by the good or
child

evil

deeds of their

existence

born

of
feels

scanty paternal

sperm becomes an Asekya and

no sexual desire
and)
child begotten

(erection) without previously (sucking the genitals

drinking the semen of another man.


in

a sordid

vagina

is

called
to

Sougandhika, whose

organ does not respond

the sexual desire without

smelling the genitals of others.

comes a passive member of


again commits
called

The man who first bean act of sodomy and then


the

sodomy with
(or

woman
and
a
2>^

(he
is

visits)

is

Kumbhika

Guda-yoni

included

within the category of a Kliva).

40.
woman
act

The man who cannot copulate with


is

without

previously seeing the sexual intercourse of another couple


called Irshaka.

child born of an

of fecund-

ation foolishly or ignorantly effected

during the menses


his

of

its

mother by

its

progenitor by
is

holding her on

bosom during the act


born of a

called a

Shanda and

invariably

exhibits effeminate traits in his character.

daughter

woman
41
the

riding on her husband


will

during the act


traits

of sexual intercourse

develop masculine

in

her character.
connexion
stops

43.
of
flow.

during
itself

period

But when the menstruation


it

of

by the

end of the third day,

also

indicates

that

ovulation has ceased and


question arises
fourth
is

no ovum

is

left

to

be

fertilized,

hence

the

how can

there be
?

conception

then

on connexion on the

day and thereafter


the
to

The explanation

(as in the following verse)

that

ovulating organ
activity
to

though quiescent

at

the

time

is

again

stimulated

by intercourse

with a male and

new ova

are shed

which are ready


*

be fertilized by the semen.

Ed.
to

Gayi interprets the term **Dharmetara"

mean

evil

deeds (other
ex-

than good) and quotes verses from S'rutis,


piations of sin in support of his view.

S'mritis

and Tantras on

j?,2
w'

THE SUSHRUTA SAMHITA

[Chap.

II.

Semen is developed in the four types of Kliva known as Asekya, Sougandhika, Kumbhikaand Irshaka,
whereas
a

Shanda

is

devoid

of

that

fluid

(Sukra).

The semen carrying ducts

of an Asekya etc. are expanded by the drinking of the semen as above described

which helps the erection of

his reproductive organ. 44-45

The conduce and character


its
{i,

of a child

nation to particular dietary are determined


parents during the
e.

and its incliby those of

act

of fecundation.

boneless
is

with cartilaginous

bones)

monstrosity

the

outcome of the sexual act in which both the parties arc female and their Sukra (sexual secretion) unite some

how

or other in the

may
The

take place in

womb of one of them. Fecundation the womb of a woman, dreaming of

sexual intercourse in the night of her menstrual ablution.

Vayu carries the dislodged ovum into the uterus and exhibits symptoms of pregnancy, which develop month after month till the full period of gestation. The
local

offspring of such a conception


less jelly-like

is

a Kalala (a thin bone-

mass) on account of the absence of the


its

paternal
sities

elements* in
serpents,

development.
or gourd

Such monstroshaped
foetus

as

scorpions,
of a

delivered from the

womb

woman
46-49.

should be ascribed

as the effects of deadly sins.

The
and

child of a

gratified during

mother whose wishes are not honoured pregnancy stands in danger of being
lame,

bom
its

palmless,

hunchbacked,

dumb

or

nasal
of

voiced through the deranged condition of the

Vdyu
its

mother's body. should

The malformation

of a child in

the

womb

be ascribed to the atheism of

parents,

or to the effects of their misdeeds in a prior existence, or


* Hair, beard, nails, teeth, arteries, veins,

ligaments and semen


said to be inherited

are

called
tlje

paternal

elements

inasmuch as these are

by

child from

its fj^ther

Chap.

II.]

SARIRA STHANAM.
condition

I33

to

the

aggravated
50

of the Vayii, Pittam and

Kapham.

51.
excrete faeces
or
,

A
owing

foetus in uterus does not

urine,
in its

to

the

scantiness of the fecal matter, etc


also to

intestines

and
in

the

obstruction and consequently

lessened admission of the

Vayu

into

its

lower bowels.
its

A
i.e.

child

the

womb

does not cry inasmuch as


the sheath
its

mouth remains covered with


foetal

of the placenta
is

membranes (Yarau) and


the

throat

stuffed with

Kapham. The processes movement of the foetus in


those of
its

of respiration,

sleeping

and

womb

are effected through

mother.

52

53.
the
in

The adjustment
of

of

different

limbs and organs


at their proper

the

body of a

child

the

womb
its

places, the

non-development of hair on

palms and

soles

and the subsequent cutting and


after the

falling off of its teeth are

spontaneously effected according

to the laws of nature

model of
in

its

own
prior
traits

species.

An

honest, pious,

erudite

man, who has acquired a vast knowledge of


his

the

Sastras

existence,

becomes largely
stamp
in

possessed
this
life

of

mental

of

the

Sdttvika
his

too

and
Acts

also

remembers
to

prior

births

(Jatismara).

similar

those,

which a man

performs
next.

in

a prior existence, overtake

him

also in the

Similarly the traits and the temperament which

he had developed in a previous


sure to be patent in the next.
Thus ends the second Chapter
Samhila which

existence

are

likewise

5455Sthanam
in

of the S'arira

ihe

Sus'ruta

treats of the purification of

sperm and ovum.

CHAPTER
Now we
pregnancy,
shall discourse
etc.

III.

on the Sariram which


i

treats of
i.

(Garbha Yakrant ^ari ram),


element (Sukra)
is
(i.e
,

The male
element

reproductive

endowed
is

with Soma-guna

thermolytic properties) the female


the opposite property and

Artava) presents
(i e.,

therefore Agni-guna

thermogenetic properties).
fire:,

The

principles of earth, water,

air

and ether are


their

also

present in

men
in

in

their

subtile

forms and contribute to

the formation of the material parts

by

molecular
in

adjustment

the

way

of supplying
2.

nutrition and

way

of the adding to their bulk.

Combination of Self with the impregnated matter : The local Vdyu (nerveforce) heightens or

aggravates

the
in

heat

generated

by
dis-

the friction of the sexual organs


tion.

an act

of copulato

The Vdyu and heat thus aggravated tend


its

lodge the semen from

sac

or receptacle

in

man

which enters into the uterus of a woman through the there it mixes with the ovum canal and vaginal

and secreted by similar causes. The combined ovum and semen are subsequently conAfter that, He who fined in the uterus vGarbhclsaya). is known by the epithet; of Self-conscious, impressioner
(Artavam) dislodged
(creator of sensations
seer,

and perceptions), toucher,


eternal,

smeller,

hearer,

taster.

Self or Ego, creator, wanderer, wit-

ness,

ordainer, speaker, though

unmanifested
takes

and incomprehensible

in his real nature,

hold

of

the five subtile or essential material principles contributed

by the united impregnating matter, assumes a subtile shape throughout, marked by the three fundamental

Chap. III.]

SARIRA STHANAM.

35

qualities of Sattva, Rajas

and Tamas, and led away by


subsequently

the Vayu,

lies

confined in the uterus to be

evolved out in the shape of a god, animal, or monster,


as

determined by his acts

in the

former existence.

3.

Factors which determine sex : The


birth of a male-child

marks the preponderance of semen


its

over

the

ovum

(in

conception)

the

birth

of a
ele-

daughter shows the preponderance of the maternal


ment.

child of no-sex (hermaphrodite)

is

the product

when ovum and sperm are equal (in their quality and The first twelve nights after the cessation quantity). of the flow should be deemed as the proper period for conception, as being the time during which the ova are
secreted.

Certain authorities hold that there are


to all appearances

women
woman

who never menstruate


(lit
:

5.

IVlemorable verses : The face of a woman of undetected menstruation)


and
for
lively.

becomes
is

full

moist and clumsy deposit


teeth

found
a

on the body,
desire

face,

and

gums.

She

feels

sexual
hair,

intercourse and

speaks sweet words.

Her

eyes,

and

belly
in

droop down.
her aims, thighs,

sort

of

distinct throbbing

is felt

mammse,
desire

umbilicus,

perineum and buttocks.


its

Her sexual

grows intense and prominent, and


her

gratification gives
will at

utmost joy and pleasure.


a

These symptoms
has

once indicate that


nally).
6.

woman
full

menstruated (inter-

Just as the petals of a

blown

lotus

flower

are

gathered up during the night, so the

uterus (Yoni)
is

of a
after

woman

is

folded up

{i. e.,

os of the uterus

closed)

the lapse of the menstrual period {ie. fifteen days from the

date of the flow).

The menstrual
is

flow,

accumulated
local

in

the course of a month,

led in time

by the

Vayu

through

its

specific

duct (Dhamani) into the mouth of

136
the

THE SUSHRUTA
uterus (Yonij
7.

SAMIIITA.
flows

[Ch&p. III.

whence

it

out

odourless

and

blackish,

Period of IVIenstruation : The


(menstruation)

process

commences

at the twelfth
till

year,

flowing

once in every month, and continues

the fiftieth* year

when

it

disappears with the sensible decay of the body. 8


to one's wife

visit"!-

on even days during the cataall

menial period (twelve days in

from the cessation of male child while


in

the flow) leads to the conception of a

an intercourse on odd
daughter.

days

results

the birth of a

Hence

a man, seeking a
in a

male-issue,

should

approach his wife for the purpose with a quiet and calm
spirit

clean

body and
9.

on an even date.
physical

A
flow

sense

of

fatigue

and

languor,

thirst,

lassitude

and weariness

in the thighs, suppression of the

of

semen and menstrual


coition)

secretion

(Sukra
in

and
the

Sonita) out of the uterus (Yoni), and

throbbing

organ

/Rafter

are

symptoms

of a recent fecun-

dation.

lO.

Signs of Pregnancy-(M.
rash
(areola) around

T.

: A

black
the

the nipples

of the

mammae,

rising appearance of a

row of hair

(as far as the umbilicus),

contractions of the eye-wings, sudden vomitings, nausea

which does not abate even on smelling perfumes, water*

Some

are

of opinion

that

the

menstruation

continues up to

the

sixtieth year.

t
days,

According

to
is

Videha,
born
if

menstrual

secretion

flows less on

even
those
so a

hence a son
;

the sexual intercourse

be made on

days

whereas menstrual secretion becomes more on odd days,


is

daughter

born
to

if

the intercourse be
is

made on odd

days.

According
a daughter
is

Bhoja, a son

born from intercourse on

even

days and
issue
is
is

born from that on odd days.


virile

The

birth

of a

male

due to the preponderance of semen

and that of a female sex


If
is

due
be

to the preponderance of menstrual secretion.

both

the

secretions

equal

(in quality

and quantity) a hermaphrodite

issued.

Chap. III.]

SARIRA STHANAM.

13;

brash,

and a sense of general lassitude are the indications


ri.

of pregnancy,

Prohibited conducts during gestation ^Immediately on the ascertainment of her pregnancy, a woman should avoid all kinds of physical
:

labour, sexual intercourse, fasting, causes of emaciation

of the body, day-sleep, keeping of late hours, indulgence


in grief, fright,

journey by carriage or in

any kind of
at

conveyance, sitting on her haunches, excessive application


of

Sneha-karmas
{i.e
,

etc.,

and venesection

an

improper time

after the eighth

month

of gestation),

and voluntary retention of any natural 12. body.

urging

of the

IVIetrical Text : The child in the womb feels pain in the same part of its body as the one in which
its

mother

feels

any

whether

this

(pain)

may

be from

an injury or through the effect of any deranged morbific


principle (Dosha) of her organism.
13.

Development of the Foetus: In the first


month
formed
of
(in

gestation
the

a
;

gelatinous
the

substance

is

only

womb)

molecules of the primary


earth, water,

elements (Mahabhuta

air, fire,

and

ether)

being acted upon by cold


air

(Kapham\
appearance

heat

(Pittam) and
in

(Vdyu or nerve-force) are condensed

the second

month.
matter)

lump-like
the

(of

that

confused

indicates

male-sex (of the

embryo).

An

elongated-like
foetus

shape of the matter


;

denotes that the


its

belong to the opposite sex


(like
e,

whereas

tumour-

like

shape
{i

a Salmali-bud) predicts the absence of In


the

any sex
five

a hermaphrodite),

third month,

lump-like protuberances appear at the places where

the five organs

namely the two hands, two


be and the minor limbs

legs

and the

head
the

would
body
are

and members of

formed

in

the shape of extremely small

138
papillae.

THE SUSHRUTA SAMHITA.


In the fourth

[Chap. III.

and organs (of the body of the embryo) become more potent and the foetus is endowed with consciousness owing to the
all

month

the limbs

formation of viscus of the heart.


of consciousness, so a? the heart

As

heart

is

the seat
is

becomes potent, it endowed with consciousness and hence it expresses


desire
for

its

things

of

taste,

smell

etc.
is

(through the
called

loneincfs of its mother).

The

enciente
time,

double-

hearted
desires
birth

(Dauhrida) at the
a
paralysed,

whose wishes and

not being
of the

honoured and

gratified

lead to the
Hence

of

hump-backed,

crooked -armed,

lame, dwarfed,
the
desires

defect-eyed, and a blind child.

enciente should

be gratified, which

would ensure the birth of


lived son.
14.

a strong, vigorous

and long-

IVlemorable Verses : A
cause the longings
to be
gratified

physician should

of a

pregnant

woman (Dauhrida)
gratifications
;

inasmuch as such
birth of a

would

alleviate
fulfilled

the discomforts of gestation

her desires being


long-lived, and
desires during

ensure the
son.

strong,

virtuous

non-fulfilment

of her

pregnancy, proves injurious


ownself.

both to

her child and her


sensual

A
its

non-gratification

of any

enjoy-

ment by
to
child.

mother ;Dauhrida) during gestation


afTect

tends
of the

painfully

the

particular sense-organ

Longings and its effects during pregnancy An enciente longing for a royal
:

interview
birth

during
child, in

her gestation

(fourth

month)

gives

of a

who

is

sure to be

rich

and
for

to
fine

hold a
silks,

high

position

life

Her longing

clothes,
ful

ornaments

etc. indicates the

birth of a

beauti-

child of aesthetic
is

taste.

The

birth
its

of a pious

and

self-controlled child

indicated by

mother's longing

Chap. III.]

SARIRA STHANAM,
to

39

for

visit

hermitage.

The

desire of a pregnant

woman
of

to see a divine

birth of a child in

image or an idol, predicts the her womb who would grace the council
in
life.

an august assembly

Similarly,

a desire to

see a

savage animal on the part of a pregnant


presence of a
in

woman

signifies the

child

of savage

and cruel

temperament

her

womb.

desire for

the flesh of a

Godha
in

indicates the presence of a sleepy,

drowsy person
beef on

her

womb who
in
life.

would be tenaciously fond of good


longing for
the

things

Similarly a

part of the mother (during gestation) indicates the birth

of a

strong and

vigorous

child

capable of sustaining

any amount of fatigue and physical pain


for

longing

bufifalo-meat of the

hairy,

mother indicates the birth of a child (in her womb); a valiant and red-eyed
indicates the
birth of a

longing for boar-flesh


child

drowsy

though valiant
of an
;

longing for venison indicates


sylvan-habited

that
child

energetic,

determined and

a longing for
;

Srimara-meat indicates that of a


a

distracted person
bird

longing for the flesh of Tittira


a
child

indicates

that

of

of timid

disposition

whereas a desire on the part of an enciente for the


flesh
in

of

any particular animal indicates that the

child

the

womb

would be of

such stature
in
life

and would
are peculiar

develop such traits of character


to

as

that

animal.

The

desires

of a

woman
fate

during her

pregnancy are determined by ordained


of the acts of the child in
its

and

effects

prior existence (that are to


life).

be happened during the present

15.

Development of the FcBtus s In


fifth

the

month

the foetus

is

endowed with mind (Manah^


its

and wakes up from the sleep of


tence.
in.

sub-conscious exis-

In the sixth

In the seventh

month cognition (Buddhi) comes month all the limbs and members

I40
of
its

THE SUSHRUTA SAMHITA.


body are more markedly developed.
(in the heart of the foetus)
*

[Chap.

III.

The Ojo-

dhdtu
in the

does not remain silent

eighth month month) dies for want of Ojo-dhatu soon

child born at that time (eighth


after
its

birth,

a fact which

may

be equally ascribed to the agency of

the malignant monsters.


gestation) offerings

Hence (in the eighth month of of meat should be made to the demons
the
safe continuance
in

and monsters

(for

of the

child).

The

parturition takes place either

the ninth, tenth,

eleventh

or

twelfth

month
the

of

conception,

otherwise

something
hended.

wrong

with

foetus

should

be appre-

i6.

The
be

umbilical chord (Nadi) of the foetus

is

found to
its

attached to the cavity of the vein or artery of

maternal part through which the essence of lymph-chyle


(Rasa) produced

from
its

the

assimilated

food
its

of

the

mother, enters into

organism and fastens

growth

and development,
Immediately
after

(a fact

which
or

may

be understood from
of blood).
process

the analogy of percolation

transudation

the

completion of the

of

fecundation, the vessels

(Dhamani) of

its

maternal body
laterally

which carry the lymph-chyle (Rasa) and run


longitudinally in
all

and

directions through

it,

tend to foster
all

the foetus with their

continuance in the

own transudation womb. 17.

through

its

of

Different opinions on the formation the foetal body : Saunaka says that
head of the
foetus
is

probably the
since head
is

first

developed

the only organ

that

of

all

other organs possible.


is first

makes the functions Kritaviryya says, it is


heart
is

the heart that


of

developed since

the

seat

Manah and Buddhi (mind and


* Sometimes
it

intellect).

The son

of

passes

from the body of the child to that of the

mother and vice versa.

Chap. III.]

SARIRA STHANAM.

I4I
re-

Para'sara says that the development of the umbilical

gion of foetus
part of
its

must necessarily precede


it

(that of

any other

body) inasmuch as

is

through umbilical

chord that an
body.

embryo draws

its

substance from mother's


feet

Matrkandeya says that the hands and


be developed since they
in the

of a

fcetus are first te

are

the

only

means

of

movements

womb.

Subhuti Gautama
is

says that the development of the trunk

the earliest
lie

in

point of time since

all

other limbs and organs


the

solderall

ed to and imbedded in that part of


these are not really the fact.

body.

But

development of

all

the parts of the


;

Dhanvantari body of an embryo


holds that the
the a

goes on simultaneously

and they can not be perceived


attenuated
size

or detected in their earlier stages of development in

womb owing
mango
pith
etc.

to their extremely

like

fruit or sprouts

of bamboo.

As

the stone, marrow,

of a

ripe

and matured mango-fruit or the


in

sprouts of

bamboo, cannot be separately perceived


growth but are quite

the earlier stage of their

distin-

guishable in the course of their development,


in the early stage

likewise

of pregnancy the limbs

and organs of
therefore

the

body

(foetus)

are not perceptible for their extremely

attenuated stage but become potent (and


are distinctly perceived)
in

they

the course of time

for their

development.

18.

Factors respectively supplied by the paternal and maternal elements :-Now


we
the
shall

describe
foetus

the

parts

and

principles

of the

body of a

paternal

element,

which are respectively contributed by maternal factor, the serum

(Rasaja),the soul (Atmaja), the natural (Sattvaja)

and the
hairs

innate physiological conditions (Satmyaja).


of the head
nails,

The

and body, beard and moustaches, bones,


veins
(Sira),

teeth,

nerves, arteries

(Dhamani),

142

THE SUSHRUTA SAMHITA.


all

[Chap.

III^

semen and
the

the

steady
a
child)

and
are

hard substances

(in

organism

of

contributed by the
;

paternal element
flesh,

in the

conception Pitraja

whereas

blood,

fat,

marrow,
their

heart, umbilicus,
all

liver, spleen,

intestines,

anus (Guda) and


origin

other soft
the

matters in

the

body owe
;

to

(Matrija)

strength, complexion, growth, rotundity


to

maternal element and

decay of the body are due

the

serum

(Rasaja\

The

sensual organs,
of
life

conciousness, knowledge, wisdom,


pleasure and pain
etc.

duration

(longivlty),

are

the outcome

of the spiritual

element

in

man

(Atmaja).

We shall
the

describe the Sattvaja features of the

body

in

next chapter.

Valour, healthfulness, strength, glow

and memory are the


born
with
(Sdtmyaja).

products

of

child

naturally

physiological
19.

conditions of

the

parents

Signs of male and female conception


is
:

An enciente,
detected,

in

whose
lifts

right

mammae the

milk

first

who

first

up her right leg

at the

time of locomotion, whose right eye looks larger, or

who
and
of

evinces a

longing

largely for things of masculine


(red

names, dreams of having received lotus flowers


white), Utpala,

Kumuda, Amrataka,
in

or flowers of

such masculine denomination

her sleep, or the glow

whose

face

becomes brighter during pregnancy,

may

be expected to give birth to a male child; whereas


the birth of a

daughter or a female child should be


contriety
of the foregoing indiraised

pre-assumed from the


cations.

An

enciente whose sides become

and

the forepart of whose

abdomen

is

found to bulge out

will give birth to a sex-less

(hermaphrodite) child.

An

enciente, the

middle part of whose abdomen becomes


in

sunk or divided

the middle like a leather-bag, will


20.

give birth to a twin.

Chfip.

ni-3

SARIRA STHANAM.

I43

lYIemorable verses : Those


are

women
a clean

who
body

devout

in

their

worship of the gods and the


in

BrAhmins and cherish a clean soul


during
virtuous

pregnancy
during

are

sure

to
;

be blest with good,

and generous children


the
fruits.
etc.

whereas a contrary
sure
to

conduct
with

period

is

be

attended

contrary

The development

of the limbs
is

and the members

of a foetus in the

womb

natural

and spontaneous, and the qualities and conditions which mark these organs are determined by the acts of the child which arc anterior to its genesis and wcro

done

in its prior existence.

21-22.
in

Thus ends

the third Chapter of the S'arira Sihiinain


treats of the generation

the

Su

'ru(a

Samhita which

and pregnancy.

CHAPTEE
Now we
treats
shall

IV.
the
fcetus

discourse

on

Sariram
in

which

of the

development of a

the

womb,
growth

as well as of the factors which contribute to the

of

its

different bodily organs

and principles
i.

(GarbhaSleshma

Vyakaranam-^gfriram).
The Pittam
(fiery

or

thermogenic) and

(lunar principles of the body, the bodily

Vayu, the three

primary qualities of Sattva, Rajas, and Tamas (adhesion,


cohesion and disintegration), the
the Self (Karma-Purusha) are
five

sense organs, and


of the
life

the preserver

(Prdnah) of the Fcetus.


:

2.

Folds of Skin Seven ing (Tvaka skin) are formed


rapidly transforming

folds or layers of cover-

and deposited on the


the

product of
Sonita

combination of

(semen) Sukra and

(fertilized

ovum)
individual
(of

which

have been

thus

charged

with
as

the
layers

or Self in the

same manner
first

Soul cream) are

formed and deposited on the surface of

(boiling) milk.

Of

these

the

fold

or layer
all

is

called Avabha'sini
is

(reflecting) as

it

serves to reflect

colours and
all

cap-

able of being tinged with the hues of


rial

the

five

mate-

principles

of the body.

The

thickness of this fold


(rice grain)

measures eighteen-twentieth of a Vrihi^


it is

and

the seat of skin diseases, such as

Sidhma, Padmafirst

The complexion
is

of a person
is

is

due

to

this

layer

and as the
from
its

colour of an opaque body


surface, this layer

due

to the rays

that

are

reflected

rightly

named Avabba^'ini

or reflecting layer.
(or
for

**
so

The

text runs

"Vriherashtadashabhaga," which means eighteen


;

mnny)

parts of a Vrihi

and Dalian comments that "Vrihi" stands

a measure equal to the twentieth division of a Vrihi or rice grain.

Chap, IV.]

SARIRA STHANAM.
etc.

I45
the
surface)
is

kantaka
called

The second
;

fold

(from

Lohitai
is

Vrihi and
Tilakilaka,
or
layer

measures a sixteen-twentieth of a the seat of such (cutaneous affections; as


it

Nyachcha and Vyanga


called

etc.

The

third fold
in

is

S'/^ti

which measures

thick-

ness, a twelve-twentieth of a Vrihi,

of such diseases as Aj.igalli,


etc.

and forms the seat Charmadala, and Mas'aka


is

The

fourth

fold

or

layer
of a

called

Tstmrak

measuring an eight-twentieth

Vrihi and
kinds
or

forms

the seat of such diseases as the various

of Kilasa
is

and Kushtha

etc.

The
in

fifth

fold

layer

called

Vedini, measuring

thickness a

five-twentieth
etc.

of

Vrihi and forms the seat of Kushtha, Visarpa,


sixth fold or layer
is

The

called

Rohini, which

is

of equal

thickness as a Vrihi (grain),

and

is

the seat of Granthi,


etc.

Apachi, Arvuda,
seventh fold
or

SHpada and
is

Gala-ganda
seat

The

layer

called
is

Matasa-dhara( twice a
of

Vrihi in thickness

and

the

Bhagandara,

Vidradhi, and Ars'a etc.

These dimensions should be


fleshy parts

understood to hold good of the skin of the


of the body, and not of the skin

on the forehead, or
is

about the tips of the fingers,


surgical

inasmuch as there

dictum to the

effect that

an incision as deep as
be

the

thickness of the

thumb

may

made

into

the

region of the

abdomen with
3.

the help

of a Vrihi-mukha

(instrument).

The
at the

Kala(s too

number seven

in all

and are situated


(Dhatus) of the

extreme borders (forming encasement and support)

of the different fundamental principles

organism.

4.
:

Memorable Verses As
core of a piece of

the

duramen

or

wood

or stem

becomes exposed

to view

by cutting

into

it,

so the root principles (Dha'tus) of the


layers

body may be seen by removing the successive

or

19

146
tissues of

THE SUSHRUTA
its flesh.

SAMlilTA.

Chap. IV.

These Kalds are extensively supplied


tissues),

with Snayus (fibrous

bathed
-

in
5-6.

mucous, and

encased in a membranous covering.

lYIansadhara-Kala:
is

Of these Kalas,the
in

first

named Ma^nsadhara
tissues),

(fascia),

the

contained

flesh

(bodily substance of the Kala) of the Sira (veins),


(fibrous

Snayu

Dhamani

(arteiies)

and other Srotas


7.

(channels; are found to spread and branch out.

lYlemorable Verse As
:

the roots and stems

of a

lotus

plant

respectively

situated in the ooze

and

water (of a tank;, do si.nultaneously grow and


so

expand,

the

veins
8.

etc

situated

in

the

flesh,

grow and
Kald
is

ramify.

Raktadhara- Kala -The


:

second

called Raktat-dharai (Vascular tissue of the blood vessels


etc.).

The blood

is

contained in these inside the flesh


in

and specially in the veins (Sira) and the body as the liver and spleen. 9.

such viscera of

IVIemorable Verse: As
latex
in
its

a piant containing
or pricked, exudes

tissues,

when

injured

milky
flesh

juice,

so blood oozes out instantaneously on the

of the

body (supplied with the Raktadhara-kala)


10.

being injured.

lYIedadhara-Kala : The
Medadharai (adipose
in the

third

Kald

is

called

tissue).

Meda

(fat) is

present (chiefly)

abdomen
is

of

all

animals, as well as in the cartilafatty substance present in large


ir.
is

ges (small bones).

The

bones

called Majjai (marrow),

lYIemorable Verse : Marrow


large

found inside

bones, whereas a substance similar in appearance


structures (cartilages) should

and found inside other bony


present
in

be considered as Meda, mixed with blood.


purely

The

fats,

muscular structures, go by the name


12-13.

of Vassi (muscle-fat).

[Chap. IV.

SARIRA STHANAM.
fourth Kala

147
is

dleshmsLdhar^C-Kala : The
called Sleshmaidharai (Synovial tissues)

and

is

present

about

all

the bone-joints of animals.


:

14.

IVIemorable Verse

-As

a wheel easily turns

upon a well greased axle, so the joints moistened by the mucous (Sleshma) contained in these sacs admit of easy movements, i^.

Purishadhara-Kala : The
called Purishadharai

fifth

kala

is

and being situated


faecal

in

the Kostha
in

(abdomen) serves to separate the

refuse

the
16.

(Pakvasaya) lower gut (from other ingested matters).

Memorable Verse
viscera

This Kala extends about


lower intestines (Un-

the liver, upper and lower intestines and other abdominal

and keeps the

foeces in the
is

dukam) separate and hence


Pittapharat-kalSL
it

called

Maladhara-kald
sixth Kald
is

17.

Pittadhara-Kala: The
;

called

holds

(the

chyme derived from)

the

four kinds of solid

and

liquid foods (in the Pitta-sthanam

or biliary region; propelled from the


or

stomach (Amds'aya
to

Grahani-Nadi) and on
the proper

its

way

the

(Pakasaya)

intestines (for

action

of the

digestive juices

upon

it)

18.

IVIemorable Verse : The

four kinds of food,


or
licked,

viz. those that are chewed, swallowed, drunk,

and brought into the intestines (Kostha) of a man,


digested
in

are

proper

time through the heating agency


19.

(action) of the

Pittam

^Ukradhara-Kala :-Thc
called

seventh

Kala
20.

is

S'lkradharsi

(semen-bearing),
all
:

which
physician

extends

throughout the entire body of

living creatures.

Memorable Verse
know
that
like

-The

should
in the
is

fat (Sarpi) in the milk, or

sugar

expressed juice

of sugar-cane, the (seat of)

semen

co-

extensive with the whole organism of a

man

(or animal).

148

THE SUSHRUTA SAMHITA.

[Chap. IV.

The semen
fingers'

passes through the ducts situated about two

breadth on either side (vas deferens) and just


finally flows out

below the neck of the bladder and


through the canal. The semen of a
sexual
intercourse

man

during an act of

with a female under exhilaration


all

comes down from

parts

of his body owiiig to the


act).

extreme excitement (engendered by the

21-33.
(vessels

The
structed
is

orifices of the

Artava carrying channels


of a

of the uterine mucosa)

pregnant

woman

are

ob-

by no show of menses (during gestation). The menstrual


in
it

the foetus during pregnancy and hence there

blood thus obstructed

its

downward

course

ascends

upwards

part

of

accumulates and goes to the


,

formation of placenta (Apara'

while the
;

rest

ascends

this is the reason higher up and reaches the breasts why the breasts of a pregnant woman become full and

plump.

24.

The
of blood

spleen
;

and

liver

of the

foetus are

formed out
of

the

lungs are

made
25,

of

the froth

the

blood

and the Unduka or

faecal receptacle,

of the refuge

matter (Mala) of the blood.

Metrical Texts : The


bladder
(Vasti),

intestines (Antra),

the

and the anus (Guda) of the

foetus are

formed out of the essence of the blood and Kapham, baked by the Pittam into which VAyu enters as well.

by draughts of air refines the dregs of golden ore and transforms it into pure metal, so blood and Kapham acted upon by the heat of the Pittam

As

fire

fed

are

transformed

into

the shape

of the

intestines etc.

in the

abdomen.
flesh,

of the

The tongue is made of the essence blood and Kapham. The Vdyu, com-

bined with heat (Pittam) in adequate proportion, rends through the internal channels into the flesh and trans-

forms them into muscles (Pesi). The Vdyu, by taking

off

Chap. IV.]

SARIRA STHANAM.

149

the oily principles of fat (Meda), transforms


(Sirat'

them

into

and

(fibrous tissues) Sna^yu,the

underbaked (Mridu)

ones being converted


(Kshara) ones
(As'ayas) of the
into

into

the Sir^ and the overbaked

the Sndyu. The internal cavities body mark the spots or regions where the

Vayu had constantly stayed in its embryo stage. 26-29. The kidneys (Vrikkas) are made out of the essence The testes are formed out of the of the blood and fat. flesh, Kapham and fat. The heart essence of the blood,
is

formed out of the essence of blood and


vital

Kapham

and the vessels (Dhamanis) carrying the


of the body are attached to
it

principles

(heart).

The

spleen and the

lungs are situated


left side,

below and beneath the heart on the

and the
it

liver

and Kloma (Pancreas


on the
right.

?)

below
is

and beneath

(heart)

The

heart

the

special seat of consciousness (ChetaiiS^)

in all

creatures.

Sleep

sets in

when

this viscus

heart) of a person

becomes
of

enveloped by the effects


illusion or nescience).

of the

Tamas

(principles

30-31.

IVIemorable Verse S The


the shape of a lotus
folding itself

heart

which

is

of

bud hangs with

its

apex downward,

return of

up during sleep and expanding with the wakening or consciousness. 32.

Sleep and
sive

energy of
has

virtues : Sleep God ^lit. the all-pervading


its
sway over
all

is

the

illu-

deity;

and

naturally

its

created

beings.

The

kind of sleep which sets in

when

the sensation-carrying

channels iSn^yu) of the

which abounds
Tatmasi-nidrai.

in the
It is

body are choked by Sleshma, quality of Tamas, is known as this sleep which produces uncon-

sciousness at the time of dissolution or death.


of Tatrnxsika-temperament sleeps both in the

man
in

day and

night
the

one of the Ra^asika-temperament sleeps either


in

day or

the night

while sleep never visits the

T50
eyelids of a
night.

THE SUSIIRUTA SAMHITA. man

Chap. IV.]

of Sa^ttvika-temperament before mid-

Persons

with

enfeebled

Kapham and
is

aggra-

vated Vayu, or suffering from bodily and mental troubles,


get
little sleep,

and

if

at all, their sleep


{i.e.

of the

Vaika-

rika or delirious type

much
:

disturbed)*

33-34.
!

IVIemorabIC Verses -O
the animated beings. the
heart
is

SusVuta

the heart

is

said to be the primary seat of consciousness (Chetan^) in

Sleep overcomes a

man whenever
Tamas.
of the
is

is

enveloped

in the illusive effects of

Sleep

the offspring of

Tamas and
The

it is

quality

Sattvam that brings on awakening.


mental law of Nature.
(Self),
is

This

the funda-

self-conscious individuality

ensconced

in

the
five

material
material

frame of
elements,

man which
recollects

composed of the

through the agency of the mind (Manah), which abounds


in the quality of Rajas, the

renaissance
in his

of his

by-gone

existences,
tures of

and wakens up
evil

psychic plane the pic-

good or
are

deeds

done

by

him

therein.

Dreams The self

but the embodiment of these recollections.

or Jivatmai,

though he sleeps not himself,


energy of Tamas.
in
all

is

said to be sleeping, whenever the sense organs

are over-

powered by the

illusive
is

35.

Day
except
in

sleep

forbidden
in the

seasons of the year,

case of infants, old men, by sexual excesses, or in Kshataand persons enfeebled kshina diseases and in case of habitual tipplers. A sleep
in

summer and

the

day may be enjoyed


or

after the fatigue of a long

journey, riding,

physical

labour,

or
to

on an empty

stomach.

It

may
of

be allowed as well
fat,

men

suffering

from
*

the

loss

Kapham

or

blood,

to those

of

Such persons

may

get sleep only,


affairs.

when bting

tired

and exhausted

they cease to think of their

f.

Charaka : When the active

self

of a person,

tired in

body and

jnind, loses touch with his worldly affairs, sleep

comes

to him,

Chap. IV.]

SARIRA STHANAM.
or parched

151
constitution

scanty perspiration, or of dry

and also to those who have been suffering from indi^


gestion and
in

who may
time.

sleep for a

Muhurta

(48 minutes)

Those who have kept late hours in the night may sleep in the day for half the time they have watched in the night (and no more). Day sleep is the outcome of perverted nature and all the Doshas of the body are aggravated by a sleep in the day, bringing
the

day

on

many

troublesome complaints

such

as

cough,

asthma, catarrh,heaviness of the body, aching or lassitude


in the limbs, fever, loss of

appetite etc.
in

On

the

other

hand, the

keeping of late hours

the night develops

symptoms (Upadrava) which

are peculiar to the deranged

Vayu and

Pittam.

^6.

lYIemorable Verses :~Hence,


sleep in the day, nor

one should not


observe

keep

late hours.

Having known both


should

these

acts

to

be

injurious,

the wise

moderation
rule of

in sleep.
is

conformity to the preceding

conduct

rewarded with health, good humour,

strength,

healthful
is

complexion,

virility

and beauty, a
life

frame which

neither too fat nor too thin, and a long

day sleep may not prove injurious^ to those who are habituated to it and conversely keeping late hours at night may not tell upon the health of those
of a hundred years).
to

whom it is customary. 37-39. An aggravated condition of


an
aggrieved
state

the

bodily

Vayu

or

of the mind, loss of vital and a hurt or an injury may bring on insomnia, the remedy being the adoption of measures antagonistic to
fluid,

Pittam,

those which destroy sleep.


useful in cases of

The following measures

are

sleeplessness

-such as anointing the

body, rubbing of oil on the head, soft massages of the body (with cleansing paste) and shampooing a diet consisting of cakes and pastry made up of Sali-rice and
;

152

THE SUSHRUTA SAMHITA.

Chap. IV.]

wheat prepared with sugar or other derivatives of sugarcane, sweet or soothing articles with milk or meat juice
or flesh of animals of
the

Biskira or Viles'aya class,


at night, are

and eating of grapes, sugar and sugar-cane


beneficial
(^in

such cases;

so also a soft

and pleasant
loco-

bed, and easy and convenient seats and

means of

motion.

Hence, a wise physician should advise those and similar other measures to allay insomnia. 40-41.
Excessive sleep
should be

by emetics, Sansodhana measures, fastings, bleeding, and works which tend to disturb the mental equanimity of man.

remedied

Keeping up
in the

at night

is

beneficial to persons afflicted with

obesity, poison or the

deranged

Kapham

so also a nap

day

is

beneficial to people troubled

with hiccough,
42-43.
:

colic pain, dysentery, indigestion, or thirst.

Somnolence or Drowsiness etc.


this

-in

kind of ligHt sleep, or


the

in

th^

preliminary stage of

sleep,

sense

organ? are overpowered and remain


objects

only partially cognisant of their respective


all

and

(subjective

and

objective)

symptoms

of

sleepy

person such as, yawning, sense off atigue and heaviness


o(

the limbs, present themselves in succession

these are

the special features of Tandrai.


ling of the
air

One

(prolonged)

inha-

through a widely

open

mouth

and
or

subsequent exhaling with the contraction of the limbs

and

tearful eyes

are

(all

together)

called Jrimbha^

yawning.

sense of fatigue without

any physical labour which


resIt

comes upon a person unaccompanied by hurried


piration
is

called

Klama.

obstructs

the

proper

functions of the senses as also the workings of the active

organs.*

An

inordinate

love

of pleasure and a great


all

aversion to pain, attended with an apathy to


*

sorts of

Hand,

leg, anus,

and generative organ

etc.

Chap. IV.]

SARIRA STHANAM.
of carrying

53
is

work even with the capacity


called

them through

Alasyam

(laziness).

Nausea, without vomiting of


salivation

invested

food, attended with

and formation

of sputum,

and cardiac

distress

are the

symptoms of
and non-relish

Utklesham.
a beating

A
pain

sweet taste in the mouth, drowsiness,


in the

heart, dizziness,

for food are the signs of


if

Glaiai (languor).
in a

feeling as

the

whole body were wrapped

wet

sheet,
is

accomcalled

panied by an extreme heaviness of the heart,

Gauravam.

44- 50is

Loss of consciousness (Murchchai)

due to an excess

of the deranged Pittam and to the quality of the

Tamas

vertigo

(Bhrama)

is

due to an

aggravated state of the


;

Vdyu, Pittam, and to the quality of the Rajas drowsiness (Tandra() is due to a similar condition of the Vdyu,

Kapham and
(Nidratj
is

to

the quality of the

Tamas

while sleep

produced by the predominance of

Kapham and
51.

to the quality of the

Tamas

in the

organism.
is

The growch
the serum

of a foetus in the

womb
Vdyu
it

effected

by

(Rasa) prepared out of the food (assimilated


in

by

its

mother) incarcerated by the


its

the internal

passage of

body.

52.

Memorable Verses : Be
stood that there exists region
of the
foetus
fire

dearly

under-

or heat (Jyoti) in the umbilical


is

which

fanned by

its its

bodily

Vdyu and thus The same Vayu


generated),

contributes
in

to the growth of

body.

combination with the heat (thus


lateral

expands the upward, downward, and


foetus.

channels (in the


to the

body of the embryo) and thus leads

growth of the

The

eyes

(Dristi aper-

ture of sight)
*

and
we

the
the

hair-follicles of a

man do
refers

not
both

lo the text

find

word "Indriya" which

to

Jnanendriya (sensory functions)


the body.

and Karmendriya (motor functions) of

20

I$4
participate at

THE SUSHRUTA SAMHITA.


all (in

[Chap. IV.

the general expansion of the body).


is

This

is

a law of nature, and

the opinion of Dhanvantari.

.On the other hand the growth of hair and finger nails
continue even

when

the

body

enters the stage of decay.

This also

is

a law of nature.

SS'S^*

The Temperaments : The


(Prakriti) of persons

temperaments

may

be of seven different types,

according as the deranged


involved
therein,
all

Doshas
or

of the
in

body are

either

severally,

combination

of two or of

the

three together.
is

The temperament
by the preponder-

(Prakriti) of a

man

determined

ance of the particular Doshas at the time of his generation (actual combination of the
is

semen and ovum) and

marked by

that preponderant Dosha.

The

character57-58.

istics of

the different Prakritis are

now

described.

Vataja-Temperament : A man of
temparament
contact,
is

Vdtikacold

wakeful,

averse to bathing and

unshapely, thievish, vain,


;

dishonest and fond

of music

the

soles

of his
;

feet,

and the palms of


a rough

his

hands are much fissured


beard and

has often

and
in

grisly

moustache, finger nails and


is

hairs

him

he

is

hot-tempered and

given to biting his finger

nails
is

and grinding
his

his teeth

(when

asleep).

Morally he

impulsive, unsteady in
;

his friendship, ungrateful, lean,

and rough

body

is

marked with a
;

large

number
in

of

prominent veins (Dhamani)

he

is

incoherent

his

habit and vacillating in his temper.-

He
his

is

a fast walker

and dreams
are

of scaling the skies in

sleep.

His eyes

always moving.
friends,
is

His mind
capable

is

never steady.

He
of

makes few
little

of

accumulating very

money

and talks incoherently.

The

traits

a goat, his characteretc. seem to resemble those of jackal, hare, mouse, camel, dog, vulture, crow, and of an
ass.

59-60.

I
Chap. IV.]

SARIRA STHANAM.

55

Pittvaja-Tcmperamcnt : A

man

of

Pittvaja temperament perspires copiously emitting a fetid

smell.

His limbs are loosely shaped and yellowish

in

colour.

The

finger nails, eyes, palate, tongue, lips,

soles

and palms of such a person are copper-coloured.


averse to

He looks

ugly with wrinkles, baldness and grey hair; he eats much,


is

cools

warmth and irritable in temper, though he down very soon. He is a man of middling strength
up to middle
a
age.

and

lives

He

is

intelligent

and
to

possesses

good
the

retentive

memory

and

loves

monopolise
speaker
is

conversation

(by pulling

down

any

that

may

be present).
in
battle.

simply

irresistible

He is vigorous and He dreams in his


lightning-flashes,
fire,

sleep of such things

as

meteors,

Ndgeshvara, Palas'a or Karnikara plants.

He
is

is

never

overpowered
antagonist
afflicted
;

with

fear

nor bends

before

a powerful

he protects the suppliant and


in

very often

with suppuration

the

cavity of the of a

mouth.
serpent,
cat,

The

traits of his

character resemble those

an owl,

monkey^
of

tiger, bear,

Gandharba (heavenly musician), Yaksha, and of a mongoose. 61-64.


:

Kaphaja-Tempcrament The complexion


a

man

of

5 leshmd temperament
blade of
grass,

resembles either
polished

the colour

of a

blue lotus,

sword, wet Arishta, or that of the stem of the Sara grass.

He

is

comely

in

appearance,

fond of sweet tastes,

grateful, self-controlled, forbearing, unselfish

and strong
fast in

he does not hastily form any opinion, and


enmity.
black.

is

his

His eyes are white

his hair curly

and raven
or the
large
lotus

He

is

prosperous in

life.

His voice resembles the


lion,

rumblings of a rain-cloud, the roar of a

sound of a Mridanga.
lakes or pools decked
flowers,

He dreams

in his sleep of
full

with myriads of

blown

swans and Chakravdkas.

His eyes are slightly

156

THE SOSHRUTA SAMHITA.

[Chap IV.

red towards the corners, the limbs are proportionate and

symmetrically developed with a cool effulgence radiating

from them

He

is

possessed

of the

qualities

of the

Sittvika stamp, capable of sustaining pain

and fatigue

and

respectful towards his superiors

He

possesses faith

in the Sdstras

and

is

unflinching and unchanging in his

friendship
large
gifts

he suffers
after long

no vicissitudes of fortune, makes


deliberation,
is

true to his

word
Indra,
eagle,

and always obedient


character

to his preceptors.

The

traits of his

resemble those
lion, horse,

of

Brahma, Rudra,
bull,

Varuna, a

an elephant, cow,

an

swan and of the lower animals. 65-68. A combination of two different temperaments should be called a double temperament or a Dvandaja one
;

and one of

all

the

three

temperaments

in

a person

should be stated as a Satnnipaitika one.

69.

The temperament
does
it

of a

man

is

never altered, nor


or
in

suffer

any

deterioration

abatement.

change, abatement or deterioration


case

any particular
death.
it,

should be

regarded

as

the harbinger of
is

As

a worm, bred in

poison,

not

troubled

with

so the

temperament of a person however painful

to

others does
authorities

no inconvenience to himself. Several hold that the temperaments of persons have


elements of the body and

their origin in the material

accordingly they classify them as the Va'tika Prakriti,


the

Taijasa Prakriti, and the

Apya

(watery) Prakriti,

the characteristic traits of which respectively correspond


to the
first

three temperaments described above.


of the
is

7071.
large
in

A man
A man

Pairthiva
firm,

his stature, and

temperament strong and muscular

is

in his limbs.

of the

long-lived, has large aural cavities.

Nabhasa temperament is pious and The mental temperaaccording to their qualities.


72.

ments are

classified

Chap. IV.]

SARIRA STHANAM.
features

57

Sattvika Features : The

of

Brahma-kaiya person are cleanliness of person and conduct, belief in the existence of God, a constant reader of

the

Vedas, a

worship

and reverence of

elders

and

preceptors,

hospitality

and celebration

of

religious

sacrifices. Those of a Mahendra-ka^ya person are valour, command, constant discussion of the Sastras, main-

tenance

of servants and dependents and magnanimity.

The

features of a

Karnna-ka^ya person are a liking

for

exposure to cold, forbearance, a brown hue of the pupils, golden colour of the hair and sweet speech. The
features of

Kouvera-kaya person

are,

arbitration

of disputes,

capacity of bearing hardships, earning

and

accumulation of wealth,
or fertility.
are love

and capacity of propagation

The

features of a

Gandharva-kaya person

of garlands

and perfumes, fondness of songs

and music, and love making. The features of a YamyaSattva person are sense of duty, promptness, firmness
of
action,

courage,

of anger, illusion,

memory, purity, and absence fear and malice. The features of a


are

Rishi-Sattva
of

man

divine

contemplation,

obser-

vance of vows, complete sexual abstinence, performance

Homas, celebration of religious wisdom and cultivation of divine

sacrifices,

knowledge,
science.
as

or spiritual

These seven types of men should


belonging to the

be considered

Sattvika group (of Sdttvika mental

temperament).

Now

hear
(of

me

describe the
73.

features

of

men

of Rdjasika

stamp

mind).

R^ijasika
jealous of other

Features : Asura-Sattva

men

are affluent in circumstances, dreadful, valorous, irascible,

men's excellence, gluttonous and fond


sharing with any one
irritable,
else.

of eating alone without

Sarpa-Sattva

man

is

laborious,
in

cowardly,

angry, double-dealing,

and hasty

eating and sexual

i$S
intercourse.

THE SUSHRUTA SAMHITA.

[Chap. IV.

^akuna-Sattva
is

man

is

gluttonous,

intemperate in sexual

matters, irritable and fickle.


solitary in his

Ratkshasa-Sattva man
vain and ignorant.

habits, fierce,

jealous of others excellence, externally pious, extremely

The

characteristics of a Paisacliairri-

Sattva man
tability of

are eating food partaken of by another,

temper, rashness, shamelessness, and covetous-

ness of female possessions.


are utter

Those of Preta-Sattva man


laziness,

want
to

of

knowledge as regards duty,


cast

miserableness, envy, covetousness, niggardliness.


six belong

These
hear
the

the Rajasika
the

of mind.

Now
of

me

describe

characteristic
74.

traits

of

men

Tamasika temperaments.
Pais'ava-Sattva

Tamasika Features: The


man
or

features

of

are perverseness of intellect, parsi-

moniousness, frequent sexual dreams and incapacity of


ascertaining

discerning

anything.

The

features of

Matsya-Sattva man are unsteadiness, stupidity, cowardice, fond of intermissive quarrel and oppression and a
longing for water.

The

features of a

Vanaspati-Sattva
place, constant
piety, riches

man

are fondness of staying at the

same

eating

and absence of truthfulness,

and

enjoyment.

Thus the

three types of

Tamasika tempera-

ment have been described, A physician should take in hand a patient with an eye towards these mental traits
etc.

physician
of

should

coolly

deliberate

upon the

different types

temperament described herein and


7S'7^Sthdnam
in the S'uss'ruta

their characteristic features.

Thus ends the


Samhita which

fourth Chapter of the S'arira

treats of foetal

development

etc.

CHAPTER
Now we
of
shall discourse

V.

on the Sariram which treats

the

anatomy

of

the

human
i.

body

(SsTrira-

^ankhya-Vyakaranam). Definition of Garbha and ^arira ;


The combined semen and ovum (Sukra and Sonita) the womb, mixed with (the eight categories known the Prakriti and (her sixteen modifications known
Vikdra, and ridden in by the Atmat
is

in
as)

as)

(self-consicous
in
it

self^,

called

the

foetus.

There
limbs,

is

consciousness

the
into

embryo.

The Vatyu

(or the vital force) divides


etc.,

Dosha, Dhdtu, Mala,

and organs,
the

etc.

The

Teja (or the heat latent in the fecundated matter) gives


rise to the

metabolism of the tissues


;

Apa
is

(water)

keeps
in the

it

in a liquid state
its

the Kshiti (earth)


;

embodied

shape of
its

butes to
foetus

and the Akas'a (ether) contrigrowth and development. A fully developed


species
all
its

with

parts, such as the hands, feet, tongue,

nose, ears, buttocks etc.

and the sense-organs,


is

is

called

Satriram

or

body.

The body
four

composed of
2.

six

main

parts,

namely, the

extremities (upper and

lower), the trunk or

middle body, and the head.

Different
we
shall describe

members of the body : Now


the

Pratyangas or members of the

body.

The

head, the belly (Epigastrium), the back, the

navel (umbilical region), the forehead, the nose, the chin,


the

bladder,

and the throat


the the
cheek,

(neck), occur singly

the

ears, the eyes, the nostrils,

eye-brows, the

temples,

the shoulders,
testes,

the armpits, the breasts, the

the sides, the buttocks, the arms, the thighs,


etc.,

and
and

the knee-joints,

occur

in

pairs.

The

fingers

l6o
toes

THE SUSHRUTA SAMHITA


which number twenty
likewise
in
all,

[Chap, V.

and

the

interior

channels (Srotas) of the body, to be presently described,


are

included

within

the

Pratyangas.
3.

These

are the different Pratyang'as or members.

Enumeration Of the different limbs and members of the body : The different
layers of the skin, the Kalas, the

Dhatus

(root principles,
,

such as blood,

chyle,

etc.),

the

Doshas (morbific principles, such


or

Mala (excrements the as the Vayu, Pittam,


the lungs, the

Kapham\

the spleen, the liver,

colon

and caecum (Unduka), the


the Srotas
(internal

heart, the cavities or viscera

(Asayas), the intestines (Antras), the

Vrikkou (Kidneys)
the

passages

or ducts),

Kandara
the

(nerve trunks), the Jalas (membranes), the Kurchas,*

Rajjus (tendons)
(facets), the

the

Sevanis (sutures),

the

Sanghdtas
Snd,yu

Simanta, the
the
Pes'i

bones, the joints, the

(ligament),

(muscles), the

Marmas

(vital parts,

such as anastomosis of veins and


(veins),

arteries, etc.), the Sira

the

Dhamani
4.

(arteries),
is

and the

Yogavahini
called

Sr5tasf,

constitute

what

collectively

the

organism.

Their number : The


number seven
seven
in
all.

in all.

layers fof skin (Tvaka) There are seven connective tissues


cavities or viscera (Asayas)

or fascia (Kalds).

The

are

The
number.

root principles (Dhatu) of the

body
S'ird

are seven in
(veins),
five

There are seven hundred


Pes'i

hundred

(muscles),

nine

hundred

Snayu
(vital

(ligaments),

three

and ten Sandhi


parts),

^joints),

hundred bones, two hundred one hundred and seven Marmas


etc.),

twenty-four Dhamanis (arteries


as

three

Doshas (morbific principle such


*

the

V^yu, Pittam,
as
at

Meetings of muscles, ligament?, veins, nerves and bones

the

annular ligament.
t Those, that are in connection with the Dhamani.

Chap, v.]

SARIRA STHANAM,

i6g^

to the
sides

Sushira type.
a

The ligaments
of planks of

of the chest,

back,

and head are of the Prithu


boat

type.

3435.
of

As
together
is

made

and timber fastened

by

means

large

number

bindings
;

enabled to float

on the water and to carry cargo

so the

human frame being bound and fastened at the Sandhis or joints by a large number of ligaments.
is

(Snayu)
diseases

enabled to bear pr:^ssure.

An
if

injury

to,,

or

of,

the bones, veins, joints or muscles are not so


to the system as
in
is

detrimental
are affected

the case

the

Snayus

any way.

acquainted with the


(Sndyus) of the body,

internal
is

Only the physician, who is and external ligaments


to

qualified

extract a
etc.)

hidden

and imbedded Salyam (extraneous matter


part of the body.
36.

from any

The
number
are
in

lYIuSCleS (PcsiS) : The muscles


five

(Pesis)

hundred
four

in

all,

of
;

which four hundred


Sixty-six*
in.

the

extremities

the

trunk (Koshtha) and thirty-four in the region above the


clavicles.

37.

IVIuscIes in
in the toes of

the Extremities : There


toes,

are

three muscles in each of the

thus

making

.fifteen

one leg

ten in the anterior part of the foot


(ten")

and the same number


ten
in

attached to the Kurchcha

the sole and the ankle-bone (Gulpha,


in the region
five in

malledi)
in the

twenty
joint
;

between the Gulpha and the knee;

the knee-joint (Janu)


in the groin
in

twenty
;

thigh

(Uru)

and ten

(Vankshana)
in

thus

one hundred

muscles
in

all

each

leg.

making The same


;

number
(thus

is

found

each of the other three extremities


all).

making

four hundred in

2^.
:

Muscles
six
*

in

the Koshtha
and
forty

-(Of the

sixty-

muscles in the trunk), three are in the region of the


Gayadasa reads
sixty in the trunks

above the

clavicles,

22

170

THE SUSHRUTA SAMHITA.


;

Chap. V.]

anus (Pa/u)
(Sevan i)
bladder
;

one
in

In the

penis; one

in

the
in

perineum
of the

two

the
;

scrotum
in

five

each

haunches
;

(Sphik)
five in
;

two

the

top or head of
;

the

the

abdomen (Udara)

one about the


six

umbilicus

five

along each side (of the spinal column),


in all)
;

on the upper part of the back (making ten


in the sides
;

ten in the chest

seven around the armpits


;

and shoulders (Akshaka-Ansa) two in the region of and six in the region heart and stomach (Amas'aya)
;

of the liver, spleen and colon (Unduka).

39.

IVIuscIesof the
the throat (Grivd)
;

Head and Neck : (Of


two jaw-bones (Hanu)
in the
;

the thirty-four muscles found in this region), four are in


eight in the

one each
Gala)
;

in

the

regions of the
palate
;

throat (Kakalaka and

two
:

in the in the
in

one

tongue
;

two

in

the lips

two two

nose

two
;

in the eyes

four in the
;

cheeks

the

ears

four in the forehead


positions

and

one
tions

in

the

head.
five

Thus the

and

distribu-

of the

hundred muscles (Pesis) have been


ligaments, veins,

described.

40.

Metrical Text :~The


and joints
from the
etc.,

bones

of a

human

body, derive their strength

fact of their
41.

being supported by or covered over

by the muscles.

Extra IVIuscIes
have twenty extra muscles
about the two breasts,
attain their full
;

in
in

Women
each,
;

: Females

ten muscles are to be found

five

which (muscles)
four

growth during puberty


passage
;

muscles

are present about the parturient


(four)

and of these
in the internal

two are about the external and two


vagina)
;

orifices (of the


OS,

three about

the

region

of the

and three along the passages of the ovum and sperm. The Garbhasaya or uterus is situated in the space
bounded by the Pittas'aya (small
intestine)

and Pakv^s'aya

Cliap. V.j

SARIRA STHANAM.
and the
their
foetus lies
in

I^I
this

(large intestine)

during the

period of gestation.*

42-43. position
in

According to

the

system, these

muscles are found to be thick, slender, small, expanded,


circular, short, long, hard, soft,

smooth or rough.
are

The

muscles cover the

veins,

ligaments,
size

bones and joints;

hence

their

shape and

determined by the
44.

exigencies (organic structures) of their positions.

Memorable Verses
are found in the penis

-The

muscles which

and scrotum of a
the
to

man

as

des-

cribed before correspond to


in

covering
the

of the uterus

the case of a

woman owing

absence of those

organs in her body.


of the
veins,

channels,

The positions and classifications Marmas and arteries will be


45-46.

dealt with in a separate chapter.

The vagina

of a

woman
is

resembles the navel of a


involuted

conch-shell in shape and

possessed of three

turns (Avartas) like

the interior of mollusc.

The

uterus

(Garbhas'aya

foetal

bed)

is

situated at the third posterior

involuted turn.

The shape
The

of the uterus resembles

the

mouth of
in the

a Rohit-fish (narrow at the


foetus

mouth and expanded


in

upper end).

lies

crouched

or

doubled up posture in the uterus and thus naturally at


the

time of parturition

its

head

is

presented

at

the

entrance to the vagina.

47-48.

Superiority of ^alya-Tantram :-The


different parts or

members
even
the

of the

body
cannot

as

mentioned
correctly

before

including

skin
is

be

described

by any one who


one
desirous

not versed in Anatomy.

acquiring a thorough knowledge of anatomy should prepare a dead body and carefully observe (by dissecting it) and examine
of
* If

Hence,

any

we read

Mutras.'aya (bladder) in

place

of

Piltda'aya

it

explains

the anatomy better. Ed,

-iJ2

THE StJSHRUTA SAMHITA.

Chap. V.]

its

different parts.

For a thorough knowledge can only


the

be acquired by comparing
SAstras'

accounts given

in

the

(books
49.

on

the

subject)

by

direct

personal

observation.

IVlode of dissection
for this

: A
lived

dead body selected


its

purpose should not be wanting in any of

parts,

should not be a person


years
(i.

who had
ol

up to a hundred

e.

too old age) or

one who died from any

protracted disease or of poison.

The excrementa should


and the body should
still

be

first

removed from the

entrails

be

left to

decompose
fish

in the

water of a solitary and


cage (so that
it

pool,

and securely placed

in a

may

not be

eaten
it

away by

nor

drift

away), after having covered

entirely with the outer sheaths of

Munja

grass, Ktis'a

grass,

hemp

or with rope etc.

After seven days the body

would be thoroughly decomposed, when the observer should slowly scrape off' the decomposed skin etc. with a
whisk made of grass-roots,
strip of split
hair,

Kusa blade

or with a

bamboo and

carefully observe with his

own

eyes

all

the various different organs, external and internal,

beginning with the skin as described before,

50

56.
occult

IVlemorabIc Verses : The


or invisible Lord of the

Self, the

body cannot be detected except


He, who

with the psychic eye or with that of the mind.


has observed the internal

and

is

well read in the


all his

mechanism of the human body works bearing on these subjects


science of

and has thus

doubts expelled from


the

alone qualified

in

mind is Ayurveda and has a


his 57.

rightful claim to practise the art of healing.

Thus ends the


Samhitii

fifth

Chapter

of the

S'arira-sthanam in the Sus'rula

hich treats of the anatomy of the

human body.

CHAPTER
Now
vvc shall discourse

VI.

on the Sdrlram which specior vital parts of the

fically treats of the

Mannas*

body
i.

(Pratyeka-marma-nirdcsa Sariram.)
Classification of IVI arm as : There
one hundred and seven
ism),

are

Marmas

(^in

the

human organclasses,

which

may

be

divided into

five

such as

the Mcinsa-Marmas, Sira-Marmas,

Sndyu-Marmas, AsthiMarmas and the Sandhi-Marmas. Indeed there are no


other
in the

Marmas

(vulnerable or vital

parts)
2.

to

be

fuund

body than the preceding ones.

Their different numbers : There


eleven

are

Mansa-Marmas (vulnerable

muscle-joints)
;

forty-

one Sird-Marmas (similar veins, anastomosis)


seven

twenty;

eight Snayu-Marmas (vital ligament-unions) Asthi-Marmas (bone-unions) and twenty Sandhi-Marmas


3.

(^vulnerable joints).

Their Locations :~0f


one
leg,

these,

eleven

are

in

tremities,

making twenty-two in the two lower exThe same number counts in the two hands. There are twelve Marmas in the regions of the chest and the abdomen (Udara) fourteen in the back
thus
;

and thirty-seven

in

the region of the neck

(Griva)

and

above

it.

4.
:

The Marmas which are situated


as Kshipra,

Names and distributions of IVIarmas


in

each leg are known


Kurchcha-Sirah,

Tala-Hridaya, Kurchcha,
Ani,
Urvi,

Gulpha, Indravasti, Janu,


Vitapa.

Lohitaksha and
the

The twelve Marmas which


which proves

are situated in
joints

Places where veins, arteries, ligaments,

and

mu.cles unite

and an

injury to

j^encrally fatal.

i;?'4

THE SUSHRUTA SAMHItA.

Chap. Vl.]

thorax and the abdomen (Udara) are Guda (anus), Vast!


(bladdery,
xN^abhi

(umbilicus),
of

Hridaya

(heart),

Stana-

mula

(the

roots

two

breasts),

the Stana-Rohita,

(muscles of the breasts\ the two Apalaps

and the two


be found
in

Apastambhas.
waist', the

The

fourteen

Marmas

to

the back are the Katika-tarunas

(Taruna-bones of the
(hips),

two Kukundaras, the two Nitamvas


(shoulder-blades)

Pars va-Sandhis (the two side-joints), the two


the two Ansa-phalnkas

Vrihatis,

and the two


an

Ansas

(shoulders).

The

eleven

Marmas

to be found in

arm

are

known

as the Kshipra, Tala-Hridaya, Kurchcha,

Kurchcha-Sirah,

Manivandha,

Indravasti,

Kurpara,
is

Ani, Urvi, Lohitaksha and Kakshadhara.


the one

What

said of

arm holds good of

the other.

The Marmas

situated

above the clavicle regions are known as the four Dhamanis,


the eight Matrikas,the twoKrikatikas, the two Vidhuras,

the two Phanas, the two Apangas, the two

Avartas, the
five

two Utkshepas, the two Sankhas, one Sthapani


Simantas, four Sringatakas and one Adhipati.

59.

The
the

different heads of IVIarmas: Of


Marmas,
Indravasti,

aforesaid

Hridaya,

Mayas a- Marmas.

those known as the TalaGuda and Stana-rohita, are Those known as Nila-dhamani,

Matrika, Sringataka, Apanga, Sthapani,

Phana,

Stana-

mula, Apalapa, Apastambha, Hridaya,

Nabhi, Pars'va-

Sandhi, Vrihati, Lohitaksha and Urvi, are Sirat-Marmas.

Those

known

as

the

Ani,

Vitapa, Kakshadhara,
Kshipra,

Kurchcha,
(shoulders),

Kurchcha-Sirah,

Vasti,

Ansas,

Vidhura and Utkshepa, are Snaiyu-Marmas. known as the Katika-taruna, Nitamva, AnsaThose The Janu, the phalaka, Sankha, are Asthi-Marmas.
Adhipati,
the
the

Kurpara, the Simanta, the

Gulpha, the

Manivandha,

the

Kukundara,

Avarta and the

Krikatika arc Saudhi-Marmas.

1014.

Chap. VI.]

SARIRA ST HAN AM.


these

1/5

Qualitative classes : Again


(vital

Marmas
heads,

unions of the body) are under

five distinct

namely,

Sadya-Pranahara,

(fatal

within

twenty-four
a fortnight

hours), Kalantara-Pranahara,

(fatal

within

or a month), Visalyaghna (fatal as soon as a dart or any

other imbedded foreign matter

is

extracted

therefrom),

Vaikalyakara,

(maiming
effects].

or

deforming) and

Rujakar

(painful) [according as

an injury respectively produces

the

aforesaid

Of

these,

nineteen
;

Marmas
to

belong to the Sadya-Prdnahara group


the Kalantara-Pranahara group
;

thirty-three

three to the

Visalya;

ghna group; forty-four

to the

Vaikalyakara group
15.

and

eight to the Rujcikara group.

Memorable Verses : To the


hara group
Sankhas,
(fatal in

Sadya-Prainaanywa\' hurt)
the

the course of a day

if

belong the four Sring^takas, one


the
eight

Adhipati,
the

two
the

Kantha-Sirds,

Guda,

Hridaya, the Vasti and the Nabhi.

To
if

the Kailadltara-

Pranahara group

(fatal

later

on,

any way
five

hurt)

belong the eight Vaksha-Marmas, the


the four Tala-Marmas,
four
Indra-vastis,

Simantas,

the

four

Kshipra-Marmas, the

the

two two

Katika-tarunas, the two


Vrihatis,
class

Parsva-Sandhis,

the
the

and

the

two

Nitamvas.

To

Visalyaghna
the

belong the two

Utkshepas and the one Sthapani.


(deforming) group belong
four

Vaikalyakara Marmas, known as the


the the

To

Lohitakshas,

the four

An is,

two Jdnus, the

the two Vitapas, the two Kurparas, the two Kukundaras, the two Kakshadharas, the two Vidhuras, the two Krikatikas, the two

four Urvis, the four

Kurchchas,

Ansas (shoulder), the two


blades), the

Ansa-phalaka.s,

(shoulder-

two Apangas (tips of eyes), the two Nials, the two Manyas, the two Phanas and the two Avartas.

learned physician should

know

that the two Gulphas,

176

THE SUSHRUTA

SAMIIITA.

[Chap. VI.

the two Mani-vandhas and

the four Kurchcha-S'irah (of

the hands
(painful
if

and
hurt).

legs)

belong to the Rujakara group


piercing
;

A
16-2

of

the

Kshipra-Marma

ends in an instantaneous death


at a later time.
t.

or

death

may

follow

Firm unions of Mdnsa


(or vital parts of the

(muscles), Sira

(veins),

Snayu
specifi-

(ligaments), bones or bone-joints are

called

Marmas
to

body) which naturally and


life

cally form the seats of

(Pratna),

and hence a hurt


22.

any one of the Marmas invariably produces such symptoms


are
as arise

from the hurt of a certain Marma.*


to the

The Marmas belonging


possessed
of
fiery

Sadya-Pranahara group
;

virtues (thermogenetic)

as

fiery virtues are

easily

enfeebled, so

they prove

fatal

to life (in

the

event of being any


to

way

hurt)

while

those belonging
fiery

the Kalantara-Pranahara group are


(cool)
in

and

lunar

their

properties.

And
cooling
so,

as the fiery virtues are enfeebled easily and the


virtues

take a
of
this

considerable

time

in

being

the

Marmas
like

group prove

fatal in the
if

long run (in

the event of being any


the preceding

way

hurt,

not instantaneously

ones).

The Vis'alyaghna Marmas


(that
is,

are possessed of Vataja properties

they arrest

the escape

of the

vital

Vayu)

so

long as the dart

does not allow the


interior, the life

Vayu
;

to escape

from their injured


the
dart
is

prolongs

but as soon as

extricated, the

Vayu
of

escapes from

the inside

of the

hurt and necessarily proves fatal.


are

The Vaikalyakaras
they
cooling

possessed

Saumya

(lunar properties) and

retain the vital fluid owing to their steady and


virtues,
*

and hence tend only

to

deform the organism


and

Some
Mar

are of opinion that hallucination, delirium, death, stupor


in

coma
thes

as described
as.

the

Sutrast

anam

are

the

results

of injuries to

Chap. VI.]

SARIRA STHANAM.
hurt,

IJJ
of

in

the event of their being

instead

bringing

on death.
properties

The Ruj^kara Marmas of fiery and Vataja become extremely painful inasmuch as both
are

of

them

pain-generating

in

their

properties.
result

Others,

on the contrary, hold the pain to be the


of

of the properties

the

five

material
23.

components of

the body (Pancha-bhautika).

Different Opinions on the IVIarmas


Some
and
hara)
in

assert that

Marmas, which are the firm union of


first

the five bodily factors (of veins, ligaments, muscles, bones


joints),
;

belong to the

group (Sadya-Pranaprove

that those, which form the junction of four such, or


is

which there

one

in smaller quantity, will

fatal

in the

long run, in the event of their being hurt or injured

(Kdldntara-Pranahara).*

Those, which are the junction

of three such factors, belong to the Vis'alya-Prcinahara-f*

group
*

those
Marmas,

of the two belong to the Vaikalyakara


such
as

The

Stana-mula,

Apalapa,

Apastambha,
be;

Simanta,

Katika-Taruna,

Parsva-Sandhi,

Vrihati,

and Nitamva

longing to the Kalantara-maraka group, are devoid of

Mansa

(muscles)

and the 'Marmas' known as Stanarohita,


Indravasti, belonging to the
t

Talahridaya,

Kshipra,

and

same

class, are

devoid of Asthi (honest


to

The
is

Ulkshepa marma,
Sthapani- Marma,

belonging

the
(joint).

Vis'alya.pr^nahara

group, X

devoid of Mansa (muscles) and Sandhi

The

belonging
S'ira

to

the
;

Vaikalyakara
(he

class,

is

devoid of
(of the

Mansa

(muscle),
is

and

Snayu

Lohitaksha-marma
;

same group)
(of the

devoid of Snayu, Sandhi


is

and Asthi (bones)


S'ira

the

Janu-marma
the
the

same group)

devoid of
is

Mansa,

and Snayu:
;

Urvi-marma

(of the said

group)

devoid of Asthi, Mansa and Snayu


is

Vitapa-marma
Snayu
Mansa,
is

(of the

same
the

class)

devoid of Mansa, Sira and Asthi


is

the

Kurpara-marma
;

(of

same

class)

devoid

of

Mansa,
is

S'ira,

and
of

the
S'ira

Kukundara-marma
and Sandhi
;

(of

the

same

class)
(of

devoid

the

Kakshadhara-marma
;

the

same

class)

devoid of S'ira, Asthi, and Sandhi


is

the
;

Vidhura-marma
the

(of the

said group)
is

devoid of Mansa, Sira and Sandhi

Krikatika-marma
(of the

devoid of Mansa, S'ira,


is

and Sandhi;

the

Ansa-marma
;

same

group)

devoid of Mansa, Snayu and Sandhi

the

Ansa-phalaka-marma

2\

178

THE SUSHRUTA SAMHITA


;

[Chap. VI.

group

and those
last

in

which only one of them exists


not a sound one, inas-

belongs to the

or pain-generating type (Rujdkara)*.


is

But the

fore going theory


is

much
vein,

as blood

found to exude from an injured joint


in

which would be an impossibility


ligament (Snayu) and
it.

the absence of

any
be
five

muscle being intimately


should

connected with

Hence every Marma


veins,

understood as a junction or meeting place of the


organic principles of ligaments,
muscles,

bones

and

joints.

24-25.

IVletrical by the
are

text: This
Vdyu,
into

is

further corroborated

fact that the four classes of Sira or vessels Pitta,

(which

respectively carry the

found to enter

the the

Kapha and the blood) Marmas for the purpose


moisture of the local

of keeping or maintaining

ligaments (Snayu), bones, muscles and joints and thus


sustain

the

organism.f

The Vayu, aggravated by an


(those four
classes

injury to

Marma, blocks up

of

vessels) in their entire course

throughout the organism


all

and gives
body.

rise to

great pain which extends

over the

All the internal

mechanism of a man

(of

which a

Marma

has been pierced into

with a shaft or with any

other piercing

matter) becomes extremely painful, and

seems as

if

it

were being constantly shaken or jerked,


of syncope are found to set in.
affected

and symptoms
careful
(of

Hence a
should
;

examination of the
said

Marma

the

group)

is

devoid of Mansa, Snayu and Sandhi


(of the

the Nila,

Manya and Phana Marmas


Sandhi and Asthi
;

same group)
is

are devoid of
S'irsL,

Mansa,

the

Avarta-marma

devoid of
is

Sniyu and

Mansa

the Apdnga. marma (of the said class)

devoid of Mansa, Sniyu

and Sandhi. * The Gulpha,


to the

Manibandha,

and Kurchcha-s'ira Marmas, belonging


S'ir^,

Rujakara group, are devoid of Mansa,


is

Sniyu and Asthi,

i.e.

Sandhi alone
t

present in these.
is

Hence

the piercing of a bone

attended with bleeding.

Chap. VI.]

SARIRA STHANAM,

179

precede
its

all

the foregoing acts of extricating a Salya from

inside.

From

that similar aggravated conditions

and

actions of the Pitta


in

and the Kapha should be presumed the event of a Marma being any v^ay injured or

pierced into.

2629.
of

A Marma
perforated at
its

the

Sadyah-Pr^nahara type being


a later time
of the

edge brings on death at

(within seven days), whereas a deformity

organ

follows

from the piercing

of

Kdlantara-Miraka*
Similarly,

Marma

at the side (instead of in the centre).

an excruciating pain and distressful after-effects mark a


similar perforation

of a

Marma
of the

of the Vis'alyaghnaf

group.

And

Marma

Rujdkara|:

class

proin

duces an excruciating pain (instead of a sharp one)


the event of
its

being pierced at the fringe.

30.

An

injured
in

Marma

of the

terminates

death within seven

Sadyah-Pranahara type days of the injury,


or a

while one of the Kaldntara type, within a fortnight

month from

the date of hurt (according to circumstances).

case of injured

Kshipra-Marma seldom proves

fatal

before that time (seven days).

Vis'alyaghna or
in the

Marma of the Vaikalyakara group may prove fatal


injured

An

event of

its

being severely injured.

31.

Marmas of the Extremities : Now we


shall
* If

describe
any of the

the

situation
of

of every

Marma.

The
be

Marmas
act
like

the

Kalanlara-Pranahara

group

deeply perforated,
a day
{i.e.
it

then

this perforation is sure to bring

on death within
of the Sadyah-

will

slightly

injured

Marma

Pranahara group).
t

Any

M.-irma of

the

Vis'aiyaghna-group,

being deeply

perforated,
slightly

brings on death within seven


injured

days

(/. e.

it

will

behave like a

Marma

of the Kalantara-Prknahara class).


of the. Rujakara class, being deeply perforated (injured),

t Any
is

Marma
bring

sure to

excruciating

pain etc,

(i.e.,

it

will act

like

slightly

injured

Marma

of the Vis'alyaghna group).

rSo

THE SUSHRUTA SAMHITA.


as

[Chap.

VI.

Marma, known
region

the

Kshipra*,

is

situated

in

the

between

the

first

and the second


injured

toes (Tarsal

articulation),

which, being

or

pierced,

brings
as the

on death from convulsions.

The Marma, known


the

Tala-Hridayat,
the middle
toe.

is

situated in

middle of the sole


of

of the foot in a straight line

drawn from the root

An

injury to this
in death.

Marma

gives rise to

extreme pain which ends


as

The Marma, known

the

above
foot.

Kurchchat, is situated two fingers' width from the Kshipra one on each side of the
injury
in

An

to

this

Marma
foot.

results

in

shivering
called

and

bending

of
is

the

The Marma

Kurchcha-Sirah
injury
affected
to
it

situated
foot

under the ankle-joints,


(Gulpha-Sandhi)
;

one on each side of the


gives
rise

an

to

pain

and swelling of the

part.
is

perforation
at
in

of the

Gulpha-Marma
of

!!,

which
the

situated
results

the

junction
paralysis

the

foot

and

calf,

pain,

and

maimedness
in

of the affected leg.

32-37-

An

injury to the

Marma which
calf

is.

situated

the

middle muscle of the

to

the

distance

of between

twelve and thirteen fingers' width

from the ankle, and


results in excessive

known

as the

Indravasti-Marma^lT
in

haemorrhage which ends


*
It is

death.

38.

Snayu-Marma (ligament)

to

the width

of half a

finger,

and

belongs to the Kalantara group.


t
It is

Mansa-Marma
a

to the

width of half a finger and belongs

to the

Kalantara group.
:;

It

is

Snayu-Marma
Snayu-Marma,

to

the

length

of four

fingers'

width, and

belongs to the Vaikalyakara group.

It
is

one

finger in

length

and belongs

to

the

Vaikalyakara group.
II

It is

a Sandhi-Marma, to the length of two fingers',

and belongs

to

the Vaikalyakara group.


IF

Indravasti measures two fingers in length according to

Bhoja and

Chap. VI.]

SARIRA ST HAN AM.


to

iSl

An
in

injury

or

piercing

of

the

Jatnu-Marma*
results

situated at the union of the thigh

and the knee,


situated

lameness of the patient.

39.

A
sides

piercing of the

Aui-Marma,+

on both the

above three

brings
leg.

fingers' width from the Jdnu (knee joint), on swelling and paralysis (numbness) of the

40.

perforation

of the

Urvi-Marma,t situated
results in

in the

middle of the Uru


of the leg, owing
to

(thigh),

the atrophy

the incidental haemorrhage.

An

injury to the Lohitaiksha-Marma,ll situated respectively

little

above and

below the

Urvi-Marma and the


thigh,
is

Vankshana

(groin-joint),

and placed near the

attended with excessive


lysis (of the leg).

haemorrhage and causes parasituated between


region), brings

41-42.

An
the

injury to the

Vitapa-Marma,^

Scrotum and the Vankshana (inguinal


loss of

on

eleven

manhood or scantiness of semen. Sakthi-Marmas of one leg have been

Thus

the
;

described

those in the other being of an identical nature with the

preceding ones.

The Marmas
Kurpara and
in

in the

hands are almost

identical with those of the legs, with the exception that

Manivandha,

Kakshadhara
to

Marmas
It
is

Gayadasa, though half a finger

width according

others.

Mansa-Marma and belongs


*
It is

to the

Kalantara group.
fingers
in

a joint-Marma,

three

length

and belongs to the

Vaikalyakara group.
t
It is

ligam';nt-Marma,
is

half

finger

in

length,

(three

fingers

according to Gayadasa) and

of the Vaikalyakara class.


in length

It

is

S'ira-Marma, half a finger

and of the Vaikalyaand of the Vaikalya.

kara group,
II

It is

a S'ira-Marma,

halfa finger

in

length

kara group.
IT

It

is

Snayu-Marma

to

the

length

of one

finger

and of the

Vaikalyakara group.

l82

THE SUSHRUTA SAMHITA.


in

[Chap. VI.

occur

the

place

of

the

Gulpha,
the

Jdnu

and

Vitapa-Marma Vankshana (inguinal region), so the Kakshadhara-Marma is situated between the Vaksha (chest) and the Kaksha (armpit). An injury to these causes supervening symptoms. An injury to the Manivandha-Marma (wrist-marma)
is

Vitapa Marmas respectively.


situated

As

between the scrotum and the

results

specially

in

inoperativeness

(Kuntha) of the

affected
in

hand

an injury to the Kurpara-Marma ends


the

dangling

(Kuni) of

hand
in

and an injury

to

the

Kakshadhara

results

forty-four
ties

Marmas

of the upper

hemiplegia. Thus the and the lower extremi-

have been described.


describe
the

43-46.

Marmas on the Thorax


shall

etc. : Now we
in

Marmas, situated

the region of

the the

thorax

and the

abdomen
which
is

(trunk).
to

A
and
the

hurt to
large
flatus,

Guda-Marma*,
and

attached

the

intestine

serves as the passage of stool

ends fatally (within

twenty-four

hours of

hurt).

An

injury

to

the

the cavity of the

Vasti-Marma,t situated inside pelvic region and the bladder and


(and

composed of small muscles and blood


serves
in

which
with-

as

the

receptacle

of urine), proves fatal


the
cases
to

the

day,

except in

of

extracting the

gravel,

only when the


perforation

injury
of

the

organ
its

is

short

of complete

both of

walls.
in

The
case

urine

oozes out through the


its

aperture

the

where only one of


which

walls

has been perforated, and


healed

may

be

closed

and

up with proper
injury
to

and
*

judicious
a

medical treatment.
to the

An

the

It is

Mansa-Marma

length of four fingers'

width and be.

long? to the Sadyo-maraka class.

It is

a ligament combination

(Snayumarma)
class.

to the length of four

fingers,

belonging to the Sadyah-Pranhara

Chap. VI.i

SARIRA STHANAM.

183

Natbhi-Marma,* the root of all the Siras and situated between the Amdsaya (stomach) and the Pakv^s'aya
(intestines) ends in death within the day.

47-50.
is

A
in

hurt to the

Hridaya-Marma,t which
the seat of

situated

the thorax between the two breasts and above the

pit of the

Amasaya and forms


Rajas and
injury

the

qualities

of Sattva,

Tamas,

proves fatal within

the

day.

An

to the

Stana-mula-Marmas,]: situated

immediately below each of the breasts and about two


fingers in

width

fills

the

Koshtha (thorax) with deranged


difficult

Kapha, brings on
and
the

cough,

breathing (asthma)

proves

fatal.

An

injury

to

any of the Stanathe


nipples
of
fills

Rohita-Marinas,
of the
of

situated

above

breasts about two

fingers in width,

the cavity

Koshtha (thorax) with blood, producing symptoms


fatally.

cough and asthma, and ends


of the

An

injury to

the

Apalaipa-Marmas,!! situated below the

Ansa-kuta

(balls

shoulders) and above the sides (meeting

of the
axilla',

different

branches of the sub-clavicle veins

ue.

transforms the
fatal thereby.

blood

of the organism into pus

and proves

51-54.
vessels,

An
as the

injury to

any of the Vayu-carrying


bronchi
lying

known

Apastambha-Marmalf (meeting
of

of the bifurcated

branches
*
It is

the

on both the sides


fingers,

a S'ira-Marma to the length of four


class.

belonging to the

Sadyah-Pranahara
t
It is

a S'ira-Marma to the length of four fingers and of the


class.

Sadyah-

Pranahara +
class.
It is

a S'ira-Marma, two

fingers

in

length

and of the Kalantara


length

It

is

Mansa-Marma about

half a

finger

in

and of the
class).

Kalantara
II

class,

(according to Vgabhata,
half a finger

of the

Sadyo-Maraka

It is

a S'ir^.Marma,

in length,

and of the Kalantara

class.

It is

S'ira-Marma,

half

finger

in

length

and belongs

to the

Kalantara

class.

1 84

THE SUSHRUTA SAMHITA.


breast),
fills

[Chap. Vl.

of the

the

Koshtha
in

with the deranged

Vayu
pepsia,

(tympanites) accomapanied

and terminates
situated
55-56.
in

by cough and dysdeath. Thus the twelve

Marmas
described.

the

thorax and abdomen are

PriShtha Marmas : Now


on the

we

shall discourse

Marmas

in the

back (of a man).

An

injury

to

any of the Katika-tarunas*


situated in the

(sacro-iliac articulation),

region of

the S'roni Csacrum)

on both
excessive

sides of the spinal column,

gives

rise

to

an

haemorrhage and consequent pallor and ends in death.

hurt to

any of the Kukundara Marmas


sacro-sciatic notch), situated

| (lit

hollow
sides

the great
of the

on both
complete

spinal

column and
the
loins),

in

the region slightly


in

below

the

waist

(in

results

anaesthesia
ties.

and inoperativeness of the lower extremito

hurt

the

Nitamva-Marmas,| attached

to

the side above the Sroni (pelvis) and attached

inside to

the muscles of the waists, gives rise to


in the lower extremities,

Sosha (atrophia)

weakness and ultimately brings

on death.
(caelic

An

injury to the

PairsVa-Sandhi-Marmas
at

axes) which

are situated just

the middle below

the extremities

of

the

sides

(P^rsva)

and which
at their

lies

attached at the middle between the loins


regions, feels the

lower

Koshtha (abdomen) with the blood

and

results into

death

hurt to the
finger in length

Vrihati-Marmas
and of
the

1]

* It

is

an Aslhi-Marma, half a

Kalantara-

maraka
t

class.

They

ate Joint-matmas (Sandhi), half a finger in length

and of

the

Vaikalyakara group.

It is

a bone

Marma,

half a finger in length, half

and of the Kalantara


a
finger

clas,

It is

a S'ira-Marma to the length of

and belongs

to

the Kalantara class.


li

They

are

S'ira-Marmas

(arterial

anestomsis)

to the lengt

of half

a finger and

belong to the

KaUntara

class.

Chap. VI.J

SARIRA STHANAM.
from
the
roots

iS$
of

which
course

commencing
round

the breast

both the sides of

the

spinal

column

(Pristha-vams'a), cause excessive bleeding,


dies,

and the patient

as

supervening symptoms arise from an excessive

loss of blood.

An

injury to

Marmas*

situated on either side of the vertebral

any of the two Amsa-phalaka column


There are two Marmas

and connected with the scapula brings on anesthesia


or atrophy (Sopha) of the arms.

known as Amsa-Marmasf which are situated on either side midway between the neck and the head of the arms
and connect the Amsa-Pitha (glenoid cavity) and the

Skandha
is

(shoulder).

An

injury to

any of these Marmas

attended with an

incapacity
in

of

moving the hands.


back have
been

Thus the fourteen Marmas


described. 57-65.

the

The Jatrugata- Marmas :-Now


describe
the

we

shall

Marmas which

are situated in the regions

above the clavicles (Urddhva-Jatru).

There are four

Dhamani

(arteries)

about the two sides of the

Kanthaand
are

Nadi (wind-pipe).

Two

of

them

are

known
(i.e

as Nilai,

the other two as Manyai.

One

Nild and one


,

Manyd

situated on either side of the larynx,

anterior

and

posterior side of the larynxl

An

injury to

any of them

produces dumbness, and

change of voice (hoarseness),


|

and also the


of

loss of the faculty of taste.


(arteries), four

An

injury to

any of the eight Siras


the

being on each side


as

neck
)

(Griva),

and known

Sirak-Ma^trika-

Marmas
*
It is

ends fatally within the day.


Snayu Marmas,

65-69.
is

an Asthi-Marma, half a finger in length and


are
half

Vaikalyakara.

They They They

finger

in

length

and of the

Vaikalyakara

class.

are S'ira-Marmas, to the lengrh of


class.

four

fingers

and of the

Vaikalyakara

are S'ira-Marmas, four fingers in length

and

of

the

Sadyo-

Matan

class,

24

86

THE SUSHRUTA SAMHttA.

[Chap. Vl.

An

injury to

junction of the head and


Krikaitikat*

any of the two Marmas lying at the neck (Griva) and known as
atlas)

(transverse process of the arch of the

results in a free

movement
attached

of the head.

hurt to
of an
as

any
ear
the

of the

Marmas

to

the

lower end

(posterior

extrensic

ligament)
the

and
loss

known

Vidhurat Marma
injury to the

results in

of hearing.

An

Phana-Marmast

attached to the interior

channels of both the nostrils, results in the loss of the


faculty of smell.

An

injury to

the

Apaknga-Marmas

(Anastomosis of the infra-orbital artery) situated below


the tips of the eye-brows and about the external corners of the eyes, brings on blindness or defective vision.
injury to the

An

Avarta-Marmas

11

situated above

and below

the eye-brows, brings on blindness and impaired vision.

An

injury to the

Sankha-MarmasIT (meeting or suture


Pterion)^

of the temporal, frontal and sphenoid bones

situated over the tips of the eye-brows and between the

ears

and the forehead,


situated
at the

results in

death within the day.

The Marmas
and

over the two temples (Sankha)

border of the hair (sculp) are called Utkshepa-

Marma
*

(meeting of the posterior and anterior temporal

arteries)$.

An

extraction of a shaft (Salya) or of any


half

They
It is

are

Sandhi-Marmas,

finger

in

length,

and of the

Vaikalyakara group.
t
a

S'nayu-Marma, and

is

of the Vaikalyakara class.

They

are S'ira-Marmas to the length of


class,

half a

finger

and of the

Vaikalyakara

They

are S'ira
class.

Marmas

to the length of half a

finger

and of the

Vaikalyakara
II

They
They

are Sandhi-Marmas, to the length of half a finger


class.

and of the

Vaikalyakara

^
$

are

Asthi-Marmas

to the

length of half a finger.


finger
in

They

are

S'ndyu-Marmas, half a

length

and of the

Vis'alyaghna class.

Chap. V/.

SARIRA STHANAM.
thing

liy
these

extraneous pointed

lodged

into

Marmas,
or

results in the death of the patient,


lives as long as the shaft is
if

who, on the contrary,

allowed to remain inside

the shaft comes out itself (after putrefaction).

70-75.
of

An

injury to the
veins),

Sthapani-Marma*
situated
in

(nasal arch

the frontal

the middle
the

of the eye-

browSj ends in the


injury
Co

manner

of

preceding one.

An

any of the

five joints of

the head which are

bility

as the Simanta-Marmast, results in fear, insensiand madness of the patient and terminates in death. An injury to any of the four Sringaktaka-

known

(nerves), (branches

Marmas]: which forms the junction of the four Siras of the facial artery) and soothes the
nose, the eyes, the

ears

and the tongue, proves


the

fatal

within the day.

An

injury to

A dhipati- Marmas
is

(the vertical groove

on the frontal bone) which

marked
Sifd-

in the inner side of the roof of the

cranium by the
sinus),

Sannipdta

(superior longitudinal

and on the

exterior side

by the

ringlet

of the hair (Romavarta)

proves fatal within the day.


the thirty-seven

Thus we have described


in the region

Marmas, situated

aboVe

the clavicles (Urddhva-Jatru).

76-80.

be

IVIeinorable Verses : An incision should made at the spot a fingers width remote from the
Kurchcha-Sir^, Vitapa,
;

Urvi,

Kaksha and a Pdrsva-

Marma
*

whereas, a

clear

space of two fingers should


of half
a
finger

They

are S'ira-Marmas to the length


class.

and of the

Visalyaghna
t

They

are

Sandhi-Marmas
class.

to the length of

four

fingers

and of the

Kalantara-Pranahara

t They are S'ira-Marmas to the length of four fingers and of the

Sadyah-Pranahara
It
is

class.

a Sandhi-Marma, half a finger in


class.

length and of the

Sadyah-

Pranahara

88

THE SUSHRUTA SAMHITA


its

[Chap. VI.

making any incision about the Stanamula, Manivandha or Gulpha-Marma.


be avoided from
situation
in

Similarly a space of three

fingers

should be avoided

from the Hridaya, Vasti,

Kurchcha,

Guda

or

Nabhi
and
half
(fifty-

Marma
in

and a space of four


of the
in

fingers should

be avoided

respect

four Sringatakas, five Simantas

ten

Marmas

the neck

(Nila

etc.)

a space

of

a finger being the rule in respect of the remaining


six).*

Men, versed
the

in the science of surgery,

have laid

down
be
first

rule that, in a case of surgical operation, the

situation

and dimension of each

local

Marma

should

taken into account and the

incision

should be

made
in

in a

way

so as not to affect that particular


incision,

Marma,

inasmuch as an
the
least,
fatal.

even extending or affecting,

the

edge
all

or the side of the

prove

Hence

the

Marma, may Marma-Sthanas should be


8i.

carefully avoided in a surgical operation.

The amputation of a hand or a fatal whereas a wound in any of


therein
is

leg

the

may not prove Marmas situated


vessels

sure to bring on death.

The

contracted in the case of a cut in the leg or in


of a man, and hence the incidental bleeding
tively scantier.
is

become the hand

compara-

Therefore

it is

that a cut in

any of these
necessarily

parts of the body,

however
the

painful, does not

prove
tree.

fatal,

like

lopping off of the branches of a

On the contrary, a man pierced into in any such Marmas, as the Kshipra or the Tala, suffers from excessive
*

Some

are of opinion that a surgical

operation

(in

the

case

of the

remaining
to the

fifty-six)

should be made, leaving a space equal in measurement


part).

dimensions of a palm (from the affected

Gayadasa, having
left

learnt from Bhoja, explains that a space of

two fingers should be

(from

the affected part) in

making

surgical operations of the ten

marmas, namely,

the two Gulphas, the roots of the two breasts, the four Indravastis, and the

two Manivandhas.

Chap. VI.]

SARIRA STHANAM.
affected part)

89

hemorrhage (from the


an excruciating pain,

and attended with

owing to the derangement of the Vdyu, and meets his doom like a tree whose roots have been severed. Hence, in a case of piercing or of injury to any of these Marmas, the hand or the leg
should
be

immediately amputated at the wrist or at


82.

the ankle (respectively).

The medical authorities have described the


to

Marmas

have covered half


presently

in

the scope of

Salya Tantra
in

(Surgery), inasmuch as

person

hurt

any of the
result
if

Marmas
hurt).

dies

(i. e.,

within seven days of the


is

deformity of the organ

sure to

from

an injury to one of these Marmas,


averted by
treatment.
a

even

death be
medical

course

of judicious

and

skillful

83.

The
in

life

of the patient of fracture

is

not to be despaired of even


crushing of a bone of the

the case

or

Koshtha, Sirah and Kapdla or perforation of the intestines


etc
,

if

the local

Marmas
the

are found not to be in any


is

way
of

hurt
cuts

or

affected.
in

Recovery
Sakthi,

common

in

cases

(pierce)

Bhuja,

Pdda

and

Kara

or in

any other part of the body and even where a


is

whole leg or hand

found to be severed and carried


are

away

if

the
84.

Marmas

not

in

any

way

hurt

or

affected.

These Marmas form the primary


the

seats of the

Vayu,
of the

Soma

(lunar)

and Tejas

(fiery

principles

organism), as well as of the three fundamental qualities


of Satva, Rajas
a

man, hurt

in

and Tamas, and that is the reason why any of the Marmas, does not live. 85.

(in

An injury to a Marmaof the Sadyah-Prdnahara class which death occurs within a day) is attended with
of conscious-

the imperfection of the sense organs, loss


ness,

bewilderment

of

Manah

(mind)

and

Buddhi

IQO
(intellect)

THE SUSHRUTA SAMHITA.


and .various kinds of pain.
KAlantara group

[Chap VI.

An

injury

to

Marma

of the

(of a person) is sure to


etc.)

be attended with the loss of Dbatus (blood


various kinds of supervening

and

symptoms (Upadrava) which end in death. The body of a person, hurt in any of the Vaikalyakara Marmas, may remain operative only
under a
of the
skillful

medical treatment

but a deformity

affected

organ

is

inevitable.

An
in

injury to
for

any
the

of the reasons

Vis'alyaghna

Marmas ends

death
to

mentioned above.

An
to

injury

any of the
about

Rujdkara Marmas gives


in the affected organ,

rise

various kinds of pain

which

may

ultimately bring

a deformity of the same,

if

placed under the treatment

of an ignorant and unskillful

Vaidya (Surgeon).

S6.

An

injury to the adjacent part of a

Marma, whether

incidental to

cut,

incision,

blow (Abhighdta), burn,

puncture, or to
series of

injury

the same symptoms as an actually affected one. An to a Marma, whether it be severe or slight, is
Sy.
in

any other cause exhibits

sure to bring deformity or death.*

The

diseases

which are seated


but

the

Marmas, are
to

generally

serious,

they

may

be

made

prove

amenable with the greatest care and


*

difficulty.

88-89.

Gayadasa does not read


sixth

this verse.

Thus ends the

Chapter of the S'arira Sthanam

in

the

Sus'ruta

Samhita, which treats of Marmas.

CHAPTER
Now we
system
*
(

VII.
treats

shall discourse

on the Siriram which

of the description

and

classification

of Sira or vascular

^irsL-Varnana-Vibhaktinama
seven

^ariram).
There
are

hundred Sirds (vessels)


attenuated

in

the

human organism
for

(except those which cannot be counted


size).

their

extremely
their

The

vessels

(Siras)

by

contractibility

and expansibility
in

sustain
as

and nourish the organism


and canals serve
fruitful.

the

&c same manner


field

streamlets

to

keep a

or a

garden
tral

moist and

From

the principal or cen-

trunk hundreds of small and minute vessels branch

off

and spread

all

over the body, just as small or minute


vein

fibres are

found to emanate from the large central

of the leaf of a plant.


cal region

They

originate from the umbiliall

and thence they spread

over the body up2.

wards and downwards and obliquely.

IVIemorable Verses : All


ginate

the Siras (vessels)


beings,
ori-

that are found in the organisms of created

from the umbilical region (Nabhi)-)* and thence


all

they spread

over their
is

bodies.
in

The

life

of an

orits

ganic animal

seated

the vessels surrounding


point.

navel which forms their starting


its

The
it)

navel

in
life-

turn

rests

on or

is

attached to the Pranas (the attached to


in

carrying vessels
*
tic

nerves
Some

the

same

The Sanskrita term


as well.

S'ira denotes veins, nerves, arteries

and lymphaof the

vessels

read S'ird- Varna (different

colours

Siras) in lieu of S'ira-varnana (description of S'iras).

t Most probably the idea


in their foetal state.

is

derive! from the appearance of the S'iras

192

THE SUSHRUTA SAMHITA.

tChap. Vll.

manner

as the nave of a wheel supports the spokes,


3-4.

and

the spokes in their turn support the nave.

Principal ^iraS:-Of
forty are principal ones, of

these

Siras

(vessels),

which ten are Vayu-carrying


(veins),

Siras (nerves), ten are Pitta-carrying Siras

ten

convey Kapha (lymphatic vessels?) and ten are bloodcarrying Siras (arteries).

Of

these

the

Vayu-carrying
of that

Siras, situated in the specific receptacle

bodily

principle

(Vata), are again found to branch out in one


five

hundred and seventy


carrying

smaller branches (ramifications).

Similarly, each of the remaining Pitta-carrying,

Kapha-

and blood-carrying vessels


,

(Sirds) situated in

their specific receptacles, {ie

in the receptacles of Pitta,

Kapha and
branch out

spleen and
in

liver respectively) are

found to

as

many numbers
making
a
total

(one

hundred

and

seventy-five),
in all.
5.

thus

of seven

hundred
are

Their Specific Locations :- There


twenty-five Vayu-carrying Siras
the
(nerves) in
other.

one

leg

and
of

same count applies

to the

Similarly there

are twenty five Vatyu-carrying Siras (vessels) in each

the hands.
in the

There are thirty-four Vayu-carrying


;

vc^ssels

Koshtha trunk)

of these eight occur in the pelvic


the

regions attached with the anus and

penis

two

in

each of the sides, six


(cavity of the
chest.
sels)

in

the

back, six in the


in the

Udara
of the

abdomen), and ten


are
in

region

There
situated

forty-one

Vayu-carrying

Sira's (ves-

the

region

above the
;

clavicles.

Of
;

these fourteen occur in the neck

four in the

two ears

nine

in

the tongue

six

in

the nose and eight in the

two

Thus we have finished the description of the one hundred and seventy-five Siras that carry Vayu. 6.
eyes.

What

has been said of these Vayu-carrying

vessels

(Siras) will also hold

good

to the rest (in blood-carrying,

Chap. VII.]

SARIRA STHANAM.
and Kapha-carrying channels
cases,
Pitta,

193
in the res-

Pitta-carrying

pective regions of the body),


in

with the exception that

these

three

Kapha and blood


ears
in

ten

occur in the eyes and two in the

lieu

of eight

and four respectively, as in the case of VAyu-carrying Thus we have described the seven hunSiris (vessels).
dred Sirds with their branches.
7.

Memorable
Sirds
:

Verses The
in
its

Vdyu-carrying

The Vdyu
its

normal

state

and coursing

through

specific Siras (vessels) helps the unobstructed

performance

of

its

specific

functions viz.^ expansion,

contraction, speech,
non-illusivencss

of

and produces the clearness and Buddhi ( intellect ) and the sense&c.,

organs, whereas a coursing of the

said

Vayu

in a de(vessels),

ranged condition through the aforesaid Sirds


gives
rise to

host

of such diseases as are due to the


8.

derangement of Vdyu.
normal
state

The Pitta-carrying ^iras: The


its

Pitta in

and coursing through


the

its

specific S'iras

(vessels)

produces

healthy glow
the

of

complexion,
healthfulnoss

relish for food,

kindling of

appetite,

and other good

effects, characteristic of

the Pitta, which

however being aggravated and coursing through them


gives rise to a host of Pittaja diseases.
9.

The
Kapha

Kapha-conveying firsts: The


normal state and coursing through
its specific

in its

Sirds (vessels)

smoothes and contributes to the firmne33


joints,

of the limb3

and

improves the strength and proeffects

duces

all

other good

specially belonging to
in

it,

whereas the same Kapha, flowing through them


aggravated condition, ushers in a large

an
the

number

of

Kaphaja distempers of the body.

10.

The Rakta-carryi ng
in its

^i rsis : The
its

blood

normal state and flowing through

specific S'irds

25

t94

THE SUSHRUTA SAMHITA.


the

[Chap. VII.

(vessels) strengthens

other

fundamental principles
the

(Dhatus) of the body,


the organ of touch
in

improves
the

complexion, aids
performance of
its

proper

functions and produces other functions characteristic of


it

in the

body.
it

Flowing through them


ii.

in

a vitiated

condition,

begets diseases which are

due to the de-

rangement of the blood,


There
is

not

a single
the

which

carries

either

Sira (vessel) in the body Vayu, or the Pitta or the

Kapha

alone.

Hence each

of the

vessels
for

should be
all

regarded as affording

an opportunity

conveying

kinds of the Doshas of the body, for as soon as they are

deranged and aggravated they seem to flow through


the
Sirds promiscuously.
12.

all

Hence they

are called

Sarva-

vahah.
vessels

Specific colours of the ^iras:-The


which carry the bodily Vayu (nerves) have a
to be stuffed
(veins)

vermilion (yellowish red) hue and seem

with

Vdyu.

The
are

Pitta-carrying

vessels

are

coloured blue and


carrying
coloured.
vessels

felt

warm

to the touch.

The Kaphared

hard, cold to the touch and whitevessels (arteries) are


13.

The blood-carrying
hot,
shall

and neither too

nor too cold.


describe
the

Now we
result
in

Siras (veins)

which a
it

surgeon should not pierce or open, inasmuch as


death, or

may

bodily deformity.
in

An

intelligent

surgeon shall

always bear

mind

that sixteen out of

the four hundred vessels in

the

extremeties,

thirty-two

out

of the
fifty

hundred and thirty-six vessels


should
not

in the

trunk

and
the

out of the sixty-four vessels in the region above

clavicles,

be

opened

or bled

on any
the

account.

14-15leg,

Of

the one hundred vessels in a single


is

one

Jdla<ihard (which

attached

to the connective tissue

Chap, vn.]

SARIRA STHANAM.
as

,lg5
internal

of the Kurchcha-Sirah)
ones, of

well

as

the three

which two are known


the

as the Urvi- veins

and the

other as the Lohitiksha, together with the


ing

correspond-

ones in

other

leg

and

in the

two hands, thus


in

making sixteen

in all,

which are situated

the

upper

and lower extremeties, should be held

unfit for

opening.

Of

the thirty-two veins in the pelvic region (Sroni), eight

such,

known
side)

as the four)Vitapas (two on

each side of the

testicles)

and the four known as the Katika-tarun as (two


should be considered unfit for bleeding or
the sixteen veins (eight on each side) at the

on each

opening.
sides, the

Of
is

one which courses upward from each of the two


attached to the

sides

and

Marma known

as the Patrs'va-

Sandhi, should be considered unfit for similar purposes.

Of

the twenty-four Siras which are found in either side

of the spinal column, an incision


into

should

not be

made

any of the two Siras (on each side) known as the Vrihati and which run upward along either side
of
in
it

(spinal column).

Similarly of the twenty-four Siras

the abdomen, the two along each of the two sides of


unfit
for

symphis pubis should be held


bleeding.
heart,

opening

or

Of

the forty veins in the chest, the two in the


root
of each breast and

two

in the

two

in

each
in

of the Stana-rohita (muscle of

the breast) and

one

each of the Apastambhas and Apalapas, making fourteen


in all,

should not be opened.


of

Thus thirty-two
e.,

Siras

in

the

regions

the back

(i.

the sides and the pelvic

regions), the

abdomen and

the chest should be

regarded

as unfit for opening or other surgical purposes.

1621.
in

There are one hundred and sixty-four Sirds


region above the clavicles.

the

Of

these the eight

and four
out
.

(making twelve and respectively known as the eight


Matrikas,
the

two Nilas and the two Manyas)


the
throat,

of the fifty-six in the neck and

should

be

196

THE SUSHRUTA SAMHITA.

tChap. Vll.

regarded as unfit for opening.


in

Similarly the two veins

the two

Krik^tikds and two in the two Vidhuras,


;

should be held unfit for similar purposes


sixteen in
all in

thus

making

the neck.

Of

the sixteen vessels (eight

on each
opened.

side) of the

Hanus

(Jaws), the

two Siras about


should never be

each of the joint of


22.

the jaw-bones

Of
in the

the thirty-six* vessels in the tongue,

sixteen are

situated in the under-surface of that organ

and twenty
unfit

upper surface

of these the

two speech-carrying
for
in

and the two taste-carrying ones should be held


venesection.

Of

the

twenty-four vessels

the

nose,

the four adjacent to the nose proper and the one running
into

the

soft

palate should

be

held

unfit for similar

purposes.
the

Of Of

the thirty-eight vessels in


at

the

two

eyes,

one situated

each

Apanga

should
ears,

not be

opened.

the ten vessels in the two


in

the sound-

carrying one
the
sixty

either

ear the

should not be opened.

Of

vessels

of

nose and eyes


forehead,
the

coursing

through the region of


adjacent
to the

the

four vessels

sculp proper and the


unfit

Avarta-Marma

should

be

held

for

opening or bleeding.

One
in

vessel (Sird) in each of the

two Avartas and the one


in

the

Sthapani-marma should not be opened (on any

account).

Of

the ten vessels

the

temple, the one

about each temple-joint should be held unfit for opening


or bleeding.

Of

the twelve vessels in the head, the one


Pitta-

*Gayi asserts that there are eight each of the Vayu-carrying,


Carrying,

Kapha-carrying and blood-carrying S'iras in the region of the

neck, thus making a total of 32 in place of 36 of the text.

He
16 in

also holds that there are 28 in place

of

36 S'irds in the tongue,

place of 24 in the nose, 24 in place of 38 in the eyes, 16 in place of

10 in the ears and 8 in place of 10 in the temple.


S'iras

In the counting of the

situate
text.

in

the other parts of the body, he, however, does not differ

fiom the

Chap. Vlt]

SARIRA STHANAM.

TQ;

in

each of the two Utkshepa-Marmas, one in each of the

(five)

Simanta-Marmas and one


for

in the

Adhipati-Marma,

should be held unfit

the

purpose.

No

incision

or

opening should be made into any of these


situated in the region above the clavicles.

fifty vessels

23-31.

Memorable verses : As the


etc, of a lotus plant,

stem and leaves


bulb,
(lit
:

originated

from

its

spread
water),

over the whole surface of a pool


so the vessels emanating from the

or tank

umbilicus
32.

of a

man

spread over his whole organism.


Thus ends
the

seventh

Chapter

of

the

S'arira

Slhanam
and

in

the

Sus ruta Samhila which


S'iras (vessels).

treats

of the

description

classification of

CHAPTER
Now we
of the
shall discourse

VIII.

on the Sariram which treats

method

of Venesection etc.
i

(^ira-Vyadha-

Vidhi-^ariram). Persons unfit for Venesection: The


vessel or vessels (Sira) of

an

infant,

an old man, a per-

ched man, one fatigued and emaciated with endocarditis


(Kshata-kshina), a person of timid or coward disposition,

a person

used

up with excessive drinking or sexual

enjoyments or tired with the troubles of long journey,

an intoxicated person, a patient who has been treated


with
purgatives,

emetics

or

with

Anub^isana

and

Asthdpana measures (enemas), a man who has passed


a sleepless night, an impotent (Kliva) or emaciated person,

an enceinte, or one
fever,

afflicted

with cough, asthma, high


thirst,

phthisis

convulsions, paralysis,

epilepsy,

or effects of fasting,

should not be pierced or opened.

Incisions should not be

made

into

those
the

veins (Siras)
fit

which are not


invisible
;

fit

for opening, or into

ones,

if

it

should be the same with those which cannot

be properly ligatured or
raised up.
2.

even

if

ligatured cannot be

Diseases which are amenable to acts of venesection

have been described before (Sonita-Varnaniya-Adhydya).


Venesection
well
as
in

may

be performed

in the said diseases as

those which have not

been enumerated in

connection with them and also in other cases whether

suppurated or unsuppurated,

if

such a proceeding

is

deemed necessary and


Sveda.

after the application of


in

Sneha and
the
cases
cases of

Venesection should be made even


it

declared unfit for

(such as in an infant

etc.) in

Chap. VIII.]

SARIRA STHANAM.
etc.)

99

blood-poisoning (such as snake-bite


diseases (Vidradhi
etc.).

and

in

fatal

3-4.
:

Preliminary rules The


preparations.

patient should be

duly fomented i^Sveda) atid anointed (Sneha) with oily

liquid* food or diet consisting of articles

which are antidotal to the bodily principles (Doshas)


which engendered the disease or Yavagu
be given to him at
first.

(gruel)

should
(i.e.,

Then

at the proper season


etc.)

not in the rainy or winter season

the patient should


to sit or
lie

be brought near the surgeon and

made

down

and the part to be incised upon should be bound, neither too loosely {e.g., in the extremities etc.) nor too tightly
(^.^.,in

the head

etc.),

with any of the accessories, such as


etc.,

cloth, linen, skin, the inner fibres of a bark, creepers

so as

not

to

create

any pain or agitation

in his

mind.

Then the vein should be duly opened with proper instrument (and with a careful regard to the situation of any
local

Marma).

IVletrical
performed
day.
It is

text

Venesection should not

be

in

an extremely cold or hot, cloudy or windy

forbidden to open a vein without necessity

or in a healthy person, or in a disease in

which such as a
patient

proceeding

is

absolutely prohibited.

6.

The Yantra-Vidhi : The


vein
is

whose
stool

to be operated

upon should be seated on a


the

to the height of an Aratni (distance of

elbow from
towards

the

tip of the small finger)

with
his

his face turned


in

the sun.

He

should keep his


resting

legs

drawn up or
his

contracted

posture

elbows (Kurpara) on
his

knee-joints and the hands with


in

two thumbs closed


of; his

his

fists

placed

on

(the

upper ends

Manyas

(sterno mastoid muscles),


*

Then having cast the binding


for

liquid food

is

recommended
.

the

purpose of liquefying the


.

blood so as to bleed easily.

200
linen on the

THE SUSHRUTA SAMHITA.


two closed
take
fists

[Chap. VIII.

thus placed on the neck, the

surgeon should ask another


the patient to

man from
of the

the back

side

of

hold

two ends of the cloth

hand having the palm turned upward, and then ask him to tie up with his right hand the bandage
with his
left

round the

part, neither too diffusely

nor too tightly nor

too loosely, so as to

raise

the
for

vein

and to press the


good out-flow of
previously

bandage
blood.
in

round

the

back

Then he
sit

(surgeon) should perform the operation

the desired spot, the patient having been

asked to
confine
pleted).

with his mouth


breathing
till

full

of air

{i.e.,

he should
is

his

the surgical operation


in

comin the

This proceeding should be adopted

opening

any vein of the head, save those which are situated


cavity of the

mouth

7.

In

the

case of opening a vein (Sird) in the leg, the


level

affected leg should be placed on a

ground, while
contracted
leg should

the other leg should be held in a


posture, at a
little

higher place.

somewhat The affected


below
its

be bound with a piece of

linen

knee-joint

and pressed with the hands down

to the ankle.

liga-

ture of the above kind should then be tied

four

fingers

above the region to be incised upon,


vein should be opened.
8.

after

which the
the

In the case of opening a


the
patient
his

vein

(Sira)
sit

in

arms,

should

be caused to
in

easily
fists

and fixedly
(as

with

two thumbs closed


ol

his

above).
etc.,)

ligature

the

above-mentioned

kind (rope

should be tied (four fingers above the part to be incised

upon and the vein opened in the aforesaid manner. The knee-joint and the elbow should be held in a
contracted or drawn up posture at the time
of

opening

a vein

in

a case of Gridhrasi (Sciatica^ and Vis'vachi,

respectively.

The

patient

should hold his back raised

Chap. Vlli.]

SARTRA STIIANAM.
his

201

up and expanded and


at the time of

h^ad (and shoulders) bent down


in the back, shoulders

opening a vein

and

the Sroni

(hips).

He

should hold his head thrust back


at the

and

his

chest

and body expanded


his

time of open9-12.
at the

ing a vein in the chest or in the abdomen.

He

shall

embrace

time of opening a vein


be drawn

in

own body with his arms his sides. The penis


in

should

downward
to the roof

(2>.,

an

flaccid

state)

on a

similar occasion in that region.


raised

up

of

the

The tongue should be mouth and its fore-part


in

supported by the teeth at the time of opening a vein


its

under-surface.

The

patient should be told to keep his

mouth fully open at the tim^ of opening a vein in the gums or in the palate. Similarly a Surgeon should devise proper and adequate means for the purpose of raising
up
(distinct

appearance

of) a Sira (vein)

and determine
accordinor

the nature of the bandao'e to be used therein


to the exigencies
{i.e.,

the health and the kind of diseases


1

of the patient), of each case.

3-17.

An

incision to the

depth of a barley-corn should be


instrument
(Into

made with

Vrihimukha

vein

situated) in the muscular parts of the body, whereas the

instrument should
the depth
signifies

b3 thrust oily half that depth or to


in

of a

Vriki seed

other places (Vrihi here

S'likadkdnya as well
be

as Rakta-s':ali\

An
a

inci-

sion

over a bone should


surgical
18-19.

made with
half

the Kutharikd
barley-

(small
corn.

axe)

to

the

depth of

IVIemorable Verses : An
be effected be devoid
the cold
in

opening
season as

should

such a day

in the rainy

would

of the rumblings of a thunder-cloud, during

(2>., in

the fourth) part of the

day

in

summer,
These

and at noon

in

the winter season (Hemanta).

are the only three

times

of

opening a vein.
26

well

202

TiiE SIJSHRUTA SAMHITA.


successfully

[Chap. VIII.

and

pierced vein bleeds in streams (almost

simultaneously with

the

thrusting

of

the

knife)

and

spontaneously stops after a Muhurta (a


vitiated

little while).

The
of

blood

is

seen

first

to

flow out of an opened


first

vein, like the

drop of yellow pigment

coming out

Kusumhha flower. Blood does not flow out from an incision made into a vein of an unconscious (Murchchhita), much frightened, or a thirsty patient. An incision of a
vein without proper

bandaging and
20-23.

raising

up

is

attend-

ed with a similar result.

weak

person,

or one

afi"ected

with the unusual


or one fainted

derangement
of continuous

of the bodily

Doshas

etc.,

(under operation), should not be subjected to a


blood-letting at a time
;

measure

instead of that,

the

vein should be opened afresh in the


third

same afternoon
day
(as the exi-

or on the following day, or on the

gency
allow

requires).

An

intelligent surgeon
to

should not

the

flow

of blood

an excess but should stop


blood
in

the flow even with a remnant of the diseased the

system

and administer soothing internal remedies


purification of the diseased

(Samsamana) for the


nant.

rem-

Bleeding to the quantity of a Prastha* measure

should be deemed sufficient for a strong and adult patient,


stuffed with a large quantity of the deranged

Doshas

(in

the body).

24-26.

The vein should be


ment
of the
at

incised with a

Vrihimukha
as

instru-

distance

of
in

two

fingers

above the seat

Kshipra-marma

such diseases

Padadaha,

Pada-harsha, Ava-vahuka, Chippa, Visarpa, Vata-rakta,

Vdta-kantaka, Vicharchika, Padadari


of opening a vein in the
* In

etc.

The mode

case of Slipada (Elephantiasis)


a

medicinal

preparalions,

Praslha

four seers in the case of liquids, but in Cises

measure is understood to be of excreta due to emetic and

purgative measures and


thirteen Palas

of blood-lettiDg, a Prastha and a half only.

m meant

to

be

[Chap. VIII,

SARIRA STHANAM,

203
disease.

would b2 described under the treatment of that


In

Vata-rogas,

such as

Kroshtuka-s'irah (Synovites),

maimedness (Pangu)
(vein) of the

and lameness (Khanja\ the Siia


leg-calf),

Jangha (lower

four

fingers

above

the

Gulpha, should be opened.

In

cases

of Apachi

(scrofula), the vein

should be opened simultaneously with


disease

the appearance of the

two

fingers

below the
(sciatica),

Indravasti-marma.

In

a case of Gridhrasi

the vein should be opened four fingers


the Jdnu (knee-joint).

above

or

below
veins

In a
of the

case

of goitre, the
(thighs)

attached to the roots

Uru

should

be

opened.

The

instructions regarding the

opening of a
of that
in

vein in one leg shall hold good in

the

case

the other, as well as

in

cases

of those situated in
is

the
that

two upper extremities (hands), but the speciality


in a case of enlarged spleen, the vein

sandhi (elbow-joint) of the


fourth

left

near the Kurparahand or that inside the


Similarly

and the
vein

fifth fingers

should be opened.

in a case of

Yakriddalyodara or Kaphodara, the corresin

ponding

the

right

hand

should

be

opened.

Several authorities advise the opening of the


in

same vein

cases

of cough and asthma* due to the action of the


27-35.

deranged Kapha.

In a case of Vis'vachi, the


(four

same argument holds good


in

fingers

above or below the Kurpara-sandhi) as


the vein
(Sroni)

a case of Gridhrasi.

In a case of Pravdhikd (diarrhoea)


(colic),

attended with Sula

within two fingers

width around of the

Pelvis

should be opened.
in

The

vein of the

penis should be

opened
on

case

of

Parikartikd (D.R.-ParivartikA),

Upadansa, Suka-dosha
vein
either
side of

and seminal disorders.

The

Gayi holds that

in cases

of asthma and cough venesection


are in a mild form.

should

be had recourse to only

when they

204

THE SUSHRUTA SAMHITA.


in

Chap. VIII.]

the scrotum should be opened

case

of

hydrocele

(Mutra-Vriddhi).

36-39.

The
left

veui four fingers below

the navel

and on the
in

side of the Sevani (suture)

should be opened
In
a
case

case

of

Dakodara

(ascites).

of

internal
in

abscess and colic in the sides (Pleurodynia), the vein

the

region

between the breast and the

left

armpit
in

should be opened.
case of

Several authorities assert that

Avavahuka and Vahusosha (atrophy


between
the

of the hand),

the

vein

Amsas

(shoulders) should

be

opened.

In a case of Tritiyaka (Tertian) fever^ the vein

inside the Trika-Sandhi should be

opened.

In

case of
a

of Chaturthaka fever, a vein jo hied with either

side

and

below the shoulder-joint should

be opened.

In

case of Apasmara, the middle vein

adjacent to the joint

of the jaw-bones (Hanu-Sandhi) should be

opened.

In

a case of insanity and hysteria* (Apasmara), the vein

between the temple and the edge of the sculp or those


in the

Apanga

(tips of the

eyes), the

forehead

or the

chest should be opened.

In cases of the diseases of the

tongue and the teeth, the veins


(Adho-Jihva) of
be opened.
a case of
the

on the under-surface
In
vein should
in

tongue should be opened.

the case of a disease of the palate, the local

In diseases of the ears and specially

inflammatory ear-ache (Karna-Sula), the vein along the region above the ears should be opened. In
diseases of the nose and specially in a case

of the
of the

loss

of the smelling faculty, the vein at the tip

nose

should be opened.
*

In

cases

of eye-diseases,

such as
on the

Dallana, however, differs here

from the

text.

He

says,

authority of Vagbhata, that the opening of a vein


the edgt of the sculp or those in the

between the temple and

should te recommended in

cases of insanity only,

Apanga, the forehead and the chest and not in the case of

of .^pas^mdra as well (as in the text).


Chap. VIII.]

SARIRA STHANAxM.
etc.,

205
as well

Timira (blindness), Akshipdka (ophthalmia)


as In diseases of the head

and

in

Adhimantha, the veins


and the Apdnga
40-51.
shall

about the nose,

the

forehead

(the

outer canthus of the eyes), should be opened.

Defective Venesection : Now we


describe the twenty

kinds

of defects

relating

to
:

an

opened vein (Dushta-vyadhana;.


Aprasrutd,

They

are as follows

Durviddha, Atividdha, Kunchita, Pichchita,


AtyudirnA,
Ante-abhihata,

Kuttita,

Parisushka,

Kunita, Vepita,
viddhd,

Anutthita-viddhd, Sastrahata,

Tiryag-

Apavlddlia,

Avy^dhyd,

Vidrutd,
i.e.,

Dhenukd,
about

Punhpunarviddha and Marmaviddha,


the Sira-marma, the

incised

Sn^yu-marma, the Asthi-marma and the Sandhi-marma. 52-53.

Their definitions : The


act

vein in

which an
with an

of

venesection

is

unattended with a satisfactory


its

outflow of blood owing to

being

incised
is

extremely slender instrument

and

marked by an
is

extremely painful
called

swelling

in

consequence thereof,

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
in

opened vein

in

which the incision has been


is

made
going

a curving
is

manner and

attended with the fore-

results,

called Kunchitai (crooked or contracted).

An

incised vein presenting a flattened or


its
is

thrashed

ap-

pearance on account of
knife

being
called

opened

with a blunt
(thrashed).

(Kantha-Sastra)
at

Pichchitai
incisions
its

The vein

the

sides

of which
of
in

have been
is

successively

made,

instead

body,

called

Kuttitat (lacerated).

An
is

incised vein, unattended with

any bleeding owing

to the patient's fright,

coldness or

loss of consciousness,

called Aprasrulai (unbleeding).

2o6

THE SUSHRUTA SAMHITA.


large
incision in
its
is

[Chap. VIII.

vein with a

body made with


called

a sharp and flat-edged instrument,

Atyudirnat
in

(improperly
blood
oozes

wide-incised).

An

opened vein
is

which

out

in
in

small quantity
the
interior).

called

Anteabsence

abhihatat (struck
in

An

opened vein
total

an anaemic patient (marked


bleeding and) stuffed with

by a

of

Vayu

(lit.,

as

if

the

flow

has

been

dried

up

Paris'ashkaL (dried up).

by the Vayu), is called vein opened but to a quarter

part of the

proper length and attended with a scanty


is

outflow of blood,

called Kunitai (partially incised).


its

A
a

vein which trembles owing to

being bandaged

at

wrong place and from which blood does not flow out
in

consequence,

is

called

VepitaL (quivering i.

vein

incised without being previously properly raised up

and
is

attended with a similar result


called

(ie.,

absence of blood),
cut
into

Auutthita-viddha^.

vein

two and

attended with excessive bleeding and


of the organ
incised
is

inoperativeness

called

Sastrahata' (knife-cut).

vein

with

an

instrument applied
is

slantingly

and

(consequently) not fully opened,


(obliquely
incised),

called Tiryagf-viddha'

vein

incised

several
is

times
called

and (every time) with an improper instrument,

{i,e.,

A vein Apaviddhat (wrongly incised) whose opening has been forbidden


is

unfit for
in

opening
Sastras\

the

called Avyskdhyai (unfit for opening),

vein

opened

carelessly

and hastily

is

called

Vidrutai
its
is

(erratic).

vein bleeding continuously owing to


pressed

being repeatedly
called

and successively opened,


cut

Dhenuksi.
into

vein variously

owing

to

its

being pierced

the same part with an extremely slender-pointed instrument, 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.
in

20/

called

Marma-viddhai and
54.

such cases severe pain,

emaciation (Sosha) deformity or (even) death


the result.

may

be

Memorable Verses
not give the necessary
veins
etc.,

Practice (even) docs


operation of the

skill in

surgical

as they are naturally

unsteady and changing

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
like fishes.

aforesaid dangers and

many

other distresshig symptoms.

An

act of venesection, properly performed, gives


relief

more
of

speedy

than that derived from the application


or of plaster
is

medicated

oil &c.,

as

well.

Venesection

(bleeding) properly performed

half of the

treatment
of Vasti55.

described

in

surgery like the

application

karmas (enematic measures)

in therapeutics.

A man
rised

medically anointed

(Sneha-karma), diapho-

(Sveda\ vomited

(Vamana), purged (Virechana),


Vasti-karmas (Anuvasana and
physical
labour,

or treated with both the

Asthdpana) or bled
sexual
intercourse,

shall forego anger,

sleep

in

the

day time, excessive


cold,

talking, physical exercises, riding or driving etc., sitting

on

his

haunches, frequent ramblings, exposure to

winds and the sun, hardly digestible, uncongenial


incompatible food until the strength
or,
is

and

perfectly restored

according to some authorities, for a month.


will

These

subjects

be fully dealt with

later

on Aturopablood

drava-chikitsa, ch.

39).

56.

Memorable Verses : The


incarcerated in
Sira (pipe), a horn, a gourd, or leeches, or

vitiated

any part of the body should be abstracted therefrom by scarifying it, by cupping it with a
by the opening
of the
in

of a

vein respectively, according

to the density

blood.

(Others assert that) leeches should be applied

208
the
case
of

THE SUSHRUTA SAMHITA.


the
(vitiated)

[Chap. Vlll.

blood
a

being confined deep


surgical

into the body, scarification with

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


case of the
skin.

and with a horn or a gourd

in
in

the

deranged blood having been seated

the

57-58.

Thus ends
Samhita which

the

eighth Chapter of the S'arira

Sihanam

in the Sus'ruta

treats of venesection.

CHAPTER
Now we
shall discourse

IX.

on the Sctriram which treats

of the description of the arteries, nerves

and

ducts, etc.*
r.

(Dhamani-Vyakarana-^ariram).
There are twenty-four Uhamanies
all

(ducts) in

all,

and

of

them have
assert

their

origins

in

the

naval

region
Several

(which includes the whole abdominal


authorities

region*|-).

that

no arbitrary distinctions should

be

made among
but different
(vessels).

the Siras (veins),

Dhaman is
one

(arteries),

and the Srotas, (channels), since Dhamanis and Srotas


are

modifications

of

original

kind

of Sira

But

this opinion is not a

sound one
origins

inasmuch

as

they have got different natures,


in the

and functions and as being described so


of several authoritative

Ayurveda.

But owing to their adjacent positions, the existence


dicta

(Apta-vak) regarding the

oneness of their character, similarity of their functions,

and the minute nature of


diversities in their

their shape, they

appear to
the
real

be homologous in their action, even

amidst

work and
in

office.

2.

Of
have

the
their

twenty-four Dhamanis,
roots

which
region

(originally)

the

naval

(Nabhi), ten
course,

have upward

course,

ten have

downward
3.

and

four flow laterally or transversely.

Functions of the up-coursing Dhamanis: 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.

2;

210

THE SUSHRUtA SAMHITA.

[Chap. IX.

perform such specific functions of the body, as sound,


touch, taste, sight,
smell, inspiration, sighing, yawning,
etc.,

sneezing, laughter, speech, and weeping,

and tend

to

maintain the integrity of the body.


reaching the heart, respectively ramify
three branches, thus

These Dhamanis,
themselves
into
all).

making

thirty (ramifications in
,

Ten

of these serve the following purposes, viz

two serve
Pitta,

as the channels of the bodily

Vayu, two of the

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


taste.

sight

or

colour,

two smell, and two

Moreover a man speaks with the help of another

two,

makes sound with the help of another couple,


through the instrumentality
of

sleeps

another

pair

(couple),

and wakes up with the help of another couple.

Two
of a

of the

Dhamanis

(ducts) carry the fluid of lachry-

mation, two of them

(ducts),

attached

to

the

breasts

woman, cany milk


we

of her breasts, which, coursing


fluid.

through the breast of a man, convey his seminal

Thus
their

have described the thirty Dhamanis with

ramifications.

These sustain and maintain the

integrity (of the limbs

and members of the body) above


the

the (line of) umbilicus, such as the back, the chest, the

Udara, the
shoulders

sides,

neck, the

and the

arms.

4.

IVIcmorabIcVcrSe:Theup-coursing Dhamanis

duly

perform the

offices

stated

above.
etc.,
{i.e,,

Now

shall describe the


office,

specific

functions,

nature,
5.

and

situations, etc.,) of the

down-coursing ones.

Functions
:

of the down -coursing


down-coursing
for the

Dhamanis The
of

pectively form the channels

Dhamanis resdownward conveyance


catamenial

Vayu

(flatus),

urine,

stool,

semen, and

Chap. IX.]

SARIRA STHANAM.

211

These Dhamanis reaching down into the PittAsaya (receptacle of the Pitta) separate the serum prepared out of the food and drink through the agency
fluid,
etc.

of the local heat (and pitta), and carry

it

to the remotest

parts

of

the

organism maintaining
(ultimately) conveying

their

healthy
principles

moisture, supplying
of nutrition

and

them with the necessary them


Dhamanis,
in order to

to the up-

coursing and lateral


to the parts traversed
indirectly

be conveyed

by them

respectively.

Thus they
its

serve

to

supply the heart with


not in

quota of

healthy Rasa (serus

fluid), if

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


and Pakvas'aya).
is

intestines (Amds'aya

Each

of the down-coursing

Dhamanis

found to ramify into three branches at a place midway

between the Amas'aya (stomach)


(intestines).

and the
in

Pakvds'aya
all.

Thus

they number thirty

The
two

functions of the
follows, viz.,

ten out of these (thirty vessels) are as


Pitta,

two serve to carry Vdyu, two


intestines,

Kapha, two blood, and two Rasa (lymph-chyle). Two of


these Dhamanis, running into the
food, another

carry the

two carry the Toya* (watery)


serve
to

part,

another
out the

two, running into the bladder,

carry

urine (from the bladder), another

two carry the semen,

and another two serve as the channels of transmission and emission of the same
ovarian discharge in women.
fluid

and serve to carry the

The two Dhamanis, attached


remaining
eight

to the large intestine (Sthulantra), serve as the channels

of

faecal

matter,

while

the

convey

Thus we have finished describing these thirty Dhamanis with their ramifications. These sustain and maintain the
perspiration to the lateral-coursing
*
Xhi,s

Dhamanis,

watery p^rt reaching the bladder

is

tKansformed into urine,

212
integrity of

THE SUSHRUTA SAMHITA.


the
parts

[Chap. IX.

of

the

body below the naval


urine,

region, such as the

Pakvasaya
of
stool

(Intestine), the waist, the

organic principles

and
to

the

organs of

generation, the anus, the bladder, and the lower limbs of the

body (Sakthi) (according

their
6.

utility

in the

physical

economy

of the organism).

Memorable Verse ; These


Dhamanis
shall

down-coursing

perform
the

the

afore-said

functions.
{i.e.,

Now

describe

specific functions

nature, office,

and

situations, etc.,) of the lateral-coursing

Dhamanis.

7.

Functions of the lateral-coursing*

Dhamanis: The
gradually

four

lateral-coursing
into

Dhamanis,

ramifying

themselves

hundreds and

thousands of

branches,
these

net-work of

simply baffle counting. The Dhamanis spreads over the whole


its

orgnism and maintain


orifices are

integrity.

Their

exterior

attached to the roots of hairs (pores

of the

skin) through

which they convey the perspiration and


body, both
inter-

the Rasa (serum), thus supplying the


nally

and externally,
of the

with

the

soothing nutritions

(moisture of healthy
potencies

lymph-chyle).
of

The

effects

and

articles

anointment, sprinkling,
orifices

immersion, and plasters, enter through these


into the internal organism

through the agency of the

and sensations of a pleasant or painful contact are experienced through their instru-:
heat in
the
skin,

mentality.

lateral-coursing

Thus we have Dhamanis

finished describing

the four

with
8.

their

ramifications

throughout the whole organism.

Memorable Verses : The


got
the

Dhamanis have
like

pores

in

their

sides

through which they carry

Rasa (lymph-chyle) throughout the organism,


lotus.

the filaments and fibres of water-lily and

The.'^e
in

Phan\anis furnish the self-conscious Ego, confined

Chap. IX.]

SARIRA STHANAM.
is

21

the material body, which

the resultant

of the

combidistinct

nation of the

five

material elements, with


to

sensation* peculiar

each of the

five

sense-organsf
five

and break

up the combination (of the


9 10.
shall

material

elements) at the time of death.

Now we

describe the

symptoms produced by a

Srota (duct or channel) pierced at its root or starting The ducts or channels respectively conveying point.
the
the the
life,

the food, the water,


(serum),

(the

organic
the

principle

of)
fat,

Rasa
urine,

the

blood,

muscles,

the

the

stool,

the
fall

semen,
within

and
the

the

cata-

menial

blood,

naturally

scope

of

Surgery (Salya-tantra).
the

Several

authorities assert that

Srotas

(vessels)

are

innumerable]:,

and perform

different functions in their different aspects.

The two
nis

Srotas (channels) of

Prana
injury

(bronchi) have

their roots in the heart

and the Rasa-carrying Dhama-

(pulmonary

arteries).

An

to

any of these

Srotas (vessels)
the

produces groaning, bending


consciousness

down
The

of

body, loss of
or

(Moha), illusion, and


food-

shivering,

may

ultimately prove fatal.

carrying Srotas (^Esophagus) have

their roots in the

Amasaya (stomach) and


(intestines).

in the

food-carrying

Dhamanis

An

injury

to

or

piercing of such a duct


pain, aversion to

(Srota), gives rise to

tympanites, colic

food, vomiting, thirst, blindness or

darkness of vision, or

may
in

There are two water-carrying (Udaka-vaha) ducts or channels which have their roots
in death.

even end

the

palate

and the Kloma^ and a pie-cing of any

Hearing, touch, smell, taste, and sight.

t Eyes, ears, nose, tongue

and

skin.

t But

this

science

does not take any cognisance of them, since the


of,

pain incidental to a piercing

or an injury to, any of these


its

extremely

attenuated channels, tnust be slight in

character.

214
of these

THE SUSHRUTA SAMHITA.


makes the patient
(/.

[Chap. IX.

thirsty

and ends
two
in

in his instan-

taneous death

within seven days).


are

carrying (Rasa-vaha) ducts


serum-carrying
sumption) and

The serumnumber and


and the
to

have their roots in (the viscus

of)

the heart

Dhamanis
symptoms

(vessels).

An

injury

or

piercing of any of these ducts gives rise to Sosha (conidentical with those developed

by a hurt to the Prana-vaha channels of the body, ending in death. The blood-carrying Srotas (channels) are two in number and have their roots in the spleen and
the liver, and
in general).

the blood-carrying
injury
to

Dhamanis

(capillaries
is

An

any of these channels

attended with

pallor,

bluishness

of complexion, fever,

burning sensations, excessive haemorrhage, and redness


of the eyes.

The two muscle-carrying


their

Srotas (ducts or
(Sndyu), nerves

channels)

have

roots

in

the

Tvak

(serum),

and
injury

the
to

(capillaries).

An

Dhamanis any of these channels is


blood-carrying

characterised by swelling, loss or atrophy of the muscles,

appearance of varicose veins or


in death.

may

(ultimately)

resu't

The fat-carrying

Srotas (ducts) are two in

number and have


of these bring in (a gloss

their roots in the region of the Kati

(waist) and the Vrikkas

(kidneys).

An

injury

to

any

copious

flow

of)

perspiration, oily

of the

skin,

parched
(of

condition

of the

palate,

extensive swelling

the affected locality) and thirst.


(channels)
(urethra).

The two urine-carrying Srotas


roots in the bladder
to

have their

and the penis

An

injury

any of these

is

marked by constipation

or epistaxis

in the bladder, retention of urine,

and numbness of the

genitals.

their

The two stool-carrying Srotas (ducts) have roots in the Guda (anus) and the Pakvas'aya
;

(intestines)

an injuiy to any of these


of
st;ool

is

characterised

by complete retention

(in

the bo\vels), accom-

Chap.

I)?.]

SARIRA STHANAM.
foul smell

^I5

panied

by a distention of the abdomen,

and

intussusception of the intestine (as in a case of ententes).

The
roots

two semen-carrying
in

Srotas (ducts)
testes.

have their
to

the breasts and the


to
loss

An

injury

any
that

of of

them leads
semen,

of manhood, delayed

emission
of

or

blood-streaked

character
Srotas

fluid.

The two Artava- carrying


in

(ducts) have

their roots

the

uterus as well as in

the

Dham.anis

which carry the Artava (ovarian product).


to

An

injury

any of

these

brings

on
for

sterility,

suppression

of

the menses

and incapacity
identical

copulation.

cutting

to the Sevan!

(median raphe of the perineum) exhibits


with those
of a
case of

symptoms

injured

bladder or anus, described before.

physician

may

take in hand the medical treatment of a case of a Srota

which has been pierced, but he


entertain

shall not

necessarily

any hope of

ultimate

success.

(But

time
in

works wonders, and such a case


recovery).

may sometimes
matter)

end

case
or

of

pierced duct, from which the


like

dart (Salya,
extricated,

the

piercing

has been

may

be medically treated (without holding


to

out

any prospect of recovery


according to the

the

friends

of the

patient),

direction

laid

down under

the head of ulcer (^Vrana).

11-12.

IVIetrical
(arteries),

Text : The ducts emanating from the


Dhaman is
to course

cavity of the heart, other than the Siras (veins),

and found
(lit.

through the whole body,


13.

are called Srotas


Thus ends
Sus'ruta

channels or currents).
Chapter
of

the

ninth

the

S'arira

Sthanam
of

in

the

Samhita which

treats

of

the

descriptions

the

arteries,

cucts and nerves.

CHAPTER
Now we
of
the
shall discourse

X.
treats

on the Sdriram which


etc.,
till

nursing
the

and management, day of


conception

of pregnant

women from

parturition
i.

(Garbhini-Vyakarana-^ariram). General Rules : An cnciente, from the


day
of conception,

first

should

always cherish a clear joy-

ful spirit in

clem body.

She should wear clean and


herself in the
rites

white garments, ornaments, &c., engage

doing of peace-giving and benedictory


devotion to the gods, the Brahmins and
superiors.

and

live in

and She should not touch nor come into contact


her
elders

with unclean, deformed or maimed persons, and


forego
sights

should

the

use

of fetid smelling things, avoid dreadful

and painful or agitating sounds and the use of


stale

dry,

overnight.

and dirty food as well as that prepared Long and distant walks from home, resorts
solitary
retreat,

to cremation-grounds or to a

or

to

Chaitya*, and sitting under the shadow of a tree should

be absolutely forbidden (to


gestation).

her
anger,

during the period

of

Indulgence in

fright or other agita-

ting emotions of the

mind should be deemed


to

injurious.

To
all

carry a hea vy

load,

talk

in

loud voice and

other things which

might occasion injury to the


should be refrained
the

foetus, (sexual intercourse, &c.)

from.

The

practice of constant anointment and

cleansing

of the

body,

&c., (with

Amalaki, Haridrd,
up,

etc. lit. cos-

metics) should

be given

All

fatiguing

exercises
for
to

should be discontinued and the rules laid


*

down

the

Chaitya

is

a haunted or

diefied

tree,

or

according

others a

Budhistic monastery.

Chap. X.]

SARIRA STHANAM.

217
strictly

guidance of a

woman

in her

menses should be

adhered

to.

The couch and

the bed of a pregnant

woman
a

should be low, soft and guarded on all sides by number of soft pillows or cushions. The food should be amply sweet, palatable (Hridya)* well-cooked, prepared with appetising drugs and abounding in fluid

substances.
delivery.
2.

These

rules

should

be followed

up

till

Special regimen during the period of Gestation -During the first three months of
:

pregnancy an enciente should partake of food abounding


in

sweet,

cool

and

fluid articles.

Several medical

authorities

recommend

a food

made

of

Shashtika

rice

with milk, to

be given to

her specially in the third


fourth,

month
in

of gestation, with curd in the


fifth

with milk
the
sixth

the

and with
pregnancy.
as

clarified

butter in
largely

month

of

Food
flesh
in

composed of
(Hridya) food

milk and butter,


with the soup of
should be given to

well as

relishing

the

of jdngala (wild) animals

her
in

the

fourth, food with milk

and
of

clarified

butter

the

fifth,

adequate quantity
decoction
;

clarified butter prepared

with (the

of)

Svadamshtra, or gruel (Yavagu) in the sixth


butter

and

clarified

prepared
in

with

(the

decoction

of)

the Prithak-

parnyddi group

adequate quantities in the seventh

month of gestation.
For the purpose of
for

These help the


restoring

foetal

development.
of her

the

Vayu

body

(nervous system) to the normal course and condition and


the

cleansing of the bowels, the enciente should be

given
tion of

an

AsthApana (enema), composed of a decoc-

Palala
*

(flesh),

Vadara mixed with Vala, Ativala, Satapushpa, milk, cream of curd, oil, Saindhava salt,
in

"Hridya" here means the diet

which there

is

an abundance of

Ojo-producing (albuminous) properties.

2t

2l8

THE SUSHRUTA SAMHITA.


fruit,

[Chap. X.

she

honey and clarified butter. After that Anuvdsana (enema) made up of oil prepared with milk and decoction of the drugs known as the Madhuradi-gana. This restores the Vdyu
should have an

Madana

to its

normal course and condition, which brings on


Henceforth up to the time of

an easy and natural parturition unattended with any


puerperal
disorders.

delivery the

enciente should have liquid food (Yavagu)


of the

made up
flesh of

of emollient substances (fatsj and soup


(deer, etc.).
If treated

Jangala animals
enciente

on these

lines

the

remains

healthy

and strong,

and
evils.

parturition

becomes easy and unattended with


should
the

An
under

enciente
in

her pregnancy and happy stars and propitious lunar conditions. The chamber of confinement (Sutikagriha) in respect of a Brdhmin, Kshatriya, Vais'ya and Sudra mother should be raised on grounds respectively possessed of white, red, yellow and black soils, and made of Vilva, Vata, Tinduka and Bhallataka wood.

chamber

made to month of ninth


be
of

enter

the

lying-in

the

auspices

Couches should be made of these woods respectively


in

cases

of

the

different

social orders.

The
the

walls of

the

room should be well-plastered and


be
placed

furniture

(necessary accessories) should

tidy in their

proper places.

The door

of a lying-in
east,

chamber should
and the inner
in length

be made to face the south or the

dimensions of the room should be eight cubits

and four

in

breadth.

Religious

rites

for

warding off
stars

the visitation of evil spirits and malignant

should

be undertaken at (the door

of) the

room.

3.

Signs of imminent parturition-(M.~T.) : A looseness of the sides of the abdomen and


untying of the umbilical cord of the child
cardiac

(from the
of the

cord of

its

mother) and

a perception

ap-

^l
pain

SARlRA STHANAM.
at

2tg
indicate

characteristic

the

waist

would

the

approach of the time


severe pain at the

of delivery.

constant and
(in-

waist

and the back, constant

voluntary) motions of the bowels

and micturition and mucous discharge from the vulva are the symptoms which are manifest at the time {i.e., a little before) of
parturition.
4-5.

Preliminary Measures : Rites


diction

of bene-

should be
in

performed for the

safety

of

the

enciente

pronounce
babies on

and she should be made to benedictory Mantras surrounded by male


her travail
sides.
in

all

A
her

fruit

with a

should be given

hand.

masculine name Her body should be


a gruel (Yavagu)
virtue
at

anointed with
she should be

oil

and washed with warm water and


to drink largely

made

made
time).

of articles (which exert a beneficial

the
soft

Then she should be


spacious

laid

on her back on a
her

and

sufficiently

bed,

head being placed

on a pillow and her legs slightly flexed

and drawn

up.

Four elderly ladies with paired


in the art of

finger-nails

and skilled
she
feels
6.

accouchement and with

whom
the

no delicacy, should attend and nurse her

at the time.

Then

after

having gently lubricated

mouth

of

the parturient canal along the natural

direction

of the

pubic hairs (Anuloma) (so as not to


fort in the

create

any discomdamsel,

part)

one of them (elderly ladies) should


follows
:

address the enciente as


try to bear

"O fortunate
On
cord
of the
urgings,

down

the

child;

but

do not make such an


experiencing
child,

attempt in the absence of real pain."

an untying of the
enciente should

umbilical

the

gently

make such
in

whenever

she will experience pain

the

pelvic,

pudendal and

pubic regions and in


the bladder and
the

the

region

between the neck of


urgings should be

pelvis.

Deep

2^C

THE SUSHRUtA
the
exit

SAMttlTA.
foetus

Chap. X.]

made on
and
the

of the

out

of

the

uterus,

after that

deeper urgings should be


of

made during
canal
until

passage

the

child

through the

delivery. 7.

An
of

urging (made by the enciente) in the absence


real

any

pain

may

lead

to

deafness,

dumbness and
or subject

deformity of the jaw-bones


it

of the

child

to attacks of cough, asthma, consumption, etc., or lead


its

to the diseases of

head,
child.

or to the birth of a haunch-

backed or deformed

case of abnormal presentainto

tion (Pratiloma) should be

converted

the

normal

or cephalic one (Anuloma)

by version*
e,

8-9.
g.,

In the case of protracted delivery,


tion of the child at the vagina,

an obstruc-

the

vagina should be

fumigated with the fumes of


of a

the

slough (cast-off skin)

cobra (snake) or with the

fumes

of Pinditaka

(Madana) or the roots of Hiranyapushpi (Kantakdri) should be tied (round the neck or the waist) or Suvarchala {Atasi) or Vis'alyd (Patald) should

be tied round
the
parturient

hand (wrist) woman. 10.


the
or

and leg (ankle)

of

Post-parturient Measures : The shreds


membranes
lying on the

body of the
its

child should

be

removed

immediately

after

birth

and

its

mouth
be
the
out,

should be cleansed with

clarified

butter and

rock-salt.

Then a

linen pad soaked in clarified butterf

should

applied on the head


umbilical

of the new-born

baby.

cord, after having been

slightly

Then drawn
other

should be ligatured with one end of a string at a point


eight

fingers

apart

from

its

navel,

the

end

The

various forms of (Pratiloma)

abnormal presentations have been


(Nidan-Sthana

described

under

Mudha-Garbha Nidanam
is

and

their treatment

to

be found in Chikitsa-Slhana

Chap. Chap. XV.

IX.)

t Ijrahmadcva

recommends Vala-Taila instead

of clarified butler.

Chap. X.]

SARiRA STUANAM
its

2^1

of the string being tied round


bilical cord

neck

then the um-

should be severed

immediately above the

ligature,

ii.
:

Natal Rites
ofj

Then having
After that the

sprayed (the face

the baby with cold water, the post-natal rites should


it.

be performed unto

baby should be
clarified

made

to lick

an electuary composed of honey,


juice

butter and the expressed

of Brdhnii leaves
of)

and

Anantd, mixed with (half a Rati weight


given with the ring-finger of the feeder.
of the
it

gold dust and


the

Then

body

child

should

be anointed with Vald-taila and


in

should

be bathed
the

an infusion of the barks of


water

Kshiri

trees, or in

washings (decoctions) of drugs


in

known
in

as the

Sarvagandha (ElAdi group), or


silver

which red-hot gold or


in

bar has been


leaves,

immersed,
according

or

a tepid decoction

of Kapittha

to the nature of the season,

the

preponderance of the
to
its

deranged Doshas
cal conditions.

in its

body and according

physi-

12.

Diet for the Child (M.T.) : The


the breasts of a newly parturient four days after
orifices of

milk

in

woman

sets in three or

parturition

owing

to the dilation of the

the milk ducts (galactoferous ducts).


thrice

Hence
clarified
ofj

the

baby should be fed

daily

(morning, noon

and evening) on a handful (child's own hand) of butter and honey mixed with (a Rati weight
verized
first

pul-

Anantd
;

roots

sanctified

with Mantras on the


third

day

and on the second and


on
clarified
,root).

days the child


the

should

be fed

butter prepared with

Lakshand
butter

On
its

the following (fourth; day the child

should be fed

on

handful
in the

of honey and

clarified

only twice

(/. ^.,

morning and
day)

at

noon).

(From the evening


first

of fourth

the mother should

squeeze

off a

quantity of her milk

and then give

222
the child

THp:
her

SUSHRUTA SAMHITA.
(This
rule

CChap. X.

breast.

should

be

observed

at the time of tending the child every day).

13-14.

Treatment of the mother: The


of the

body
and

mother should be anointed


treated

(after

parturition)

with the Vald-Taila and


externally) with

sboth internally

a decoction of Vayu-subduing drugs


etc.). If still

(such as the

Bhadra-D drv ddi gvou^,


in

there be
(the

any abnormality
should
treacle

the

condition
/
e.,

of the
lochia),

Doshas
the
solution

discharge of vitiated

blood
drink a

mother
of

be given to

luke-warm

mixed with powders of Pippali, Pippali roots, Hasti-pippali, Chitraka and S'ringavera, and the medicine should be continued for two or three days or
longer,
(if

necessary),

till

the

disappearance

of

the

vitiated blood (lochia).


(i e.,

When
take

the discharge gets normal

on the appearance of healthy lochia), the mother


be

should

made

to

for

three

days
of

a the

gruel

(Yavdgu) prepared with the decoction


constituting the Viddri-Gandhddi
(a

drugs

good quantity

of; clarified

Gana and mixed with butter or a Yavagu prepared


of

in milk.

After that a

meal of boiled Sali-rice and a

broth

made
for

from the

meats

Jangala
pulse,

animals
should be
the

boiled with barley, Kola and Ktdattha

prescribed

her,

taking

into

consideration
appetite

strength and
digesting

the

condition

of her

(Agni or
this

power).

regimen of diet and conduct


(after

The mother should observe for one month and a

half
at

delivery).

After this period she

may
to

be

liberty

to

choose

any food
a

to

her

liking

and revert
several

to

her natural

mode

of living.

According
does not

authorities, however,

woman

regain

her

natural

temperament of body
strong

till

the reappearance of
15.

the healthy menstruation (after parturition).

but newly delivered

woman,

born and

Chap. X.]

SARIRA STIIANAM.
in a

223

bred

up

Jdngala country should be given to drink,


nights,

for three or five


in

either

oil

or clarified

butter

an adequate quantity with an

after-potion

consisting

of the decoction of drugs constituting the


as the Pippalyddi Gana.

group known
she

She should be daily anointed


delicate
or
health,
five

with

oil,

etc.

If,

however, of
to

should

be

made

take,

for three

nights in
in

succession, a medicated

Yavagu

(gruel) as described

the

last

para.

Thenceforth a diet of demulcent probe


prescribed
for

perties

should
be

her and

her

body
should

should

regularly

washed with a copious quantity


mother, after parturition,
time)
in

of tepid

water.

forego

(for

considerable

sexual
irascible

intercourse,

physical labour and indulgence


etc.
1

emotions/

lYIemorable Verses : Any


conduct of
life
;

disease acquired

by a newly delivered mother (Sutika) by her injudicious


soon lapses into one of
a
difficult
if it

type

(hard to cure)

and

it

becomes incurable

be due to

Hence a wise physician should treat her with such measures as are natural and congenial to
too
fasting.

much

her temperament, the

time,

the place

and the nature

of the disease, so that she


evil effect.

may
the

not be afflicted with any

17.

A
tion

placenta retained in

uterus

causes

constipa-

(Anaha) of the

bowels and

distention

of

the

abdomen (^tympanitesX
throat
hair
;

Hence

in

such

a case her

should

be tickled with a finger covered with


orifice of

or the exterior

the

vagina should be
a snake,

fumigated with the fumes of the cast-off'skin of

Katuka, Aldvu, Kritavedhana and mustard seeds mixed


with mustard
* Fifteen kinds
oil.

In the alternative, a plaster of Ldngali

of emotions as described in the thirty-ninth chapter of

ihe Chikitsa-sthanap,!,

224

THE SUSHRUTA

SAMIIITA.

[Chap. X.

roots should be applied to the

palms and soles of her


of

hands and

feet

or

the

milky juice
;

Snuhi

tree

should be applied over her scalp


of pasted Ldngali roots and

or a compound made Kushtha mixed with either


for

wine or the cow's urine should be given her

drink.

Kalka

either

of

S'dli roots

or

of

the

drugs con-

stituting the Pippalyddi

Gana mixed with wine (Sura)


purpose
In the
alterna-

should be given her for the


tive,

an Asthapana (enema) of white

mustard

seeds

Kushtha (Kuda), Ldngali, and the milky juice of MahdvriksJia, mixed with Sura-manda should be prescribed.
(If the

above measures

fail)

an Uttara-Vasti (uterine
in

douche) prepared with the aforesaid drugs and boiled

mustard

oil

should be applied

or else

the

placenta

should be removed by the hand lubricated with an olea-

ginous substance and with the nails clipped

off.

i8.

IVIakkalla
lochia of a

and

its

Treatment : The
account of profuse
use

newly delivered woman whose organism


or deranged

has become excessively dry on


of absorbants

by any other causes,


its

the

lochia being obstructed in

gives

rise

by the to Granthis (nodules) which


exit

local

Vayu,
appear

may

below the navel, on the sides


pain

of the

pelvis

about the

region of the bladder or of the pubis.


(Sula)
is

Severe piercing

felt

about

the

region of the navel, the

stomach and the bladder and a sensation of pricking


with
needle
the

and cutting

pain

in

the

intestines.

At

with the retention of urine.


of Makkalla.

same time the abdomen becomes distended These are the symptoms
In such a case, a decoction
of the drugs

of the Viratar-vddi

6^<^;/^ mixed with a powdered compound of the Ushakddt Gana should be given her. In the

alternative, a potion of carbonate of potash

[Yavakshdra)
;

dissolved

in

tepid water or in clarified butter

of rock-

Chap. X.]

SARIRA STHANAM.
decoction'of the Pippalyddi

225

salt dissolved in the

Gana

of a

compound made of Gana with Surd-manda


PancJici-kolas

the powdered drugs of the latter


;

of the powders
in
;

of

cardamom
of
the

and
and

dissolved

the

decoction

drugs of the Vaninddi Gana

of the
in

powders of pepper
decoction
of the
Trikatu^
;

Bhadraddrii

dissolved

the

Prithakparnyddi

Gana

or

of

pulverized

Chaturjdtaka and Knstiimhuru mixed with old treacle


or of simple Arishta, should be prescribed.
19.

Management of the Child: The


being wrapped up
in silk
;

baby

should be laid on a bed covered

with a

silken

sheet

it

should

be fanned

with the
tree.

branches of a Pilu,

Nimba, Vadari, or Parushaka


oil

A (thin^i pad

(Pichu) soaked in

should be
its
(^,^.,

constantly

kept on the head of the child, and

fumigated with the fumes of drugs


etc.)

body should be Vac ha, mustard,


tied

potent enough to
evil spirits.

keep

off

the (evil) influences of

demons and

The same drugs should be

round the neck, hands, legs and head of the infant and the floor of the lying-in room should be kept strewn
over with pounded sesamum, mustard, linseed [Atasi).
fire

should also be kept kindled in the chamber. Measures

laid

down

in the chapter

on the nursing of an

Ulcer-

patient

(chapter

IX.

Sutra.) should be observed in the


20.

present case as well.

Then

on the tenth day of its birth the parents having


rites

performed the necessary

of benediction
festivities,

and
shall

cele-

brated the occasion with suitable


the child a

give

name

of their

own
21.

choice or one

determined

by

its

natal a^trism, etc.

Lactation and selection of a wetnurse -For the healthy gro vth of the child a wet:

nurse should be selected


its

from among the matrons


of the

of

own

caste

(Varna\ and possessed

following

29

'

226
necessary

THE SUSHRUTA SAMHITA.


qualifications.

[Chap. X.

She

should

be of middle

stature, neither

too old

nor too young (middle-aged),

of sound health, of good character (not irascible or easily


excitable), not fickle, ungreedy, neither too thin nor

too

corpulent, with

lips

unprotruded, and with healthy and


neither

pure milk

in

her

breasts which should

be too

much pendulent nor drawn


observed that her skin
is

up.

It

should

be carefully

healthy and unmarked by any


free

moles or stains, she being


(such
as

from any sort of


etc.).

crime

gambling, day-sleep, debauchery,


affectionate
heart,

She
her

should be of an
children living.

and with

all

She should be of respectable parentage and consequently possessed of

many good

qualities,

with an exuhabit
of

berance of milk

in

her breasts, and not in the

doing anything that degrades


girl

woman

in

life.

"Syama

possessed of the aforesaid

qualities

makes a good
of a
is

wet-nurse.

child nursed at the

breast

woman
be

with upturned

or unprominent nipples
in features,

apt to

deformed (Karala)

while extremely pendu-

lous (large and flabby) breasts

may

suffocate

the

child

by covering
wet-nurse of

its

mouth and nostrils. Having chosen the commendable type, the child with
in a clean

a
its

head well-washed should, on an auspicious day, be laid

on her lap wrapped

and untorn
to

linen.

The

face of the child should

be turned
look

towards the north,


at

while the nurse should

the east

the time.

Then, after

first

having a small quantity

of the

milk

pressed out and the breast washed and

consecrated with

the following Mantras (incantations) the child should be

made

to suck her right breast.

22.

Metrical Texts : ''O,


may
the four oceans
of the

thou beautiful damsel,

earth contribute to the

secretion of mjlk in thy breasts for the

purpose of

in^-:

Chap. X,]

SARtRA STHAKAM.

227
O, thou with

proving the bodily strength of the child.


a beautiful face,
attain a long

may
like

the

child,

reared

on your milk,

life,

the
22.

gods made immortal with

drinks of ambrosia".

child

nursed

at

the

breast
of

of

any and every


type,

woman for want may fall an easy


its

of a nurse

the

commendable

prey to disease, owing to the fact of the

promiscuous nature of the milk proving incongenial to


physical

temperament.

The milk
off at

of a nurse the
outset

not

being pressed out and spelled

may

produce cough,
the child,

difficulty of breathing, or

vomiting of

owing
its

to the

sudden rush of the accumulated

milk into

throat

choking up the channels.

Hence
23.

a child should not be allowed to suck in such milk.

The
a

loss or
is

suppression of the milk in the

breasts of

woman

usually due to anger, grief, and the

absence

of natural affection for her child, etc.

For the purpose of


Sdli-rice, barley,

establishing a flow in her breast, her equanimity should

be

first

restored,

and diets consisting of

wheat,

Shashtika, meat-soup, wine (Surd\ Souviraka,


fish,

sesamum-paste, garlic,
stalk, Viddri-kandi,

Kas'eruka, S'ringdtaka, lotusflower, S'atdzari, Nalikd^


24.

Madhuka
etc..

Aldvu, and Kdla-S'dka,

should be prescribed.

Examination,
it

etc., of
is

milk : The breastcold,


is

milk of a nurse or a mother should be tested by casting


in water.

The milk which


with
water,

thin,

clear,

and
to

tinged like the


easily froths

hue of a conch-shell,
neither floats

found to be
give
in
rise

miscible

does not

and shreds, and

nor sinks

water,
fed

should be regarded as pure and healthy.

A
to

child

on such milk
health.

is

sure to thrive and gain in

strentgh and

child

should

not be

allowed
fatigued,

take the

breast of a hungry,

aggrieved,

too thin, too


of one
in

corpulent, fevered, or a pregnant

woman, nor

22S

THE SUSHRUTA SAMHITA


the assimilated food
is

[Chap. X.

whom

followed by

an acid reac-

tion, or of

one who

is

fond of incongenial and unhealthy


principles

dietary, or

whose fundamental
is

are

vitiated.

child should not be given the breast until an adminis-

tered medicine

assimilated in

its

organism,

lest this

should give

rise to

a violent aggravation of the pharmaco-

logical action of the medicine, as well as of the

deranged

Doshas (Vdyu,
of
its

Pitta, etc.),

and the

refuse matters (Malas)

body.

25.

IVIemorable Verses: The


Pitta

Doshas (Vayu,

and Kapha) of a wet-nurse are aggravated by

ingestion of indigestible or incompatible food, or of those


articles

which tend to derange the Doshas of the body,


vitiated.

and hence her milk may be


vitiated milk

child, fed

on the

of a
to

woman,
injudicious

vitiated

by the deranged

Doshas owing
and
living, falls

and intemperate eating

an easy prey to physical disease,

An

intelligent physician in such a case should devise


for the purification of the

means

milk as well as of the derangproduce any

ed Doshas which account for such vitiation (inasmuch as


the medication of the child alone will not
satisfactory effect).

26-27.

Infantile diseases
sis
:

and their Diagnoits

-A child
its

constantly touches

diseased

part or

organ and
part of

cries for the least

touch (by another of that

body).

If the seat of disease

be

its

head, the

child cannot raise nor


its

move

that organ

and remains with


in
its

eyes closely shut.

disease seated

bladder

gives rise to retention


sional fainting
fits.

of urine, thirst,
retention

pain
urine

and occa-

of

and

stool,

discolouring of complexion, vomiting, distention of the

abdomen, and gurgling


seat

in

the intestines
its

indicate
(colon).

the

of

the

disease

to

be

Koshtha

constant crying (and the child's refusal to

be consoled)

Chap. X.]

SARIRA STHANAM.

229

would signify that the diseased principle (morbiferous


diathesis) extends all through
its

organism.

28.
laid

Treatment of Infants : Medicines


down under
wise be prescribed in the
child or an infant
;

the head of a particular disease should like-

case

of

its

appearance

in

but then only the remedies of mild

potency and those which do not tend to disintegrate the


bodily
doses
after
fat

and Kapha should be given


to
age,
etc.)

in

adequate

(according mentioned hereand administered through the vehicle of milk and clarified butter, to a child living on milk alone, while the
as

nurse also

is

to take the

same medicines

as

well *

In
rice

the case of a child fed both

on milk and (boiled)

{KshirdnnddaX .Q.,
wet-nurse.

living

on both solid an d liquid food) the

medicine should be administered both to the child and


its

In the case of a child living on solid food


etc.

only, decoctions (Kashdya)


child

should be given

to

the

and not

to the nurse.

Medicines to the quantity of

small pinchful

may

be prescribed for a suckling

who

has completed

its first

month

of

life.

pastes) should be given to a child fed


rice to the size of a

Kalkas (medicated on both milk and


only being to

stone of a plum-fruit (Kola), and the


rice (solid food)

dose for a child fed on


the size of a
*

plum (Kola).t
clarified

29.
to

Milk and
should

butter

being congenial

the

constitution

of

infants

be

used

as vehicles for drugs in their cases but, these are

not necessary in the case of the nurse.

t According to several other authorities,


children
is

the

dosage

in the

case

of

to

be regulated as follows

In the case of a child, one month old, drugs should be given in the form
of an electuary through the vehicle of milk, honey, syrup, clarified butter,

etc, the dose being one Rati (about two grains) at


increased by a Rati a month,
till it

first,

and gradually

completes one year. After this time the


for

dose

is

to

be one Masha (about twenty grains)

each year

of age

till

he

is fifteen.

This dosage, however, does not apply in the present age. Ed.

230

THE SUSHRUtA SAMHITA.

tChap. X.

Metrical Texts : in

the case of

any disease
nurse

of a child nursed at the breast, the breasts of the

should be plastered with the pastes of drugs recommended

by physicians
suck the same.
ficial

for

the

particular
child),

malady
is

(instead

of

giving the drugs to the

and the child made to


not bene-

The

use of clarified butter


first

to a child

on the

day of an attack of VataPittaja


fever,

jvara (fever due to the derangement of the bodily Vayu),

within the

first

two days of an attack of


first

and within the

three days of that of Kaphaja fever.


butter

But the use of

clarified

may

be prescribed for
boiled
rice

an infant fed on milk and boiled rice, or on


alone, according to requirements.

30-3

f.

In case of fever a child should be given


all, lest

no suck
in

at

the

symptoms

of thirst

might develop.

Pur-

gatives, Vastis, or

emetics are forbidden

the disease

of children, unless the disease threatens to take


course.
32.

a fatal

If the local

materials
child

Vayu aggravated by (Mastulunga), bends down


an excessive

the

waste of brain-

the palate bone of a


thirst

attended with

and

agony,
of)

clarified butter boiled

with (the decoction and Kalka

the drugs of the


internally

Madhura Gana, should be used both


as

and externally, and the patient should


(to

well

be treated with spray of cold water

stimulate

him).

The

disease

in

which the navel of a child becomes


is

swollen and

painful,

called Tundi.

It

should

be
oils,

remedied by applying

fomentations,
virtue

medicated

Upanahas,
Vayu.
ing)

etc.,

possessed of the

of subduing the

suppuration of the anal region (Guda-pSika) of

a child should be treated with Pittaghna (Pitta-destroy-

measures and medicines.

Rasanjana used

interefifica-

nally

and externally

(as

an unguent) proves very

cious in these cases.

33-35.

Chap.

X.']

SARIRA STHANAM.

23I
butter

Infantile

Elixirs : Clarified
of)

cooked

with (the decoction and Kalka

white mustard seeds,


Sdrivd,
salt

Vachd, Mdnsi, Payasyd, Apdmdrga, S'atdvari,

Brdhmi, Pippali^ Hai^idrd^


should be given to an

K^ishtJLa

and Samdhava

infant

fed

exclusively

on milk.

Clarified butter prepared with (the docoction


of)

and Kalka

Madhika (Yashtimadhu), Vacha,


rice (solid

Chitraka, Pippali

and Triphald should be given to an infant fed both on


milk and (boiled)
butter boiled with (the

and liquid food). Clarified decoction and Kalka ofj Das'amula,

milk, Tagara,

Bhadraddru, MaricJia, honey, Vidanga,


the two sorts of

Drdkshd and

Brdhmis should be given

to an infant fed

on

(boiled) rice (solid food)

By

these the
the
child

health, strength,
is

intellect

and

longivity of

improved.

36-37.

child

should

be

so

handled or

lifted as

not to

cause any discomfort.

A
up

baby should not be scolded,


(from sleep), lest
it

nor suddenly

roused
It

might get

awfully frightened.

should not

be suddenly drawn

up nor suddenly laid down,

lest this

should result in the

derangement of
it

its

bodily Vdyu.
to
sit

An

attempt to seat

(before

it

has learnt

steadily),

may
a

lead to
child

haunch-back
be

(Kyphosis).

Lovingly should

fondled and
child

amused with toys and play-things. unruffled by any of the above ways becomes
and
intelligent as
it

healthy, cheerful

grows

older.

An
the

infant should be guarded


rains, the

against any

exposure

to

sun, or the glare of lightning.

He
in

should not

be placed uuder a tree or a creeper,

low lands,
;

and

in

lonely houses or in their

shades (caves)

and

it

should be protected
evil stars

from the malignant influences of


38.

and occult powers.

IVIctrical

Texts : A

child should not

be

left

(alone) in an unclean

and unholy place, nor under the sky

232

THE SUSHRUTA SAMHITA.

[Chap. X.

(uncovered place), nor over an


should
water.
i
e.,

undulating ground, nor

it

be exposed to heat, storm, rain, dust, smoke and

Milk
is

is

congenial to the organism

of

chiid,

it

its

proper food

Hence

in

the

absence of

sufficient breast-milk, the child

should be given the milk


39.

of a

cow

or of a she-goat in adequate quantities.

In the sixth
fed on light

month of its birth and wholesome boiled


in

the
rice.

child

should

be

child should

always be kept

an

inner

apartment of the house,


performed on
it

and

religious rites should be

its

behalf for

the propitiation of evil deities, and

should be carefully
40.

guarded against the influences of

evil stars.

Symptoms when
etc., strikes
agitated, cries,

a malignant star,
looks frightened
at times,

: The

child

becomes unconscious
nurse with
its

and wounds

himself or

its

teeth

and
its

finger-nails,

gnashes its teeth, crooks,

yawns, or moves

eye-brows
its

with upturned eyes, vomits frothy matter, bites

lips,

becomes

cross,

passes

loose

stool

mixed with shreds


becomes
or
dull
in

of mucus, cries in an

agonised

voice,

complexion, becomes weak, does not sleep in the night,


does not suck the
bug-like
or

breast

as

before,
its

emits a

fishy,

mole-like smell from

body

these

are

the general

symptoms exhibited by
or

a child under the

influence of a malignant star


specifically described later

planet which will

be
41.

on

in the

Uttara-Tantra
:

Education and IVIarriage -The


tion of a child should be

educaage

commenced

at

suitable

and with subjects proper


or order
it

to the particular social

Varna

belongs

to.

On
girl

attaining the twenty-fifth year


of twelve.

he should
these

marry a

conformity to

rules, is

sure to crown

him with

health, satisfaction,

progeny and a capacity


rites

for fully discharging the religious


42..

and paying

off his parental debts.

Chap. X.J

SARiRA StHANAM.

2^$

IVIetrical
the

Texts : An

offspring of a girl below

age of

sixteen by a

usually found to die in the

man below twentpjr-five is womb. Such a child, in the


(I ndriyas).

event of

its

being born alive, dies a premature death

or else becomes

weak

in

organs

Hence

agirl
all.

of extremely tender age should not be fecundated at

An

extremely old woman, or one suffering from


(of the generative organ),

chronic affection

or afflicted

with any other disease, should not


nated.

be likewise

impreg-

A man
foetus,

with similar disabilities should be held

likewise unfit.

40-44.

on the point of being miscarried on account


causes,

of the above-mentioned
uterus,

produces pain

in the

bladder, waist (Kati),

and the inguinal regions

(Vamkshana) and bleeding.

In such a case, the patient

should be treated with cold baths, sprays of cold water

and medicated plaster (Pradeha)


milk
*

&c.,

at

the

time,

and
of
the

boiled

with drugs
to

constituting

the
In

Jivaniya
case

group, should be given

her for drink.


foetus
in

unusual

movements

of

the

the

womb,

enciente should be given a drink of milk boiled with the

drugs

of

Utpalddi Gana^^QX soothing and making


its

It

steady in

place. 45.

A
in

foetus

being displaced

from

its
,

normal position
pain
or spasms
sensation,

produces the following symptoms, viz


the back and the

sides (Pars'va), burning

excessive discharge of blood


fceces

place

and retention of urine and A foetus changing place or shifting from one to another, swells up the abdomen (Koshtha).
in

Cooling and soothing measures should be adopted such cases. 46.


*

Jivaniya drugs two Tolas, milk sixteen

Tolas and water sixty-four


?'.(?.,

Tolas, to be boiled and reduced to sixteen Tolas,


milk,

to

wtight of the

30

234

THE SUSHRUTA SAMHITA.

[Chap. X.

Medical Treatment : in

case

of pain

under the circumstances, the enciente should be made


to drink a potion consisting of milk boiled with
sdha,

Mahd-

Kshudrasahdf Madhuka
of urine,

flower,

S'vadanstrd and
In the case of

Kantakdri, mixed with sugar and honey.


retention

the

patient

drink a potion of milk boiled

made to with drugs known as the


should be

Ddrvddi Gana (mixed with sugar and honey). In the case of A'naha (retention of stool attended with distention

of

the

abdomen),

potion

consisting

of

milk
In

boiled with asafetida, Sauvarchala

salt, garlic

and Vacha

(mixed with honey and sugar) should be given.


cases of excessive bleeding, linctus

made

of the powdered
,

chamber of a Koshthdgarika insect * Samangd^ Dhdtaki flowers, Navamdlikd, Gairika, resin and Rasdnfana, or of as many of them as would be available, mixed with honey, should be licked. In the alternative, the bark and sprouts of the drugs known as the Nyagrodhddi Gana mixed with boiled milk should be administered, or a Kalka of the drugs of the Utpaladi group mixed with boiled milk should be used, or a Kalka of S'aluka, S'ringataka and Kas'eru mixed with
boiled milk should be given.

As

a further alternative, the

enciente
Sali
rice

may

be

made

to eat

cakes

with the decoction of

made of powdered Udumbara fruit and

Audaka-kanda, mixed with honey and sugar. A piece of linen or a plug soaked in the expressed juice of the
drugs of the

Nyagrodhadi
of pain

group
47.

should be inserted

into the passage of the vagina.

In

case

unattended

with bleeding, the

enciente should be

made

to drink a potion

composed of

milk-boiled with J/<^<//////^^(Yashtimadhu),


*

Devaddm and

There

is

kind

of insect

which makes

its

chamber with earth

generally under the ceiling or on the walls.

This earth should be used.

Chap. X.]

SARIRA STHANAM.
;

235

Payasyd

or with As'mantaka^ Satdvari and

Payasyd

or with the drugs of the group of

V iddrigandhddi Gana
S'atdvari,

or with Vrihati, Kantakdri, Utpala,

Sdrivdy

Payasyd and Madhuka (Yashtimadhu).


foetus steady in the

These remedies

speedily applied tend to alleviate the pain and

make

the

womb.

48.

After the foetus has been steadied


mesaures, a diet consisting
of

by the aforesaid
cow's
of Udmnvara,
the

(boiled rice and)

milk, boiled with the dried tender fruits

should be

prescribed for the patient.

In

event of

miscarriage, the patient should be made to drink a

Yavigu

(gruel) of the

Udddlaka

rice, &c.,

cooked with

the decoction of the Pachaniya group (Pippalyddi)

and
of

devoid of

all

saline

and

fatty matter, for a

number

days

corresponding to that of the month of gestation.

Old treacle mixed with the powdered drugs of the Dipaniya group (Pancha-kola), or simply some Arishta
(Abhay^rishta,
of
etc.),

should
in

be
the

given,
pelvis,

in

the

event

there

being
49.

pain

bladder

and

abdomen.

and channels (Srotas) stuffed with aggravated Vdyu lead to the weakening (Laya) of the

The

internal ducts

foetus and, if the

state

continues,

it

leads

even to

its

death.

Hence

the

case
etc.,

should

be treated with mild


etc.,)

anointing measures,

(Sneha-karma,

and gruels and

made

of the flesh of the birds of the Utkros'a species

mixed with

a sufficient quantity of clarified butter, should

be given to her.

with .Masha,

As an alternative, Kulmasha sesamum and pieces of dried

boiled
(tender)

Vilva

fruit

should be given her, after which she should

be

made
*

to drink, for a week,

honey and Mdddhvika (a

kind of weak wine).

At

the non-delivery of the child

**Kulmdsha" may mean either Kulattha pulse or half boiled wheat,

barley, etc.

236
even after

THE SUSHRUTA SAMHITA.


the
lapse of the
full

[Chap. X.

term of gestation, the

eaciente should be
9,;n

made

to thrash corn with a pestle in

Udukhala or mortar (husking apparatus) or should he il9,de -to sit or move (on legs or by conveyance), on an
juneven ground.
50.

Atrophy of a
to

foetus in the

womb

should be ascribed

the action of the deranged

Vdyu.

This

is

detected

by the
of
tiie

comparatively lesser fulness of the abdomen


enciente

the

and slow

movement
the

of the foetus in

womb.

In

such a case,

enciente should be
(of

treated with milk, with Jhe


a.^d

Vrimhaniya

restorative

construQtive
51.

properties)

drugs, and with meat-

soup.*

combination of

deranged Vayu in the womb,


SjUccessful

ovum and semen affected by the may not give rise to a


matter),

fecundation (living impregnated

but

leads to a distention of the

abdomen

(as in

pregnancy),
itself.

which again, at any time,


this
is

may

disappear of

And

ascribed

influence of

by the ignorant to the malignant Naigamesha (spirits). Such an impregnated


in

matter,
called

sometimes lying concealed


Nagodara, which

the uterus,

is

should be treated with the


the

remedies laid

down under
52.

head of
the

Lina-Garbha
of

(weak

foetus).

Now we

shall

discourse on

management

pregnancy according to the months (period) of gestation.


Metrical Texts: The following receipes, such as, Madhuka (Yashtimadhu), S'dkavija, Payasyi, and
;

(i)

Devadiru

(2)

As'mantaka,
(Durvi), Utpala

black

sesamum,
;

pippali,

Manjishth^, Tcimra-valli and Satcivari

(3)

Vrikshddani,
;

Payasya, Latd.
Siriya, RdsnA,
*

and Sdriv^

(4)

Ananta,
;

Padma,
in

and Madhuka (Yashtimadhu)


the
text
signifies

The panicle "chA"

the

use

of

any other

consiructive tonic.

Chap. X.]

SARIRA STHANAM.

237

(5)

Vrihati,

Kantakdri, Kas'mari, sprouts (Sunga) and


(as,

barks of milk-exuding trees


butteri*
;

Vata,

etc.),

and
Visa

clariiied

(6)

Pris'ni-parni, Vald,
;

Sigru,

S'vadanshtra
(stalks

and Madhuparnika
of
lotus),

and

(7)

S'ring'taka,

Draksha, Kasaru,
;

Madhuka (Yashtimadhu),
month
of

and sugar
gestation,

should successively be given with milk* to


first

an enciente, from the


in
53.

to the seventh

her

the case

of a threatened

miscarraige or

abortion.

An
Ikshu

enciente should be
of

made
(in

to

drink milk
Vilva,

boiled
Patola,

with the roots

Kapittha,

Vrihati,

and

Kantakari,
miscarraige)

case

of impending

or

threatened

in

the eighth

month
under
of

of

her

pregnancy.

In

the

ninth month (and

similai*

conditions), the

potion should be

made up

Madhuka
In

(Yashtimadhu),
the tenth
consisting
is

Ananta-mula, Payasha and Sariva.


boiled

month (and under


of milk

similar conditions), a potion

with

Sunthi and

Payasyd

beneficial, or, in the alternative,

made up
fcetus

of milk with Sunthi,

may be given a potion Madhuka (Liquorice, and


would
vanish and the
in the

Devadaru.

The

severe pain

would continue to develop safely


child born of a
for

womb,
sterile

under the aforesaid mode of treatment.

54-57'

woman, who had remained


a

(not-conceived)
prasava)* after
lived one.
*

period of

six

years (Niviitta-

previous child-birth, becomes a short-

58.

ChakradaUa reads "Visam"

(stalks

of lotus)

instead

of "Ghritara"

(clarified butter).

t If a conception does not occur in a


five

woman

for a

period of more than

years
*

a''ter

a child-birth, she

is

called

Nivritta-prasaVSl.
these

Sivadasa also says that powders of


milk, but
in

drugs should be given

with boiled

he adds that some authorities recommend theaQ

drugs to be boiled

milk according to Kshira-paka-vidhi.

238

THE SUSHRUTA SAMHITA.

[Chap. X.

Application of mild emetic medicines, (though for-

bidden

in

the

case

of a

pregnant

woman), may be

resorted to, in the case


stage).

of a fatal disease, (even in that

diet consisting of sweet


for
her,

and acid things should


bring the deranged

be prescribed

so as to
state
;

Doshas

to

the

normal

mild

Sams'amaniya
mild in their

(soothing and pacifying)

medicines should be applied


articles

and food and drink consisting of


to

potency, predominently sweet-tasting and not injurious


the foetus,

should be advised

and mild (external)

measures not baneful to the foetus should be resorted


to,

according to the requirements of the case.

59.

IVIemorable Verses : The


strength and intellect of a child
are

growth, memory,

improved by the

use of the four following medicinal compounds, used as


linctus (Prds'a),
viz.,

(i)

well-powdered gold, Kushtha,


;

honey, clarified butter and Vacha


(Brdhmi),

(2)

Matsyakshaka*
clarified butter

Sankha-puspi, powdered gold,


;

and

honey

(3)

Arkapuspi, honey,
;

clarified

butter
gold,

powdered gold and Vacha


Kaitaryyah
butter and honey.
Thus ends
Samhita,

and

(4)

powdered

(Maha-Nimba),
60.

white

Durba,t clarified

the tenth Chapter of


treats

the S'arira

Sthanam

in
etc.

the

Sus'rula

which

of

the nursing and

management

of pregnant

women.
*

Some, however, explain Matsyakshaka


a kind of red-flowered shrub

to be
in the

Dkuslura; others again

say

it is

grown
Text,

Anupa
either

country.

The word "S'veta," in t "DurvgC" and mean "white"


Aparajita or white Durvt.

the
or
it

may

be adjective
or

to

may mean white Vacha

white

Here ends the ^arira Sthanam.

THE

SUSRUTA SAMHITA
CHIKITSA-STHANAM.
(Section of Therapeutics).

CHAPTER
Now we
of the two
shall

I.

discourse on
of inflamed
i.

the
ulcers

medical treatment

kinds

(Dvivraniya

Chikitsitam).
Ulcers

may

be grouped under two heads according

as they are Idiopathic or

The

first

group includes within


the

Traumatic in their its boundary all


vitiated

oiigin.

ulcers

that are caused through

condition

of the

blood or the several deranged conditions of the


Pitta

Vayu,

and

Kapha, or
while

are

due

to

their

concerted

action (Sannipata),

the

second group embraces


bites

those which are


birds, ferocious
fall,

caused
animals,

by the
reptiles

of men,
lizards,

beasts,

or

or

by a

pressure and

blow, or by

fire,

alkali,

poison, or

irritant drugs,

or through injuries inflicted

by pointed
axes,

wood,

skeletal

bones*
(a

horns,

discus, arrows,

tridents, or

Kuntas
in

kind of shovel\ or such other

weapons.

Although both th3se classes of ulcers possess

many

features

common, they have been grouped


measures to be
in

under two distinct heads on account of the diversity of


their origin, the difference in remedial

adopted

in their
*

treatment,

and

the

variation

their

Fragments of broken

pottery.^

Dallana.

240
Strength

THE SUSHRUTA SAMHITA.


and tenacity.
2.

[Chap.

I,

Hence the

chapter

is

called

Dvivraniya.
In
all

cases of

traumatic ulcers, cooling measures


to,

should be at once resorted

just

after (the

fall

or

blow or

stroke), for the cooling of the

expanding
the
of enraged)

(radialaid

ting) heat of the

incidenta'

ulcer,

in

manner

down

in respect

of (the

pacification

Pitta,

and a compound of honey and


applied on the

clarified butter

should be

wounded

locality
parts,

for

the

adhesion
pacifica-

(Sandhdna) of the lacerated


tion, i.e, restoration to

[and for the

normal
the

state, of the

local

blood

and Vdyu aggravated through an obstruction of their


passage].

Hence

arises

necessity

of

making the
(a

two-fold classification

of ulcers.

After that
as

week)

a traumatic ulcer should

be treated

an

idiopathic
as
it

one

(to

all

intents

and purposes\ inasmuch


that

is

found to be associated with deranged

Vayu, Pitta or
treatment
3.

Kapha

Hence

at

stage
is

the

medical

of both the forms of ulcer

(practically) the

same.

In short, ulcers are further


into fifteen

subdivided (particularly)
the

groups, according to

presence
Pitta

of the

morbific

diathesis

(deranged
either

Vayu,

Kapha
combi-

and

blood therein),

severally

or

in

nations as described (before) in the Chapter on Vrana-

Prasna
ities,

(Sutra

Sthanam. Ch. XXI).

Several authorulcers

by adding the simple uncomplicated

(un-

associated with

any of the morbific


Pitta, &c.)

principles

of the

deranged Vayu,
of

to

the

list,

hold the number

types

to

be

sixteen.

(Practically

they are

in-

numerable, according to the combinations made of the

deranged Vdyu,
system).
4.

etc.

and the different Dhaitus of the

Symptoms
General and

of ulcer

may

be divided into two kinds


is

viz.^

Specific.

Pain

the general characteristic

Chap.

I.]

CHIKITSA STHANAM.
ulcer),

24t

(of all

forms of

while the symptoms, which are

exhibited in each case

according to the

virtue

of the

deranged Vdyu,
Specific ones.
(the

Pitta, etc, involved therein, are called the

Vrana

is

so

named from

its

etymology
skin

term being derived from the root Vrana


signifies a

to break)
assumes a

and

cracked or broken condition


afflicted part) of the

^of the
5.

and flesh of the

body.
ulcer

The Vataja- Ulcer : The


brown
and
or

vermilion

colour and
largely

exudes a
attended

thin,

slimy

cold

secretion,

with tension,
pain
(in

throbbing and a sort of pricking and


its

piercing

inside),

which seems

as

if

being

expanded and

extended.

This type of ulcer does not extend

much

and

is

characterised by a

complete destruction of the


ulcer
is

tissue (flesh).
It

The Pittaja

rapid in

its

growth.

assumes a bluish yellow colour, exudes a hot secretion

resembling the washings of Kims'uka flowers,


attended with burning, suppuration and
redness,

and

is

being

surrounded
pustules.

with

eruptions

of
is

small

yellow-coloured

The Kaphaja
its

ulcer

found to
is
is

be extended

and raised around

margin and
It

irresistible itching sensation.


(in its

accompanied by an thick and compact


of vessels

depth), covered with a large number

and

membranous

tissues

(Sira-sndyu-jala),

grey

in

colour, slightly painful, hard


thick, cold, white

and heavy, and exudes a


secretion.

and slimy

The Raktaja
is

ulcer (resulting looks


to like

from a vitiated condition of the blood)


coral.
It

lump of red be surrounded by black


a
alkali.
if

often

found

vesicles
It

to smell like a strong

and pustules and becomes painful and


the
specific

produces a sensation, as
(of
it).

fumes were escaping out

Bleeding
of

(is

present)

and
are

sympto

toms

the

Pittaja

type

likewise

found

supervene.

9.
31

242

THE SUSHRUTA SAMHITA.

Chap.

I.]

The Vata-Pittaja Type : An


the concerted action of the
is

ulcer

due to

deranged Vayu and Pitta

marked by a pricking and burning pain and a red

or vermilion colour.
of
it

sensation of fumes arising out

(is

also

felt)

and the ulcer exudes a secretion

which partakes of the characteristic colours of both the deranged Vdyu and Pitta. An itching and piercing

due to the combined action of the deranged Vayu and Kapha (Kapha- Vattaja type), which becomes heavy and indurated, constantly dispain
is felt

In the ulcer

charging a cold, slimy secretion.

An

ulcer

resulting

from the deranged condition of the Pitta and Kapha

(Kapha-Pittaja type) becomes heavy, hot and yellow. It is marked by a burning sensatian and exudes a pale,
yellow-coloured
secretion.

An

ulcer

marked by
is

the

aggravated condition of the deranged

Vayu and blood


largely
It
is

(VsLta-Raktaja type)
attended

is

dry and thin and


pain

with
or

a a

piercing

and

anaesthesia.

exudes blood

vermil-coloured

secretion

and

combined hues respectively peculiar to Vayu and blood. An ulcer due to the the deranged combined action of the deranged Pitta and blood

marked by

the

(Kakta-Pittaja

type)

is

marked by a colour which


clarified

resembles the surface

cream of
a hot

butter.

It

smells like the washing of


pelatous),
ulcer

fish, is soft,

spreading (erysi-

and

secretes

blackish matter.
of the
is

An

due to the combined


glossy

action

deranged
usually

Kapha and
heavy,

blood (Kapha-Raktaja type)

red-coloured,
is

slimy,

and indurated.
exudes a

It

marked by
secretion.

itching
ulcer

and

yellowish bloody
of the

An

due

to the concerted action

deranged Vdyu, Pitta and blood (Va'ta-Pitta-Raktaja type) is maiked by a sort of throbbing, pricking and
burning pain.
It

discharges a flow of thin yellowish

Chap.

I.j

CHIKItSA STHANAM.
produces a sensation, as
its cavity). if

243

blood

and

fumes were
blood

escaping (out of
certed

An
is

ulcer

due to the conattended with


thick, grey,

action of the deranged Vayu,

Kapha and

(Vaita-Sleshma-Raktaja type)
itching, throbbing

usually

and tingling sensations and

blood-streaked
the deranged

discharge.
Pitta,

An

ulcer

associated with

Kapha,
is

and blood (Kapha-PittaIt

Raktaja type)
greyish,

largely attended with redness, itching,

suppuration and burning sensation.

emits a thick,

bloody secretion.
action

An

ulcer

marked by the
kinds

concerted

of

the
is

deranged Vayu, Pitta and


attended with diverse
&c.,

Kapha
of pain,

(Satanipaitika)
secretion,

colour,

peculiar

to

each of

these types.

An

ulcer

associated
Pitta,

with the combined

action of the deranged

Vayu,

Kapha and blood


is

(Va^ta-Pitta-Kapha-Raktaja type)
sensation, as
if it

attended with a
It
is

were being burnt and lacerated.


itchin^^

largely

accompanied by throbbing,
of

sensation,

a sort

pricking

and burning pain, with complete


various
further

anaesthesia in the locality; redness, suppuration,

other kinds of colour, pain and secretion are


characteristics.

its

10

20.
which
is

An

ulcer (Vrana)

of the

same colour with the

back of the tongue,


shaped and marked

soft, glossy,

smooth, painless, well-

by the absence of any kind of


is

secretion whatsoever,

called

a clean

ulcer

(Suddha-

Vrana).

21.

Therapeutics : The
treatment of a
into

medical

(and surgical)

Vrana
different
diet),

(ulcer)

admits of being divided


such as, Apatarpana
(plastering),

sixty *

factors,

(fasting

or low
or

Alepa

Parisheka

(irrigating
*

spraying),

Abhyanga
total

(anointing),

Sveda
factors,

N.B.

Authorities, however, differ in

enumerating these

although every oiae of them sticks to the

number

of sixty.

^44
(fomentations,

THfe

SUSHRUTA SAMhITA.
Vimldpana
(resolution

fChap.

t.

etc.),

by massSneha

age or rubbing), Upanaha (poultice), Pdchana (inducing


suppuration), Visrdvana (evacuating or draining),
(internal use
of

medicated

oils,

ghrita,

etc.),

Vamana

(emetics),

Virechana (purgatives), Chhedana (excision),

Bhedana (opening
by medicinal
(extraction^

e.g.,

of an abscess),

Dirana (bursting

applications),

Eshana

(probing),

Lekhana (scraping), Aharana Vyadhana (puncturing


or adhesion),

opening a
(suturing),

vein),

Vidrdvana (inducing discharge), Sivana


(helping re-union

Sandhana
(cooling

Pidana

(pressing),

Sonitasthdpana (arrest of bleeding),


application),

Nirvdpana
poultices),
(lint

Utkarikd

(massive

or

Kashaya (washing with decoctions), Varti plug), Kalka (paste), Ghrita (application of
clarified

medicated
medicated

butter),

Taila

(application

of

oil\

Rasa-kriya (application of drug-extracts),

Avachurnana (dusting with medicinal powders), Vrana-

Dhupana
of

(fumigation of an ulcer), Utsddana

(raising of

the margins or bed of an ulcer),

Avasddana (destruction Mridu-Karma (softening), Daruna-Karma (hardening of soft parts), Kshdra-Karma (application of caustics), Agni-Karma (cauterization), Krishna-Karma (blackening), Pandu-Karma (making
exuberant
granulation),
cicatrices),

yellow-coloured

Pratisarana (rubbing

with

medicinal powders), Roma-sanjanana (growing of hairs),

Lomdpaharana
injections\

(epilation),

Vasti-karma (application of
(urethral

enemas), Uttara-Vasti-karma

and

vaginal

Vandha

(bandaging), Patradana (application


Infra),

of certain leaves

vide

Krimighna (Vermifugal
tonics),

measures\ Vrimhana (application of restorative

Vishaghna

(disinfectant or anti-poisonous applications),


(errhines),
in the

Siro-virechana

Nasya

(snuff),

Kavala-

dharana (holding

mouth

of certain drug-masses for

diseases of the oral cavity or gargling),

Dhuma

(smoking

Chap.

1.]

CHIKLITSA

STHANAM.

245

or vapouring), Madhu-sarpih (honey and clarified butter),

Yantra

(mechanical
(diet)

contrivances,

e g.,

pulleys,

&c.),

Ahara

and Raksha-Vidhana

(protection
22.

from

the influence of malicious spirits).

Of these, Kashaya, Varti, Kalka,


kriya and

Ghrita, Taila, Rasa-

Avachurnana

are the measures for the cleansing


its

(Sodhana) of an ulcer and for helping


(Ropana).
are surgical

granulation

The
as

eight

acts

(from Chhedana to Sivana)

operations.

We

have already spoken of

such

acts

Sonitasthapana,

Kshara-karma, Agni-

karma, Yantra, Ahdra, Raksha-vidhana and

Vandhashall

Vidhana

(in

the

Sutra-sth^na).

Later on, we

discourse on Sneha, Sveda,

Uttara-vasti, Siro-virechana, Nasya,

dharana.
in the

Of

the

Vamana, Virechana, Vasti, Dhuma, and Kavalaremaining measures we shall speak


23.

present chapter.

There are six kinds of swellings (Sophas), as described


before,

and the following eleven


ending

measures.,
in

commencing
be

with Apatarpana and


regarded as their cure.

Virechana, should

These are the proper remedies for


in,

a swelling and do not (cease to be efficacious


hostile to cases of swelling
ulcers.

nor) prove

which are transformed into


be
is

The
to

other
ulcers

measures should
but

deemed
the

as
first,

remedial
general

Apatarpana
in all

and principal remedy

types of swellings

(Sophas). 24.

Memorable Verses
should

--Apatarpana
case

(fasting)

be prescribed

in

the
in

of a patient, full of

enraged Doshas, as well


principles

as,

one having his organic


purpose of bringing

(Dhatus) and refuse matters (Malas) of the

system, deranged

by them,

for the

them
to

to

their

normal condition, with a regard both


with diseases which result

their

nature and to the strength, age, &c., of the

patient.

Persons

afflicted

246

THE SUSHRUTA'SAMMITA.

tChap.

t.

from the up-coursing of the'deranged Vayu(Urdhva-vata)


such as cough, asthma, &c.,
dryness
infants,

or

with

thirst,

hunger,

of the

mouth and
persons,

fatigue, as well as old

men,

weak

men

of timid dispositions
fast.

and

pregnant vvom^n should' never

swelling and an

extremely painful

ulcer

should be respectively treated

with a proper medicated plaster at the very outset.


pain in such a case will yield to
the medicinal

The

plaster

as a blazing room or house is readily extinguished by means of steady watering. Such plasters not only give comfort to the patient (by removing the pain and leading
to the absorption of the swelling), but heaves

up the bed
its

of the sore or the ulcer


purification

and contributes to

speedy

and healing up (granulation).


affected part should be

2528.

In the case of a swelling brought on by the deranged

Vayu, the

washed or sprinkled
oil,

(Parisheka) with a

warm

lotion

of clarified butter,
or

Dhanyamla and
of

essence of meat

with
the

decoction

the drugs

that

tend to pacify

enraged

Vayu
of
1

and to
the
a

relieve the pain.

A
or

swelling due to the action of

deranged

Pitta

blood
be

or to

the

effect

blow

or

poison

should

washed

or

sprinkle

with a lotion of milk, clarified butter, honey and sugar dissolved in water, the expressed juice of sugar-cane

and a cold decoction of the drugs of the Madhura group (Kakol>'*adi-gana) and the Kshira-Vriksfias. A Kaphaja
swelling on the

body should be
of
oil,

washed or sprinkled
cow's urine,
alkaline

with a luke-warm lotion


solution, wine
>^Sura),

Sukta and with a decoction of


jets of

drugs that destroy the deranged Kapha. 2931. IVIetrical Text : As a fire is put out by
water, so the
fire

of the deranged morbific principles

(Doshagnl) of the body are spe idily subdued and put

down

by

the application of (medicinal lotions) washes.

32.

Chap.

I.]

CHIKITSA STHANAM.

247
used,

An
with a
Doshas,

anointing (Abhyanga), duly prescribed and


full

regard

to

the

nature of the

aggravated
the

leads to

their pacification (restoration to

normal condition) and to softness (subsidence) of the


swelling.
33.

lYICtrical Texts: An application of an anointment (Abhyanga) should precede the measures of fomentation, resolution,

&c

while

it

should follow

all

evacuating
swell-

measures, &c.
ing, as well as

A
an

painful,

extended and indurated

ulcer
act

of

a similar nature, should be

fomented, while an
gentle

of

Vimlapana

(resolution

by

massage) should be done

in respect of a fixed or
little

unfluctuating swelling attended with

or
first

no pain
annoint

whatsoever.

wise

physician

should

and foment the part and then gently and slowly press back of his thumb it with a bamboo-reed or with the
or

palm.

non-suppurated

swelling or one that

is

partially

suppurated should

be treated with poultice


to
its

(Upandha\ which would lead ration, as the case might be.


beginning with
(in

resolution or suppu-

swelling, not resolved

or not subsiding even after the adoption of the

measures

Apatarpana and ending


.

in

Virechana

the

given

list),

should

be caused to suppurate

with the drugs enumerated in the ^chapter of Mis'raka,

such as curd, whey, wine (Sura), Sukta and


(a

kind of fermented

paddy

gruel).

Dhany^mla They should be


and
be

formed into a paste and the paste should be cooked into


an
efficacious poultice-like composition:(Utk^rikd),
salt

mixed with
with the

and
of

oil

or clarified butter,

it

should

applied over the affected part (swelling) and


leaves

bandaged
patient

an

Eranda

plant.
(?^.,

The

should be allowed to take a wholesome


not.

which does

produce Kapha) diet as soon as suppuration would


34-39.

set in (in the swelling),

248

THE SUSHRUTA SAMIilTA

[Chap.

I.

Blood-letting' : Blood-letting
sorted
its

should

be

re-

to

in

case
for

of newly

formed

swelling

for

resolution
is

and

alleviating

the pain.

Bleeding

(Visratvana)

which

is

recommended in the case of an ulcer indurated, marked by a considerable swelling

and inflammation and is reddish black or red-coloured, extremely painful, gagged in its shape and considerably
extended at
its

base (congested), specially in the case

of a poisonous ulcer, for the subsidence of the


for

pain and

warding

off a process of

suppuratiou therein, either

by applying
locality)

leeches

or

by

opening

(a

vein

in

the

by means of an instrument. of a dry or parched temperament


should be

An

ulcer-patient
dis-

affected with

tressing supervenients or ulcer-cachixia or

who

is

weak

made

to

drink an
of)

emulsive potion cooked

with

(a

decoction

appropriate drugs.

patient

afflicted

with an ulcer with an elevated


the deranged

margin and

attended
presence
blackish

with swelling and specially marked


of

by the
flow

Kapha and by
purgatives
to

of

red blood should be treated with

emetics.

Ulcer-experts
afflicted

recommend

patient

with an old or long-standing

ulcer,

attended
Pitta.

with a

deranged condition of

the

Vayu and

An

excision should be

made
is

into

an ulcer which refuses


a

to suppurate

and which

of

hard and

indurated

character attended with sloughing of the local nerves and

ligaments (Snayu).
should be

An
an

opening^ or excision
ulcer (Vrana) in the

(Bhedana)
inside of

made

into

which pus has accumalated and makes it heave up and which not finding any outlet consequently eats into the
underlying tissues and makes fissures and cavities.
40-46.

Measures which contribute to a spontaneous bursting

by medicinal applications (Da(rana) of

a swelling

should

be adopted in the case of an infant or an old or enfeebled

Chap,

i.]

CHlklTSA StHANAM.
or of one incapable of bearing the

249
pain
(of a

patient,

surgical operation), or of a person of a timid disposition,


as well as
in

the case of a

woman, and

in

the

case

of

swellings which appear on the vulnerable parts (Marmas)


of the body.

Remedies which lead


a swelling

to the

spontaneous

bursting

of

should

be

applied

by a wise
alkaline

physician to a well-suppurated swelling

drawn up and
or an
surface

with

all

its

pus gathered to a head


be

substance should

applied

on
the

its

and a

bursting should be effected


to be just aggravated

when

Doshas are found

by the incarcerated pus. 47. An ulcer which is indurated, whose edges are thick and rounded, which has been repeatedly burst open,
and the
an
flesh

of

whose cavity
should
be

is
;

hard
or,

and elevated,
other words,

should be scarified by a surgeon

in

indurated

ulcer

deeply scarified, one

with thick
scarified,

and

rounded edges should be excessively

while the one

which has

been
off.

repeatedly

burst open should

be

entirely

scraped

An

ulcer

with a hard and elevated bed should be scraped evenly

and longitudinally along the length of


performed with a piece of
fibres of

its

cavity.

In

the absence of a scarifying instrument, the act should be

Kshauma

(cloth

made

of the

an Atasi

plant), a linen (Plota) or a cotton

pad

(Pichu), or with such alkaline substances

as nitrate of

potash, Samudra-phena, rock-salt,


trees (e.
g.,

or

rough leaves of
48.

those of Udumbara, &c.).

The

cavities or courses of a sinus, or of

an ulcer which
or

had any foreign matter lying imbedded


of the one

in its inside,

which takes a crooked or round about direction, as well as

formed into cavities within

its

interior, should

This scraping

off of the ulcer

should be done by
like,

an instrument of

Surgery and not by any rough leaf or the

nien'ioned hereafter.

^2

250

THE SUSHRUTA SAMHITA.

[Chap,

t
of

be probed by gently introducing the tender

fibres

bamboo

sprouts (Karira), a (lock of) hair, a finger, or an


its

indicator into

inside.
in

The

course of a sinus occurring


of

about the anus or

the

region

the

eyes (Netrafibres

Vartma)
their

should

be probed
or

with

the slender

of Chuchchu,

Upodika,

Karira, in the

event of

mouths being narrow and attended with bleeding.


(incarcerated pus,
etc.)
is

The Salya

should be

extricated,

whether the

mouth

of the sinus

constricted or

other-

wise, in conformityw ith the directions laid

down

before

on that

behalf.

In diseases amenable to acts of puncturinto

ing (Vyadhana), the knife should be inserted


seat of the disease to a proper

the

depth and extent, to be


in

determined

by

its

situation

the
as

body, and the


stated
before.

Doshas

(pus, etc.)

should be

let out,

Ulcers with a wide mouth, unattended with any symptoms


of suppuration, and

occurring in a fleshy part of the


up,

body, should

be sutured

and the adhesion (San-

dhana) of the edges should likewise be effected, as directed before.

plaster

composed of drugs (capable of


ulcer
full

drawing out and secreting the pus), as described before,


should be applied around the mouth of an
in
in

seated
of pus

any
its

of the
inside,

Marmas
with

(vulnerable parts), or

a narrow-mouthed

aperture.

The

plaster should be

removed when dry, and should not


it

be applied on the orifice of the ulcer, as


case,

would, in that

interfere

with the

spontaneous secretion of pus

(Dosha).

49-54-

An

excessive haemorrhage incidental to such acts, as


etc.,

excessive hurting of the vein,


suitable styptic* measures

should be arrested with

and remedies (Sonitasthdpana).

Styptic measures are of four

kinds Sandhana,Skandana, Pachana,

and Dahana.

See Sutra- Sthanam, Chap. XIV.

Chap.

I.J

CHIKITSA STHANAM.

25

An
Pitta

ulcer attended with fever, suppuration

and burning
deranged
(Nir-

sensation

due

to

the

excited

state

of

the

and congestion

of blood

should be allayed

vapana

literally

putting out) with suitable and proper


It

medicinal

remedies.

should be allayed

with com-

pounds made up of the proper cooling drugs (of the Mis'raka chapter), pasted with milk and lubricated with
clarified butter.

Cooling plasters (Lepa) should then be


55-56.
flesh
is

applied as well.

An
and
is

ulcer

whose

is

eaten away, which discharges


in
its

a thin secretion, or

non-suppurating

character,

marked by roughness, hardness, shivering and


of an aching

the presence

and piercing pain, should

be fomented with a poultice-like efficacious preparation


(UtkairikaL )cooked

with the drugs of Vayu-subduing

properties, those included within the

Amla-varga, and
mustard,
moist and

those which belong to the


the
oily

Kdkolyddi group, and with


linseed,

seeds (such

as

sesamum,
faetid,

castor,

etc.).

An

indurated, painful,

slimy ulcer should

be

washed with a disinfectant or


of the drugs
57-58.

purifying lotion consisting of a decoction

mentioned before
Plugs or

for the purpose.

lints plastered

with a paste of the purifying

drugs (enumerated before) should


ulcer with
in
it,

be inserted into an

or into one with a


in

any foreign matter (e.g., pus) lying embedded deep but narrow opening, or into
a fleshy part of the body.

one situated

An

ulcer

full

of putrid flesh

and marked by the action of the highly

deranged Doshas (Vayu and Kapha) should be purified


with a paste of the aforesaid available drugs making up
the
plug.

An

ulcer of a Pittaja origin,

which

is

deep-

seated

and attended with a burning sensation and with


application of

suppuration, should be purified with the

^ medicated clarified butter, prepared with the purifying

252

THE SUSHRUTA SAMHITA.


with

tChap.

I.

drugs

an

admixture of
dry

Kdrpasa-phala*.

An

intelligent
flesh,

Surgeon should purify an ulcer with raised


is

and which

and

is

attended with scanty

secretion with an application of medicated

mustard

oil.

An

indurated ulcer, refusing to be purified with the foreoils,

going medicated
prepared

should be purified with a duly


the drugs

decoction

of

enumerated

before
in

(Sutra, chap.

38, the Salas^rddi group) and prepared

the

following

manner
of

of Rasa-kriyat.

decoction of

the said drugs duly prepared

should be saturated with

an

after- throw

Haritdla,

Manahs'ild, Kdsisa and


;

Smirdshtra earth, and well compounded together


preparation
juice of

the

should also be mixed with the expressed Mdtulunga and with honey. The medicine thus
applied to the ulcer on every third

prepared should be
or fourth day.
59.

Deepf and

foul-smelling ulcers

covered with layers

of deranged fat (phlegmonous

ulcer)

should be purified

by the learned physician with the powders of the drugs with which the purifying plug or the lint has been
enjoined to be plastered

(Ajagandha,

&c.).

Decoctions

of the drugs which are possessed of the virtue of setting


in a process of granulation

(Ropana)
before,

in

an

ulcer,

sucn

as

Vata,

&c.,

as

stated
it

should

be used by a

surgeon (Vaidya) after

had been found to have been

thoroughly purified.

Medicated plugs,
as,

composed

of

drugs possessing healing properties (such

So7na,Amritd,

As'vagandhd^

etc})

should be inserted in deep-seated ulcers,


60-62.
of

when
*

cleansed and unattended with pain.


total weight of the purifying

The

drugs should be equal

to

that

the Karpasa-phala alone and they should be boiled together with four times
their qnantity of clarified butter

and with sixteen times of water.

There

is

a difTerent reading of

"Agambhira"

in place of

"Gabhira,"

but Gayi thinks the emendation undesirable.

Chap.

I.]

CHIKITSA STHANAM.

2^3
of

A
applied
in

Kalka
for

or

levigated

paste

sesamum and

honey (mentioned
the

in the

Misraka Chapter) should be


putrid
flesh

purpose of healing up an ulcer situated


all

a muscular part from which

has

been removed or sloughed off and which exhibited a clear


cavity.

This paste (of sesamum) tends to allay the


its

deranged Vayu through


ness
Pitta through

sweet
;

taste,

oleaginous-

and heat-making potency


its

subdues the deranged

astringent, sweet

and

bitter

taste

and

proves

beneficial
its

even

in

the

case

of the

deranged
bitter

Kapha through
and astringent
paste of

heat-producing potency and

taste.

An

application

of the levigated
of purifying and

sesamum mixed with the drugs

healing properties tends to purify and

heal

up an

ulcer.

An

application of the levigated paste of

sesamum mixed

with honey and Nimda-\es.ves leads to the purification


of sores
(?>
,

whereas an application of the same paste sesamum, honey and leaves of Nimbd), mixed with
;

clarified

butter

tends

to

heal

up the
to

ulcer.

Several

authorities atribute the

same

virtue

a barley-paste.*

barley

Levigated pastes of barley and of sesamum (or a paste of mixed with sesamum) contribute to the resolution
or subsidence of a non-suppurated swelling, fully suppurate

one which

is

partially suppurated,

lead to the spon-

taneous bursting of a fully suppurated


as well as heal

An

one, and purify up one that has already burst out. 63-65. ulcer,whicb is due to the effects of poison, vitiated
is

blood, or aggravated Pitta, and which


of traumatic origin, should be healed
clarified butter

deep-seated oris

up with a medicated

prepared with the drugs of healing virtues

(Ropaniya enumerated before) and milk. An ulcer marked by an aggravated condition of the deranged
Jejjada and Gayadasa interpret the term mixed with sesamum."
to

mean

'*barley-paste

254

THE SUSHRUTA SAMHITA.

[Chap.

I.

Vayu and Kapha


tion

should be healed up with the applicaboiled

of an

oil,

and prepared with the proper


66 6y.

purifying drugs mentioned before.

Rasa-kriyat* with the two kinds of Haridrd should

be resorted to for the purpose of healing up an

ulcer, in

which bandaging
of poison),
joints,

is

forbidden (such as those due to the


&c.,

deranged Pitta or blood, or to blow,

or to the effects

and an

ulcer

appearing on the moveable


all

which,

though exhibiting

the

features

of

a well-cleansed sore, has not been marked by any process


of healthy

granulationf.

Healing medicinal powders


of an
ulcer

should be used in the case


fined to the skin,

which
shape

is

con-

and

is

firm-fleshed
its

and marked by
{i.e.^

the absence

of

any

irregularity in

not

uneven

in its

margin).

The mode
68-69.

of applying medicinal

powders, as stated in the Sutra-sthana, should be adopted


in the present instance.

The
in

healing and purifying measures described above


to,

should be deemed equally applicable


cases of
ulcers
in

and

efficacious

general

with regard to their

Doshas (both idiopathic and traumatic).


of these measures has been witnessed
cases
in

The

success

thousands of

works on medicine).
efficacy.

and has been recorded in the Sastras (authorised Hence they should be used as incantations without any doubt as to their tested and
infallible

An

intelligent

physician
in

should

employ

the

drugs,

mentioned before,

any of the

seven forms (either in the


*

shape of a decoction, or a

The

decoction of IriphalA and the drugs of the Nyagrodhadi group


filtered

should be duly prepared,


tteacle.

and then condensed

to the consistency of

Powders of Haridrd and


In
the

Daru-haridra should be then thrown


well-stirred,

into

it.

end,

the

whole preparation should be


This
is

mixed with honey and applied.


t

what

is

called

Rasa-kriya.

Several editions read "though cleansed yet ungranulating ulcere."

Chap, t]

CHlklTSA STHANAM.

2^5
of

plug, or a paste, or through the

medium

medicated

oils

and

clarified butter, or in the

shape of Rasa-kriya, or as

powders), according to the requirements of each case. 70.

The drugs which

constitute the

two groups ofPanchain the case of

mulas (major and minor), as well as those of the Vayusubduing group, should be employed
an ulcer
forms

due to the aggravated Vatyu

in

any

of the

seven

decoction,
be used
ulcer
in

etc.

Similarly the drugs which are included

within the groups of Nyagrodhadi or Kakolyadi

should

any of those seven forms,

in the case of

an

and healing

due to the aggravated Pitta (for the purification Drugs which form the group of thereof).
as

Aragvadhadi, as well

those which

have been desbe used


of
of two

cribed as heat-making in their potency, should


in

any of those seven aforesaid forms,


of those groups,
of those

in the case

an ulcer due to the deranged Kapha.


or three
in

The drugs

should
in

be combinedly used
connection with an
of

any

seven

forms,

ulcer

marked by the aggravated condition


:

any two
pain

or three of the deranged Doshas respectively. 71-74.

Fumig'ation

Vataja ulcers with

severe

and secretion should be fumigated with the fumes of


Ks/iauma, barley, clarified butter and other proper fumigating substances
Sdlatree)].
75.

[such as turpentine and resin

(gum of

Utsadana-Kriya
plasters (consisting of

(Elevation)

: Medicated
etc.)

Apdmdrga, As'va^andhd,
butter

medicated

clarified

(prepared with

the

and same

drugs should be used in ulcers (due to the aggravated Vayu

and marked by the absence of any secretion, and affecting a considerably smaller area or depth of flesh, as well
as in those (due to the

deranged and aggravated Pitta


flesh,

and) seated deep into the

for the

purpose of raising

up

(filling

up) the beds or cavities thereof.

Meat

of carni-

256

THE SUSHRUTA SAMHITA.

tChap.

t.

vorous animals should be taken in the proper manner by


the
patient,

inasmuch as meat properly partaken of

in

a calm and joyful frame of mind adds to the bodily


of
its

flesh

partaker.

J6.
(destruction

Ava.Sada.na
Proper drugs or
etc.)

of

super-growths)

articles

(such

as sulphate

of copper,

powdered and pasted with honey should be applied


soft

for destroying the

marginal growths of an

ulcer

found to be more elevated than the surrounding surface


of the affected locality.
IVI

77.

rid U- Karma
flesh

(softening)

: In

respect

of

indurated and fleshless (not seated in a part of the

body
the

where

abounds) ulcers

marked by a deranged
measures
(with
of lotions

condition

of

Vayu,

softening

help of repeated

applications

and

plasters

composed of sweet and demulcent substances mixed


with
salt

in

a tepid

or

luke-warm
to.

state)

and blood-

letting* should be resorted

Sprinkling (Seka) and


oil

application of clarified butter or

prepared with the


to.

Vayu-subduing drugs should also be resorted

yZ.

D^runa-karma: The
ning measures (Daruna-karma)
nection with soft ulcers
ner.

employment of hardeis

efficacious

in con-

and

in

the

following

man-

Barks

of

Dhava,
flowers,

Priyangu,

As' oka,

Rohini^

Triphala,

Dhdtaki

Lodhra and Sarjarasa^ taken


fine

in equal parts

and pounded into


i.e.,

powders, should be
should be dusted

strewn over the ulcer,

the

ulcer

with the same.

79.

Kshara- Karma
The measure
*

(Potential

cauterization)

of applying alkali should be adopted for the


to in

Blood-letting should be resorted

the

event of
;

any vitiated

blood being found to have been involved in

the case

but in the event of


lotions

a similar participation of any deranged Kapha, oils and


of the Va'yu-destroying drugs should be

composed

made

use

of.

Chap.

I.]

CHIKITSA STHANAM.

257

purification of the sore of a long-standing ulcer

which

is

of an indurated character

with

its
is

margin raised higher

(than the surrounding skin), and

marked by

itching

and a stubborn resistance to

all

purifying medicines. 80.

Agni-Karma

(actual cauterization)

: An

ulcer

incidental to an act of lithotomic operation allowing the

urine to dribble out through

its fissure,

or one

marked

by excessive bleeding, or in which the


ised

connecting ends

have been completely severed, should be actually cauterwith


fire.

81
:

Krishna- Karma -The


white cicatrix, which
granulation, should be
is

blackening

of a

the result of a bad


(after the

or defective

made
first

complete healing
Several Bhalld'

up of the ulcer) in the following manner.


taka (and
seeds

should be
dried
in

soaked
sun,

in the urine of a

cow
be

then

the

this

process should

repeated for seven days consecutively), after which they

should be
milk.

kept

(a

week) immersed

in a pitcher full of

After that the seeds should be cut into two

and

placed in

an iron pitcher.
with
a

buried in the ground

Another pitcher should be thin and perforated lid


with

placed over

its

mouth, and the pitcher containing the


it

seeds should be placed upon


(so that the

its

mouth downward
(with
lit

mouths of the two pitchers might meet), and


be
firmly joined
fire

then the meeting place should


clay).

This being done a cow-dung

should be

around the upper pitcher.


the heat) and dribbling
into the

The oily matter (melted by down from the Bhallataka seeds


(such
as

underground pitcher should be slowly and care-

fully collected.

The

hoofs of village animals


live

swamps (Anupas horses, etc.) such as buffaloes, etc.) should be burnt and pounded The oil (of the together into extremely fine powder.
and those which
in

Bhalldtaka seeds collected

as

above) should then

be

258

THE SUSHRUTA SAMHITA.


with
this

[Chap.

I.

mixed
cicatrix.

powder, and
oily

applied
of

to

the white
piths

Similarly, the

essence

the

of

some kinds
oil

of wood, as well as of

{Phala-snehd) prepared in the

some kinds of fruit manner of the Bhalldtaka


82-83.

(and mixed with the powdered ashes of hoofs) should

be used for the blackening of a cicatrix.

PandU-karana : The

natural

and healthy
colour

colour (Pdndu) of the surrounding skin should be imparted to a cicatrix which has assumed

a black

owing to the defective or faulty healing up of the sore in the following manner. The fruit of the Rohini* should be

immersed
finely

in goat's

milk

for seven nights and, afterwards

pasted

with the same milk, should be applied

to

the skin.
a

This measure
yellow
or

is

called

Fandu-karana
to

(imparting
cicatrix).

natural

skin-colour

the

To

attain the

same

result, the

powder of a
Sulphate of

new earthen
iron,

pot, Vetasa roots, S'dla roots.

and Madhuka (Yashti-madhu) pasted together with honey may be used. As an alternative, the hollow rind
of the Kapittha fruit, from which
the

pulp has been

removed, should be

filled

with the urine of a goat to-

gether with Kasisa (Sulphate of iron), Rockand, Tuttham


Haritdla^ Manahsild, scrapings Prapunndda (seeds of Chakunde), of and Rasanjana and buried a month beneath the roots of an Arjuna tree after which it should be taken out

(Sulphate of copper).

raw bamboo

skin,

and applied

to the black cicatrix.

egg, Kataka^

The shell of a hen's Madhuka, (Yashti-madhu), sea-oysters and


according to Jejjata and Brahmadeva)
should bs pounded and pasted with

crystalsf (pearls

taken

in equal parts

Rohini, according to som^ co nmentators, means a kind of Haritaki


according to others,
it

means Ka*u-tumbi.
and pearls
etc.,

I Burnt ashes of

sea-oysters,

should be used.

Chap.

I.]

CHIKITSA STHANAM.

2^9

the urine of a

cow and made

into boluses

which should

be rubbed over the cicatrix *

84-87.

Roma-Sanjanana hair-producers
burnt
ashes
of

The
(black

ivory

and

pure Rasdnjana

antimony; pounded (and pasted with goat's milk) should


be applied
{Lomotpatti)
to
is

the

spot where

the appearance of hair


plaster

desired.

An

application of this

would lead to the appearance of hair even on the palms Another alternative is a pulverised of the hands.

compound
nails,

consisting
skin,

of the

burnt ashes of the bones,


horns of any quadruped,

hair,

hoofs and

over a part of the

body, previously

anointed (rubbed)
in

with

oil,

which would lead to the appearance of hair

that region.
of iron,

And

lastly,

a plaster composed of Sulphate

and tender Karanja leaves pasted with the


of

expressed juice
the

Kapittha,

would be attended with


an
the
ulcersatis-

same

result.

88 90.

Hair-dcpilators
ated part of the
factory

'.The hair of
to interfere with

body found

healing up of the ulcer, should be shaved with

a razor or clipped with scissors, or rooted out


help of forceps.

with the

As an

alternative,

an application of a

plaster consisting of
of) conch-shell

two parts of pulverised (burnt ashes


arsenic)

and one part oi Haritdla (yellow orpiment


pasted
spot,

or yellow

oxide of
the

acid gruel) over

desired

with Sukta (an would be attended


of the
oil

with the same result

A compound made

of

Bhallattaka mixed with the milky exudation


should be used by an intelligent physician as
tory measure.

of Snuhi,

a depila-

As an

alternative, the burnt ashes of the

stems of

plantain leaves and


rock-salt,

Dirghavrinta (Syondka)

mixed with
*

Haritdla and the seeds of Sami,

This also

is

remedy

for

giving a natural colour to the skin.

26o

THE SUSHRtJTA SAMHITA.

[Chap.

I.

pasted with cold water, should be


depilatory.*
tail of a

plaster

deemed a good haircomposed of the ashes of the


Haritala
(oxide of

domestic lizard, plantain,

arsenic),

and the seeds of Ingudi burnt together: and


oil

pasted with

and water, and baked

in the

sun

may

also be used for the eradicating of hair


locality.

in

the

affected

94-95.

Vast! -Karma : A

medicated Vasti (enema)


ulcer

should be applied to the rectum in the case of an

marked by an aggravated condition of the deranged Vayu which is extremely dry and is attended with an
excruciating pain occurring specially in the lower region
of the body.

measure of Uttara-vasti

(Vaginal or

Urethral syringe) should


strictures

be adopted in the cases of


urine,
ot
is

and other disorders connected with


menstruation,
as

semen
gravel

and

well

as

in

cases
ulcer

in case these are

due to an

ulcer.

An

purified, softened

no room
bandaging

for
is

and healed up by bandaging leaving the apprehension of a relapse. Hence


96-98.

recommended.

Patradana (application
into consideration the particular

of leaves on an ulcer)

Leaves possessed of proper medicinal virtues taking

Dosha and season

of the

year should be tied (over the medicinal plaster applied)


over an ulcer of non-shifting or non-changing character

and not affecting a large depth of


refuses to be healed

flesh

and which

up owing to

its

extreme dryness.

An
the

ulcer of the deranged

Vayu

should be tied over with

leaves
as

of

the
as

Eranda, Bhurfa, Putika, or Haridrd


with those of
the

plants

well

Upodikd and

Gdmbhdri. An
*

ulcer

marked by an aggravated condition


may be used
internally for the purpose.

According

lo

seme
read

this

D. R.

Some

"Tathaiiiile"

in place of

As'mari-vrane."

."Taiharjile"

means and

in cases of (aggravated)

Vayu.

Chap.

I.]

CHIKITSA STHANAM.

26l
condi-

of the deranged Pitta, or incidental to a vitiated


tion of the blood, should be tied in the aforesaid

manner

with the leaves of the Kds'mari, the Kshira trees (milk-

exuding
with the

trees),

and aquatic
of

plants.

An

ulcer due to the


tied over

deranged and aggravated Kapha, should be


leaves

the Pdthd,

mdchi, Haridrd or of

Murvd, Guduchi, Kdkathe S'ukandsd, Only those leaves


soft

which are not rough, nor putrid, nor old and decomposed,
nor worm-eaten and which are

and tender should.be

used for purposes of Patradana.*


a procedure (Patra-vandha)
intelligent
is

The

rationale of such

that the leaves tied

by an

physician

in

the

manner above
retain

indicated

serve to generate heat or cold and

the

liniment

or medicated oil in their seat of application.

99-102.

Vermifugal : The
to
flies

germination of

worms due
worms
of

in

an

ulcer

is

attended with various kinds of


in case the

extreme pain, swelling and bleeding


eat

up the

flesh.

decoction of

the

drugs

the

Suras ddi gana proves efficacious as a wash and healing


medicine
in

such a

case.

The

ulcer should be plastered

with such drugs as the bark of

Saptaparna, Karanja,

Afka, Nimba, and Rdjddana pasted with the urine of a


cow, or washed with an alkaline wash
(for

expelling the

vermin from
on the

it).

As an

alternative, the

worms should be
be divided into

brought out of the ulcer by placing a small piece of raw


flesh

ulcer.

These vermin

may

twenty groups or
later on.

classes,

which

will be fully dealt

with

(Uttara-Tantramkinds

ch. 54).

103.

Vrinhanam
tonics)
:

(use of restorative

and constructive
and constructive
of a
patient

All
leaf

of tone-giving
in

measures should be adopted


The
ulcer

the

case

which does not poison the Sneha and the esserxe of the
(and applied
over an

medicinal drugs placed in a folded piece of linen


is

the proper leaf and) should be used for tying over the paste.

262

THE SUSHRUtA SAMHITA.

[Chap.

t.

weak and emaciated with the


sore, taking
full

troubles of a long-standing

precaution

not to tax

his

digestive

powers. Anti-toxic (Vishaghna) medicines and measures

and symptoms of poisonings


their respective heads in the

will

be described

under

Kalpa-Sthanam.
should
be

104-105.

^iro-vircchana and Nasya


chana measures
skilful

:-S'iro-vireto
in

(errhines)
in

resorted
situated

by
the

physicians

respect

of ulcers

clavicle regions

and marked

by itching and swelling.

The use of medicated (fatty) snufF (Nasya) is recommended in cases where the ulcers would be found to be seated in the regions above the clavicles and marked by
an aggravated condition of
the deranged Vayu, pain,
106-107.

and absence of the


sisting

oily matter.

Kavala-dharana : Medicated
of decoctions
virtues either

gargles (^con-

of drugs) of purifying or healing cold *


in

hot

or

(according
case of an

to ulcer

requirein

ments) should be used

the

the

mouth,

for the

purpose of alleviating the Doshas therein,

for allaying the local pain

and burning, and

for

removing

the impurities of the teeth and the tongue. 108.

Dhuma-pana
of the deranged

inhaling of smoke or vapours

(of medicated drugs) should be prescribed in cases of ulcers

Vayu and Kapha attended with swelling,


above the and clarified butter, sehoney

secretion and pain and situated in the region


clavicles.

Application of

mixed together should be prescribed in cases of extended or elongated ulcers which are traumatic or
parately or
incidental in their character (Sadyo-Vrana) for

allaying
its

the heat of the ulcer and


sion
*
.

for

bringing about

adhe-

Surgical instruments should be used in connec-

Hot gargles are recommended in cases of ulcers of the deranged Vayu and Kapha while cold ones in cases of ulcers of the aggravated Pitta
and blood.

Chap.

I.]

CHIKITSA STHANAM.
which
is

263
but provided

tion with an ulcer

deep-seated
is

with a narrow orifice and which


tration of a Salya (shaft)

due to the penere-

and which could not be

moved with the hand alone. 109-111. The diet of an ulcer-patient should in all cases be made to consist of food which is light in quantity
as well a? in quality, demulcent,

heat-making

(in

potency)

and possessed of appetising properties* Protective rites should be performed for the safety of an ulcer-patient
from the influences of malignant
the major
stars and spirits with and the minor duties (Yama and Niyama)

enjoined to be practised on his behalf.

112-113.
seats
in

The causes body number


terise

of ulcers

are sixf
;

their

the

eight| in all
five $.

the features which charac-

them
in

are

The medicinal measures and


ulcers

remedies

respect of

are

sixty

Ij

in

number.

And
tion

these ulcers are curable with the help or co-operaof

the

four

necessary factors (the physician, the


114.

medicines, the nurse and the patient).

The comparatively smaller number


I

of drugs
of

which

have

mentioned
etc.,

(under
the

the

heads

Ropana,

Sodhana,
prolixity,

in

present
in

chapter)

from fear of

may

be increased

combination with other

drugs or substances of similar virtue, (digestionary transformation


*

and potency,

etc.)

without any apprehension

See Chap.

XIX. Sutra-Sthanam.
an ulcer are Vayu,
Pitta,

The
The The

six causes of

Kapha, Sannipdta,
Snayu, Sandhi,

S'onita aud Agantu.

eight seats of an ulcer are

Tvak, Mansa,

S'ira,

Asthi, Koshlha and

five

Marma.
of

symptoms

an

ulcer

are due
to

to

Vata,

Pitta,

Kapha,

Sannipata and Agantu.

The symptoms due

S'onita

being identical

with those due to Pitta, are not separately counted.


II

The

sixty

medicinal measures and

remedies are those describee^

before in the present chapter.


THE SUSHRUTA SAMHITA.
doing any mischief
or

264
of

[Chap.

I.

thereby.

Recipes
or

consisting
ingredients,

of rare

a large

number
as

of drugs
of

should be
available

made up with
in

many
all

them

as

would be

the

absence of

of them, as mentioned

in the present

work.

A
if

drug belonging to any partiseparately described as nondisease,

cular

Gana

or

group

efficacious to

any

specific

should

be

omitted
be added
beneficial

whereas a drug not belonging to a group


to
it if it is

may

elsewhere laid

down

as

positively

thereto.

11 5-1 17.
:

Upadrava The distressing


toms which are found
different

supervening symp-

to attend a case of ulcer, are quite

from those of an ulcer-patient.


the
ulcer

Those which
all

confine themselves solely to


smell, colour, etc.,
fest in the

are five in

and those which are exclusively manihiccup, vomit-

patient are fever, diarrhoea,


fits,

ing,

fainting

aversion to

food,

cough,

difficult

breathing,

indigestion

and

thirst.

The medical

treat-

ment of
chapter,

ulcers
will

though described
118-120.

in detail in the

present

be further dealt with in the next chapter

on Sadyo-Vrana.
Thus ends the
first

Chapter of the Chikitsita-Sthanam

in

the
ulcer.

Sus'ruta

Samhita which deals with the treatment of the two kinds of

CHAPTEK
Now we
shall discourse

II.

on the medical treatment of


or sores

recent or traumatic

wounds

(SadyOVranaDhanvantari, the
all discoursers,

Chikitsa).

i,

Metrical Texts; -The


thus

holy

foremost of the pious and the greatest of


discoursed
2.

to

his

disciple

Susruta,

the

son

of

Visvdmitra.

Different Shapes Of Sores : I


scribe the shapes of the various

shall

de-

or wounds) caused
in

kinds of Vrana (sores by weapons of variously shaped edges

the

different

parts of the

ulcers

have a variety of
others
are

human body. Traumatic shapes. Some of these are


or
triangular,

elongated,
circular,

rectangular,

or

while some are crescent shaped, or extended, or


in the

have a zigzag shape, and some are hollow


like a saucer,

middle
of

and

lastly

some have she shapes


the
middle).

barley corn
or a

(bulged out at

An

abscess

swelling,

due to the several Doshas and which

spontaneouly bursts out,

may assume any

of the aforesaid

forms, while the one effected

by a surgeon's knife should

never have a distorted or an improper shape.

surgeon
is

thoroughly familiar with the shapes


puzzled
shape.
at
3

of ulcers

never

the
5.

sight of one of a terrible

and distorted

Physicians of

yore

have grouped these variously

shaped traumatic ulcers under six broad sub-heads, such


as

the

Chhinna
(pierced),

(cut),

Bhinna (punctured or
or
lacerated)
I

perforated),

Viddha
their

Kshata
features

(contused), Pichchita (crushed),

and the Ghrishta (mangled

according to
their

common
6.

and

shall

describe

symptoms.

34

266

THK SUSHRUTA

SAMIIITA.

[Chap.

II.

Their definitions: A
is

traumatic ulcer which


is

oblique or straight and elongated

called a

Chhinna

l^cut) ulcer,

while

complete severance of a part or

member

of the

A
the
or

perforation

body is also designated by that name, of any of the cavities or receptacles of

body by the tip of a Kunta, spear, Rishti, or a sword by a horn, attended with a little discharge, constitutes what is called a Bhinna (punctured) wound or ulcer.

The Amas'aya (stomachy the Pakv^saya (intestines), the Agnyasaya (gall-bladder ?\ the Mutras'aya (urinary
bladder), the

Raktasaya (receptacle of blood), the


the lungs constitute

heart,

the

Unduka and
(viscu>).

what
filled

is

called the

Koshtha
which
is

perforation (of the wall of any)


it

of the As'ayas

causes

to

become

with blood

discharged

through the urethra, the anus, the


is

mouth

or the nostrils and


fits,

attended with fever,

thirst,

fainting

dyspnoea, burning sensations, tympanites,

suppression of stool, urine


aversion for food,

and

flatus

(Vata) with an
a

perspiration,

redness of the eyes,


feted

bloody smell

in

the

mouth, and

one

in the

body

and an aching pain

in the heart

and

in the sides.

10.

Now

hear

me

discourse on (their) detailed symptoms.

perforation of the wall of the Ama'saya

(stomach)

is

marked

by

constant

vomiting

of

blood,

excessive

tympanites and an excruciating pain.


the Pakva's'aya
fills it

A
is

perforation of

with blood and


in

attended with

extreme pain, a heaviness

the limbs, coldness of the

sub-umbilical region, and bleeding through the (lower)

ducts and orifices of the body.

Even

in the

absence of
with

any

perforation,

the

Antras

(intestines) are filled

blood through the small pores or apertures in their walls


in the

same manner

as a pitcher

with

its

mouth

firmly

covered

may

be

filled
is

through the pores

(in its sides),


r

and

a sense of heaviness

also perceived in their inside,

i-i 3.

Chap. 110

CHIltlTSA
or
in

STHANAM.

'267

A
Salya

wound
(shaft)

an ulcer caused by any sharp pointed any part of the body other than the
(pierced one).

aforesaid As'ayas with or without that Salya being extri-

cated
is

is

called a

Viddha

An

ulcer

which

neither a cut nor a perforation or puncture but partakes

of the nature of both

and

is

uneven

is

called a

Kshata

(wound).

part

of the

body

with the local bone

crushed between the folds of a door or

by a blow becomes extended and covered with blood and marrow and
is

called a

Pichchita (thrashed) wound or

ulcer.

The

skin of any part of the


friction or

body
is

suffering abrasion through


like causes

from any other such

and attended

with heat and a secretion


or lacerated)

called a
14-17.
:

Ghrisbta (mangled

wound

or ulcer.

Their Treatment A
body any wise
is

part or

cut, perforated, pierced or

member of the wounded which


the
local

attended with excessive bleeding and with

Vayu enraged
of

or aggravated by the incidental bleeding,

or haemorrhage will occasion excruciating pain.

Potions
as

Sneha

(oily or fatty liquids)

and using the same

washing
cases.

(in

a lukewarm state) should be advised in such


of

Preparation

Ves'avaras

and other Krisaras

mixed with oil or clarified butter should be used as poultices and fomentations with the Masha pulse, ungents and emulsive Yastis etc., and the use of oily
largely

(enematas)* prepared with decoctions of Vayu-subduing


drugs should be applied.
or

crushed or thrashed

wound

abrasion

is

not attended wi:h any excessive bleeding


'^on

an absolute absence whereof,


to

the contrary) gives rise

an excessive burning sensation and suppuration in Cold washes and cooling plasters the affected part.
be
used in these cases for the alleviation of the
is

should
*

Snehapana

recommended when

the ulcer
is in

is

in a region

above the

umbilicus and Vasti-karma

when

the ulcer

a subumbilical region.

268

THE SUSHRUTA SAMHITA.

[Chap.

IT,

burning and suppuration as well as for the cooling of


the (incarcerated) heat.
said
of these

What

has

been specifically

six forms of ulcers, or

wounds should be
all

understood to include the treatment of

kinds of trau-

matic wounds or ulcers as well.

i8

20.

Treatment of cuts or incised wounds &C Now we shall discourse on the medical treatment
:

of of

Chhinna

cuts.

An

open mouthed ulcer on the side

the head* should be duly sutured as described before

and firmly bandaged.


should
oil

An
its

ear severed

or

lopped
position

off

be sutured

in

the proper

way and

and

should be poured into

cavity.

Chhinna cut on
if

the Krikatika (lying on the posterior side of the junction


of the neck

and the head) and


to

even
its

it

allow

the

V^yu t
manner
between\
with

(air)

escape through

cavity

should be

brought together
(so

and
to

duly sutured and bandaged in a


leave

as

not

any

intervening

space

The

part thus adhesioned should be sprinkled


butter

clarified

prepared from goat's milk.


to take
his

The
his

patient should be

made
his

food

lying

on

back, properly secured or fastened with straps (so that he

might not move


that position).

head and advised to perform


as,

all

other physical acts such


21-24

urination, defecation etc

in

In the case of a lateral


(sword-cut,
etc.)

and wide-mouthed wound


extremeties, the
bone-joints
as instructed

on
set

the

should

be duly

and joined together


be sutured a

before and the

bandaged
* Several

in

the

wound should manner of

and speedily

Vellitaka bandage, or

commentators explain those that are situated either on the


sides.

head or on the
t
nels

The dictum
is

that a hurl
to

on any of the wind-carrying sounding chanto

pronounced

be incurable, should not be supposed

hold good

in the present case.

Chap.

II.]

CHIKITSA STHANAM.
or hide
in

269
or

with a piece of skin

the

Gophana
of a

such
oil

other form as would seem proper and beneficial

and

should be poured over

it.

In the case

wound on

the back the patient should be laid on his back, while in the
case of
its

occurring on the chest the patient should


25-27.

be laid on his face*


In the case of a

hand or a

leg being carried

away

or

completely severed the


the
of a

wound
oil

should be cauterised with


in the

application of hot

and bandaged

manner

Kosha bandage and proper

healing

medicines

should be applied.

An

oil

cooked with the eight drugs

Chandana, Padmaka, Rodhra, Utpala, Priyan^u, Haridrd,

Madhuka^ (Yasthimadhu) and milk, forms one of the A Kalka of most efficacious healing (Ropana) agents
the
thirteen

drugs

Chandana,
Amritd,

Karkatdkhya, the two


Hatenu,

kinds of Sahd (Mugani and

Mashani), Mdnsi, (D.R.

Mashahva,
Triphald^
oil

Somahva),

Mrindla
in

Padmaka and Utpala should


with milk (four times that of
(lard,
oil

be cooked

mixed

oil)

and the three


clarified

other kinds of oily matter


butter)

marrow and
should
be

and

this

medicated

used

for

sprinkling

over a

wound
28.

of this type for the purpose of

healing (Ropana).

IVIedical Henceforth we
of

Treatment
shall

of

Bhinna :
treatment

deal

with the

medical

Bhinna

(excised) wounds.

A
up

case of an excised eye


as

(Bhinna) should
the case

be given
(ball)

incurable.

But

in

where an eye

instead of being completely


to

separated would be
*

found

be dangling out
i.e,^

(of its

For the complete elimination of the deranged Dosha

pus,

eic

of the

wound

invloved in the case

Jejjata.
on
his

He who
he

has got a wound on his back should be laid


ulcer

face

and

who

has got an

on

his

breast

should

be laid on his back

Dififereut

Reading Gayi.

2^0

THE SUSHRUTA SAMHITA.


be
as

[Chap.

It.

socket) the affected organ should


natural cavity in a

re-instated

in

its

manner so

not to disturb the

connected Siras (nerve arrangements) and gently pressed

with the palms of the hand by

first

putting a lotus leaf


filled

on

its

(eye) surface.

After that the eye should be

(^Tarpana)

with the
i.e.,

following (D.R, - Ajena in place of

'Anena'
clarified

prepared

from goat's milk) medicated


in the

butter,

which should be as well used

form of an errhine.
butter

The

recipe

is

as follows

Clarified
Utpala,

prepared from

goat's

milk,
in

Madhuka,
equal
parts

fivaka

and

Rishavaka taken

should

be pasted together,
cow's
use

and cooked with sixteen seers of


clarified

milk and four seers of


the

butter.*

The

of

medicated

Ghrita thus prepared should be


in all

regarded as commendable
injury.
29.

types of occular hurt or

In the case of a perforation of the

abdomen marked
Varti
(fat)

by the discharge of lumps or


through the wound, the

rope-like

emitted

or

ejected

fat-lump

should be dusted with the burnt ashes (D. R. -powders)


of astringent

woods (such

as

Manu, Arjuna,

etc.)

and

black clay (pounded

together).

ligature

of thread

should then be bouid round the

fat-lump and

the

fat-

lump
be

cut off with a heated

instrument.

Honey

should

then be applied and

the

duly bandaged.

wound (Vrana) should then The patient should be caused


the
this
full

to drink clarified butter after


injested

digestion

of his

food.

Instead

of

Ghrita, milk prepared

Several authorities,

however,

say

that

equal

parts

of

clarified

butter prepared from goat's milk and from cow's milk should be taken and

cooked with l6 seers of cow's milk and with the

four drugs as a

Kalka.
from

Bui Gayi recommends only four seers of clarified butler prepared


goat's milk

cooked with 16 seers of cow's

milk

and the four drugs as

a Kalka.

Chap.

II.]

CHIKITSA STHANAM
and

27
Gokshura^
oil

medicinally with Yashtimadchi, Ldkshd

mixed with
(as

(a proper quantity of) sugar


is

and castor
for

Prakshepa)*

equally

commendable

the
(in

alle-

viation of the pain and the

burning sensation,
(pariental
fat)

the

wound

or

ulcer).

The fat-lump
fatal in the
oil

afore-

said causes a rumbling sound with pain in the

abdomen
being
left

and may prove even


uncut.
in

event of

its

The medicated
30-32

to

be

mentioned hereafter
should
be

connection with such cases.

Medaja-Granthi

applied

in

Foreign bodies

t^Salya)

piercing

into

any
etc

of

the
of;

Koshthas
skin,

after

having run through the (seven layers


^

whether passing through the veins,


or not, produces

(muscles,

nerves, bones or joints

the

distressing

symptoms

described before (Ch. III.

Sutra).
its

The blood
case
lies

(of the affected

chamber or

receptacle) in such

incarcerated therein in the event of


outlet

failing to find

an

and causes a paUor of the face and a coldness of the


patient.

extremities and of the face in the

Respiration

becomes
of these

cold, the eyes red-coloured, the

bowels consti-

pated and the abdomen

distended.

The manifestation
character of

symptoms

indicates the

incurable

the disease.

33-34.

This explanation

is

given

on

the

authority

of old Vagabhata.

Dallana, however, explains the verse in a different way.


to

He
the

explains

it

mean two

different preparations of
oil

milk one with Yashti-madhu and


and
other

mixed with sugar and castor

as a Prakshepa
oil as a

with

Gokshura and mixed with Laksha and castor

Prakshepa.

A
oil

third in'erprctation

would make three preparations of milk prepared

separately with Yashti-madhu,

Laksha and Gok&hura

sugar
oil

and castor

being mixed in the

first

(as

Prakshepa) and castor

alone in the

second and third.

fourth preparation

would be

to

prepare
in the

the

milk separately wiih

Yasbtimadhu, Laksha and Gokshura as


Addition of castor
oil (as

preceding case without the

Prakshepa),

272

THE SUSHRUTA SAMHITA.


Emesis
is

[C^ap.

II.

beneficial to

in

the

case

where the blood


in

would

be

found

be

confined

the

Am as ay a
be
pre-

(stomach).

Purgatives should

unhesitatingly

scribed where the blood would be found to have been

lodged

in

the

Pakvas'aya (intestines) and


oil

Asthapana
hot,

measures

without

should

be

employed with
as

purifying i^Sodhana) substances (such


etc.)

the

cow-urine,

The

patient

should
salt

be made to drink a Yavagu

(gruel) with

Saindhava

and

his diet

should

consist

of boiled rice

mixed with the soup of


oil.

barley,

Kola and

Kulalttha pulse divested of

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 fever

of outlet and by the absence

and tympanites
37-38.

and other dangerous symptoms, (Upadrava), may end


in the ultimate recovery of the patient.

In a case of a perforation of the Koshtha (abdomen)

where the

intestines

have protruded or bulged out

in

an

untorn condition, they should


into the cavity

be gently re-introduced
original
others,

and placed in their According to and not otherwise.

position,

however,

large black ants should be applied even

to the perforat-

ed intestines in such a case and their bodies


separated from their heads after they had
the perforated parts with their
claws.

should

be

firmly

bitten

After

that
to

the

intestines with the heads of the ants

them back into the cavity and reshould be gently pushed The bulged instated in their original situation therein. out intestines should be rinsed with grass, blood and with claridust, washed with milk and lubricated
attached
fied butter

and gently re-introduced into the cavity

of

Chap.

II.]

CHIKiTSA StHANAM.
the

^^^
cleanly

the

paired.

abdomen with The dried


their

hand with

its

finger nails

intestines should be
clarified

washed with milk


introducing
the
in

and lubricated with


it

butter

before

into

former

and natural place

abdo-

men.

39-41.

In a case where the intestines could be but partially

introduced,

the

three
interior

following
of the

measures
throat

should be
patient

adopted.

The

of the

should
for

be

gently rubbed

with a finger [and the urging


help
the
full

vomiting thus

engendered, would

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


air with the help

hands and

lifted

up into the
in a

of strong

attendants and shaken

manner

that

would bring
into

about a complete
the

introduction
in

of the

intestines

natural

position

the abdominal cavity.

They

should

be so introduced as to press upon their specific


(facia).

(Maladhara) Kald
In
tines

42-43.

a case where the


into

re-introduction of the

intes-

the

abdominal cavity would be found


to

to be

difficult
orifice

owing
of the

the

narrowness or largeness of the


it

wound,

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
as

forthwith

carefully sutured as

soon

the

intestines

would be

found to

have been introduced


correct

into their right place.

Intestines dislodged from their proper seat, or not intro-

duced

into

their

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

35

274
with

TtiE
clarified

SUSHRUTA SAMHITA.

[Chap.

it.

butter,

and the patient should be given a


R. tepid milk) with

draught of tepid
castor oil for

clarified butter (D.

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.
intro-

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
sewn up
in the

duced into their proper place within the scrotum, and

manner

of a Tunna-sevani (raised seam).


in

The scrotum should be bandaged


Yantra)
placed
against

the

shape

of a

Grophansb-Vandha and a restraining apparatus (Ghattaround the waist of


its

the

patient

(to

guard

it

oscillations or

hanging down).
with

The

wound should not be


oil

lubricated

any kind of

or

Ghrita

inasmuch as
prepared

moist and slimy.

it would make the wound The wound should be healed with a

medicated

oil

with Kdldmisdri, Aguru^ Eld,

Jdti flower, Chandana, Padmaka, Manahs'ild, Devaddru,

Amrita and sulphate of copper (pounded

together). 49-50.

A
the

plug of hair should be inserted into a


after

wound on
matter
of the

head,

having extracted the foreign


view to arrest the exuding

therefrom, with a

brain matter (Mastulunga) which invariably proves fatal


to the patient through the aggravation of the

deranged

Vayii

in

consequence thereof.

The
the

hairs of the plug

should be taken out one by one as


progresses (granulation).

healing process

An

oleaginous medicated plug


a

or lint should be inserted into

wound on any

other

Chap. II.]

CHIKITSA STHANAM.
body,

275

part

of the

which should be treated with the


in

measures and remedial agents laid down


with a traumatic
ulcer
after

connection
the

having

first

allowed

vitiated blood to escape.

51-52.

The medicated
should

oil

known

as

the

Chakra-taila*

be poured (frequently applied) by means of a


is

slender pipe into an ulcer (wound) which

deep-seated

but narrow-mouthed, after

first

letting

out the vitiated

bloodf.

An

oil

duly prepared and boiled with Samangd,


Tuttha,

Haridtd, Padmdy TriiargaX

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
in cases of

good healing remedy


treated with

traumatic ulcers.

53-55its

A
own

cut

wound (Kshata) should be


measures and
(to

specific

remedies, while
all

bruised

one (Pichchita) should be treated


purposes) as a case of

intents

and
first

Bhagna

(bone-fracture).

The

treatment of a mangled or contused


is

wound

(G-hrishta)

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,


of having

caused by a

fall

(from a tree), or in the event

been run over or trampled down (Mathita


or

by a carriage
a

by a
*

beast),

or of being

wounded (by

blow,

etc.),

chips of
to

The oil just pressed out of an old oil-miil or squeezed out of the wood belonging to an old one, in the manner of the Anutaila be described hereafter, is called the Ohakra-taxla t The vitiated blood should first be lei out for fear of putrefaction
Triphala, Trikatu

of the ulcer.
:;:

and Trimada

are called

Trivarga.

276
the

THE SUSHRUTA SAMHITA.


patient

[Chap. II.

should

be

kept

immersed

in a large

tank

(Droni) of

oil

and the diet should consist of the soup or


meat.

essence (Rasa) of
labours
of

man

fatigued

(from

the

a journey),
likewise
58.

or hurt at

any of the Marmas,


the

should

be

treated

with

preceding

measures.

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
treatment of
in the case of

the

nature of the season.


in

Medicated Ghritas, yet to be

mentioned
a Pittaja a traumatic
tions).

connection with the medical

abscess,

should be used as well


(according
to
its

ulcer

respective

indica-

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
59

the

season and the temperament of the patient).*

61.

An
Pathyd,

oil

codk^dvilthSamangd^Rajani, Padmd{fih.-krg{),
sulphate
of

copper,

Suvarchald,

Pad^naka,

Lodhra, Yashti-madhuka,
patra^
kes'ara^

Vidanga, Harenuka, Tdlisa(red)

Nalada (fatdmdnsi),
Manjishthd,

Chandana,

Padma-

Usira^

Ldkshd, and the tender


of

leaves of Kshiri trees,

Piydla seeds, raw and tender


as

Tinduka

fruit,

or with

many

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,
for

cooling
in

and

oily

medicines should

be

used

a week

a case of a

traumatic ulcer (Sadyo-vrana), after which those mentioned


before, in

the

Chapter of Divraniya, should be

adopted.
*

6263.
oil in

With

autumn and

in
in

the

case

of a

patient

of Rakta-pitta

temperament, and wih Vala-oil

winter and in the case of one of a Vata-

kapha temperament.

Chap.

II.]

CHIKITSA STHANAM.

277
the

Treatment
case
of

of

Dushta-Vrana: In
pungent and

malignant ulcer (Dushta-Vrana)

emetics,
sorts

errhines,
of diet

purgatives,

Asthapana, fasting, specific


bitter,

(composed of

astringent

things)

and

blood-letting, should be prescribed (accord-

ing to the
sore

requirements of each

case).

The

ulcer

or
the

should

be washed with the decoctions of

drugs of both the Aragvadhddi and the Surasddi ganas,

and
drugs

an

oil

cooked with a decoction


be
applied
to

of

the

said

should

the

wound

for |the

purification (Sodhana) thereof.

As an

alternative, an oil

boiled
(four

and prepared
times that of
as

in
oil)

an alkaline water or solution


with a Kalka of alkaline subsPalas'a,
etc.)

tances (such

Ghantdparuli,
end.
to

should

be

used

for

that

Oil

cooked

with

Dravanti

(Satamuli, according

certain

authorities,

MushikaChit-

parni

according to others), Chiravilva^ Dantiy

raka, Prithvikd
Tejovaii,

Nimba-leaves
the

Kdsisa^ Tuttha^ Trivrit,

Nili (indigo),
salt,

two

kinds of

Haridrd,

Saindhava
khyd,

Tila,

Bhumi-Kadamba^ Suvahd, S'ukdNaipdli^


Jdlini,

Ldngaldkvd,

Madayanti^

Mrigddani,

Sudhd^

and Karanja, or
nant sore or

Murvd, Arka, Kitdri, Haritdla^ with as many of them as would be


If

available, should be used for the purification (of a maligulcer).

found applicable, a medicated


with the foregoing drugs

Ghrita prepared and cooked

and substances as Kalka should be used for the same


purpose.

malignant ulcer, due to the Vayu, the purifying remedy should consist of a Kalka of Saindhava salt, Trivrit and castor leaves.
aggravated
In the case of a (malignant)
Pittaja sore,

In the case of a

the

remedy
ulcer,

should

consist

of a

Kalka
the

of Trivrit, Haridrd, Yashti-

madhu and

Tila.

In

case

of

malignant

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
in the

presence of the virus of

Meha

or

Kushtha

system,

measures and remedies mentioned under the treatment


of Dushta-vrana should be adopted and used.

64

68.

The
list,

recognised school of physicians, which recognises

these six types of traumatic sores, does not


herein mentioned, other types of

add to the
whereas

ulcers,

vain

pedagogues try to swell


of the aforesaid six.
so, since

it

with a larger number of

types by adding connotative prefixes and suffixes to the

names

It is
all

mere vain-gloriousness
the

on their part to say


to

other types

that

they can devise are but single instances and can be


fall

under one of

these six general heads.

made Hence
and

there should be only six kinds (of traumatic

sores)

not more.
Thus ends

69.

the second Chapter of the Chikitsita

Sthanam

of the Sus'ruta
sores).

Samhita which deals with the treatment of Sadyo-vrana (traumatic

CHAPTER
Now we
shall

III.

discourse on

the medical treatments


i.

of fractures and dislocations

(BhagTiaS).
fracture

Metrical Texts : A
(Bhagna) occurring
in

or dislocation

a person

of

a Vatika temperain

ment, or of intemperate habits, or


in his diet, or is affected

one who

is

sparing

with such supervening disorders

(as fever, tympanites, suppression of the stool

and

urine,

&c.)

is

hard

to

cure.*

fracture-patient

must forego
avoid

the use

of salt, acid,

pungent and alkaline substances


expo-

and must

live a life of strictest continence,

sure to the sun

and forego physical exercises andparchi-.


of
food.

fying (devoid of oleaginous) articles


consisting
butter,

diet

of

boiled

rice,

meat-soup, milk,
all

f clarified

soup of Satina pulse and

other nutritive

and

constructive food

and drink, should be discriminately

given to a

Udumbara, Madhuka, As'vattha, Palds'a, Kakuhha^ Bamboo^ Vata


fracture-patient.

The barks

of

or

Sdla trees should be used

as

splints (Kusa).

Manji-

shthd,

Madhuka,

red sandal
clarified

wood and
butter
(i.e.,

Sdli-ricQ
clarified

mixed
butter

with S'ata-Dhauta

* Jejjata does not read the first verse, but

Gayi does.
prescribed
to

As

general

rule,

milk should not be


;

patient

suffering from an ulcer (Vrana) in general

but a case of fracture


tepid

forms

an exception

thereto.

Some
if

authorities

hold that

milk

may be
the
to

given to a fracture-patient,

there be no ulcer (Vrana).

Others, on

contrary, are of opinion that milk should not, in any case, be given
fracturc'patient for fear of suppuration

and the

setting in of pus.

Others, however, take "Kshirasarpih" to be a


explain the term to

compound word and


from milk (as

mean

the

clarified

butter

prepared

distinguished from that prepared from curd).

But experience
tion,

tells us that in

cases of excessive weakness or

emacia-

milk may be given without any hesitation Ed.

28o

THE SUSHRUTA SAMHITAin succession)


2-6.

[Chap.

lit.

washed one hundred times


for

should be used

plastering the fracture.

Bandag'e
day
in

Fractures should
in
{i.e.,

be (dressed and)

bandaged once a week

cold weather,
in

on every

fifth

temperate weather
in

spring

and autumn),
in

and on every fourth day

hot weather
for

{t.e.,

summer),

or the interval of the period

bandaging should be
in

determined by the intensity of the Doshas involved

each individual

case.

An
pain,

extremely loose bandage


bone, a light

prevents the firm adhesion of a fractured

bandage gives
of the
local

rise

to

swelling
in

and suppuration
of fractures,
tight nor

skin, &c.

Hence
is

cases

experts prefer a bandage which


too loose.
7-Z,

neither too

Washings : A
affected
part),

cold decoction of the

drugs of

the Nyagrodhddi group should be used in

washing (the

whereas

in

the

presence of (excessive)

pain, (the part) should be

washed with milk boiled with

the drugs of the (minor) Pancha-mula, or simply with the


oil

known

as the Chakra-taila

made lukewarm*. Cold

(or

warm)

lotions

and medicinal

plasters (Pradehas)ofDosha-

subduing drugs should be prescribed with due regard to


the nature of the season

and the Doshas involved

in

each case.

9-10.

A
first

preparation of milk f from a cow, delivered for the time, boiled with the drugs of the Madhurddi group
clarified butter (as

and mixed with powdered shellac and


patient
as

an afterthrow) should be given (when cold) to a fracturea

beverage every morning.


pain
is

In
due

a
to

case of
Vayu and

* In winter

and where the aching

present

Kapha.
t Consisting of the drugs of the Kakolyadi group weighing two Tolas,

milk sixteen Tolas, water sixty-four Tolas, boiled together with the water
entirely evaporated.

Ghap.

III.]

CHIKITSA STHANAM.
part,

2^1

fracture attended with ulcer on the


plaster plentifully

an astringent
clarified butter

mixed with honey and


;

should be applied

and the

rest (diet

and regimen of

conduct) should be as laid


fracture.

down

in the case of a (simple)

11-12.
:

PrOgTIO^iS
winter,
is

-A

case of fracture occurring in

a
in

youth or a person with slightly deranged Doshas or


aforesaid medicines

held to b3 easily curable (with the help of the

and

diet).

A
in in

fractured

bone

in

youth
of a

is

joined by the
in

aforesaid

treatment in the course


the case of a middle13-14.

month,

two months

aged

man and
it

in three

months

one of old age.

An
set

elevated and fractured joint should be reduced

by
its

pressing

down, while one hanging down should be


it

by raising

up,

by pulling

it

in

the
it

case
its

of

being pushed aude, and by reinstating


(proper) position in the event of
its

in

upward
(Bhagna)

being lowered down.

An intelligent physician should


joints,

set all dislocated

whether fixed or movable, by

the

mode

of

known as Anchhana, Pidana, (pressure), Sankshepa and Vandhana (bandaging). 15-16.


reduction,

Treatment : A
should not be shaken
cold lotions or washes
(/.6'.,

crushed

or

dislocated joint
at
rest)

should be kept

and

and medicated

plasters (Pradeha)
is

should be applied to the part.


reset to
its

A joint

spontaneously

natural or normal state or position after the


its

correction of

deformity incidental to a blow or hurt

having been
should
clarified

effected.

The

fractured or dislocated part

be

first

covered with a piece of linen soaked in


Splint

butter.

should

then

be placed over

it

and the part properly bandaged.

17-19.

Treatment
limbs
:

of fractures in particular
the measures to

Now we shall discourse on


in

be adopted

fractures

occurring in

each particular

36

282
limb.

THE SUSHRUTA SAMHITA.


In the case of a
nail-joint,

[Chap. HI.

being

in

any waybe
part

crushed or swollen by the accumulation of the deranged

blood

(in

the locality), the incarcerated blood should the

first let

out with the help of an awl (Ard) and


S^li-rice.

should be plastered with a paste of

finger or

phalanx bone put out of joint or fractured should be first set in its natural position and bandaged with a piece of thin linen and should be then sprinkled over with
clarified butter.

In the case of a fracture in the foot the

fractured part should


butter, then

be

first

lubricated

with

clarified

duly splinted up, and bandaged with linen.


all

Such a patient should forego


the affected
part

kinds

of locomotion.

In the case of a fracture of the knee-joint or thigh-bone

should

be lubricated with

clarified
it

butter and carefully pulled straight, after which

should

be splinted with barks (of Nyagrodha,

etc.)

and band-

aged with clean linen.


out

In case of the fracture projecting


reset

a thigh-bone should be circular splint and bandaged.


or

with the help of a

In the case of Sphutita


thigh-bone, the part

(cracked)

Pichchita (bruised)

should be also

bandaged

in the aforesaid

manner. 20-24.
it

In a case of a fracture in the

Kati (Ilium-bone),

should be reduced

by the fractured bone being


(as the case

raised

up or pressed down
oils

may

be)

and the patient


fracture

should then be treated with Vasti (enematas of medicated


or
Ghritas*;.

In

the

case

of a

of one

of the rib-bones (Parsaka), the patient should

be lubribe
rib
lifted

cated with clarified butter.

He

should then

up

(in

a standing posture) and the fractured


left

(bone),

whether
with
*

or right, should be
butter.

relaxed by being rubbed


of

clarified

Strips

bamboo
stated
that

or
a

pad
case of

In the Niddna-SthanaChap. XV.,

it is

fracture in the

Kati should be given up (Varjjayet).

Jejjata,

however,

explains "Varjjayel" as "hard to cure."

Chap. III.]

CHIKITSA STHANAM.
placed
a

283

(Kavalikaj should b3

over

it

and the patient


full

should be carefully laid in


oil

tank or cauldron

of

with the bamboo splint duly tied


In the
case
of

up with straps
of the

of hide.

a dislocation the

Sandhi

(shoulder-joint),

region

of the

AmsaKaksha
thus

(arm-pit) should be raised

up with an iron-rod (Mushala)


part,

and the wise physician should bandage the


reduced, in the shape of a Svastika (8-shaped)

bandage.

A dislocated
to set
it

elbow-joint should

be

first

rubbed with

the thumb, after

which

it

should be

pressed with a view

in its right place

by fixing and expanding the


sprinkled

same.

After that the affected part should be

over with any oleaginous substance.


should be adopted
in

The same measures


a
dislocation
of

the

case of

the knee-joint (Janu-sandhi),

the

wrist-joint (Gulpha25-29.

sandhi) and the ankle-joint (Mani-vandha).

In

the

case

of fractured

bones in the palms of the

made even and opposed, and then bandaged together and the affected parts should be sprinkled with raw and unmedicated oil (Ama-taila).
hands, the two palms* should be

The
in

patient should be

made

later first to hold

ball of

cow-dung, then
his

a ball of clay and then a piece of stone

palms and so on, with the progressive return of


first fomented up with a Mushala
it

strength (to the affected parts). In a case of a fracture of

the Akshaka, the affected part should be

and then reduced by raising


(iron-rod) in the arm-pit or

it

by pressing

down

(as

the
case

case

may

be)

and should be firmly bandaged.

of
to

fractured

arm-bone should be
given
in

treated

according
a fractured

the

directions
30-32.

the

case of

thigh-bone.
*

The

text has

''Ubhe

tale

same

kritvd.'' Jejjata explains

"Ubhe

tale"

to
it

mean "palms of
to

the hands and soles of the feet j"


of both the bands."

Gaya Dasa

explains

mean "the palms

284

THE SUSHRUTA SAMHITA.

[Chap. HE.

Iiith3cas3of a banding (twisting) or intussusception of the

neck downward, the head should be lifted up by putting the fingers into the hollow (Avatu) above the nape of the neck and at the roots of the jaw-bones (Hanu;*.

Then
after

the part should be bandaged with a piece

of linen

having evenly put the splint (Kusa round the neck).


patient
for

The
back

should

be caused to

lie

constantly on his

a week.

In a case of a dislocation of the joints

of the jaw-bones

ed and duly set

(Hanu\ the jaw-bones should be fomentin their right position, bandaged in the
a Ghrita boiled
(the

manner

of a

Panchangi-vandha, and

and prepared with

Kalka and

a decoction of) the

Madhura (Kdkolyadi) and Vdyu-subduing (Chavy^di)


groups should be used as errhines by the patient.
33-3 ^
loose,

A tooth of
after
root.

young person, not broken but


its

should be plastered with a cooling paste on

outside
at

having pressed out the accumulated

blood

the

The tooth should

be

sprinkled

or

washed with

cold water and treated


(adhesive) properties
to

with drugs having Sandhdniya

The

patient

should be caused

drink

milk with the help of a lotus stem.

The
nose

loose tooth of an old

man

should

be drawn.

A
it

sunk down or depressed (by a blow) should be raised

up with the help of a rod


be straightened
in

or

director,

while

should

a case

of simple

bending.

Then

two
the

tubes,

open at both ends, should be inserted into


(to

nostrils

facilitate

the

process

of

breathing)

and the organ should be bandaged and sprinkled with


clarified

butter.

In the case of (the cartilage of) the

ear being
*

broken, the organ


lifting

should
of the

be rubbed with
fingers
in

According to Gayi, the


in the

up

head by putting
in

ihe

Avatu and
Honey,

Hanus should be made

cases of bending

and

intussusception of the neck respectively.

clarified butter,

and drugs of the Nyagrodhddi group.

Chap. III.]

CHTKITSA STIIANAM,
straightened, and

285
set in
its

clarified butter

evenly

right position

and bandaged.
in

Measures and remedial


with

agents

mentioned

connection

Sadyo-vrana,

should be likewise adopted and employed in the present


instance.
37.

In a

case

of a fracture of the

unattended by

bone of the forehead any oozing out of brain matter, the


rubbed with honey and

affected part should be simply


clarified butter

and then duly bandaged.

The
38.

patient

should take clarified butter for a week *

Cooling plasters and washes should be applied to a


part of the body, swollen but not in

any way ulcerated


should
to five

on account of a
be laid
stakes

fall

or a blow.

In the case of a fracture

of the bone in the leg

and

in the thigh, the patient

down on a plank
or

or board and

bound
limbs.

pegs in

five different

places for the


of
his

purpose

of preventing

any

movements

The

distribution of the (bindings) pegs in each case should be


as follows.

In the

first

case (fractured leg-bone), two on

each side of the two thighs making four and one on the
exterior side of the enguinal region of the affected side.

In the second case (fracture of knee-joint) two on


side of the ankle-joints

each

making
in

four and one on the side

of the sole of the affected leg.

The same
cases

sort of

bed and

fastenings should

be used

of

fractures

and

dislocations of the pelvic-joint, the spinal

colnma, the
long-standing

chest and the shouldersf.

In

cases

of

dislocations, the joint should be lubricated

with oily or
(with

lardaceous
*

applications,

fomented and softened


a

In the case of such an emission or oozing out

plug

of bristles or
laid

hiir as described in the preceding chapter


in

and remedial agents

down

conneclion therewith, should be


t

used.

The

principle

of

splintering
in

and bandaging

may be

profitably

compared with those followed

Agnur's splint.

286

THE SUSHRUTA SAMHITA.

[Chap. III.

proper medicinal drugs) in the manner mentioned above


in order to reduce
it

to its natural state.

39-40.

In the case of a faulty


lying between two
joints

union of a (fractured) bone

(Ka^ada-bhagna^, the union

should be again disjointed, and the fractured bone should

again be set right and treated as a case of ordinary


fracture.

In the case where a fractured bone would

be

found to have protruded out of the ulcerated part and


dried,
it

should be carefully cut off near the

margin of

the (incidental) ulcer, (so as not to create a fresh ulcer on

any other spot

of the

affected

part)

and subsequently
fracture occurring

treated as a case of fractural ulcer.


in the upper part of the

body should be
oil

treated

with

applications of Mastikya-Sirovasti [oil-soaked

pads on

the head] and pourings of

into the cavity of the ears.


errhines

Potions of

clarified

butter,*

and Anuvasana
of fractures
in

(enematas) should be prescribed in cases


the extremeties.

41-43.
shall

Gandha'-Taila ; Now we
the
recipe

discourse
of

on

of a

medicated

oil,

capable

bringing

about the union of fractured bones.

quantity of black
linen)

sesamum-seeds

(tied

up into a knot with a piece of


in the

should be kept immersed at night in a stream of running

water and taken out and dried


cutive days). It
(at

sun

(for

seven conse-

should then be saturated with cow's milk

night and dried in the sun, during the second week).

During the third week the sesamum-seeds should be


saturated with a decoction
of Yashti-madhu (at night)

and dried

in

the
it

sun the next day.

Then
said

(during

the fourth week)

should be again saturated with cow's

milk and dried and


*

powdered.

The

sesamumpotions of

According to

Jejjata, not. only

Anuvds;ina-enematas but

clarified butter

and errhines also should be prescribed

in cases of fractures

in the extremeties*

Chap. Hi.]

CHIKITSA STHANAM.
and

287
constituting

powder

powder

of

the drugs,

the

Kdkolyddi Gana

as well as Yasthi-madhu^ Manjishthd,


(red)

Sdrivd, Kushtha, Sarja-rasa^ Mdnsi, Deva-ddru,

Chandana^ and S'atapushpd should be mixed together.

Then

a quantity of cow's milk

boiled with the aromatic

drugs (of the Eladi group) should be used with the preceding pulverised
out the
oil

therefrom.

compound for the purpose The oil thus pressed

of pressing
out" should

be boiled in four times the quantity of cow's


the

milk with

drugs such

as Eld^

S'dlparni, Tejapatra, Jivaka,

Tagara, Rodhra^

Prapaundarika^ Kdldnusdri, (Tagara),


S'ringd-

Saireyaka, Kshira-Viddri, Anantd, Madhulikd,


taka^

and those of the aforesaid


Yasthi-madhu^
etc.,

list

(Kdkolyddi group
pasted
over

and
gentle

up

to

S'atapushpd)

together.
fire

The
and

oil
is

should be

duly

cooked

Gandha-Taila. This oil should be administered with good results in possible ways (e.g., as potions, liniments, unguents and errhines)
called the

to a fracture-patient.

Its efficacy is

witnessed in

cases

of convulsions,
the palate, in

hemiplegia, parchedness
Ardita
(facial

or atrophy of
as

paralysis)

well

as

in

Manyd-stambha
in diseases

(Paralysis

or

stiffness

of the

neck),
in

of the head
in

(cephalagia),

in

ear-ache

Hanu-graha,

deafness

and

in

blindness

and

in
in

emaciation due to sexual

excesses.

Administered

food or drink, or employed as a liniment, in Vasti-karma

(enemata
sovereign

measures)
restorative.
it

or

as an

errhine,

it

acts

as

Rubbed

over the neck, chest

and shoulders,
lovely
*

adds to the strength and


body, makes the face
lotus

expansion
fair

of those parts of the


like

a full-blown

and and imparts a sweet


part of

There should be three

parts of

sesamum powder and one


ManjUhthd,
etc.

the powders of Kakolyadi,

Yashti-madhu,

(combined).

But siva Dksa says that four parts of sesamum-powders should be taken.

288

THE SUSHRUTA SAMHITA.


It is

[Chap.

III.

fragrance to the breath.

one of the most powerful


of the

Remedial agents in
(diseases

disorders

aggravated
It

V^yu
used

of

the

nervous
for

system).
it

may

be

even by kings
prepared.

and

them

should be specially

44-45.

The expressed oil of the seeds of the Trapusha, Aksha and Piydla should be cooked with a decoction of drugs of the Madhura group (Kakolyadi gana) and with
ten times the quantity of milk.
available, should be poured into

A
it

quantity of lard

if

(during the process of


oil

cooking).

It is

an excellent medicated

and used

as

a potion for anointing, and as an

errhine,

Vasti-karma
union of

and

washes,

it

speedily brings
46.

about the

fractured bones.

physician should exert his utmost to guard against

the advent of any

suppurative setting in in a fractured

bone, since a suppuration of the local veins,

nerves and

muscles

is

difficult

to

cure.

complete union of a

fractured joint should

be

inferred

from

its

painless or

unhurt character, from

its full

and perfect development


its

(leaving no detectable signs of


dition)j

once fractured con(unevenness)

from the absence of


its

all

elevation

and from
etc.

perfect

freedom

in flexion

and expansion,

47-48.
third

Thus ends the


locations.

Chapter of the Chikitsita


the

Sihanani

in the Sua'ruta

Sanihila which deals with

medical

treatment

of fractures

and

dis-

CHAPTER
Now we
shall discourse

IV.

on the medical treatment of


i.

nervous disorders

(Vata-vyadhi).
;

IVIetrical

Texts
in

The
the

patient

having been

made

to vomit in the event of the deranged

Vayu being
(stomach),

incarcerated
pulverised
(a

(lodged)

Amais'aya

compound known as the Shad-Dharana-yoga compound of six Dharanas or twenty-four Mash^


seven
days.

weight) with tepid water should be administered to him


for

compound made up
is

of Chitraka,

Indra-yava^
in

Pdthd, Katuka^ Ativishd, Abhayd (taken


together

equal

parts)

known
2-3.

as

the

Shadof

Dharana-yoga* and contains the


duing an attack of Vdta-vyadhi.
In the event of the

properties

sub-

aggravated Va} u being incar-

cerated in the Pakvsts'aya intestines), purgatives of fatty

matters (Sneha-Virechana,

i.e

,Tilvaka-Sarpih,ctc.),

and
in

Sodhana- Vasti of purifying drugs (with decoctions and

Kalka of

fatty matters)

and

diet (Pras'a)

abounding

saltf or saline articles should be prescribed.

In the case

of the aggravated

Vayu

being incarcerated in the Vasti


(lit.

(urinary

bladder),

diuretic

bladder-cleansing)

measures and

remedial

agents should
oils,

be resorted

to.

Anointing with medicated


of poultices

Ghritas, etc., application

(Upanaha) compounded of Vayu-subduing drugs, massage, and plasters (Alepa) of similar properties are the

remedies

in

cases where

the

aggravated

Vayu
*

is

lodged in the internal ducts or channels such

One Dharana

is

equal to four Mashas.


etc.

Sneha-Lavana and Kanda-Lavana,

17

290
as the
ears,
is

THE SUSHRUTA SAMHITA.


etc,

[Chap.

iV.

of

the

body.

Blood-letting
the

(vene-

section)

the

rem edy where


(Sirds).

aggravated
in

Vayu
flesh,

would
matters

be

found to be

confined

the

skin,

blood or veins

Similarly, application

of

fatty

(Sneha),

actual

cauterization, massage, appli-

cation of poultices and binding of ligatures should be the

remedies where the aggravated


to have

Vayu would be found

become involved

in the Siia(yu (ligaments), joints

Where the aggravated Vayu would be and boaes found to have become situated in the bone, the skin and
flesh of that part of the

body should be perforated with

a proper surgical instrument (Ara-Sastra) and the underlying bone should be similarly treated with an awl.

A
the

tube

open

at

both ends should

be

inserted

into

aperture, thus

made, and a strong physician should suck

the aggravated

applying his
tube.
4-9.

Vayu from out of the affected bone by mouth to the exteiior open end of the

In the case of the aggravatd

V^yu having contamindis-

ated the semen, measures and remedies for seminal


orders (Sukra-doshai* should be employed.
(physician)

The

intelligent

would take recourse to measures, such as blood-letting, immersion or bath in a vessel (full of Vayusubduing decoctions), fomentation with heated stones, as
well as in the a
closed

manner of Karshu-Sveda, vapour-bath


(Kuti sveda),

in

chamber
etc., in

anointment,

Vasti-

Karmas,
bleeding

the event of the aggravated


the

Vayu having
;

extended throughout

whole

organism

whereas

by

regarded as
*

means of a horn (cuffing) should be the remedy when the aggravated Dosha
as,

Treatmenls, such
s for

the purification of the semen, etc., and the use


for

of

medicin

making Aphrodisia (Vaji-karana) and


(Mutra-dosha) should

the

remedy
and

of the disordered urinary organ

be adopted

employed.

Chap. IV.]

CHIKITSA STHANAM.
to

291

would be found
part of the

have been confined


10-12.

in

any

parti ular

body*

In the event of the aggravated


either with the Pitta or the

Vayu being connected


a course of treathostile to the

Kapha, such
as
(in

ment should be adopted


two other Doshas.
should

would not be
times

Blood-letting
to

small
in

quantities)

be

resorted

several

case

of

complete senesthesia (Supta-Vata)


be anointed with
oil

and the body should mixed with salt and chamber-dust


(Phalamla),

(Agcira-dhuma)

Milk bailed with a decoction of the


soup of
(well-cooked)
beneficial
in

drugs of the Pancha-mula group, acid-fruits

meat-soup

or

corn
cases

(Dhanya)
of

with clarified butter are


roga.
13-15.

Vata-

^alvana-Upanaha :-A
of the

drugs of the
(those

poultice composed Kdkolyadi group, the Vayu-subof


all

duing drugs

Bhadra-ddrvddi

and

Vidarias,

gandhadi groups), and


Kanjika,

kinds of acid articlesf (such


etc.),

Sauvira, fermented rice-gruel,


in

the flesh of
in

animals which live


(Audaka)l,
lardaceous
oil,

swamps (Anupa)
butter

or

water
of

clarified

and

all

kinds

mixed together and saturated profuse quantity of salt and then slightly heated with a is known by the name of Salvana A person suffering from any form of Vata roga should be always treated
substances,

with such Salvana poultices (Upanaha).


should

be applied to
understood
of

such part
measures
should

of

the

The poultice body as is


laid

It

is

to

be

that

and remedies
be

do^vn

under

the

head
to

Sarvanga-gata

used when the Vayu

would be found

be diffused throughout the whole

organism instead of

being confined to any specific pari.


t

According

to others

it

means

all

kinds of acid- fruits,

etc.

t
of

Chakradatla reads "^CT^^flt^l ^rf^S:" (well-cooked with the


in place of ^l'Tqt^8Rl^t'^
I

flj.h

"Anupa" animals)

292

TJ'E

SUSHRUTA SAMHITA.
or

[Chap. IV.

numbed, painful
should be fiimly

contracted

and the affected part


a
piece of

bandaged
(

thereafter with

Kshauma*

linen

woollen cloth.

As an

alternative,

the affected part should be plastered (and well

rubbed)

with the ingredients of the Salvana-Upanaha and inserted


into a

bag made

of cat or
i6.

mungoose skin
if

or

that of a

camel or deer hide.

The aggravated Vayu,

located in the shoulders, the

chest, the sacrum i^Trika) or the Manya, should be subdued by emetics and errhines judiciously employed. Siro-Vasti

should be applied to the head of the patient as long as

it

would take one to sound), more or


in

utter a thousand
less, as

Matras

(a short

vowel

the case

may

require,

where the
itsellf

aggravated Vayu would be found


the

to have

located

head,

(if

necessary)
is

blood-letting should

be

resorted to.

As

mountain

capable of obstructing the


is

passage of the wind, so the Sneha-Vasti (oily enema)


alone capable of resisting the action of
the

aggravated

Vayu whether
or
is

it

extends throughout the whole system


17-19

confined to a single part.

Measures beneficial to Vata-Vyadhi:

An app'.ication of
oils

Sneha, fomentations, anointment of

the body, Vasti, oily purgatives, Siro-vasti, the rubbing of

on the head, oily fumigation, gargling with tepid

oil,

oily

errhines, the use of meat-soup, milk, meat, clarified

butter, oil

and other
acid
fruits,

lardaceous
salt,

articles (of

food), all

kinds

of

massage, the use of saffron,


Tagara, the wearing of

lukewarm washes, gentle Agura^ Patra^ Kushtha, Eld^


in a

woollen, silken, cotton or any

other thick kind of garments, living


in

warm room
fire,

or

one not exposed to the wind or in an inner chamber,


use of a soft bed, basking in the glare of
entire

the

sexual
*

abstinence, these
lead
it

and such
made up

like

other

things

Some

as Valka,

i.e.^

bark.

Chap. IV

CHIKITSA STHANAM.

293

should

be generally adopted by a patient suffering from


20.

Vata-roga

The Tilvaka-Ghrita : A
the following drugs, viz, Trivrit, Danti,

paste

(Kalka) of

Suvarna-kshiri,

Saptald,

S amkhini^

Triphald and Vidariga, each weightolas\

ing

an

Aksha vtwo
of

and
curd,

Tilvaka- roots and


tolas),

Kmnpillaka^
decoction
Patras
'''

each weighing a Vilva (eight


Triphala and

each weighing two

^^thirty-two seers)

and

clarified butter,

weighing

sixteen seers, should be duly cooked together.


authorities

Medical
an oily

recommend
in

this

Tilvaka Ghiila
in the

as

purgative

cases

of

Vata-roga.

As'oka-Ghrita and

Ramyaka-Ghrita aie prepared


Tilvaka).
21.

same manner,

(viz.,

by substituting As'oka and Ramyaka respectively

for

The Anu-Taila: The


wooden
globules of

log of a long-standing

oil-mill should be cut into

small chips and then


cauldron.

thrashed and boiled in water in a large


oil

The
with

that will be found floating on the surface

of the boiling water should be .'^kimmed off either


the

hand or with a saucer.


as
in

should then be cooked with the

The oil thus collected Kalka of Vayu-subduing


oil.

drugs
oil
is

the preparation of a medicated


as the Anu-Taila-

This
has

known
This

The

use of this
cases

oil

been advised by medical authorities in


roga.
oil
is

of
its

Vdtabeing

so

named from
oily

the fact of

pressed out of small chips of


above).
22.

wood

(as

described

The Sahasra-paka-Taila
of drugs belonging to the

:-The wood
burnt

group of

Maha-pancha-mula
on a

should be collected in large