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1

AN ENGLISH TRANSLATION
I
OF

THE SUSHRUTA SAMHITA
Vol.
II.

NIDANA-STHANA TO KALPA-STHANA.

;

AN ENGLISH TRANSLATION
OK

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

IN

THREE VOLUMES

KDITKD

liY

KAVIRAJ KUNJALAL BHISHAGRATNA,

M.R.A.S.

Vol.

II.

NIDANA-STIIANA, S'ARIRA.STIIANA, CIIIKITSITASTIIANA AND KALAl-A-STIIANA.

CALCUTTA
PUBLISHED BY THE AUTHOR,
NO.
10,

KASHI GHOSE'S LANE
1911

AH

Rights Reserved.

•,sr

Ti, i-fui

Poo/ia. ^-ook-Supplyini Agency.

rulNTliD UY M. UHATTACIIARYYA, AT
25,

J

HE BUAKAT

MllllR TRESS,

ROY UAUAN STREET, CALCUTTA.

1907
V.

2-

PREFAGE.

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

part

of Medicine

— requires
our

Hindu System greater leisure and more
ancient

extensive reading than
tension
to.

we can

lay

any

pre-

Years of patient study and constant
sainted

discourse with

preceptor the

late

lamented Mahamahopadhyaya Kaviraj Dwaraka

Nath Sen, Kaviratna,
golden
chain
of
us,

that refulgent link of the

the

Dhanvantaric succession,

have enabled
facts,

however, to grasp the leading
few years we have moments snatched from an anxious profession that knows
last

and during the
practice of

worked
the

continuously, in

no

respite, to
It

arrange these facts
our heart
to

in their

present
the sad

form.

breaks

record

departure of our venerable

sublunary sphere

to

Acharyya from this a land "from whose bourne

no

traveller e'er returns.'*
It is

hardly necessary for us to reply to those

critics

who, through their ignorance of the original

(

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
aofainst us.

Exception
ing
in

has been taken to our not includ-

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
was
in
first

our possession,

or on which

we have been able to lay our hands.
sudan Gupta and we believe that
this

The work
Madhuwas only
it

put into print by the late Dr.

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.

we are supported by the fact, noneof the various commentaries and annotations on the Susruta Samhita is any mention
In this opinion
that in

made

of the line in question, whereas,

had
it

it

been

the opening stanza of the original work,
certainly
at

would
notice

have received

at least a passing

the hands of the commentators, however easy
it

or simple

might have been.

Further,
it

were

it

composed by Susruta himself,

would not have

(

3

)

been

in the

form

in

which we

find

it

in the printed

editions.

The

ancient

sages

used

invariably
or
"
''

the

auspicious

expression

"^^Tc?*. "

girtrr

and the Hke.
termination
the
of

when commencing
their

a work
for

and

never invoked any particular deity

a

happy
the

undertaking.*

These are
omit

reasons
in

which have led us to

passage

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

no

account,

be

rendered into a Mlechchha Bhdshd and thus
accessible
to

made

the

public

at

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 \^edas themselves have been transinto many European languages. To keep
the

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

privileged

classes

and thus

to deprive

the educated public of the

*

Thus :~

'a)
(/')

"^tWf
''^^mt

f;^#f^^?i^-«iTa sgi^nMRT:''— Charaka Samhita.

\^

"^^Tsjmw!'

— Kanada Vaiseshika
Sutra.

Sulra

{c)

"^^Tm ^^frsT^l"— Vedanta

(

4

)

benefit

of

such
In

truths

would certainly be
to

a

sacrilege.

i^iving

preference

English as

the nicdiiini of translation

we have been actuated

by more reasons than one.
It

cannot

be

gainsaid that Iinglish has

now

become almost the lin^^ua franca of the world, and to disseminate the ancient wisdom of India throu(£hout the world, we could not have selected
a

medium

better than the English language.
this,

Besides

we have been actuated by
to the scientific

the

hope of drawing the direct attention of our benign

Government

value

of our

system of Medicine by
procedure.

the

adoption of such a

Here we must
valued friends

not

stop without expressing

our sincere and hearty thanks to our learned and

Kaviraj Jogindranath Sen, M.A.,

Vidyabhusana, Kaviraj Jnanendranath Sen, B.A.,
Kaviratna and
Professor

Satyendranath

Sen,

M. A., Vidyavagisa, who have rendered us material We must help in the publication of this volume.
freely

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

duo

to Dr. S. Sanyal, to

B.Sc, L.M.S.

for his

kind
for

h'elp,

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.

(

5

)

In

conclusion,

we implore our
omission and
in

readers

to

excuse the

errors of

commission
of such a
is

which are inevitable

the execution

huge work,
profession

more

especially

when
do,

the author

encumbered with the responsible duties
involving,

of his
life

as

they

the

and

death of persons entrusted to his care.

10,

Kashi Ghoshe's Lane, Calcutta.
Novemberi igii.

\
'

KlNIA LaL BlIISHAGRATNA.

INTRODUCTION.
In the introduction of the
first

volume of our translation
correct
.

of the Susruta-Samhita we have attemptis not Encyclopaedia of ancient medical

Ayurveda

an

ed to place before the public
interpretation of
^^^
^^^^"^^^

a
,

,_,,_,.
Vayu,

Fitta

tand Kapha,

tise

on Biilogy^"^^^'

so-called
it

humours

of

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 encyclopsedic work,
* Berdoe says

— an
known

Encyclopcedia
as

of the

Indian

:

— "What
part
all

is

the

Humoral Pathology formed
Dogmatics.
the mixture

the

most

essential

of

the

system
as

of the

Humoral
of the four

Pathology

explains

diseases

caused

by
or

cardinal humouri, viz., the blood, bile,

mucus

phlegm and

water.
it.

Hip-

pocrates

first
is

leaned

towards

it,

but
of

it

was Plato who developed
these humours.
is

The

stomach

the

common
of

source

all

When

diseases

develop, they attract humours.

The

source of the bile

the liver, of the

mucus the head,

the water the spleen.

Bile causes catarrhs

and rheu-

matism, dropsy depends on the spleen."

Be
logy
this

it

observe!

that

among

the

humours

of Hippncrates there

is

no

place for Vala although in point of fact both his
are
to

Physiology and

Patho-

be
is

traced to

the "Tri-dhatu" of Ayurveda.

The

secret of

anomaly

that the theory of

Vata was found
to
its

to
its

be a complicated one
original import, left

and Hipprocates, not being able
it

comprehend
stead, his

out and cautiously introduced, in
find

own

theory
;

of "water".
it

Sowe

"Humoral Pathology
It is
)

is

not of Indian origin

neither

is

the

same which the Indian Rishis
Tridhatu."
(

of

Rigveda developed under the name of

simply an imitation of Susruta

who

introduced

blood

'itf^ff^'^';

^s ^^^ fourth factor in the genesis of diseases.

But the bor-

rower, in his interpretation of Susruta, had

made

a mess of

it.

He

retain-

ed blood,

but

substituted

"water"

in place of

Vata, 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 such phenomena as are termed mental and such of them as
are exhibited by rnen
in society,
it

under the heads of Psycho-

logy and

Sociology, yet

must be allowed that there are no
Nature,

absolute demarcations

in

corresponding

to

them,

and so
are

in

the entire Science of Life, psychology and sociology

inseparably
with

linked

with

Anatomy and
Hygiene
and

Physiology, nay,

more,

Pathology and

above

all

with

Treatment.
whatever

In short the Biological
are
is

Sciences must deal with

phenomena
it

manifested
placed.

by living
(

matter in
%rgrq:
)

whatever condition
well as Life
in

Life in health
therefore,
fall

as

disease

(

^'.WWlife

)>

within the
in Society

scope
(

of
)

Biology— even
is

exhibited
it.

by

man

f%fnf%cf

not exempted from

i{TT^ era

^W^pf^: ^
we
of
facts
will

^=^%

II

'^T^,

^*^IT,
by

m

^<5ITg

I

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

J

.,

are

not guided

any prejudice
rely
solely

entire
^

Science

of

our

own,

but

we
and

on

®'

and

figures,

these,

when
same

closely studied,

lead

any one

to

arrive at

the

conclusion,
as

not

unlike

our

own and

to interpret
all

Ayurveda
we

a

collection
firsl

of Biological
for

Sciences in

departments.
will

In

the

place,

the guidance of our readers,

mention that the name

Ayurveda

itself

is

a strong evidence

in favour of its

Negative Evidences thereof :—
1.

^« y -ir 01 Life.
^j^g

being called the Science o ji n r Secondly, we will refer to

The Name

it-

self.

arrangement of the subject-matter '
the " Sarira-sthana
, ,

in

which
of the

is

popu-

larly

belived to be

the anatomical

portion

book, as
In
.,

tending

to
.

the
,

same conclusion.
.

XL

The arrange-

,.

ment of the subject-matters.

this

section,

chapters

on

Midwifery
follow

.,.,

^nd

close to the heels of those

Management of on Anatomy and

Infants

Physiology, and

INTRODUCTION.
these
latter

iii

again

are

immediately
intermixture
is

preceded

by chapters

on Psychology.

This

certainly an

anomaly

and can

in

no wise be
these

satisfactorily
as

explained
truths

unless

we

have to look upon
elucidated

general
of

of
truths

Biology,
exclu-

by

the

Introduction

special

sively collected

from the science of medicine
call
it

— ftrwjnl^^

*im^

^F^cnf'T
in the

I

To

Descriptive
the term
is

Anatomy

or Physiology,

modern sense of

simply ridiculous.

The
and
'"
is

absence of any reference to brain

ti^lnatomyTnd
Physiology in the
Ithlnaitself?-"'^^'
dency.

'P^"'^ ^°''^'

a

^° P"""^^' ^"^ ^^^'^' 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
for

Ana
bulk

tony and

Physiology,

instance, in

their

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
in scientific
all

miserable

contrast

— a contrast that
at least

calculated

no admiration,

but,

on the contrary, to generate

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 foremost of
of Ayurveda
is

that

our

beloved Science

by

no means an
^^^^

Encyclopaedic work,

distinctly possesses every

characteristic

^^Positive Eviden-

^^^^^
very

^j^^

Science
,,
.

of

Biology.
indicates

The ofAyus.
I

definition

The
.

name
actually

Ayurvada
a
^'

Same

as Life as
^^''"

that
^""^

it

is

science of

Ayus
in the

blrVspen^er'"'

^^^

""^'^
as

^^^'
Mr.

"^^^ here

same
In his masterly

sense

Herbert Spencer
Life.

understands by his remarkable definition of
classification

Mr.
first

Herbert Spencer
place to

has

in his Biology, given, indeed,

the

Anatomy and

Physiology, but

still it

is

divested of any elaborate chapters

dealing with the subjects.

B

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
as regards
least,

for

their
exists

confusion

meanings, but,
of opinion,
at

Ayurveda there
as

no
is

difference

so far

the

first

word
it is

concerned.

Ayus
they

is

/iyus everywhere in

Ayurveda and
any

the only fault
with, that

our venerable
did
not

Rishis

may be reasonably charged
into
great

put
but,

themselves

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 ''Fida" 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,

a

marked

the

two.

An
truths

ordinary

treatise

on

Biology deals

with

the

general

of

life,

and does not
truths,

represent, by

way

of illustrations, all

its

special
is

nor their practical sides,
the

but

so

far

as

Ayurveda

concerned,

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'SfJllR^

^^1^
as a

^'^fsifilf'T

),

so

much

so,

that

it

is

now regarded
has
neither

system

of

Medicine and Surgery which

Biology,
is

nor

Anatomy, nor Physiology, nor Pathology
Empiricism or Quackery.
This
is

— but
in

a systematised

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
as


V

Hindus),— is

a direct contradiction to

its

bieng considered

an Encyclopaedic work.

The

existence of the chapters on
in the

midwifery and management of infants

same, following
as

immediately the chapters on
additional

Anatomy, serves
It
is

a

strong

evidence

thereof.

an

anomaly no doubt,
the
section
of

that Midwifery has been

offered

a

place in
j

Anatomy, but the confusion does not
Reasons
for in cor.

porating Midwifery
into this Anatomical seccion-

g^^ ^^

.

,,

^''

t j confounded,

-r if

we we

are led to

i

^

^

believe
of

that

the science of generation

a

superior

race

(if

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, to

we
in

grounds to lead any
to

one

pronounce
which

our

favour

and

come

to

the

conclusion at

we

now

venture to arrive.

Besides these
cite

two important

facts,

we now
Internal evidenceour view.
of the

the
,

following passage as

, . j r a strong internal evidence in favour

of

r

Maharshi Punarvasu,

after giving us a short table

principal
this

structures of the
is

even

reference

considered
^^^

human body, remarks that by many as superfluous,
'^^'

Reasons for omitting

^'^

g'"^""^'

'" acquaintance
of an

Descriptive

with the molecular

construction

organism
as a reliable guide to treatment.

is

quite

suflScient to help us

The

passage referred to

is

quoted below

:

Now we
and
the
that

ask the reader
hilt,

if

this

is

not a
is

sufificient

evidence,

proving to the

that

Ayurveda

nothing but

Biology
if

we run no

risk of
is

committing a grave omission
wholesale dispensed with
this

chapter

on Anatomy

from

Ayurveda.
that
in

For the improvement of

awkward position
no Anatomy
wisely

the section of
is

Anatomy
that
is

there should be
as

— the entire credit
made
the
structures of the

due to Susruta,
a

he has very

suggestion,

knowledge of the anatomical
far

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
the

to lay particular stress

on the knowledge of

molecular

construction
actually

of

the

body.

The
this
still

following

memorable passages
model from which

preached

by

renowned
as a

Surgeon, some three hundred centuries ago,

stands

modern Science, even

in its

present ad-

vancement, can draw inspirations.

He

says
1.

:

ST

31,^ ^^qr

?^'

t%

fl^ff^

f%->^:

I

^^rTMT
2.

^'f^^NTgiT^^ri
^=srT

f^:

II

fT«iTf%:¥3!a Tii^

si^^ ^^ctt

i

siteflifgT 'Jft ^PRiJr

?^^s^^f^?i:
??ftfi
II
I

ii

iif?r^ f^

^. 1^ ^re??^^

?f?TrefT¥^^?i ^^] TlTTf%qtf ?T

That

is,

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

is

necessary, along with the body's
in

For acquiring efficiency
recommends
can

Surgery alone, the dissection

* Susruta

dissection on dead

human

bodies and suggests

that

it is

only required of those

who
it.

will practise surgery

and that students
dissection

of medicine
living

do without
with

Herophilus
of
practising
at

practised

on

bodies and

the object

medicine suceessfuUy,
influence

but

it

soon

fell

into disrepute

and did not

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
for
is

his vivisecting master
in

had taught him
patients.
pride.

had not helped

him

the

cure

his

Such
only
this

indeed was the fate of vivisection

which Europe now takes
considered by
It
is

But Susruta's, Avagharshana
perfect

now

many

as

the

mode

of dissection

ever
the

known.
layers

with the help of

method

of dissection

that

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 of surgery and

several

European savants, Susruta

stands as a model

European surgery has borrowed many things from Susruta and has yet

many

things to learn.

INTRODUCTION.
of

Vil

dead

body

(not

of

living

body

as

proclaimed

by

Herophilus), nay,

the Avagharshana which brings
^^^
^^^^""^

into view

The
of

knowledge

^^

^^^

epidermis and
u

the

the Molecular Construction of the body is all that is

dermis, the
.,
,
.

number and branches
and nerves
,

of

,

blood-vessels

that he

,

,•

j embed-

wanted.
Professor

^^^
Michael
in the

j^^

muscles, etc

is

only
his
all

necessary.
article

Foster's

remarks in

on

Physiology
are
just
in

Encyclopedia Britannica, to

appearnces,

the

same
in

line, if

not identical with our extract,
in the future,

when he
is

says "that the

problem of Physiology,
arriving

largely

concerned
the

by experiment and

infer-

ence,

by

mind's

eye,

and
by

not

by the body's eye alone,
to

assisted, at a

as that

may

be,

lenses yet

be

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."
In
the knowledge of the molecular construction of

the body

just the thing with

which Biology

is

concerned,

and such
in

the

unanimous
in

verdict both in the East as well as
in

the

West,

the

most ancient and

the 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.

That

is,

the

body

is

composed

of molecules and these are

said to be numberless, because

no body can count them up.


Vlll


INTRODUCTION.

By

their union, they build

up the body,
viz.,

and

this

union

is

governed

by three Laws,

the

Laws

of Vayu,

Karma and
and

Swabhava (which
Laws,
the
i e.^

are almost equivalent to the three Biological

the law of heredity, (he law of external relations of

law

molecular

motion caused by Ethereal vibrations

compared with which nerve-impulses
are grosser

— akin
far
is

to electric force,

and coarser shocks).
Ayurveda,
as

So

we think we have
not defective,
if it

proved

that

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

Physiology

molecular.

Molecular in every sense

is

the Biology of the Hindus, virtually speaking, Ayurveda is our Science of Life, and we will presently shew that Life
and Ayus are
identical.

The continuous adjustment of molecules, their successive breaking down and building up within an organised living
body, without destroying
as suggested
its identity, is

the definition of /iyus

by Maharshi Punarvasu.
:

He

says

In
slight

another place
modification

the
in

same

definition

is

repeated with a

and

this

he

enumerates %TTrgetf^:,
distinctive
to this

(consciousness) as the most

^®^^^*^°°
of'Ayu.
?f%:

characteristic of ^j'w^.

According

definition, 3iTlTf^^rc9T<?T#qt^:
re'er

and %PTTg-

to an organised living

body

;

f'M^; and ^g^^?: are
building up of

identical with processes of

breaking

down and
identity.

the organism without

destroying
is

its

The

idea of

continuous adjustment

included also in these two words.

So we

find, the definition

ofAyus, as sugessted by Punarvasu,

includes

more than what
u
.

is
/•

proposed

in

The same as

Life.

,,

Mr. Herbert Spencer sdefinition
^t%fTiT, as explained

tt

o

>

j

q\ Life.

r

^

y

The words

>sitT

and

by the great annotator
the

Chakrapani, represent two more distinct phases of Life,

INTRODUCTION.
first

IX

bearing

upon

the

existence
factor of
.^-

in

the system of a preven-

tive

putrefaction,
.l

the second
.

comprehensive than Life Mr. as defined by Herbert Spencer.

More

pointing
adjust

.

to

the

agent or agents
relations

.

.u

that
deli.

..

the internal

by
,•

cate touches, which

professor

Michael

,

Foster speaks of as "continuously passing from protoplasm to

protoplasm and compared with

which
,

the nervous

impulses
in

Michael Foster on the TheProf.
^

^

.

,

,

,

(which are perhaps electrical
^

nature)
,,

are grosser
^^-^
^^^^

and coarser shocks.
viz.,

,

.

xt Now

ory of Sensation.
plained

,.

by

Chakrapani — "#^?rf?T

epithet,

"^f^ci/' as ex-

m'JTR >?K2j1%"— furnishes us
(

with a clue to determine what

Ayus

'^rq:

)

actually means.
for-

Our Sacred Upanishads now come
the^pJnfshad? °^
are
^''^^^ ^°

^^^
"'?rrq:

^^^^^^

^"^
ie

^^'^ "^' '" '^^ ^^^^
,

place,

UTIj:,"

Ayu and Prana
"?i: rto;

one and the same principle.
,

In the second place,

^ ^:", i.e Prana and Vayu are identical. In the third place, "^ x^ xm\t ^grr^r^TyRi:", i.e., Vdyu is not unlike Ether.
In the fourth place,

"w

jr\^ ^j^fig",
is

i.e.,

the primitive fluid
viz.,

yaccording to Lord Kelvin)

divided into two parts,

one
fifth

without motion, another
place,
"4j4f*lrt^l«tit^',

endued with motion.
everything
in

In the

'.e.,

this

world

are

waves of

this

Ether endued with motion.

In the sixth place,
is

"^igrN

^"^'."

"^T^
;
;

ft^, RTO: m%g".

i e.,

Vdyu
it

the universal the

store of energy

in the Physical

world

is

known by

name

different

in the Living world it is called under a Vayu name and that name is Prana (v{]w.) From the above short table we come to know that the

of

agent that adjusts the internal
is

relations to external relations,

Ayus and

that

Ayus

is

Life,
is

and

that Life

is

a

motion of the

great etherial fluid which

known
is
.

in Sanskrit as "?^'

and that
^
• i

"^T?j"
The same as
fined
pri-

the
^

sum
^

of all

the various

mitive fluid as de-

^ uenergies— ubiological and abiological—

by

Lord

which under the name of heat,
,
.

light,
.

Kelvin.

.

'

electricity or consciousness, etc, manifest

themselves both in the Physical as well as in the Metaphysical

X
world,

INTRODUCTION.

and

that

Prana

(vciw.) is

another

name

of the

same

force
itself

that, in acting

on an aggregated
viz.,

living

body,

divides

into five distinct forces,

Prdna, A/>dna, Samdna, Uddna,

and Vydna, and subserves the functions of correlation ( ^rg: ) and sustentation ( fqrt ) and controls oxidation (^^t). So
Prana continuously helps to
adjust,
like the

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,

vJ^u and^EthS.
an organised body.
in his

^^^^

'^'

°^ ^^® etherial vibrations {sfj^w.)

as transformed

into

the

vital force

in
it

We

quote

below

what he says about

celeberated commentary on the Vedanta Darsana.

ot'^vlyu 'in'ufa"' tion on a living aggregate.

"n^:

«w ^m
,

wm

^

^^
<?t

=T,sft

^i

,^^
fluid

^c^^w ^'^

w^w^

T fw<i^

That

is

the primitive

that

is

endued with motion
,

in its

evolution of

Life gets knotted into five divisions, viz

Prdna,

Apdna, Samdna,
aggregated living

Uddna and Vydna, and matter is called Prana.
itself,

this acting

on any
call
its

So what we

Prana

is

not the

Vayu

but

a

particular

mode

of
is

motion.

Hence

the question of identity

and non-identity
is

a

matter of choice.
the
(as a

Shortly

speaking,
the

this

the Biology
into

of

Hindus.

This

too

is

sum and substance
Physiology

which
itself.

department of

Biology),

unfolds

This

too evidently serves as the line of

Biology forms the

demarcation between ^urg: and ^:WTi:i
fen,:

iM^^Tlevetpta
as so much collateral branches.

-d •^^..
Disease,

From

this

too

Health and
^^^^^^^^t,

Hygiene

and

Psychology and Sociology
fact,

have

all

their origin

and

start.

In

Biology forms the basis

upon which the great
Conclusion.
there in the Ayurveda

edifice of the Indian

Medical Science, as

a collateral branch, has been developed.
rpj^^

general truths of Biology

ae

all

;

but the special truths from medicine

INTRODUCTION.
have been given so great a prominence that the
of the

Xi

real character

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'coUateral branch of
Life,

this great

we would here touch upon
had formed
the
,.

a few of

them

in passing.

Magnetism
Magnetism.

its

way

into the therapeutics of

ancient Hindus and animal magneextensively
^
.

tism was very

,

practised
in

.•

j

in

India long before they were recognised by

Mesmer

Germany
good

and subsequently by John EUiotson

in

England.
Science
r

The Indian
Hydropathy.

writers

on
,•

Medical
,

of the
in

old days have described

length the
waters of

medicinal properties of

the

,

the principal rivers, lakes, water-falls and mineral springs

of

the country
tive

that

were known

at

the time and

their

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
of in the

India long before

was even dreamt

Western world.
from
time
of

The

ancient

Hindu

sages

immemorial had
the
benefits

been

cognizant

of

massage
to
practising

and
it

shampooing and
is

taken

them.

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 efificacious therapeutic agents.

The

Science of begetting healthy and beautiful children,

which
Genesiology.
tion

...
is

just beginning to receive atten-

in

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
of

special injunctions

which

part

the doniestic

of the orthodox

the

community.

As

a matter

of fact, they

knew

C

Xli

INtRODUCtlON.
mental
impressions of the
a great

that

parents at

the time of con
future destiny

ception

exercise

influence

over the

of the child in embryo.

Thus we read
distance,
loves ardently

in

the Sastras
a child

:

— "A

woman, though
Just as

at

a

conceives

of

the shape of the person
a tree

she
that

and thinks of

at the time.

grows

is

not different from the parent tree whether

we

plant

sow a seed, so the main features of the child partake of the features of its father, though there might be
a branch or
slight

changes due
subtle

to the soil."

The
the
objects
is

soul co-operates with the
;

Manas

(the

mind)

;

mind co-operates with the senses
;

the senses perceive

all this

takes place in

little

or

no time.

The above
?

the

connection
is

between

the

soul and objects around us.

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

it

enters another soul,

some time and an

of the

mind

to

know

the

The

soul,

which intensely

meditates on an object,

assumes the shape of that
In a

object.'' etc, etc.

book entitled Bhoja-Prabandha being a collection
of the anecdotes
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
they administered
*
Verses

the

Royal patient. Accordingly
called

an

anaesthetic

Sammohini
II.

with

Vide—'B^xh.h& Mihit's Brihat Samhita Book,
1-3.

Chapter Ixxv-

INTRODUCTION.
a

Xlll

view

to

render

him insensible

and,
they

when completely
trephined his skull,

under the influence of the drug,

removed the malignant portion of the
of the complaint,

brain, the actual seat

closed

and stitched up the opening and

applied a healing balm to the wound.
tered
a

Then
to

they administhe
felt

restoration

known
(as

as

Sanjivani

patient,

who,
ease.

thereupon,

regained

consciousness
narrated by
of

and

quite at

This
in

incident
his

Thakur Saheb
of

of

Gondal
goes to

Short
that

History

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
the

which

are regarded

greatest triumphs of

modern

surgery.

The purpose
to

of chloroform in the

palmy
but

days of yore was used
there
is

be

served by
to

Sammohini,

hardly

a drug

known
at

modern Pharmacopseias,
certainly lessens the

corresponding

whith

Sanjivani which
present

chances of deaths
ancesthetics.

that

sometimes occur under

Let
ing Art

them, who allege that the Hindu system of the healis

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,
trie

and

and which assures the world of
a half

existence of

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
the

modern Western Medical Science
point
at

its

Anatomy; but
TJi QCflpt".! nn

issue

is

whether the process of

laying

open the structures of the
lancets,
a
fact
is

body

with the

at all

a

satisfactory

method.

For,

is

it

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
into the

all

once and

not allowed

go

deeper

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
edge
out
of of

a

dead body
the water of

with
a

Kusa

grass

and place
three

at

the
it

rivulet.

After

days

take

carefully,

and

gradually

take off

the

succsesive

layers

the

epidermis

and

dermis
it

and
over

of the muscles beneath

by gently and
the

lightly

rubbing
the

with

a

soft

brush.

Thus
by
are
this

smallest

and

thinnest

arteries,

which have
existence

time

swelled

and obtained a

distinct

made

palpable

everywhere even to

the minutest.

The
easier

process

is

termed, as we have pointed before,

Avabe an

gharshana
and a

by Susruta.

The Western method might
the merit of discovering this
is

more off-hand one, but by no means

precise.

Though
Avagharshana.
blind to
generally
it

mode
It is

^f dissection
call

due

to Susruta,

we

are all
!

and

Hippocrates the father of Medicine
that

believed
his

with a view
it is

to further his researclies

and perfect
work

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
speaking, he
figured
in

name

for ever,

though, virtually

(Susruta)

was the pioneer of dissection and

the

world

more than

a

millenium before the

advent of Hippocrates and over eleven centuries prior to the
age of Herophilus.

INTRODUCTION.
It

XV
place here to mention
,

would

not,

perhaps,

be out of
,

that
in his

Dr. A. F. R. Hoernle, recent publication

M. A F. R. S C. I. E., Ph. D., on Hindu Osteology, has proved it
Hindus and what a mine of in them We, in our Intro!

to the hilt,

how

systematic, scientific, unerring and exact were

the researches of the ancient

resplendent truths lay imbedded

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 Susruta.
mentioned that the Science
to the

There

we have

incidentally

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

en

those

included

by

the

modern Western
we boldly

Scientists

and
the

investigators.

On

the other hand,

afifirm that in

theories

propounded by Susruta some two thousand
lies a

years

back there

fund of truths which might well throw a flood

of light on the field of labour of the

modern

scientific

men

of

the West.
(causing to
Virechatia

For

is

it

not a

fact that the theories of

Vamatia

eject

the
the

contents of the stomach

by mouth),

(causing
to

evacuation of the intestines), JVasya

(causing

inhale through the nose),

Anuvdsana and Asthdappellation

pana which, in ancient India, had earned the
extensively
practised
late,

of

Pancha-Karma, and had gained universal prevalence, and were
by
oriental

physicians

from time im-

memcrial, have, of
of

been hailed by the medical authorities

the

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
of
all

upon
true
logy,

experiment
Science,

and

— the
its

key-stone

and such being the case
Therapeutics
as

Anatomy, Physioerroneous.

Pathology and
cruel

are
it is,

all

The

suggestion,

and baseless

originally

emanated

from an

eminent Indian pliysician

who has earned an un-

XVI

INTRODUCTION^
reputation by
writing a Treatise on
(the

enviable

Medica.
so

He

says

:

— "It

Hindu Materia
is

Ayurvedic system)
observation

built not

much upon
expression

experiment and

as

upon an
But such

erroneous system of Pathology and Therapeutics.'

an

would not stand the

light of day.
set a

Indeed

none but the ancient Hindu sages did

high value on

experiment and observation, and where they did not

claim
that

some occult knowledge
they mainly based

or intuition,

it is

upon these two

all their

knowledge.
the

The Materia Medica
Its description

of

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 every

are

prohibited
correct.

in particular

ailments

day

being
drugs
theory

found

The European
corroborative

preparations of Indian
thereof.

and

diets

are

evidence

The

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
Materia Medica, Therapeutics and Hygiene
unrivalled and unapproachable, as
it

and perfection

and was simply

blended Philosophy with
eye.
facts

Science— the mind's eye with the body's

A
reader

dispassionate

examination of these
will
it

(and such as

can be multiplied to any extent),
that

convince

an impartial

Ayurveda, as we find
if

described in Charaka
in

Samhita and Susruta Samhita, fairness and enquiry, might
of the

approached

a

spirit

of

reveal

the germs of not a few

marvellous
of

achievement of
Science

the
afford

present
to

age in the
assiduous

domain

Medical

and

the

INTRODUCTION.
Student
a

XVll

vast

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
or

if

Western Medical Science
benefited
it is

was

ever

anywise, directly

indirectly,

by the

ancient

Medical Science

of

the

Hindus,

but

meet
all

and

fair

that the former should

come

forward

to
it

render
is

possible aid to her parent Science, and that as

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 (^latmab) in the
(outer side).
in Juijutsu.

arm

(inner side).

points recognised "J" indicates the

See Chapter VI, S'atira-S'lhana.

y

'

PLATK No n.

Vital points

(Marmas)

in the leg

Vital points

(Marmas)

in the

back

(outer side).

of the thigh

and the

leg.

"J" indicates the points recognised

in Juijutsu.

^ee Chapter VI, S'arira-Sthina^

— —

CONTENTS.
NIDANA STHANA.
(Section on Pathology).

CHAPTPR
in
its

I.

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

Diseases of the Nervous System, etc :— The action of the Vdyti normal state.— The Prana Va'yu— The Udana Vayu— The Samana Vayu The Vyana Vayu The Apana Vayu. Descriptions of the nature

Torticollis.

Its

Its

shthila.

...

...

...

i

17.

CHAPTER

II.

Haemorrhoids:— Classifications— Patholog)-—Premonitory Symptoms,

—Vataja Type — Pittaja Type — Kaphaja Type — Raktaja Type— Sannipdlaja Type — Congenital Type. — Figwarts or condylomatous growths about the 18 — 24. genitals. — Prognosis.
...

...

...

...

Urinary

CHAPTER in. — General .Etiology. — Premonitory Symptoms. Calculii*.
...
...

— S'leshmaja As'mari—Pittaja As'mari—Vataja As'mari. — Seminal Concretions. — Supervening Symptoms. — Situation of the Blad25 — 30. der. — How stones are formed in the Bladder.
Leading Indications.

— —

CHAPTER
Symptoms.

IV.

Fistula-in-ano and Fistular Ulcers :— Classifications— rremonilory

— Derivation of the term Bhagandara. — Vataja Type — — Kaphaja Type— Sannipatika Type —Traumatic Type — S'ala-ponaka Type — S'ambukavarta Tppe — UnType — Ushtra-griva Type — 31 — 34. niargi Type. — Fistulous Pustules. — Prognosis.
I'itlaja

Type

I'arisravi

...

...

CHAPTER
/Ktiology
ions.
-

V.

— Clasbitkat — Aruna-Kushtha — Audumbara — Rishya-jihva —Kapdla Kushtha (Macula). — Kakanaka— Pundarika— Dadru (ring-worm) — Sthul^rushka— Eka-Kushtha (Ichthyosis)— Charma-dala (Hypertrophy of the skin) — \'isarpa-Kushtha — Parisarpa-Kushtha — Sidhma — Vicharchika (Keloid) — Pa'ma (Eczema) — Kachchhu (Psoriasis) — Vipadika — Kitima Rakasa (Dry Erythema) — Kil^sa. — Congenital cause of Kushtha. Prognosis. — Mow Kushtha becomes contageous. — Some other contagious diseases enumerated. 35 —
...

Cutaneous Affections in general :— Premonitory Symptoms—

...

...

...

42.

CHAPTER
toms.

VI.

— — — — — — meha — Pishta-meha — Sandra-meha — S'ukra-meha. — Names and Symptoms of Pittaja Meha — Nila-Meha — Haiidra-meha — Amla-meha — Kshara-Meha — INIanjishtha-meha— Kakta-meha. —Names and Symptoms of Vataja Meha — Sarpir-meha — Vasa-meha— Kshaudra-meha— Hasti-meha. — Supervening Symptoms. — Kaphaja Types — Pittaja Types— Vataja Types. — Abscesses. Carbuncles. — Pimples. — Pustules, due Prameha. — Prognosis. Symptoms of Madhu-lNIeha. — 49.
etc.,

Diseases of the Urinary tracts :—Patholog)— Premonitory Symp— General characteristics. Kaphaja Type Pittaja Type Vataja Type. Names and Symptoms of Kaphaja Meha Sura-meha Lavana-

to

...

...

...

...

^-j

CHAPTER
Dropsy
Predisposing
causes.

VII.

with an abnormal condition of the

abdomen:— Classifications.—

— Premonitory Symptoms. —Vataja, Pittaja and Kaphaja Types —Tridoshaja Type. — Enlargement of the Spleen and the Liver with dropsy of the Abdomen. — Vaddha-gudodara — Parisravi-Udara. Jalodara (Ascites).— General Characterstics of Dropsy. — Prognosis. 50— 54.

Ill

CHAPTER

VIII.

False Presentations and Difficult Labour -.—Causes.— Definition.

— Classifications

and

Symptoms.

— Abortion. — Miscarriage. — Prognosis.
•••

Caesarian Section.

••.

55—60.

CHAPTER
Vidradhi
(Abscess,
'.

IX

Pittaja

Classification — Vataja, etc.) — Definition and — Sannipatika Type — Traumatic Type — Raktaja Type — Incurable type of External Abscess.— Internal Abscesses — Their — Differentiating diagnosis of Gulma and Vidradhi. — Incurable

and Elaphaja Types

localities.

Type

.

...

...

...

...

...

61—66.

CHAPTER
of

X.

Erysipelas, Sinus and Diseases affecting the

women

:

— Definition of Erysipelas —Vataja, Pittaja and Kaphaja Types
Type— Kshataja Type.— Prognosis.— Nadi-Vrana
Kaphaja
and
Pittaja

mammary glands
(Sinus).

—.Sannipatika

— Classification— Vataja,
Tri-doshaja
character

Types

— Dvandvaja
67

and

Types— S'alyaja
Its

Type.— Stanaroga.— Breast-milk— Its
traits.
...

normal and abnormal
...

— StanaA'idradhi
...

(Inflammation
...

of

mammary

glands).

— 71.

CHAPTER
G-lands, Scrofula,

XI.

Tumours

and Goitre :— Dosha-origened Glands
Its

— Sirija gland (aneurysm or Varicose Veins). —Apachi (Scrofula, etc-) — — Tumour— symptoms— Blood-origined Tumour. — MdmsaAr\uda. — Prognosis. — Adhyarvuda. — Dvirarvuda. — Cause of not being suppurated.— D.-finition of specific Symptoms — Vataja Goitre— Goitre — Kaphaja Goitre — Medoja Goitre. — Prognosis.— General shape of
symptoms.
Its
its

Its

Goitre.—

...

...

...

...

...

73—78.

CHAPTER Xn.
Hydrocele, Hernia, Scrotal Tumours, Upadams'a (disease of the genital organ) and Elephantiasis:— Classification of Vriddhi Definition and Premonitory Symptoms of Vriddhi. Symptoms of Dosha-origined Vriddhi Raktaja Vriddhi.— Medoja Vriddhi— Hydrocele. Inguinal

— —
IV

— Symptoms of different Dosha-origined types of Upadams'a. — Definition of Elephantiasis. — Causes and Symptoms of different of Elephantiasis. — Prognosis of Elephan—Localisation of Elephantiasis. 79 — 84.
Hernia.— Upadams'a
Upadams'a.

— Raktaja

l<:inds

tiasis.

...

...

...

CHAPTER
Diseases known by the general ailments): The Names and Symptoms

XIII.
of Kshudra-Roga (minor

name

— of the diseases included therein. Ajagallika — Yava-prakhya — Andhalaji — Vivrita — Kachchhapika — Valmika — Indra-vriddha— Panasikd — Pashana-Gardabha— Jala-Gavddabha— Kakshl — Vishphota — Agni-Rohini — Chippa — Kunakha— Anus'ayi — Vidarika S'arkararbuda — Pama — Vicharchikd— Rakasa — Pdda-darika — Kadara Alasa — Indra-lupta (Alopecia) — Darunaka — Arumshika — Palita — Masurika —Tila-kalaka — Nyachchha — Charma-kila—Vyanga— Parivartika— Avapatika — Niruddha-Prakas'a— Niruddha-guda — Ahi-putana — Vrishanaetc.

kachchhu— Guda-Bhrams'a.

...

...

...

85

93.

CHAPTER
Suka-dosha:
Progonsis.

XIV.
of
...

Its

classification.
...

— Symptoms
...

different
...

Types.
94

...

96.

CHAPTER XV.
Fracture and Dislocation, etc :— Th.ir Causes.— General
of Sandhi-mukta (Dislocation).
features

— Diagnostic Symptons of Dislocation. Different kinds of Kanda-bhagna (Fracture) — General symptoms of Kandabhagna. — Curable and incurable Types. 97 — loo...

...

...

CHAPTER
Mukha-Roga
general):

XVI.
the
cavity of

(Diseases

which

affect

the

mouth

in

— General Classification and Localisation. — Dosha-origined Types. — Raktaja Type — Mangsaja

Di.st.ases of the lips.

Type

— Medoja
specific

Type
Symp-

—Diseases of the roots of the teeth.— Their Names
proper.
Their

and

toms.— Danta-Nsidi (Sinus at the root of a tooth).— Diseases of the tooth Their Names and specific Symptoms. Diseases of the tongue

Names and

specific

Symptoms.

— — Diseases of
of the

Names and

specific

Symptoms.— Diseases

Palate— Their Throat and Larnyx
the

— Their Names and specific
toms of Rohini.— Diseases

Symptoms.

— The

different
...

Kinds and Symp...

in the entire cavity.

loi

— in.

End

of the contents of Sutra-sthana-

SAPxlRA

STHANA.

(Section on Anatomy).

CHAl TER
first

I.

The Science of Being in General :— The
Principles.

Twenty-four Tattwas or

—The Puru.sha or the Primordial Being or the Self-conscious
or

Reality.

—The Prakriti

the External

Nature personified or the nonDiversity.

conscious Eternity— Traits of
the

Commonalty and

— Comparison of
five

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

other
the

— Prakriti
...

and Purusha how understood in

A'yurveda

— Different
...

kinds of Ma}ias (mind).
specific function

— The

Primary

Elements of Creation
in creation.
...

— Their

— Their
...

mutual co-operation
...

in.

I2i.

CHAPTER

II.

— —Traits of pure and healthy Semen and Cataminal — Menorrhagia. — Amenorrhcea. — Their treatment. — Regimen to be observed during Menses. — Conduct of husband during the period. — Prohibited Conduct. — Causes of different Colours period. —Conception — Subsequent in the child. — About twins — Causes of the child being of Defective Organ the child —Fecundation without sexual intercourse — Causes of Deformity 122—133, — State of the Foetus — activity while in the womb.
Specific treatment.
in
Its
...

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

fluid.

CHAPTER
Pregnancy,
Matter.

III.

etc.

:

— Combination

of

Self

with

the

Impregnated

— Factors which determine Sex. — Period and
of

Signs of Menstruation.
Gestation.

— Signs

Pregnancy.— Prohibited conducts during

— Develop-

— —

VI

mcnt of the

FoeUis.

— Longings and
{\v2

its

effects

during pregnancy.— Develop-

ment of the Foetus from

Sixth to the Eighth

— Different

opinions on the formation of the Foetal body.

month.— Time of Delivery. The solution^

Factors respectively supplied by the Paternal and Maternal Elements, etc.
External Signs of Male, Female and

Twin

conception.

...

134—143.

CHAPTER

IV.

The development of Factors in the womb as well as the Factors which contribute to the growths of its different bo;lily organs and The definition of principles :— Different folds of skin over the foetus. Why and how semen is Kalas and their varieiies. Seat of the semen.

discharged.
Foetal

— Placenta. — Formation of different limbs and organs of the — Heart and action. — Effects of day— Sleep and sleep. — Somnolence. — Effect of -Sleep on an Enciente woman. — Gnawing. —The temperaments. — Symptoms of Vataja, Pittaja and Kafaja temperabody.
its effect.

its

ments - Symptoms

of

Dvandvaja and Sannnipalika temperaments.— Sattvika,
... ... ...

Rajasika and Tiimasika features.

1

44

158.

CHAPTER
Enumeration
of the dfferent

V.
of foetus.—

The Anatomy of the Human body :— Definition
Limbs and Membeis
of body.
^Jala

— Their Numbers or Plexuses. — Kurcha The Cavities or Viscera. — Channels. — Kandara. — or Cluster. — Sevani or Sutures. — Asthi-Sanghata. — Simanta. — Bones of the four Extremeties. — Bones of the Trunk. — Bones above the Cavicles kinds of Bones and their situation — Sandhi or Joints. Different Joints of the four Extremities. — Sandhis of the Koshtha and Clavicles. Their forms, distinctions and locations. — 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. 15c — 172.
...

..,

CHAPTER
The Marmas
Marmas
or Vital parts of

VI.

the

body:— Classifications

of

— Their different Numbers. — Their Locations. — Their Names and Distributions. — The different Heads of Marmas. — Qualitative Classes. Different opinions on Marmas. — Marmas of the Extremities. — Marmas of — Marmas in the Back. — Marmas in the Clavicular region. the Thorax, — Their specific Symptoms wh;n injured. 173 — 190.
etc.
... ...

1

— —

VI

CHAPTER
The Description and
System:

VII.

Classification of Sira or the

Vascular

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

...

...

The method of
Preliminary Rules.

CHAPTER VIII. Venesection — Persons
:

unfit for

Venesection

:—

— The Jantra-Vidhi or how the patient should be placed in cases of Venesection. — Venesection in the E.vtremeties. — Venesection on the different parts of the body. — Proper and Defective Venesection — Classification

and definition of Defective Venesection.

...

...

198

— 208.

CHAPTER
and Number of Dhamanis.

IX.
-.—Region

The Description of the Arteries, Nerves and Ducts

— Functions
...

of

the

up-coursing Dhamanis.
lateral cours-

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

Dhamanis.— The

Situation of the Srotas

and the
...

specific
...

Symptoms
209
215.

when

pierceil at the roots.

CHAPTER
day
of

X.

Nursing and Management, etc of Pregnant
conception
till

Women

from the

parturition

:^ General rules.— Especial Regimen

during the period of Gestation.— Sign of imminent Parturition— Effects of

premature

Urging

— Preliminary
etc.

Measures. —Post-parturient Measures.—

Natal Rites. —Diet for Children.— Treatment of the

Mother— Makkalla

pain

and

its

treatment.

— Management
child.

— Examination, —Infantile Diseases and their Diagonosis — Treatment of Infants.— — Symptoms when malignant —Nursing of the child.— Eductation and Marriage. — Defective Pregnancy— treatment. — Manage-, Symptoms and Medical treatment. — Miscarriage —
Wet-nurses.
I ifantetc.
ile Elixirs.

— Lactation. — Selection of of Breast-milk. —Treatment of Wet-nurses.
of
the Child.
stars,

strike

Its

Its

ment of Pregnancy and
c

special Recipe for Pregnant
... ...

Women
..

according to

months of Gestation.

216

—238.

End

of the contents of ^arira Sthana.


VIII

CniKlTSITA STUANA.
(Section on Therapeutics).

CHAPTER
The two kinds
Classification of
specific

I.

Ulcers.

of inflamed Ulcers:— The Causes, Symptoms and General and Mioiwlliic antl Traumatic ulcers.

Symptoms. —Symptoms of
ulcers.

toms of Blool-origined
tics.

—The sixty different

— Symp— Symptoms of Suddh% Vrana. —TherapeuFactors of medical trcatmcnl of ulcers. — Upadrava
different Dosha-origined ulcers.

or the Supervening

Symptoms

of ulcers.

...

...

269—264.

CHAPTER
Dirfjronl
specific

II.

Sores. — Their dcfinilions — Their —Treatment of Cuts or Incised Wounds. — 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.

The medicil tr3itm3nt of Traumitic Wounds or Sores :—
Shapjs an
1

Clasiificati mis

of

Symptoms

— Their

treatment.

...

CHAPTER
The
Symptoms
of incurable fractures.
Prrgnosis.

III.

medical treatment of Fractures and Dislocations :—

— Bandage, — Diet. — Defective
of
fractures
in

Bandaging
lir.ibs.

—Washing. —
Gandha-Taila.

— Treatment
of
...

particular

— Suppuration

fractured

Bones
...

— Symptoms
...

of Complete

union of fractured Joints.

279

—288.

CHAPTER
The medical treatment

IV.

of Vata-VysCdhi or

Nervous disorders
to

:

—Nervous

affection of the

A'mas'aya

—Nervous

afifections of the

Pakvas'aya

Tilvaka-Ghrita.

—S'alvana-upanaha. —General Measures beneficial Vata-Vyadhi. —The —The Anu-Taila. —The S'ata-paka and Sahasra-paka Taila, —The Patra-lavana. —The Kanda or Sneha-lavana. —The Kalyanaka289— 296. lavana.
••. ... ...
... ...


IX

CHAPTER
The
Vata-Rakta.
Its

V.
of

medical treatment of Maha-Vata-Vyadlii :— Causes

— definition— Premonitory symptoms — Specific features of Vata-Rakta — Prognosis. — Preliminary remedial measures. — Plasters etc — Treatment of Vata-Rakta with a preponderance of different Doshas. —The Pradehas — Guda-Haritaki and Pippali-Vardhamana Yogas. — Diet. Regimen of conduct. — The Medical Treatment of Apatanaka. — Traivrita Ghrita. — Treatment of Pakshaghata. — Treatment of Manya-stambha. Treatment of Apatantraka. — Treatment of Ardita. — Kshira-Taila. Tympanites — Hingvadi-vati.— Symptoms and Treatment of Urustambha. — Therapeutic properties of Guggulu. 297 — 315,
five
etc.
...

...

CHAPTER
remedial
measures.

VI.

The medical treatment of Ars'as (Haemorrhoids) :— General

— Application

of

Kshara

(.\lkali).

— Symptoms

of

satisfactory, excessive

and defective Cauterisation.
piles.

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

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

...

...

...

316-328,

CHAPTER
Different

VII.
etc)

The medical treatment of As'mari (Urinary Calculus,
modes of treatment
in

;—

— Treatment of Vataja, Pittaja and Kaphaja As'mari. — Alkaline treatments. — Modes of Surgical operations. — Prognosis. — Lithotomic operations. — Post-surgical measures. — Surgical treatment in Seminal Concretions. — Diet. — Parts to be guarded in LithoAs'mari.

tomic operations.

...

...

...

...

329-337.

CHAPTER
Classification.

VHl.
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.
treatment. —Specific

— General

measures.

diet.

...

...

...

.


X

CHAPTER
general);

IX.
in

The medical treatment of Kushtha (Cutaneous Affections

— 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. — Mahd-Vajraka Taila. — Treatment Khadira. — Diet. 346-361.
plasters.
treatS'vitra.
liy
...

...

...

CHAPTER
Affections).

X.

The medical treatment of Maha-Kushtha (Major Cutaneous
(Wine)

and

— Mantha-Kalpas. — Diet. — Medicated Arishtas, Asavas, Suras Powders. — Medicinal Ayas-kriti. — Aushadha Ayas-krili.
Ayas-kriti. -^Khadira
...
...

— Mahaushadha
parations.

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
.Specific

— Preliminary treatment. —The — Specific treatment of Kaphaja Meha — 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-Pidaka
Eruptions which mark the sequel of a case of Prameha)
:

— Curable cases of
for...

Prameha-Pidaka. bidden

in cases of

—Treatment. — Dhanvantara-Ghrita. — Fomentations Madhu-meha. — S'ala-saradi Avaleha. —Navayasa Churna.
...

— Loharishta. —Traits of cure.

...

379-385.

CHAPTER
The medical treatment
properties and

XIII.
origin,

of Madhu-meha :— S'ila-jatu— Its

use.— The Mdkshika-Kalpa.

— The Tuvaraka-Kalpa.

286-391.

— —
XI

CHAPTER
The medical treatment
condition of the

XIV.
with an abnormal

of

Udara (Dropsy

— 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. — Chavya Ghrita. — Anaha-Vartis. —Treatment of Plihodara. — Shat-palaka Ghrita. — Treatment by Venesection. Treatment of Baddha-Gudodara. — Treatment of Parisravi Udara.— Treatment of Udakodara. — Treatment by tapping. — Diet. 392-403.
Abdomen)
:

articles

..,

CHAPTER
The medical treatment
presentation
of

XV.
(Difikult and mal-

of

Mudha-Garbha
Labour)
Fcetus.
:

the Foetus

and

Difficult

—Varieties
...

of

Mudha-

Garbha.

— Incantations. — Postures
Foetus.

of

the

— Operations

involving

destruction of the

men

ofconduct.

— The

Bala Taila.

— Craniotomy. — After-measures. — Diet — The Bala-Kalps.
CHAPTER
XVI.
(Abscesses) and

and

regi-

404-411.

The medical treatment of Vidradhi
Classifications.

Tumours:—

— Tieatment of Vataja, Pittaja and Kaphaja Vidradhi.^ Karanjadya Ghrita. — Treatment of traumatic and blood-origined types. Treatment of 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
(Erysipelas)— Treatment of Vataja and Pittaja Visarpa.

—Treatment of Kaphaja Visarpa. —Treatment of NadiKaphaja and S'alyaja Nidi Vrana (Sinus). — Treatment of Vataja,
Gauryadi Ghrita.
Pittaja,

(Sinus).

— Alkaline

treatment— Treatment

by

Plug-stick

Taila

— Treatment of

Stana-Roga — Purification
... ...

of breast-milk
... ...

— Bhallatakadya — Surgical
418-426.

treatment of Stana-Roga.

CHAPTER

XVIII.

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


Xll

— — —

Kaiihaja and Mcdoja GrantM — Trcaliiicnt of Vataja, — Medical treatment of ApacM- — Surgical treatment of Apachi. Kaphaja and Medoja types of Arvuda — Treatment of
Iroatnicnl of
I'itlaja,

(Iranlhi.

\'al:ija,

I'ittaja,

Arvmla

(Tumour).
of

Gala-ganda— Treatment
(Ooitre).
...

of Vataja,
...

Kaphaja
...

and

Medoja types

Gala-ganda

427-438.

CHAPTER
Tumour,

XIX.
(Hernia,
(Jenital
Pittaja,

Ihe medical treatment of Vriddhi etc.), Upadams'a (Disca.sts of the
:— Treatment
of

Hydrocele. Scrotal

Organ) and Slipada
Kaktaja,

(Elephantiasis)

Vataja,

Kaphaja,

Medoja and Mutraja Vriddhi. Treatment of Antra- Vriddhi. ment of Upadams'a (jeneral treatment Treatment of Vdtaja,

— TreatI'ittaja,

Kai)haja,

Tridoshaja and

Kaktaja types of
of

Upadams'a.

—Treatment
...

of

Slipada

— General treatment — Treatment types of S'lipada — Alkaline remedies.
...

Vataja, Pittaja and Kaphaja
...

439

449.

CHAPTER XX
The medical treatment of KshudraRoga
Treatment of Aja-gallika and Vava-prakhya. (Minor Ailments)

:—

Treatment of S'arkararvuda,

etc.

— 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 Suka — The specific treatment of the different types of S'ukadosha

— General

treatment.

— Prognosis.

...

...

...

459-461.

CHAPTER
Treatment
of Vataja,
Pittaja,

XXII.
Mfdoja types of Oshtha-

The medical treatment of the Aifections of the Mouth :—
Kaphaja and


2Cm
kopa — Treatment of the diseases of the Danta-mula. — Treatment of Danta-Veshta etc. — Paridara— S'aushira — U pakus'a— Danta- Vaidarbha
Adhimamsa.
different

types of

— Treatment of Danta-nadi. —Treatment of the diseases cf the Tooth proper. — Treatment of Tongue-diseaseS —
V'ataja,

Treatment of

Pittaja

and Kaphaja types of

tongue-diseases

Treatment of the
Throat-diseases.

—Treatment of —Treatment of Vataja, Pittaja, Kaphaja and Raktaja different types of the Sarva-sara types of Rohini. — Treatment of the Mukha-Roga. — Incurable types of Mukha-Roga. 462-474.
ditTerent

types of

Talu-gata

diseases

...

...

CHAPTER
general

XXIII.
(Swellings).— Ckissifications of

The medical treatment of Sopha
S'opha
Its

— causes. — The specific symptoms of Dosha-origined typosof S'opha. — Symptom of Vishaja S'opha — Complications — Prognosis. The .Special treatment of the different types of S'opha. — General remedies.
—Diet.
... ...

...

...

...

475-477-

CHAPTER
Tooth-brushing

XXIV.
is

The Rules of Hygiene and the Prophilactic Measures :—

—Cases where tooth-brushing forbidden. — Eye Mouth—Colly rium. — S'iro'bhyanga. — Combing. — Anointing. — Parisheka. —Affusion. — —Anointments. — Prohibitions of Anointments, — Rubbing and Friction. — Massage. — Bathing. — ProhibiPhysical tion of Bathing. — Anulepana. — A'lepa. — Food. — Pravata and Nivata. Drinking Water, Sleep — General Rules of Conduct. — Rules — Curd to (Dadhi) — When and llovv to be taken. — Women —Evil
arid

washing.

Effu.sion.

etc.

E.Kcrcise.

for

etc.

unfit

visit.

Effects of the foregoing Abuses.

«

...

...

4S0-502.

CHAPTER XXV.
The medical treatment
the Ear-lobes

of a Variety of Diseases

:— Diseases
etc.

of

—Classification— Causes and Symptoms— General treatment Specific treatment. — Treatment of Palita.— Treatment of Vyanga,
503-504-


XIV

CHAPTER
Virilg

XXVI.
.4ng the Strength and the
six

The medical treatment for Power of weak persons

inc>?v:
:

— Definition of Vaji-Karana — Means of
incapacity.
etc.

— Causes and Syniplonis of the Forms of Sexual — Incurable types. — Remedies— Utkdrika— Pupalika. — Cakes
V.-iji-karana.

510-514.

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 Kasayana. — Rasayana Mental — V'idanga-Rasayana — Vidanga-kalpa — Kas'maryafor

Varahi-kalpa

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

Naga-bala,
...

Vidari and S'atJivari-kalpa.
... ...

(-seeds).

515-521.

CHAPTER XXVni.
The
Elixirs

and Remedial Agents which
the
:

tend to improve
to

the

Memory and
Duration

invigorate

Mental Faculties as well as

increase the

of Human Life — S'vetavalguja- Rasayana — Krishnavalguja— Manduka-parni-Rasayana— Biahmi-Rasayana — Brahmi-Ghrita —Vacha-Rasayana— S'ala-paka-Vacha-Ghrita. — Measures for prolonging — Uses of Gold. 522-523.

Rasayana

life.

...

...

...

...

CHAPTER
innate morbific tendencies and decays
:

XXIX.
which
arrest

The Restorative and the Constructive Agents
using the Soma.

Therapeutic

efifects.

— Regimen of Diet — Distinctive features
Habitats.
...

— Classifications of Soma. — Mode of and Conduct after taking Soma. — Its
of the Soma-plants
...

—Their des530-538.

criptions—Their

...

...

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

— Persons the use of Rasayna. — Names of the healing —The Mode of — Regimen of Diet and Conduct — Dosage — Differentiating —Mode of Culling the above 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

XXXI.
:

of Sneha, etc, — Classifications of Sneha —Measures of drugs. —The —The Kashaya-paka-Kalpa — The Sneha-paka-Kalpa. — Alternative methods. Dosha and Season. — Degrees of Application of Sneha according to of the complete cooking of a Sneha. Cooking a Sneha — Distinctive Process of Internal Use of Sneha — The Specific Uses of Clarified butter The Dosage. — Evil Effects of over-dosage— Sadyah-Sneha. — Forbidden cases of Sneha-pana. of Sneha-pana. — Good 546-557.
Description

Sneha

specific

uses.

specific

traits

Eff"ects

...

...

CHAPTER XXXU.
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 perand imperfect Sveda. — Measures to be followed after Sveda. 558-564.
Its

CHAPrER xxxni.
tives

The Distresses which prove amenable and Emetics :— Importance of Purgatives
of Emetics.

to the use of Purgaand Emetics. Mode of

application

— Symptoms
is

of excessive, satisfactory and deficient
is

— Effects of satisfactory Emetics. — Cases where Emesis forbidrecommended. — Mode of administering —Cases where Emesis Purgatives. — Classifications of Koshtha. —Diet. — Benefits of proper Purgation. — Persons who should not be purged. — Persons who should be purged. — Necessity of applying Sneha before the administration of Purgative or
Emetics.
den.
I

Emetic.

...

...

...

...

...

565-5S9-

CHAPTER XXXIV.
The treatment of the Disorders resulting from an Injudicious Use of Emetics or Purgatives ;— Their Classes.— Causes and treatment.

— Evils of an — Flatulent

Unpurged Residue of a Purgative

or Emetic.

Digested Purgative,
Doshas.

— Evils of Colic. — Partial
etc.

— Evils of a
due
to

insufficient or excessive expulsion of the

and Deficient Medication (Ayoga).
(Ati-yoga).

Over-drugging with purgatives,
excessive
to

etc.

Vomiting or excessive Purging (Jivadana).

be known.

—Flatulent distention of

— Haemorrhage —

^Jiva-s'onita,

how

the

Abdomen (Adhmana). — Cutting


XVI
pain
in

the

Anus,

etc.

— Dysenteric
the
heart.
...

(Pravahii-:a).

— Overwhi.-lming
...

stool

and

urine.

(Parisniva). — Diarrhoea stools — Retention (Vibandha) of 577 — 589.
...

flatus,

...

CHAPTER XXXV.
The Dimensions and
Classifications of a

Netra and a Vasti

— — — 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 Vasti. 590 — 598
Pipe.
...
...
...

with, their therapentic applications -.—The importance of VastiKarma. The application of Vasti in different diseases. Dimensions of the

...

...

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 Niruha-Vasti

— Remedies
...

Complications
for

and Sneha- Vasti.

—Intervals
...

the application of Purgative,
Vasli.
...

Emetic,
...

Asthapana-Vasti and Anuvasana-

...

599

— 607.

CHAPPER
Process of Annvdsana-Vasti
Oils and Snehas.

XXXVII.
preparing
several medicated

The treatment with Anuvasana-Vasti and Uttara-Vasti:— The

— The process of
for

— The excessive, and — Symptoms of satisfactory application of Anuvasana-Vasti. — Diet the application of a Vasti. — The Successive Actions of a Vasti. — Distresses from Injudicious 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
the application

of Sneha-Vasti.

mode

of applying a

Sneha-Vasti.

insufficient,

after

for

for

patient.

to

...

...

...

...


XVll

— —

CHAPTER
:

XXXVIII.

The mode of applsring, 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 ing a Vasti. treatment and Diet Drugs to b2 uS2d in a Niruha-Vasti. The Formula of a Niruha-Vasti. The process of preparation. The Dvadasa-Prasriii.

Classifications of Vastis according to the range
cations.

of their

therapeutic appli-

—Corrective Vastis. — Lekhana-Vasti. —Vaji-Karana-Vasti. — Vrimhana-Vasti. — Pichchhila-Vasti. — Grahi-Vasti. — Sneha-Vasti. — Utkles'anaVasti. — Dosha-hara-Vasti. — Soothing Vasti. — Yukta-ratha-Vasti.— Siddhathe composition of Vastis in cases Vasti. — Mustadika- Vasti. — Variations of persons of different Temperaments. — Nomenclature of different Vastis Specific Uses. 637 — 646. and
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.

647—652.

CHAPTER
(Fumes),

XL.

The treatment which consists in employing the Dhuma Nasya (Snufis) and Kavala (Gargles) ;— Classifications of Dhuma — Materials of different Dhuma-Varti. — Formation of the Pipe used in Dhuma-Pana — Mode of inhalation of different Dhumas— Prohibitive cases

—Time

of

Pana— Mode
clature of

Dhuma-pana (Smoking) The therapeutic effects of Dhumaof Smoking.— Snuffs and Errhines (Nasya)— The Nomenthe term "Nasya" Classifications of Nasya S'iro-Virechana Its

application

— Dosage

of Sneha-Nasya

— Effects of

proper, excessive and defi-

—Avapida-Nasya— Forbidden cases. — Specific use of SnehaNasya. Kavala-graha (Gargles) — Classification — Mode of application Their us js— Kavala and Gandusha distinguished — How long Kavala should be retained — Symptoms of satisfactory, deficient and excessive Gargling. — Prati-sarana — classification and 653 — 671.
cient application

of a Sneha-Nasya

Prati-marsha Nasya

when

to

be used—

Its effects.

Its

effects.

...

End

of the Contents of the Chikitsita Sthana.

— —

KALrASTUANA.
(Section on Toxicology).

CHAPTER
Poison
:

I.

The mode of Preserving Food and Drink from the

effects of

— The ncccbsary quahficaiions of a SupcrintLndent of the Royal KiUlicn — The necessary features of a Royal Kitchen. — Characteristic features of a Poisoner. — Indications of poisoned food and drink, — General 673 — 684. treatment. — The mode of preparing Soup,
etc. etc.
...
...

CHAPTER
The Indications
Poisons
:

II.

(Effects,
Its

Nature

and Operations) of Sthavara

— Sthavara I'oison — source. — Names of the different V^egetable and Mineral poisons. — 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
meaning of Dushi-visha
Poisoning

— Symptoms
...

of the different stages of

Sthavara

—The
...

medical treatment.

— Koshatakyadi-Vavagu— Ajeya-Ghrita
••• •••

—Vishari Agada. —Treatment of the supervening Symptoms of Poisoning. 685 — 694. Prognosis.
•••

CHAPTER
The Subject
Water.

III.
etc.

of

(the nature, virtue,

of)

Animal Poisons
o)

:

Different locations— Characteristic

features

and
its

purifications

poisoned

purification. — Mythological — Poisons in the Atmosphere and — Properties of Poison— Nature and Location of Snakepoisoning— Symptoms of taking poison poison — General treatment of — Prognosis. internally. — Fatal 695 — 702.

origin of Poison.

bites.

...

...

...

CHAPTER
The
tions of

IV.

Specific Features of the Poison of a Snake-bite

;— Clasifica-

— Classifications of Snake-bites—Their specific Symptoms Characteristic features of the different species of Snakes. — Features of the different Castes amongst Snakes. — Particular Habits of the different kinds of Snakes. — Names of the different species of Darvi-kara Snakes — Names of
Snakes


XIX

—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 Darviihe different species of Mandali Snakes

Rajiman Snakes

kara Snake —Specific symptoms of a bite by a Mandali Snake

— Specific

— Specific symptoms of bites by — Symptoms of the different stages Snakes of different Sexes and Ages, of poisoning from the bites of a Daivi-kara Snake — Different stages of poisoning from the bite of a Mandali Snake — Different stages of poisoning
symptoms of a
bite

by a Rajiman Snake
etc.

from the bites of a Rajiman Snake.
Stages.

—-The

Vegdnlara

(or the intervening)

—Different

Stages of

poisoning in cases of Lower
... ...

Animals. 703

Different stages of poisoning in cases of Birds,

— 714.

CHAPTER
of

V.
bites

The medical treatment of Snake
Snake-bites.

:— General
in

treatment

— Mantras
of

(Incantations)

— Blood-letting
be resorted

Snake-bites

Specific treatement of the bitJ by a

Hooded

(Darvi-kara) Snake, a Mandail

Snake and a Rajiman Snake.
Snake-bites.

— Contra-indication to blood-letting in cases of
etc., to

— Dosage

CoUyrium,

to

in

cases

of

different Beasts

and Birds.

— General dosage of medicines in cases of Snakefor

— Specific treatment of poisoning according to the Physical Symp'oms — Specific treatment of the different Supervening Symptoms. — Remedy
bites

the aggravated

Doshas due

to

Poison

— Medical treatment of persons made
— Symptoms

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

—Treatment of a Poisoned Wound Recipe of different Agadas — Mahagada — Ajitagada — Tarkshya'gada— Rishabhdgada — Sanjivana Agada — Darvi-kara Rajila-visha-hara-Agada — Manwounds from Poisoned
Darts, etc.

dali-visha hara

Agada— Vams'a-tvagadi Agada— Pancha-s'irisha Agada

Sarva-Kamika Agada

— Ekasara Agada.

...

...

71c

727.

CHAPTER
Cases Symptoms
poisoning

VI.

of
of

Varieties of I\.ats— General Kat-poisoning— Specific symptoms and treatment of Rat:

Rat-poisoning

— Different

phobia
bites

— General treatment. — Causes of Rabies— Symptoms of Hydro— Prognosis.— Symptoms of Jala-trasa— treatment— Treatment of by rabid-dogs —Treatment of teeth and nail-scratching. 728 — 736.
Its


XX

CHAPTER

VII.

Treatment with ths Sounds of a (medicated) Drum, etc, possessed of Anti-venomous Virtues — Kshaiagada— Its Uses and
:

Thirapjiilic

ElTecls

— Kaly.inaka-Gliri'a— Ainrita-Ghrita —

Mahd-sugandhi

AgacU

—^Rules

of Diet and Conduct.

— Symptoms of Elimination of Poison.
737—741.

CHAPTER
On insects,
Insect-bites,
Insects

VIII.

ie-, the
etc^

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

of Vataja,

I'iltaja,

Kaphaja

and .Sannipatika

temperaments.—

class of Insects

— The Kanabha class of Insects — The Gaudheyaka — S'ala-padi — Manduka (Frogs) — Pipilika (Ants) — Makshiki (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 their Bites
trails

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 Luta- — 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 Sthana-

THE

SUSHRUTA SAMHITA
NIDANA STHANAM.

rMAPTER
Now wc
shall

I.

discourse

on

the

Vatavyadhithe
feet

(discascs of the nervous system)

Nidaaam*.
clasped
of

IVIctrical
the

text: — HavinL;
who had
pitcher

holy

Dhanvantari,

arisen out

of

the
his

primordial ocean with the
head, and

of ambrosia
all
:

on

who was
of

the foremost of

Sus'hruta interrogated him as follows
the

—"Tell me.O thou,

knowers of

truth,

foremost

discoursers,

all

about the different

locations

both

in
it

its

and functions of the bodily Vayu (nerve force), normal and agitated conditions, (as well as
its

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 greatest

of

all

healers,

having listened to the foregoing words of Sus'hruta, replied as follows: This vital Vayu (nerve force), which courses

through the
*

body,

is

self-begotten
translated

in its

origin,
is

and
to

The term Nidanam,
factors,

usually

as Pathology,

meant

include

which

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

tliK SUSIIKUTA SAMUITA,

t<^''ai'-

1-

is

regarded as identical with the divine energy of eternal
(God),
its
is

life

inasmuch as
and

it is

unconditional and absolute
eternal

in

actions

effects,

and
the

self-origined,

and

subtile and all-pervading (like
It
is

sky and the

atoms).

the primary factor, which determines the

principle of
things,

cause

and

effect

in

all

forms of created
It
is

whether mobile or immobile.
its

so called

(Vciyu) from the fact of

coursing (skr.
It all

Va — to move)

throughout the
origin

universe.

determines the growth,

and disintegration of
it

animated organisms, and
of
all

as such,

receives

the

homage

created

brings.

Although

invisible in itself, yet its
is

works are patent or
dry and piercing, and
characterised

manifest. It

cold, light, mobile,
It
is

follows a transverse course.

two

attributes (propcr-sensiblcs or Gunas) of sound
It

by the and

touch.

abounds

in the

fundamental quality of Rajas
is

(principle of cohesion

and action),

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 their actions). It is instantaneous in its action, and radiates or courses through the organism
in

constant
in

currents.
intestinal

It

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
the

w^ith the

deranged Pittam
diseases,

and Kapham\

lies at

root

of

all

and
3.

is

accordingly termed the king of diseases (Rogarat).

of State:— Now, hear me
mark The Vayu,
the

The action
Vayu,
in its

Vayu
courses

in its

normal

describe the

symptoms, which

as

it

through the organism.

tains a state of equilibrium

normal or undisturbed condition, mainbetween the different Doshas
;

and the root principles of the body (Dhatu)

it

further

6

Chap.

I.]

NIDAXA

STIIAX.nr.

3

tends

to

maintain uniform state in the metabolism of

the body, (protoplasmic,

Agni*)

and helps the organs
the

of sense-perception in discharging their specific functions.

The bodily Vayu,
grouped under
difference in
its

like

the

Pittam

in

organism,

is

five different

subheads according to the
is

functions and locations, and

classified

as

the

Prana,
five

Udana. Samana, V}-ana and Apana.-j*
of

These

classes

Va\-u,

located

in

their

specific

regions,

contribute

towards the integration and main4

tenance of the bod}'.


:

The Prana Vayu
function being to force

—The Va}-u. that courses
is

in
its

(governs)the cavity of the mouth. ^

called the Prana.

down

the food into the cavity of

the stomach, and to assist the different vitalising principles of the bod}- (such as the internal heat or
fire

etc

)

in dis-

charging their functions

in

life,

and

to contribute to the

general sustenance of the body.
this particular

A

deranged condition of
is

kind of

Vayu
:

(Prana)

usually followed

by hic-cough,d}'spncca and other kindred distempers. 7. The Udana Vayu —The most important of the
vital Va}'us,
is

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 stomach
*

Samana Vayu
in

(Amashaya) and

the

See

Inlroduction Vol.

I.

p.p.

XLVIII — XLIX Mahamahopadhyaya
Agni as digestive heat {Jalhardoni).
nerve
centre
in the

Dvatka Natha Kaviratna
t
in the

interprets this
is

The Prana Vayu
medulla
;

identical with the energy of the

the

speech centre.

Udana vilh that of The Samana is same
is

the one which
as

is

situated

the

energy

of the

epigastric

plexus, the Udar.a

same as the energy

of the Motor-Sensory Nerves,
ple.xus.

and

the

Apana % The

is iden'.ical

with the force of the Hypogastric

field

of

its

ac'ion includes the regions of the heart, throat, head

and the nose.

^

TIIK SUSIFRUTA SAMIIITA.

tChap.

I.

rc:jion of intestines
cli<'cstin<^-

(Pakvashaya).

Its

functions consist in
in

the

chyme brought down

into the intestines

unison with the digestive ferment (Agni), and especially in disintcorating its essence from its refuse or excreted
matter.

deranged or aggravated condition of the Samana Vayu causes dyscntcr\-, Gulma, and impaired
digestion, etc.
9.
:

A

The Vyana Vayu —The
Vyana
courses
(.acts)

Va\-u

known

as the
its

through the whole organism, and
sending the lymph chyle

functions consist

in

etc. all

through the body and in helping the out-flow of blood (Asrik^ and perspiration. Five kinds of muscular movements* are ascribed to the action of the Vyana VAyu,
a deranged

condition

of

which

is

generally attended

which arc not confined to any particular with region, member, or organ of the bod>-, but are found to 10. affect the whole organism (such as, fever, etc).
diseases

The A pan a Vayu
Apana ads
in

:

— The Vayu
region
in

known
the

as the

the

lower

of

intestines

(Pakvadhana). Its functions consist
Retus and the fitces and
in

bearing

down

the

evacuating the urine, semen

and catamenial blood.
tends to bring on

An

enraged condition of this

Vayu

.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 Vaj-us 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
as expansion, flexion, lowering do

body.— In
v.'n

the cavity
up or
lateral

Such

and

lifiing

thrusting of any part of the body.

Chap.

I.]

NIDANA STIIANAM.
stomach (Amt'ishaya) the deranged or
at

5

of

the

aggrafits,

vated
thirst

Vayu

gives rise to vomiting, vertigo, epileptic

and pain

the

sides

(ParsVa Sula) and about
In

the region of the heart (Hridgraha).

the

intestines
rise

(Pakvashaya) the enraged or disturbed Vayu gives
region of the
umbilicus,

to a rumbling in the intestines, a piercing pain about the
scant}'

and painful urination and pain
Similar-

and

stool,

or their entire suppression (Anaha),

about the region of the coccyx (Trika). 13
ly,
it

15.

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

tends to deprive

them of
it

their

respective faculties.

In the skin

(lymph ch>le)

produces a discolouring of the
in the

complexion, parchedness and twitching
causes
a

skin,

and
a

complete local
piercing

anaesthesia,
in

giving

rise to

tingling,

pain

the

skin,

which spontanefissures.

ously bursts, or becomes marked with cracks and
Similarh',

the

aggravated

Vayu

interfering

witli

the
it

principle of b'ood gives rise to

ulcers.

In the

flesh,

produces painful nodes and tumours (Granthi), while
the principle of fal
it

in

brings on almost painless tumours
of ulcer.
Incar-

(Granthi)

unattended with an\' kind
Sec.

cerated in the veins

(Sira)

it

produces a stiffening or
;

painful contraction, or a varicose or neuralgic condition
in a

ligament (Snayu).it produces numbness (anaisthesia),
aching pain and convulsive jerks
it
;

pals\-,
it

in

a long joint,

tends to deprive
painful

of

its

contractibility

and produces
affected

a

inflammatory swelling
it

(about the

part).

In the bones

produces a wasting (atroph)') of

the bones which crack and begin to spontaneously burst,

attended
that
dr}'

with the characteristic bone-ache.
life,

Again
it

in

important principle of
it

the marrow,

tends to
all

up and produces a

sort of pain,

extending

over

the body which
in

the principle

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

Similarly,
a
scanty,

6
defective,

Till'.

SUSIIIiUTA SAMIIITA.

[Chap.

I.

or excessive

emission of that vital

fluid,

or a

complete stoppage thereof,

16—23.
and agitated,
over the
affects
in

The
bod\',

Vayii, thus the

disturbed

succession

lower

and

the upper extremities of the
all

body and deranges all its root-principles (Uhatu). The symptoms, which mark such conditions of the bods', are numbness
and the head, or extends
(paral)-sis),

convulsive ccmtortions of thclimbs (Akshepa),

ana^'sthcsia,

and various kinds of pain (Sula), and swelling

(S'opha) of the bod\-.

ed the natural seats of the Pittam or

The deranged Vayu, having enterKapham, develops
to
either

symptoms, which are peculiar
gives rise to

of

them, and

numerous

diseases.

24

— 25.
its

The symptoms, which characterise the union of the
deranged Vayu with the Pittam (in
ness, in addition to the

particular seat)

are a burning sensation, heat, thirst, and loss of conscious-

symptoms

of the Vataja

disease

so

generated

in

that particular part of the body, while

a similar

unison with the

Kapham
in

develops coldness,
part).

swelling

and heaviness (of the affected

The
and

disturbed or agitated
of blood gives rise to

Vayu
a

unison with the

principle
(pins

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

26

— 28.
etc. in
is

Vomiting, and a burning sensation,

the

body,

mark

the instance

when

the Prana
;

Vayu

surcharged

(Avrita) with the

Pittam

while weakness, lassitude,

somnolence
plexion
(

and a general discolouring of the comR.,

D.

loss

of

taste)

characterise

a

case

when

it is

surcharged with the deranged
in

Kapham
(vertigo)

A
and

burning sensation
epileptic
fits,

the body, loss of consciousness or
.sense

and

a

of giddiness


Chap.
I.]

^ID.\NA STIlAXAM.

7

physical

languor are the indications, which distinguish
of the
;

a

case

Udana Vayu being surcharged with
a

the

Pittam

while

stoppage or absence of perspiration,

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

coldness and a
case

numbness
of the

of

the

affected

part

characterise

same being surcharged with

the

Kapham.

29—32.
and
epileptic
fits

Copious flow of perspiration, heat with a burning
sensation in the body,
indicate a case

when

the
;

Samana Vav'u 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.

33

— 34.

Heat and a burning sensation in the affected part and a profuse mcnorrhagia mark a case when the

Apana Vayu becomes surcharged with
as a sense of heaviness in the

the Pittam, where-

lower limbs characterises

a case
5

when

it

becomes overcharged with the Kapham.
burning

y^'

[Symptoms such
limbs,
in the

as,]

and jerking

in

the

and a sense of
event of the

ph}'sical

languor become manifest

Vyana Va}-u being surcharged with
stiff-

the Pittam, while a general heaviness of the limbs,

ness or

numbness

of the bone-joints, and an incapability
its

of locomotion

indicate the fact of

being surcharged

with the

37 — 38. The Nidanam of Vata Raktam —

Kapham.

:

An
course,

over-indulgence in
inordinate

grief,

excessive

sexual

inter-

physical

exercise,

drinking

large

quantities of wine, observance of a regimen of diet and

conduct

in a particular
it,

season of the year which

is

imconor

proper to

use of articles of food which are not

genial to one's

own temperament and an improper

.S

Tin: srsiIKI'lA SAMIIITA,
(as

[CUp.

I.

baneful use of such ()Ua;4iii()U^ substances
fied buLLer etc.) are the factors,

<jil,

clari-

w hich

vitiate in

common
Vayu
or
in

the

blood

and

Pittam

of

a

person.
or

The foregoing
the

causes cspcciall\' tend to

\itiate

agitate

and blood

in

persons

of

delicate

constitutions,
(observe a

corpulent persons, or in those
perfect continence.

who

form

of

39.

The
sive

\ital

Va}

u

becomes enraged or agitated by excescamels or elephants, or through
etc.,

riding on

horses,

the lifting or carrying of great weights,

or by an in-

ordinate indulgence in things which are possessed of the
specific

virtue

of

enraging or
other

aggra\ating

that

\

ital

principle.

On

the

hand, an over-indulgence
in their

in

such articles of food as arc heat-making
or a surfeit of edibles largeh'

potency.

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 pas.sagc of
the fleet-coursing
course, Ibecomcs

Vayu.

The

\';i\u.

thus impeded in

its

more and more agitated each moment,
blood
in

and
way.

is

prone to speedily agitate the

a

similar

The antecedence

of the term

"Vata" or "Va)-u"

in the

nomenclature of the disease (Vata-Rakta)is owing
accorded to the action of the deranged
it

to the precedence

Vayu
this

in

bringing about the malady, although
concert
40.

effects

in

with

the

vitiated

blood

of

the

organism.

Similarl}', the disease

brought about by the agitated
while the

Pittam.
is

in

conjunction with the vitiated or agitated blood,

called the Pitta- Raktam.

one incidental

to

the

combination
is

of

the

deranged

Kapham
In a

with
case

the vitiated blood

called

Kapha-Raktam.

of

Vata-Raktam.

the legs, or the lower extremities

can

Chap.

I.]

NIDANA STHANAM.

9

not

bear the least touch (Hypcrsesthesia) and a sort of

pricking, piercing pain (pins
in

and needles)
legs

is

experienced
withered
or

those

regions.

The
all

become

atrophied
of Pitta
soft

and lose

sensibility

to touch.

In a case

Raktam,

and swollen,

become extremely red, hot, characterised by a sort of indescribable
the legs
In

burning sensation.
legs

a

case

of

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-Raktam,
41

the legs exhibit
to
all

symptoms, which are respectively peculiar
three preceding t\-pcs.

the

— 43.
—In
the incubalegs

Premonitory Symptoms:
tive stage of the disease the

perspire

and become
More-

cold
tion

and
is

flabby, or (on the contrary*, the local perspira-

stopped and the legs become hot and hard.
is

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 lowc extremities, or
the

some

cases,
all

upper ones

and gradually extends

over the bod\' like an enraged rat-poison.

Prognosis
skin
joint

:

—-Theform
or

of the disease inwhichthe

of the part lying between the instep

and the kneebursts

becomes abraded
flesh,

spontaneous!)-

open,

exuding pus and
(Pr^na) and

blood, attended with loss of strength

curvature of the fingers, and eruptions

of nodules, should be

regarded

as

incurable;

while

a

case

of

one year's standing admits only of palliative
44.

measures.

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

and

a

disease,

(exhibiting

such

10

THE SUSHRUTA SAMHITA.
as shaking or convulsive jerks),
is

tChap.

I.

symptoms
which
is

originated

called

Akshepaka* (spasms, convulsions).
in

The
the

form of the disease,
ground,
at

which the patient
is

falls

to

intervals,

called

Apatanaka (Epilepsy
or agitated

without convulsions).

The aggravated

Vayu,

charged with an abnormal quantity of Kapham, sometimes affects and stuffs the entire nervous system, and
gives rise to a form of disease,

which

is

called

Dandaiit

patataakamt (Epilepsy with convulsions), inasmuch as
deprives the

body of its power of movement and flexibility,
and
rigid like a rod

making

it

stiff

(Danda).

45

—46.
is
;

The
its

disease

but rarely yields to medicine and,

cured in rare instances only with the greatest
characteristic

difficulty

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

two distinct types accordis

ingly as the

(Antarstyama,

body of the patient or lit :— inwardly

curved

internally

foi-wardly

extended,
lit
:

emprosthotonos), or externally

(VahirJiyaima,

—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

{iamyale)

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, Antarayamah,
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
curvature
of the

about a
in

The disease this form is called Antarayama Dhanushtambha. The movements of the eyes become impossible, which become fixed in their sockets the jaw-bones become
inner trunk.
;

paralysed,
(at

the sides

are

broken, and the patient ejects
of)

intervals

quantities

slimy mucous (Kapham).

These are the features which mark the first type (Antarayama Dhanushtambha). On the contrary, when the same enraged Vayu, centred or lodged in ligaments
which traverse the posterior side of the body, attracts

them

violently, the

body
and

is

naturally bent

backward.
at

The
the

patient
chest,

experiences a sort of
waist
thighs,

breaking pain

(which are

ultimately

broken).

The

be looked
treatment.

disease is called Vahirayama, and should upon as beyond the pale of all medicinal

47

50.

Four types of Akshepaka are usually recognised
in

practice

such

as,

the

(i)

one incidental to
bodily

the

concerted

action
(2),

of the enraged

Vayu and
(3),

Kapham
of

the one brought about

through the union

the

enraged Vayu with the deranged Pittam,
of

the one due to the single action
(4)
(

the

agitated
injury

Vayu

and the one due to any external

or blow

Abhighataja).*

An

attack of Apatankah due to excessive
abortion
or

haemorrhage, or following closely upon an
miscarriage at pregnancy (difficult labour),
incidental to

or
is

which

an external

blow or injury (traumatic),
51

should be regarded as incurable,
*

52.

Brahma Deva designated
Akshepakab,

the four types of the disease, as Apatanakah,

Samsrishta
(traumatic).

simple

Akshepakah

and

the

Abhighataja

,12

THi;

SUSHRUTA SAMHITA.

[Chap.

I.

The
in

disease, in

affects the nerve chains

which the extremely agitated Vayu (Dhamanis) which spread either
body, whether
in

the

left

or

in the right side of the

the upward,

downward, or lateral direction, making them lax and vigourlcss, and in which the joints of the other side of the bod\- become useless and inoperative, is called
Pakshag-hata
(Hemiplegia)

by

eminent

physicians.

The patient, the whole or half of whose body has 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.

Prognosis:— A
plegia),

case

of

Pakshaghata
the

(Hemi-

brought about through the single action of the
or

enraged

agitated

Va\u

of

bod\', can be cured

only with the greatest care and difficulty.
the
in

A

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
.seat

Vayu,
and

(by

its

specifically
its

exciting factors
natural

and dislodged from

or recep-

body

in

consequence thereof, courses upwards
in the regions of the head, heart

and

finds

lodgment
It

and

temples.
convulsive

presses upon those parts and gives rise to movements of hands and legs, or at times

bends them down.

Symptoms — The
:

patient

lies

with his eyes

closely

shut,

or stares

with a sort of fixed or vacant

gaze,

the

eyes
all

remaining fixed or immovable.
perception,
or

The

patient

loses

and groans.

Respiration

becomes

difficult,

symptoms of temporary asphyxia

Chap,

I.]

NIDANA STHANAM.
set in.

.

1$

and unconsciousness
condition
of
the of the

Consciousness and a normal
the

organism return with
Va\-u from
patient the
heart,

passage
the

enraged
the

while on

other hand

relapses

into

unconsciousness

simultaneously with the envelopment of the heart
that
is

with

enraged and Kapha-^aturated Vayu.

This disease
to

called

Apatantrakah and
enraged
56.

is

ascribed

the

action

of

the

Vayu

surcharged with

the

deranged

Kaphani.

lYIanyastambha:— The
through such causes as sleep
with
the

local

Vayu. agitated

in the da\- 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 in the deranged

Kapham,
stambha
mothers
uld

gives rise to
(wr\-

the

disease

known
57.

as

Manyawomen,
\'ictims

neck or

torticollis).

Arditam

(Facial Paralysis):

— *Prcgnant
to fall

immediately

after parturition (Sutika), infants,

and enfeebled persons arc most prone
It

to this disease*.

has been also

excessive haemorrhage or loss of blood.

known to result from The local Vaj^u,

extremely enraged or aggravated by continuous talking
in

an extremely loud voice, chewing of hard substances,

loud laughter, }-awning, carrving extremely heav\- loads,

and lying down
finds

in

an

uneven position on the ground,
lip,

lodgment in the regions of the head, nose, upper
forehead

chin,

and the

joints (inner cornea) of the eye,

and produces the disease called Arditam by distorting
the face.

Symptoms: — The
shak'"

neck

and half of the face

longitudi- tally suffer distortion

and are bent.

The head
and the
rejected

the power of articulating speech

is lost,

* Tlij portion of the text included within asteribks

has been

by Jtjjal icharyya as spurious.


14

THE SUSHRUTA

SAMillTA.

[Chap.

I.

eyes arc distorted into a variety of shapes.
of the neck
affected side

The
teeth

portions

and the

chin, as well
painful.

as

the

on the

become

Premonitory Symptoms :— The
generally

disease

commences
a pricking

with

.shi\ urin'^^,

horripilation,

cloudiness of visicMi, iipcoursing of the bodily
an.nesthesia,

Vdyu and
locality,

pain

in

the

affected

numbness

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

muscles of the neck,
i^tiology of

Ph)sicians,
it

conversant with the
paralysis).

diseases, call

Arditam (Facial
patient,

Prognosis
such

:

—A

case

of Arditam,

appearing in an exor

tremely enfeebled or emaciated

exhibiting

symptoms

as a winkless vision, inarticulate

speech

which hardly seems to come out of the throat, excessive
palsy of the face, as well as the one of more
years' standing, should be

than

three

deemed as incurable. 58. Gridhras'i (Sciatica): 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

from behind the roots of the upper arms, making them
incapable of

movement and depriving them
is

of their
60.

power of flexion or expansion

called Vis'vachi*

KrOShtukas'irsha
joints):
*

(Synovitis
swelling
arm
is

of
in

the

knee-

— An
the
it

extrimely painful
aforesaid nerve of a
it

the kneeis

When

sirgle

aflecld the disease

restricted to
affected.

alone, while

attacks the both

when both

their nerves are

Chap.

I.]

NIDANA STHANAM.
is

15
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
leg

drawing up of the nerve trunks (Kandara) of a

by the deranged Vayu lying about the region of the

When
is

both the legs are similarly affected, the

patient

called a

starting for

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

on limping
bone-joints

is

Kalaya Khanja one
62

in

whom

the

become
false

loose.
:

— 63.
local

Vata Kantaka —The
making a ment in
according
step
the
to

Vayu, enraged by

on an uneven ground, finds lodgof

region

the

ankle (Khudaka, instep
rise

others), thus

giving

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
termed

deprived of
pain
is

sensibility of touch,
it is

sort of tingling

experienced in them
is

Padaharsha,

which
dries
joints

due to the deranged action of the Vayu and

Kapham.
is

The

disease in which the enraged local Va}'u

up the normal
called

Kapham

lying about the

shoulder-

Ansa-shoshaka.

The form

in

which the

aggravated local
is

Vayu

contracts the nerves of the arms

called

Avavahuka*.
the

64—67.
(deafness)
:

Vad hiry ay am
only
*

—The

disease

occurs
surVayu,

when

deranged Vayu, either singly or
is

The Ansa-shosha
is

due

to the single action

of

the the

enraged

while Ava-vahuka

due

to the

concerted

action of

deranged Vayu

and Kapharo.

6


THESUSHRUTA
SAMIIITA.
stuffs
[Chap.
I.

1

charged with the Kapham,
channels (Srota) of the
cars.

the sound -carrying

68.

Kama
sort

S'ulam:— The

disease

in

which

the

deranged Vayu
of

causing a piercing pain

in the

regions of
rise

the cheekbones, head, temples and neck, gives

to

a

aching

pain in the

tympanum,

is

called Karna-

s'ulam

(otitis).

The

local Vc-'iyu,

deranged and

saturated

with the

Kapham

stuffing the nerves

(Dhamani) which
(in
e
}^.

conduct of the sound of speech,

produces complete

some

cases partial) loss

of

the

power of speech

Muka

(dumbness

,

(indistinct speech).

Mimnina 69—70
which

(nasal voice) and Gad-g-ada

A

sort of pain,

(rising

from the bowels or the
rise

urinary

bladder and

ranging downward) gives

to

a bursting sensation in the regions of the
genitals,
is

anus and the

called

Tuui, whereas the one, rising upward

from the preceding parts and extending up to the region
of
the
intestines,
is

called

Prati-tuni.

A

distension

of the abdomen (Udara), attended with the incarceration

of flatus (Vayu) and an intense pain and rumbling in
inside,
is

its

called

Adhmanam

(Tympanites).
is

When

it first

affects the

stomach f Amasaya) and

unattended with an
sides'"

oppressive feeling about the heart and pain at the
it is

called

Pratyadhmauam.

The Va>-u

saturated with

the

deranged
71

Kapham

causes the

preceding t\-pe of

distemper.

— 74.
fixed
or

A

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 Vatasthila, (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.

A

tumour of similar shape.


Chap.
I.]

7

NIDANA STIIANAM.

1

appearing laterally or across the region of the abdomen
(Jathara)

and obstructing the passage of
(Vata)
the
is

stool,

urine
y^.
Sujhruta

and

flatus

called a Pratyashthila.
Chapter of the Niciana Slhanam
the

75
in the

Thus ends
system.

fir=t

Samhita, which treats of

Nidanam

of

the diseases of

the nervous

('llAPTiHJ

II.

Now Ars'aS
(i)

wc

sliall

discourse
i.

on the

Nidanam
classes vi::
:

of

(Hiemorrhoids'.

ll.einorrhoids

may

be divided into six
of
the

Vdtnjii (due to the action
Pittiijn

deranged Vayu\
(iii)

(ii)

(flue to the action of

deranged Pittam),

Kaphaja (due to the action of deranged Kapham),
Raktaja (due to the action
of

(iv)

the

vitiated

blood),

(v)

Sannipdtaja (due to the concerted action of the deranged

Vayu,

I'ittani

and Kai)hami and
:

(vi)

Sahaja

(congenital).
etc.

Pathology —The

deranged Vayu, Pittam,
food

enraged by their specific aggravating causes, or by such
acts or conduct as partaking of

composed
previous

cjf

in-

compatible substances, eating before the

meal

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

or

in

any natural urging of the body, cither severally combination of two or three Doshas, or vitiating

the blood of a person,

who

observes

no moderation

in

seats

become dislodged from their natural body [according to the law of Prasaranam (expansion and change of place by a deranged organic
food and drink &c.,
in the

principle)]

and arc carried down through the
lodged therein, give

large

intestine

(Pradhana Dhamani) into the descending colon
rise

and

getting

to

growths of
as piles.

polypi or fleshy condylomata, which are

known
in size

These growths chiefly appear
impaired digestion
friction

in

persons suffering from

(Agni), and

gain

through

of clay or stone, or

weeds, wood, lumps by contact with cold water. 3. The lower end of the large intestine, which passes into the flexure of the rectum and measures four and with the wearing apparel,


Chap.
II
]

NIDAXA STHANAM.
in length, is

I9

a

half

fingers

called

the

Gudam

(lit
is

the

channel of fecal matterj, the interior of which

provided with three spiral grooves. Each of these grooves
or ring-like muscles
arc respectively
lie

a finger
as

and a half
out-flow,
ani),

apart,

and

known

Pravahini,

Visarjani
defecation

and and

Samvarani, or the grooves of
closure

of

the anus (sphincter

covering a space of

four fingers
finger's

and having
4

lateral!)-

an elevation of one
grooves arc like the

width.

IVIetrlcal

Texts :— These
palate

involuted indentures of a conch shell, situated one above
the other, coloured like the of

an elephant.
as

A
it

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

usuall)is

measured from the outer

hair\5

orifice of the

rectum,

called the anus (Gudoushtha).

6.

The

first

of the aforesaid grooves or rings

lies

about

a finger's ^^^dth 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

the

eyes,
in

a croaking

sound

in

the intestines, cutting

pain

the

rectum (Guda), apparent indications of an

attack of phthisis, jaundice, dy.sentery, cough, dy.spnoea,
vertigo,

somnolence, excessive
(Indriya),

sleep,

weakness of the

organs

advent of this
M
ith its

which predict the disease, and which become more marked
are

indications

progress.

7.

The Vataja Type :— riles,
of the aggravated

due to the action Vayu, are non-exuding, rose-coloured,

and uneven
flowers
in

in their surface.

They resemble

the

Kadamba

structure

pointed like

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

20

THE SUSIIRUTA

SAMIIITA.

[Chap.

II.

the wild Tundikeri flower.

The

stool of a haemorrhoid

patient

of this type

becomes excessively hard, and can
with the greatest
pain
is

be evacuated only
pain

in a sitting posture,

and
in

difficulty.

An
the

excruciating
of

experisides,

enced

the

regions

the

waist,

back,

anus, umbilicus and
to

genitals.

Symptoms

peculiar

Gulma, Ashthila,
eyes,
teeth,

enlarged

spleen

and abdominal

dropsy add to the distress of
nails,

the patient,

face,
8.

urine and stool

whose skin, also assume a
brought

dark black colour.

The
hue,

Pittaja

Type :— Piles,

on

through the action of the deranged Pittam, are slender,
blue-topped, shifting in their nature,
or

yellowish

in

their

are coloured like shreds of liver, resembling in

shape the tongue of the Suka bird.
middle, like
leeches
stool
is

They

are thick

at

barley grains,

or

resemble the mouth of

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

a

painful,

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
to the action

a yellow hue.

9.

The Kaphaja Type :— Piles, due
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

donot

burst,

nor dothey exude any sort of secretion.

The
and

patient feels an irresistible tendency to scratch the

excrescences.
:riC

The

stools

become copious

in quantity

charged

with mucous (Sleshma),

resembling

the washings of meat.
(Sita-jvara),

Indigestion, fever with shivering

and heaviness of the

head and

cedema

Chap.

II.]

NIDANA STIIAXAM.
food
are the s\-mptom.s
of

21

with a non-i'clish for

which be-

come manifest with the progress

the

disease.

The

skin, finger nails, eyes, teeth, face, stool

and urine of the

patient also assume a white colour.

lO.

The Raktaja Type
having their origin
of the colour
of

:

-Piles (haemorrhoids),
blood

in the vitiated condition of the

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 t}-pe of this disease.

hard

by

constricted

fyeces

their

passage through the anus, they suddenly give

to

a

haemorrhage of
characteristic

vitiated (venous) blood,

and symptoms
are

of

excessive

bleeding

found

to

supervene,

ii.

The Sannipata Type:
haemorrhoids

-In

a

case

of

due

to

the

concerted

action

of the

deranged
in unison.

Vayu,
12.

Pittam

and

Kapham,

s>'mptoms

characteristic of each of these types manifest themselves

The Congenital Type :— Congenital hysmorrhoids
the

(Saliaja Ars'as) arc usually ascribed to defects in
one's

semen and ovum of

parents and should be

medicinally treated with an eye to the special deranged

Doshas involved
faces

in the case.

The

polypi

(in this

type)

are hardly visible and are rough and yellowish, with their

turned

inward.

They

are extreme!}' painful.

A

person suffering from this type of piles gets thinner and
thinner cveiy day and eats but very
(Sira)
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,
cars

THE SUSIIRUTA
and
All

SAMllITA.

[Chap

II.

eyes

follow.

A

cr(^akin^

sound

is

heard

in the intestines,

attended with a rumbling
for

in the

abdomen.

relish

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 A
ment
outer
of


as

qualified physician should undertake the medical treat-

haemorrhoids which occur cither about the

or the middle groove of the rectum, (in as

much

they prove amenable to medicine).
ing about the innermost
ring or

A

pol)'pus,

appear-

groove of the rectum,

should be treated without holding out any definite hope
of cure to the patient.
14.

Lingars'as
Vayu
etc.,

(Fig warts or cond\-lomatous growths

about the genitals):
finding

— The

deranged and aggravated
in

lodgment

the

genitals,

vitiate

the local flesh 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, in the form of soft, slender vegetations of skin, 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
body, lodged
to

:

— The

deranged Vayu

etc.

of the

in the vaginal region of a

woman,

gives rise

similar

crops

of soft

polypi in the passage.

They

may crop up may assume

isolated at the outset,

and (by coalescing)

the

shape of a mushroom, or an umbrella,

secreting a flow of slimy, foul-smelling blood.

The deranged Vayu.

etc.

ma\'

further

take

an

Cliap.

II.]

MDAXA STHAXAM.

23

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

may

bring on earache, dumbness, and afoul dis-

charge from those organs, while those (c}-sts) cropping up
in

the

eyes will obstruct the

movement

of the e}'e-lids,

giving rise to pain and a local secretion and

ultimateh'
in the

destroy the eye-sight.
nostrils

Similarh",

such growths

produce catarrh, excessive sneezing, shortness
nasal

of breath, headache,

known

as rutinas)-a.
lips,

speech and the complaint Such vegetations cropping up in

and about the
mouth, they

palate or the lar\nx,tcnd to

make

the

speech confused and indistinct.

When
mouth

appearing

in the

impair the faculty of taste, and diseases
the
cavit\' of the

which

affect

follow.

cited V\-ana Va}-u, united with the aggravated

The exKapham,

produces a kind of hard papillomatous growths on the
skin
(

(about the anus) which are called the Charmakilas
i 5.

papillomata).*

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 Vayu,

whereas those which have their origin
(lymphatics) assume
a

in the

deranged

knott}'

shape and be-

of the

same colour

as the

surrounding skin.
dr}',

On

other hand,

they become

black or white, and

extremely hard through an exuberance of the deranged
local blood

and Pittam.

16.

The symptoms
general

of polypi, appearing in the neighbourin full,

hood of the anus, have been described
characteristics of
those,

while the

which

are

found to

crop up around the genitals, have been briefly discoursed
*

Accordini; to others, Charmakilas

may crop up on

the skin of any

part of the b dy.

24
upon.

TIIK SUSHRl'TA SAMIIITA.

[Clis]..

ll.

An
of
to

intelligent

physician

should

ponder over
in

the two groups of a
case
piles.

symptoms while engaged

treating

A
Six

case of piles exhibiting

symptoms
the

peculiar

the

two deranged

Doshas

is

called

are

Samsargajam. known in practice.*

distinct types of bio-Doshaja piles
ly.

Prognosis

:

—A

case of piles

due to the con-

certed action of the three deranged Doshas of the body, (with its characteristic symptoms) but partially developCases, which ed, may be temporarily checked (Ydpya). arc of

more than

a year's standing, as well as those in

which the h;rmorrhoids 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
t)i)es

Sannipatika
be given

congenital
incurable.
is

(Sahaja)

should
in a

up as

The Apana Vayu,
is

person whose rectum

overrun with such polypus growths, tries to pass out
driven

through the anus, but
obstructed
in
its

back upward, being
imparing (the
18-19.
of the

passage by the vegetations, and then
thus
five-

mixes with his V}-ana Vayu,
functioned)
*

fire

(Pittam) in his body.
due
to

Such

as (l) the one

the

concerted action
to the

deranged

Pittam and Kapham,

(2) the

one incidental

simultaneous derange-

ment

of the

Vayu and
condition

disordered

combination of the

Kapham, (3) the one brought about through the Vayu and blood, (4) the one due lo the deranged Pittam and Kapham, (5) the one produced
the
of

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

Xidanasthanam
piles.

in

the

Sus'ruta

Samhita which deals with the Nidanam of

CHAPTER
Now we
ma.ri The
shall discourse
i.

III.

on the

Nidanam

of

As'-

(urinary calculi),

disease admits of being divided into four the

several

types, such as the Vataja, 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
who
neglects
of
to
his

:--The Kaphah of a man,
the
internal
is

cleanse

(Sams'odhana)
in

channels

organism, or

the habit of taking
its

unwholesome
exciting

food, enraged
is

and aggravated by
into the
urine,

own
rise
3.

causes,

carried

urinary bladder.

Here
to the

it

becomes saturated with the

and gives
its

formation of concretions or gravels in

cavity.

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 arc the
in

and a goat-like smell

symptoms, which indicate the formation of gravel
the bladder.
4.

IVIetrical
ed
in

Text ;— The

deranged Doshas involvtheir
specific

a particular case respectively impart

colour to the urine, and determine the character of the

accompanying
and

pain.

The

urine becomes thick, turbid,
of the

vitiated with the action

aggravated Doshas,
5.

and micturition becomes extremely painful.

Leading^ Indications :— A
ciating pain
or
in
is

sort

of excru-

experienced either about the umbilicus,
or at the

the

bladder,

median rape of the
4

26

THE SUSHRUTA

SAMIIITA.

[Chap, III.

perineum, or about the penis, during micturition when
•Tavel
is

fcnmin;^

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, sand}', red
particles of stone,
colour.

or yellow
in

which resembles
is

Gomedha gem
in in

Moreover a pain

experienced

the bladder

at the time of

running or jumping or

swimming, or
6.

while

ridin'4 <>n hnrsL'back, or after a
:

long journey.
gravel,

The ^ICShmas'mari — Stone or
ginated through the action of
the

ori-

deranged Kapham,

saturated with an excessive quantity of that

Dosha by
(Sle.sh-

the

constant

ingestion

of

phlegm-generating

mala) substances, increases in size at the lower orifice of
the bladder and ultimately obstructs the passage of the
urine.

The

pressure and recoil of that incarcerated fluid
rise to a

on the walls of the urinar)' badder gives
crushing, bursting, pricking pain in

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

t\'pe

is

called S'lcshmas'mari.

7.

The
the

Pittaja

As'mari :— The
in the aforesaid

Kapham

charged (dried) with the deranged Pittam becomes hard

(condensed) and large

way, and lying at

urine.

mouth of the bladder obstructs the passage of the The bladder, on account of the flowing back of
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

A

kind of
in the

experienced

This type of

As'mari

is

further

marked by

symptoms which characterise Ushna-vata (stricture). The concretion is found to be of a reddish, yellowish

Chap. III.]

NIDANA STHANAM.
fruit,

2^
or
it

black colour like the stone of the Bhallataka
is

coloured
8.

like

honey.

This type

is

called

Pittaja

As'mari.

The Vatas'mari :— The
acquires hardness and gains
l\-ing

deranged

Kapham

(mucus) inordinately saturated with the bodily Vayu,
in

dimensions, and these

at the

mouth

of the bladder obstructs the passage

of the urine.

The

incarcerated

fluid

causes

extreme

pain

in

the organ.

The
or

patient constantly under severe

pain

gnashes his teeth or presses his umbilical region,
penis,
fingers
his

or rubs his

rectum
is

(Pd\-u)

and

loudly screams.
in

A

burning sensation
urination, belching

experienced

the

penis,

and

and defecation
in

become
type of

difficult

and painful.*
are

The concretions

this

As'mari

found to be of a dusk\- colour,
nodular like

rough, uneven in shape, hard, facetted and
a

Kadamva

flower. This type

is

called Vdtds'mari. 9.

Infants are

more

susceptible to an attack
of As'mari,

of

any of
as

the three preceding t>'pes
are fond of

inasmuch

they

day

sleep or of food

composed of both wholeprevious meal, or of
In
in

some and unwholesome

ingredients, and arc in the habit

of eating before the digestion of a

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
i-o.

instrument)

and of the stone being

with

the greatest ease in cases of infantile As'mari.

The ^'ukras'mari
germination of semen
abrupt stoppage of a sexual

:

— Sukras'maris
adults

or seminal
to

concretions arc usually formed in
in their

owing

the

organisms,
act,

A

sudden or
coition

or
its

excessive

tends to dislodge the semen from
* Stool

natural receptacle
str.-iining.

and urine can be voided only with the greatest

28
in the

THE SUSHRUTA SAMHITA
body.

[Chap. III.

The

fluid thus dislodged, but

not emitted,
the
fluid

finds a

wrong passage.

The Vayu

gathers up
it

(semen), thus led astray, and
oval shape) at a place lying

deposits

(in a

round or

about the junction of the

penis

and the scrotum and dries up the humidity with
it is

which

charged.

The

matter, thus formed, condensed,
(Sukrds'mari),
urine,

and hardened, is called the seminal stone which then obstructs the passage of the
rise

giving

to

pain

in the

bladder,

painful

micturition,

and

swelling

of the scrotum.
its seat*,

The stone vanishes under
12.

pressure in

ii

Authoritative verses on the subject
:

— Concretions,
in the

sands and sediments found

to be

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

experienced
case
of

in a

case

of

gravel
in

{S'ar^ard) as
bladder.

in

a

stone

(As'mari)
in
its

the

The
in

local

VAyu

coursing
of

natural

direction

helps the disthe

charge

calculi

(As'mari)

with the urine
attenuated
in

event of they being extremely
Particles

structure.

of

a stone

broken

by the Vayu

are called

urinary

calculi

{S'arkard).

A

pain

about the cardiac
in

region, a sense of

weakness and lassitude
in

the

thighs,

a griping pain

the

regions of the spleen and liver

(Kukshi-s'ula), a shivering sensation, thirst, hiccough or
eructations,

darkness

or

sallowne's

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
secretions

changes of spermatozoa and other

and

their

subsequent calcification as lately discovered by the

savants of the 'West.

— Translator

Chap.

III.]

NIDANA STHANAM.
digestion
in

29

impaired
manifest
obstructed

are

the

symptoms

which
channel

are

a

gravel-patient.

A

gravel

{S'arkard)
is

at

the

mouth

of

the urinary
:

detected
lassitude,

by the following indications
emaciation, cachectic
the

via.,

weakness,

condition of the body,
(Kukshi-s'ula),

pain

over

hepatic

region

a

non-relish for food, sallowness

of complexion, hot and

high coloured urine,

thirst,
13.

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
its

opening and with mouth downward, covered with nets of nerves (Sira) and ligaments (Snayu), in the
lies

shape of
structure
is
;

a gourd.

The organ
its

is

extremely thin

in
it

and thus situated within the pelvic cavity,

connected, through

mouth

or external orifice, with

It is also known the rectum, the penis, and the testes. by the name of Maladhara (the receptacle of impure matter) and forms (one of) the primar^^^ seats of vital

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
carry
their

in

the
of

same manner
water
into

contributions

the

ocean.
to

These passages or ducts (which are two) are found
take
their

origin

from

hundreds

of

branches (or
visible

mouths
naked

tiibuli uriniferi),

which are not

to

the

eyes,

on account of
urine

their extremely
in

attenuated
sleep

structures

and carry, whether
the
has

a state

of

or

wakening,

from

below the region of the
that

The

text

Frdndyalanam, which means
with
fatal result.

an injury

to the

urinary bladder

may be attended

30

THE SUSHRUTA SAMHITA.
into the bladder keepingfluid

[Chaj).

III.

stomachf (Amasaya)
with this important
pitcher,
is filled

it

filled

of

the body,

just as a

new

In

immersed up to it;? by transudation through its lateral pores. 14. the same way the Vayu, Kapham and Pittam are
into the bladder (through their

neck in a vessel full of water,

carried

respective ducts

or channels),
rise to the

and

in

unison with the retained urine, give
the

formation of stone, on account of
deposit

slimy
in

character of the
the

produced.

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

hailstones, so the bodily V^iyu

and Pittam (heat) jointly
of the

contribute

to

the

condensation
it

Kapham
its

in the

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
various
as

in a

contrary direction,

gives

rise

to

forms of
well
as

maladies such
;

as,

in Prameha, strangury, short, it produces any urinary trouble to which the

seminal disorders

bladder ma\- be subjected,
t

i

5.

From

the kidneys.

Thus ends
Samhita which

the

third Chapter of the

Nidana Sthanam
calculi.

in the

Sushruta

treats of the

Nidanani of urinary

CHAPTER
Now
\vc shall discourse
t,

IV.

on the

Nidanam

of

Bhag"i.

a.ncla.ra.m

fistula in

ano and
Pittam,

fistular ulcers),

The deranged Vayu,
(a simultaneous

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
Samvukavarta
the

as

Sataponaka,

Ushtragriva,

Parisravi,
is

and
that

Unmargi.
it

The

disease

so

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

Pidakas

unsuppuratcd
are

stage, while they are called
in

Bhagandaram when they

a

stage

of

suppuration.

A

pain about the sacral

bone and an itching about the anus, accompanied by a
swelling

and burning sensation, arc the premonitor)this disease.
2.

s\-mptoms of

The ^ataponakah Type :— The
excited, condensed, and rendered motionless
of
b)'

Vayu,
a course

unwholesome
or two

food,

gives

rise

to

a

pustule within

one

fingers'

length from

the

rectum

(anal

region,

— Guda), by vitiating the
(of the
is

flesh

(areolar tissue)

and blood
colour and

locality).

It
b\'

assumes a vermilion
a variety

characterised
If

of pricking,

piercing pain.

neglected at the outset, the pustule runs

into suppuration.

Owing

to

its

vicinity to the bladder,

the abscess or the suppurated pustule

exudes a kind of

slimy secretion and becomes
of small sieve-like holes, through

covered with hundreds

which

a constant frothy

discharge

is

secreted in large quantities.
if it is

The

ulcer, thus

formed, seems as

being thrashed with a rod, pierced

32

THE SUSHRUTA SAMHITA.

fChap. IV,

with a sharp iiistriimcnt, 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
holes.

semen
fistula

are emitted throu'^^h these sieve-like
of
fistula
is 3.

This type

called

Sataponakah

(Sieve-like

in ano).

The Ushtra-grivah Type:— The
Pittam, carried

enraged

down

b)-

the V.i)u (^into the rectum) finds

lod;4mcit therein, and there gives rise to a small, raised,

which resembles the neck of a camel in shape, and is characterised by a varied kind of pain,
red pustule,

such as sucking

etc.

The

pustule, not medicinally treated

at the beginning, runs into suppuration.

The

incidental

ulcer seems as

if it is

being burnt with

fire

or alkali, and

emits a hot, fetid discharge.
fecal

Jets of urine, flatus (Vata),

matter and semen flow
it

out

of

the

ulcer

in

the

event of
remedies.

not being healed up with proper medicinal

This type

is

called Ushtragrivah.
:

4.

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 and swollen,
and semen
of
is
it

marked by excessive
slimy

itching and a constant secretion of

Jets of urine, fecal matter, flatus

are emitted through the

ulcer

in

the

event

not

being well
Parisravi.

cared for at the outset.
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
are

(within

the grooves of the rectum) such as the

found

within

body of

a

river or fresh water
6.

mollusc.

This

is

called

Samvukavaitah.

The Unmargi Type :— Particles
eaten with (cooked
)

of

bones,
glut-

meat by an imprudent, greedy,

tonous person,

may

be carried

constipated stool by the

down with the hard and Apana Vayu (into the rectum),
of the anus,
of
their

thus scratching or abrading the margin

or

burrowing into the rectum
evacuated
in

in

the event

being

improper directions through (transverse or

horizontal postures).

The
as

scratch or

abrasion

is

soon
with

transformed into a fetid and putrid

ulcer, infested

worms
will

and

parasites,

a

plot

of

miry

ground

soon

swarm with
of,

a spontaneous

germination of

similar parasites.

the sides
anus,

or largely of urine,

These worms and parasites eat away burrow into, the region of the
fecal matter,

and

jets

and

flatus

(V.'iyu^

are found

to

gush out of these
is

holes.
7.

This type of

Bhagandaram

called

Unmargi.

Authoritative verses on the subject: — A pustule, appearing about the region of the
anus and characterised

by a
of

slight pain

and swelling,
nature
^i.e.,

and spontaneously
from a
fistula

subsiding,
is

should be regarded as a
quite
different

simple pustule, which
in

a

ano, which has contrary features
to

invariably found

be attended with a violent pain

and

swelling

etc.,

and takes a long time
crops

to

heal).

A

Fistula-pustule

up within a space of two
(distal

fingers'

width of

the

Pdyu proper

end of the
.5

34
rectum),
is

THE SUSIIRUTA
sunk
at
its

SAMIIITA.

[Chap. IV.

root,

and attended with pain
itching

and

febrile

symptoms.

Pain,

and

burning

sensations are experienced
in

about the

anus after a ride

a carriage, or after defecation.

The anus becomes
premonitory stages
types

swollen,
of

and the waist painful Bhagandaram. 8 — 9. Almost Prognosis
:

in the

all

the
to

of

this

disease

(Fistula

in

ano)

yield

medicine
arc

after

a

prolonged course of
except the
incurable.
Thus ends

treatment, and

hard
ones,

to

cure,

Sannipatah
lo.

and traumatic

which

are

ihe fourth

Chapter of the Nidana .Sthanam
in

in the Sushrula

Samhila, which treats of the Nidanani of Fistula

ano (Bhagandaram).

CHAPTER
Now we
shall discourse

V.

on the

Nidanam
i.

of

Kushof

tham
nial

(cutaneous affections
diet

in general),

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.

a cold water bath after an and repression of any natural urging are the factors which tend to derange

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

or

ducts (Sira),

which transversely spread

over the surface of the bod)'.
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
of the blood,

the surface of the body, excess or absence of perspiration,
anaethesia of the parts, a black colour

and

a rapid growth and expansion of any ulcer (appearing on
the body) are the
tory stages of

symptoms which mark
3.

the

premoni-

Kushtham.


36


SAMllITA.

;

THE SUSIIKUTA

[Chap. V.

group of

Classification :— [Diseases, falling under the Kushth;iin, may be divided into two broad
viz.,

subdivisions],

Mahdkushthas (major) and Kshudra
first

(minor) Kushthas, the

consisting of
types,

seven,

and the
Aruna,

second of eleven
in
all.

different

aggregating eighteen
as,

The Mahakushthas

arc classified

Audumvara,Rishya-Jihva, Kapala, Kakanaka, Pundarika, and Dadru. The minor or Kshudra-kushthas (Lichen and
Dermatitis) are Sthularushkam,

Mahakushtham,

Kka-

kushtham, Charmadalam, Visarpah, Parisarpah, Sidhma,
Vicharchika, Kitima, Pamd, and RakasA.
of

All the types

of the deranged

Kushtham, whether major or minor, involve the action Vayu, Pittam or Kapham, and are conlocalities.*

nected with the presence of parasites in those

The preponderance
(Dosha)
as
its

of

any particular morbific diathesis

in an\' case of

originating
is

cause.

Kushtha,

due to the

Kushtham should be looked upon The type, known as Aruna 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
in

excess of the deranged
or

Kapham.

These types of major

minor Kushthas are successively more extensive
action

their

and more incurable on account of

their

respectively invading a greater

number

of

the

bodily

elements (Dhatus).

4

— 6.
owes
its

IVIahakushthas :— Aruna-kushtha
origin
slightly

to

an exuberance of the deranged Vayu.
thin

It is

vermilion-coloured,

and spreading

in its

* Certain

authorities

hold that,

affections) to be of parasitic origin.

all types of Kushtham (cutaneous The Garuda Puranam avers that, the

parasites,

which

infest the external principles of the

body, are the primary shlemshajd

causes

of

cutaneous

affections

Kushthaika-hetavontarjdh
4.

vdhya sambhavdh.

Ch.

CLXIXV.

Chap, v.]

NIDANA STHANAM.

37

nature.

A

sort of pricking, piercing pain (is

experienced
to

in the affected

locality)

which
as

loses

all

sensibility
is

the touch.

The type known
like

Audumbara

coloured
fruit

and shaped

a

ripe

and has
called

its

origin in the
is

Audumbara deranged Pittam. The
or

mature

t>'pc

Rishyajihva
Rish\a (Deer)
as

rough and resembles the tongue

of

a

known
(deep

The type in shape and colour. Kapala (Macula caerulae) resembles a black The Kakanaka blue) Kharpara ( baked clay ).
characterised

type
like

is

by a dark red and black colour

the seed

of

the Gutija berry.
is

A

sort

of sucking
affected

and burning

pain

experienced

in

the of the

locality in all the four

preceding types
the

disease

which are the outcome of

deranged
if

Pittam.

The
fire,

whole diseased surface seems as

burning with

and emitting hot fumes. They are speedy in their origin and rapidl)' suppurate and break. All these
types

soon

become

infested

with parasites.

These
7.

are the general features of these forms of Kushthas.

Pundarika: —The
of a
(full

patches resemble the petals
in

blown) lotus

flower

colour,
ffaint

and Dadru
blue)

(Ringworm)

assumes

the

colour

of

an

Atasi flower, or of copper.
nature and are found
to

They

are spreading in their

be

overspread

with pustules.

Both the Dadru and Pundarika
time to be fully patent.
teristics of

t\'pes are raised, circular,

and characterised by itching and take a considerable
These are the general characDadru and Pundarika. 8.
shall now desknown as) KshudraThe type known as Sthularushka
It is

Kshudra Kushthas :—We
cribe (the features of the diseases

kushthas (M.Text):
base,
is

appears about the joints.

extremely thick at
is

its

cured with the greatest difficulty, and

strewn

over with hard pustules (Arungshi).

In the type

known

38
as of

THE SUSHKUTA SAMHITA.
Mahakushtham

[

Chap. V.

the skin contracts, and with the
is felt

bursting" of

the skin (a piercing pain
all

in the affec-

ted part), which loses

sensibility to the touch,

accomIn

panied by a general
the

sense of lassitude in the limbs.

Ekakushtham

(Ichthyosis) type
It is

the skin assumes a

reddish black colour.
as

incurable. In the form

known

Charmadalam (Hypertrophy of the skin> a burning, sucking, drawing pain is experienced in the palms of the hands and in the soles of the feet which become characterised with
affects
in

an itchmg sensation.
the
(organic

The
all

disease,
ofj

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

Kuslltliam.

The form

in

which a

number

of exuding

pustules gradually extend over the surface
is

of the

body

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

and docs not create any disturbance
found to
restrict itself

(in the

patient),
is

is

called Sidhma (Maculae atrophicae). This form
to

generally

the

upper part of the body.

Vicharchika (^Psoriasis) is characterised by excessive pain and itching and gives rise to extremel)' dry crack-like marks on the bod\' [hands and feet]. The same form of

malady attended with
Vipadika.

pain,

burning and

itching,
is

and

restricting itself solely to the lower extremities,

called
(a

The type

in

which the eruptions exude
circular,
is

kind of slimy secretion) and which arc
excessively itching, glossy

thick,
called

and black-coloured

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

Chap.

V

]

NIDAxVA STHAXAM.
vesicles,

39

with burning

are

called Kacliclius
legs,

and are
pimples
all

found to be chiefly confined to the
buttocks.

hands and

A

sort

of

dry and

non-exuding

characterised

by excessive itching and appearing
is

over the body,

called

Rakasa

(dry Erythema).

9-10.

The forms known as Sthularushka, Sidhma, Rakasa, Mahakushtham and Ekakushtham should be considered as offspring of the deranged Kapham. Parisarpa-kushtham 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.

11.
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 Pittam or Kapham.
is

the action of the deranged

Vayu,

The
is

difference

between Kildsam and Kushtham

that

the former confines itself only to the

Tvaka

(the skin)and

marked by the absence

of an}' secretion.*

A

case of
is

Kilasam caused by the action of the deranged
circular, vermilion-coloured

Vayu

and rough to the touch. The
off"

affected part

when rubbed peals

scales of

morbid

skin.

A

case

of Kilasam, due to the action of the deranged
is

Pittam,

of a lotus

marked by eruptions, resembling the petals flower (^in shape and colour), and are attended
extrcmcl)-

with an

burning

sensation.

In

the

type

originated through the action of the deranged
the affected part (skin) assumes a
glossy,

Kapham,
sensation.

white colour,

becomes thick and

is

marked by an itching
soles

The form
become

in

which the eruptions or patches extend and
of the
feet,

confluent, inxading even the

A

case of

Kushtham has
it

its

primary ?eat

in the

blood and skin (of
of

tlie

patient), in

which

lies

confined during the
secretes the
it.

period

incubation,
secretion

after

which

it

attacks the skin and

characteristic

of the

deranijed

Dosha involved

in

.

40

TUF. SUSIIRUTA SAMIIITA.

[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)
sidered as incurable.
12.

should

be likewise con-

A
skin,

preponderance of the deranged Vayu
(leprosy)
is

in a case of

Kushtham
local

indicated

by a contraction
flow of

of the

ana."sthesia, a copious

perspiration,

swelling, and piercing or cutting pain in the affected part, together with a deformity of the limbs and hoarseness.

Similarly, an excess of the deranged Pittam in a

case

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.

An

excessive action of the deranged

Kapham,

in

a case of

Kushtham,
of the

gives rise to itching, discolouring

and swelling

affected

part which

becomes heavy and exudes

the characteristic secretion.

The

types,

Pundarika and
of

KAkanam, which
the
patient, are

are

due to the germinal defect

incurable,

inasmuch as

they involve
of
the

(according to
three
outset.

Dallana)

the

concerted action

simultaneously
1

deranged Doshas from the very

3

Memorial verses :— As a
course
of time, has driven
its

tree,

full

grown
and
this

in

the

roots,

which derive their
deeper
disease
so

nourishment from
into the successive

the

rain water, deeper

strata

of the

soil,

(Kushtham),

first

affecting
will

and confining

itself to

the

upper layers of the skin,

invade the deeper
if

tissues
until al-

and organs

etc.

of the patient,

unchecked

most

all

the fundamental principles or elements
its

Dhatus
14.

are attacked by

virus in the course of time.

Chap, v.]

NIDANA STHANAM.
of a case of

4I
confined only

The symptoms
to the serous

Kushtbam

(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 symptoms which manifest themselves when the disease is confined to the blood are

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

arc thickness of the

patches, dryness of the mouth, roughness

and hardness
with pustular

the

patches

which become
the affected

covered

eruptions and vesicles, and an excruciating pricking pain
in,

and numbness

of,

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 bod)' 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
arc a crippled
state

to

the principle of

semen

of the hands and distortion of the

limbs, loss
ulcers

of the
all

power of locomotion, spreading of

and

the other

ceding types of the disease.

symptoms peculiar 15—-20.

to

the pre-

A

child,

which

is

the
its

offspring of the contaminated

semen and ovum of
should

parents afflicted with Kushtham,
as

be

likewise

regarded
case

a

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.

A

palliative treat-

6

42

THE SUSIIKUTA
is

SAMIIITA.

[Chap. V.

mcnt

the

only

remedy
the

in cases

where the disease
;

is

found to invade

principle

of fat

whereas a case

where the poison is found to have penetrated into any of the remaining organic principles should be given
up as incurable.
22.
that, for killing a 13rahmana, or a

Wise men hold
man, or
(jne of his

wo-

own

relations,

for theft, as well as for

doing acts of impiety, a
this foul disease

man

is

sometimes cursed with

by way

of divine retribution.
in his

The

disease

reattacki

a

man even
it.

next rebirth in the event of
(leprosy)

his dying with

Uncurcd Kushtham

U

the

most painful, and most troublesomeof all diseases. 23

— 24.

malady by observing the proper regimen of diet and conduct and by practising expiatory penances and by resorting to
Kushthi
(leper), getting rid of this foul

A

proper medicinal measures, gets an elevated status after
death.
25.
is

Kushtham (Leprosy)
the

a highly contagious disease

;

communicated through intercourse with a leper (Kushthi), or by his touch sexual 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

garlands of flowers previously used by a person afflicted

with this dreadful disease.

Kushtham

(Leprosy),

fev'er,

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.
in the

conimunicated from one person
Thus enJs
the
fifih

Chapter of the

Nidanasihanam

Sushruta

Sainhila which treats of the

Nidanam

of cutaneous afTections

(Kushtham).

CHAPTER
Now we
It

VI.

shall discourse

on the Nidanam of
r.

Pra-

mcha (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 Vc4\-u,

Pittam and Kaphah of such a person get mixed with
improperly formed chyle of the organism. Thus deranged,
they carry

down

through the urinary ducts the defind

ranged

fat, etc.*

of the bod)' and

lodgment

at

the

mouth (neck)
through the
(generic)

of the bladder,
urethra-j*,

whence they are emitted

causing diseases,
3

known by

the

name

of

Pramsha.

Premonitory
the
feet,

symptoms :-A

burning
soles

sensation in the palms of the hands and of the
a

of

heaviness of the body, coldness or sliminess

of

the

skin

and limbs,

sweetness and whiteness of
thirst, a

the urine,

somnolence, lassitude,

bad-smelling

breath, a shortness of breath, slimy

mucous deposit on the
and an
are
4.

tongue, palate, phar\-x and teeth, clotted hair
ordinate

in-

growth of

the

finger

and toe

nails

the

indications which

mark

the advent of the disease.

General Characteristics:— A
of cloudy

copious flow
the types of

or

turbid urine characterises

all

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

morLific

matter.

Uallana.
to others.

t

Remain incarcerated then in acc^rJirg

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, Iksliu-nieha, Siird-meka, Sikatd-meha, S'anai-meha, Lavana-meha, Pislita-tneha, Sdndra-meha, S'uk-

ra-meha and PJiena-7ncJia.
curable,

The

ten aforesaid

types are

inasmuch

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

marrow, blood, semen etc) deranged (Dushya)
6.
:

from the same causes.

The Pittaja Types —The
Pittam, are

types,

which are

brought about through an exuberance of the deranged

named
all

as Nila-rneJia,

Haridrd-meha, Amla-

meha, KsJidra-meha, Ma?ijishthd-ineha, and S' onita-meha.
Palliation
is

that

can

be effected

in

these

types,

which tend to correct the deinasmuch ranged Pittam, which has brought on the disease, fail
as the medicines
to

exert

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-nieJia, Vasd-meJia^

Kshoudra-mcha and Hasti-7neha.
as

These should be regarded
no kind of medicine can
diving
[ie.

most incurable inasmuch

as

restore the fleet-coursing, deep

invading the bones and the marrow) Vayu,

which

at the

same time
8.

also

augments the Pittam,
in
its

to

its

normal

state

and thus advances (unchecked)

work

of disintegration.

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

^h^P- VI.

i^IDANA ST li AN AM.

4S
in

types

of Prameha.

The deranged Pittam,
fat

conjunc-

tion with the

deranged Vayii, blood,
;

and Kapham,
fat,

produces the Pittaja ones
unison with the deranged

while the deranged Vayu, in
Pittam,
the

Kapham,

marrow

and

Vasa

(myosin), engenders
9.

types of Vataja

Prameha.

Symptoms
the
least

Of

Kaphaja
water-like and
of

IVIchas
of
is

:

-The

urine* of a person suffering from an

attack

Udakaurine

meha becomes white and
pain.

passed without
the
It

In

a

case

Ikshnmeha
The

resembles the expressed juice of sugarcane.
colour of wine case of
to
in a case of
is

has

the

Surameha.
fine

urine in a
is

Sikatamsha
a

passed

with pain and
a
case
in

found

leave

sediment of extremely
(Si/catas).
at

and sand-like
the

concretions

In

of

Sanaimeha
and
is

urine gushes out

intervals

jets

charged

with a slimy mucous (kaphah).

The

urine

in a case of

Lavauamelia becomes limpid (non-viscid) and acquires
a saline taste.
micturition
urine
in

There
a

is

horripilation

at

the

time of
the

case

of

Pishtameha

(Chyluria),

resembling a stream of

water, charged

with a

solution of pasted rice

(Pishtam).
urine
of

In

a

case

of

Sandra,meha, the
while
in

becomes

thick

and

turbid,

a

case

Sukrameha

the urine

be

semen (or the urine is found to charged with semen :— Madhaba). In a case of
resembles

*

Tl e

Sanskiit

term

Meha

literally

means

to

micturate.

The

verbal

noun Mehanam
urethral
fact

signifies urination as well as the act of passing

any morbid

fecretion.
its

Hence

the

urine in most

of these cases denotts the

of

being charged wiih pus or any other

morbid secretion of the
etc.,

urinary

oigans such as Oj.ih (albumen), marrow,

which imparts

thiir

characteristic colours to the fluid,

—a

fact

which determines the nomenits

clature

of

the

disease

and

forms

the

keynote of

diagnosis

in

the

Ayurveda.

— Ed.

.

46

THE SUS[IRUTA

SAMIIITA.

[Chap.

I.

Phenamelia the patient passes frothy urine
jets. lO.

in

broken

Symptoms of
.shall

Pittaja IVIchas:— Now wc
features

describe

the characteristic

of the types

of Pramcha, which arc due to the action of the deran<^cd

Pittam,
froth}',

The

urine

in

a

case of

transparent and bluish.

Nilameha becomes The urine in a case of
yellow
like

Haridramaha
(Haridra) and

becomes
is

deep

turmeric

passed

with a burning pain.
acquires an acid taste

The
and

urine in a case of
smell.

Amlameha
filtered

The
urine

urine in a case of

Ksharameha* resembles

an alkaline solution

(through a piece of linen).

The

in

washing of the
the urine
is

MaDJisthameha resembles the Manjisthd, while in a case of Raktameha,
a case of
1 1

found to be of blood-colour or charged with

blood - ]\I;idha\a).

Symptoms of Vataja-IVIehas
Pramcha,

:— Now we
the

shall describe the characteristics o{ the different types of

which

are
^'i
^>-

due

to

an

exuberance of
the

deranged VayLi-

case of Saipimeha,

urine

looks like a stream of clarified butter, while in

one of

Vasameha
of

it

resembles the washings of Vasa.
the

In a case

Kshaudramelia,
a

urine
In

looks
of

like

honey and
like

acquires
patient

sweet
a

taste.

one

Hastimeha, the
of urine,

passes

copious

quantity

an

excited elephant, at a time, and in one unbroken stream,
(the organ

becoming steady immediately
I3.

after

the act

of micturition).

Supervening symptoms :— The
the
urine

fact

of

being assailed

b)-

a

swarm

of

flies,

lassitude,

growth of

flesh (obesity), catarrh, looseness of the limbs, a
a distinct alkaline taste, smell, colour

* The urine acquires (Madhaba Nidanain).

and touch.

t Charaka has included

it

within Kshaudra

Meha and Madhu Me

a.

-

Chap. VI.]

NIDANA STHAXAM.

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

Kapbaja Prameha.
pricking (vcda)

A

piercing

pain

the

testes,

a

pain in

the bladder, a shooting
at

pain
acid
food,

(Tuda)

in the penis,

a griping pain
dysentery,
if

the

heart,
for
is

eructations,

fever,

a

non-relish

vomiting, a sensation as
fumes,
epileptic

the entire body
in

emitting
thirst,

a
fits,

burning

sensation

the

skin,

insomnia, jaundice (Pandu) and a )ellow
stool

colour

of the

and urine
the
at
all

arc

the

supervening

symptoms which mark

Pittaja types of Prameha.
the
heart (Hridgraha), eager

An

oppressive feeling
for

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

mark
the

the

Vataja types.
of the twenty

Thus we
13-16.

have

described

nature

different types of

Meha
cles,

with their supervening
ten

evils as well.

The

different types of

Pidaka (abscess, carbun-

pimples, pustules etc.) arc found to crop up on the

bodies of patients, suffering from Prameha, and abounding
in fat

and Vasa, and whose fundamental principles have
affected
b\-

been

the

simultaneous

derangement
are

of
as

the Vayu, Pittam and

Kapham.

They

named

Siravika, Sarshapika,

Kachchapika,

Jalini,

Vinata,
i/-

Putrini, Masurika, Alaji, Vidarikal and Vidradhika

lYletrical Texts :— An
at the

abscess

which

is

raised

margin and dipped
in its

in its centre, so as to
is

resemble

an Indian saucer
les or

shape

called Saravika.

Pimp-

pustules
are

of

the shape and size of white mustard

seeds
(the

called

Sarshapika'.

An

abscess, resembling

back

of) a tortoise in
is

shape and

attended with a
wise.

burning sensation,

called

Kachchapika by the

48

THE SDSHRUTA SAMHITA.

[Chap. VI.

An

abscess studded with slender vegetations of flesh and
is

attended with an intolerable burning sensation
Js^liiii.

called

A

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

Vinata

A

thin and extensive abscess (studded

withslender pustules

— D.R.)

is

called Putrini. Pimples to

the size of lentil seeds are called Masurika.

A

dreadful

abscess which

is

of a red

and white
is

colour, studded over

with blisters or exuding vesicles

called Alaji.

A

hard
is

and round abscess as large as a (full-grown) gourd
called Vidsirika'. called

An

abscess of the

Vidradhi type

is

Vidradhika (carbuncle) b)' the wise. An incidental abscess in a case of Prameha should be regarded as having its origin in the same morbific principle (Dosha) as that which has produced the disease (Prameha) 18-28.

Prognosis
or
at

:

—A

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
extrom:;
the

producing
R.]
in

prostration

[impaired
be

digestion
as

— D.

patient

should

abandoned

incurable.

In

a
all

case
the

of Vataja

mcha, 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
llcncc a
abscess),

fat,

case
is

of

Vataja mcha, (or
29-30.

marrow and Vasa. its accompanying

held as incurable.

A
a

person in
of

whom

the

premonitory symptoms (Pururine

varupam
little

Prameha) have appeared and who passes
than
usual,
it.

larger quantity of
as
all

should

be

considered
afflicted

already

afflicted

with

A

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
of Prameha. 31

one suffering from an attack

32.

A
ses

Prameha patient afflicted with deep-seated abscesand other distressing symptoms, which are usually

found to supervene in the disease, should be pronounced as suffering from Madhumeha and adjudged incurable.

A

Madhumeha

patient seeks a halting place while walksit

ing,

wants a place to

on while halting,
if

lies

down

if

he

finds a sitting place,

and sleeps

he

lies

down.

^^ — 34.

As
(bluish

five

mixed colours such as grey, brown, Kapila yellow), Kapota (blackish grey), Mechaka

(light-green)
five

may

be produced
in

by combination of the
(such as
of
red), so a diversity

primary colours
green,

definite proportions

white,

black,

yellow and

causes, through the relative

preponderance of the partiof the

cular

kinds of food, and of the deranged Doshas, root

principles

(Dhatu) and excretions

body (Mala),
35.

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

of Prameha, the outset,

not properly

treated

and attended
into

to

at

may
types,

ultimately

develop

those

of

Madhumeha
:

which are incurable.
(Acute Infective)

36
Prameha compare

For English equivalents of the
Cystitis

different types of

of urine

— Frequent, painful micturition, small quantity voided with pain and urgency. Urine — slightly acid or alkaline
in

reaction, cloudy, containing blood corpuscles.

Cystitis (Chronic Infective)

— Great and
offensive
Infective)

frequent pain, in the lumbar region, rigor. Urine thick, and alkaline, containing ropy mucous and blood. Cystitis (Nonlike

— Symptoms
cloudy

those

of

acute

inflammatory type.
is

Urinein

acid

and

with

mucous.

Blood

generally

present

considerable quantity.

Neuralgia of the bladder, compare
Hcematuria,

Albuminuria,
Pyuria,

Albumosuria,

Hoemoglobinuria,

Peptonuria,

Spermatorrhoea and Diabetes, Proteuria and Polyuria.

Thus ends

the

sixth

Chapter of the Nidana Sthanam

in the

Sushruta

Samhita, which treats of the

Nidanam

of Prameha.

CHAPTER
Now wc
shall discourse

YII.

on the

Nidanam
royal

of

Udara
i.

(dropsy with an abnormal condition of the abdomen),

IVIctrical
tari,

Text — The
:

sage Dhanvan-

the

foremost

of

all

pious
of

men
the

who
of

equalled thus
to

in

splendour and glory the lord
discoursed

celestials,

blissfully

on

the

Nidanam

Udara

Sus'ruta, the son of the

holy Vis'vamitra,

who devoutly
be divided

approached him for that purpose. 2. Classification : This disease

may

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. maining types, two being known as Plihodara (including Yakritodara), and Vaddha-Gudodara (tympanites due to
the
constriction
or of the

anus),

the

seventh Agantuka

(traumatic

of

extraneous
3.

origin),

and the eighth
deranged

Dakodara

(Ascites proper).

Predisposing
Doshas of a person
addicted to the
of
of

Causes :— The
of taking
food,
in

extremely impaired digestion,

habit
putrid

unwholesome

food, or

eating

dry,

or of violating the rules of

conduct to be observed

connection with oleaginous

measures

etc.,*

are aggravated

and

find

lodgment

in the

abdomen.
,

Thus appearing
all its

in the

shape of an abdomi-

nal

tumour (Gulma), they give

rise to this dreadful disease,

attended with

characteristic

symptoms. The lymph
food gets
it

chyle formed out of the

assimilated

vitiated,

•and, impelled by the aggravated Vayu,
*

percolates

These include purgative,

emitic,

A'stha'panam and Anuva'sanatu

mesisures.

Chtp. VII.]

NIDANA STHANAM.

5'r:

through the peritoneum in the same manner as a quantity
of
oil

or clarified butter kept in a

new earthen
It

pot will-

transude through the pores of
distends the skin (Tvak)

its sides.

thus gradually

of the

abdomen.
in

The

process

becomes general

all

through the abdominal
is

region and"

the disease (Udara)

produced

consequence. 4—5.
precursory

Premonitory sypmtoms :— The
appearance of veins on
closely
in the

S}'mptoms of the disease are loss of strength, complexion and appetite, emaciation of the muscles of the abdomen,
its

surface, acid reaction of
its

food

following
bladder,

(Vidaha\ pain and swelling of the lower extremities.
digestion

upon

The

patient cannot ascertain
6.

whether

his

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 Vayu.
of the stool

A

pain (Sula), suppression
piercino-

and urine (Anaha) and a cutting and
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

a burning sensation, yellow colour of the swollen skin of the

abdomen, on the surface
colour of the

which yellow veins
nails,

appear, yellow
urine

eyes,

face, stool

and

and the rapid increase of the dropsical
of the Pittaja

swelling, are

the

characteristics

Udara.
is

In a case of

Kaphaja type the
and

dropsical swelling

cold to the touch
veins.

becomes

overspread
,

with

white-coloured

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, y—.g.

52

THE SUSHRUTA

SAMlliTA.

IChap. VII.

The TridOShaja Type :— Evil-naturcd
men
(with a view to

wo-

win the affections of

their

husbands

or lovers sometimes)

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).

Doshas of the body, vitiated by such food or drink, or through imbibing any sort of chemical poison (Gara) administered by one's enemy, or
three

The

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

will vitiate the

blood and
of the

a kind of dreadful dropsical swelling
specific

abdomen, marked by the
of

symptoms
(in

of

each

them

The

disease

is

aggravated in cold and cloudy
is

days and a burning sensation
the

felt

the

inside

of

abdomen).

The
is

patient

becomes

pale,

yellow and
in the

emaciated, and

afflicted

with thirst and dryness
at short intervals.

mouth, and loses consciousness
disease
is

This
lo.

also

known

as the dreadful

Dnshyodaram.

Plihodaram. — (Spleen
men)
:

with dropsy of the abdo-

— Now hear me describe the
or of those

symptoms
of

of Pliho-

daram. The blood and the

Kapham
is

of a person, derang-

ed and aggravated through the ingestion
gogic food,

phlegma-

which

followed by an acid

digestionary reaction (Viddha), often enlarge the spleen,

(which gives
disease
is

rise to a

swelling of the

abdomen).

This

called

protrudes on the

left side

Plihodara by the experts. Plihodaram of the abdomen, its characteristic
lassitude,

symptoms being
ing

low

fever,

impaired digestion,
distress-

loss of strength, jaundice,

weakness, and other
to

symptoms peculiar

the deranged Pittam
liver

and

Kapham.
similar

A

similar enlargement of the

through
is

causes on

the

right
ii

side

of the

abdomen

called Jakriddailyudarain.

1 2.

Chap. VII.]

N DANA STHANAM.'
I

53
fecal matter,
etc.

Vaddha-gudodaram* :— The
mixed with the deranged Vayu,
body,
lies

Pittam

of the
in-

stuffed

in

the

rectum of a person whose
(as

testines

have been stuffed with slimy food

pot herbs)
rise

or with stones

and hair

(enteritis).

They
is

give

to

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

and the umbilicus which
difficulty

called

Vaddha

Gudodaram. Scanty
est

stools are evacuated with the great-

pain and

and the patient vomits a pefecal

culiar

kind of matter with a distinctly
?).

smell

(scyabalous

13.

Parisravi-Udaram :— Now
the causes and
is

hear

symptoms
as

of the type

of

me describe Udaram which
down with
intes-

called

Parisravi-udaram.
(such

Thorny
etc.),

or sharp-pointed

substances

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

to the

perforation

of the intestines, giving rise

a copious

flow of a watery exudation which constantly oozes

out

of the anus and to a distension of the lower part of the

abdomen

situated below the
is

umbilicus.

This

is

called

Parisravyudaram 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 Aunvasanam 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
abdomen with tympanites due
intestinal obstruction.

* Dropsical swelling of the
triction of the

to the

cons-

rectum known as

§4'

THE SUSHRUTA SAMHITA.

'

[Chap. VII.

the water-carrying channels of the body.

The same
etc. in

result

may

be produced by the drinking

of

oil,

inordi-

nate quantities

The

water,

b)-

percolating or transudchannels, as
the
is

ing through the walls of these
cribed,

before

des-

inordinately

enlarges

abdomen, which befull

comes glossy on the surface and
bloated

of water,
like

being
a
fullit

rounded about the umbilicus and
water-drum.

raised
is

The

simile

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
tics of

and

thirst are
in its
:

among

the general characteris16.

the disease

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

Xidana Sihanam
Udaram.

in the Sub'rut*

Sanihitd which treats of the

Nidanam

of

CHAPTER Vm.
Now we
labour),
i

shall

discourse
(false

on

the

Nidanam

of

IVIUClhag'ai*bham

presentations and difficult

Causes of lYIudha-garbham
intercourse during pregnancy, riding on

:

-Sexual
etc.,

horseback,

or in any sort of conveyance, a long walk, a false step, a
fall,

pressure on the

womb, running,

a

blow, sitting
in

or

lying down on an uneven ground, or
posture,
fasting,

an

uneven
natural
bitter,

voluntary

repression

of

any

urging

of

the

body,

partaking of extremely

pungent, parchifying
tities

articles,

eating in inordinate quansubstances,

of

Sakas

and alkaline

dysentery
in

(Atisara), use of emetics or purgatives, swinging

a

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
its

faetus,

thus

severed

and
in

seat, excites

peristalsis

not only

uterus, but induces a sort of constant, spasmodic

contraction

of
in

the intestinal

cavities (Koshthas), pro-

ducing pain
thus
of her

the liver, spleen, etc.

The Apana Vayu,

obstructed

through

the

spasmodic contraction

abdomen, produces any of the following symptoms, viz. a sort of spasmodic pain in the sides, or
in

the
in

neck of the bladder, or
the abdomen, or

in

the

pelvic cavity,

or

in the vagina,
etc.)

or

Anaha (tympof urine,

anites

with

obstruction,

or

retention

56

THE SUSHRUTA SAMHITA.
the
faetus,
if

[Chap. VIII.

and destroys
bleeding. In

immature, attended with
continues
to

case
in

the

faetus

develop
entrance
place,

and
to

is

brought
vaginal
the

an

inverted

posture at

the

the
if

canal,

and

is

impacted

at that

or

Apana Vdyu
faetus
is

gets

disordered
of the

and consesame,
3.

quently cannot help the expulsion

such

an obstructed

called

Mudha

garbhah.

of

Classification Aludha-garbha may
such
Vijakah and
in

and Symptoms: -Cases
be

roughly divided
Kilah,
the

into

four

different classes

as, the

Pratikhurah,
sort

the

the

Parighah.
child

The
its

of false
its

presentation
legs

which the
entrance

comes with
w^ith

hands,

and head turned upward and
at

back firmly

obstructed

the

to

the vagina, like a stake
sort of presentation,
in

or a kila,

is

called Kilah.

The
and

which the
out,

hands,
its

feet

head
at

of the child

come
the

with
is

body impacted

the

entrance
in

to

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
is

of the passage in

a horizontal position, like a bolt,

called the

Parighah.

Certain

authorities

aver that, these are the only four

kinds of Mudhagarbha.
presentations), inasmuch

But we can not subscribe to
four

the opinion (which recognises only
as the
in

kinds

of false

deranged Vayu (Apana)
different

can present the
at

faetus

various

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

comes
up, so

with

its

Sometimes the body, bent double, and thighs
breech
is

drawn

that only
child
is

obliquely presented.

Sornetimes

the

presented, impacted at the head

Chap. VIII.]

NIDANA STHANAM.
its

57

of the

passage with
is

chest, or sides, or back.

Some-

times the child
resting

its arm around its head, and the hand coming out first. Sometimes only the two hands are first presented, the head leaning on one side; sometimes the two hands, legs

presented with

on the

side,

and the head of the
impacted
at

child, the rest

the
is

exit in

body being a doubled up posture. Someof the

times one leg
at

presented, the other thigh bsing impacted
I

the

passage (Payu).
sorts

have briefly described these
of

eight
are

of

presentation

which

the last two

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,
contraction
of the repro-

convulsions, displacement or

ductive organ (yoni) a peculiar pain like the after-pain of
child birth, cough, difficult respiration, or vertigo. 4.

Memorial verses :— /^s
is

a

fruit, fully

matured,
to

naturally

severed from

its

pedicel and

falls

the

ground and
the
foetus

not otherwise,
to
its

so

the cord,
is

which binds
course
(

maternal

part,

severed in

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 fcetus be expelled out of

its

mother's

womb,
of

before

its

time.

For four months
remains
or
in

after the date

fecundation, the
its

faetus

a

liquid

state,

and hence

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.

PrOgTIOSiS
her

— The enceinte who violently
3

tosses

agony (at the time of the surface of whose body becomes
head
in

parturition)

and

cold, compelling

58

THK SUSHRUTA SAMHITA
forego
all

[Chap. VIII.

her to

natural

modesty,
with
dies

and whose sides
of large

and

abdomen
veins,
in

arc

covered

nets

blue-

coloured

invariabl)'

with

the

dead child
in

locked

her W(jmb,

The death

of the

frjetus

the

womb may

be ascertained by the absence of movements

of the ftetus (in the

womb)

or of an)- pain of child-birth,

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

distension owingto 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

an\'

serious

disease of the mother

may

also

produce the

like result.

A

child,

moving

in

the

womb

of a dead mother,
etc.)

who had just expired (from

convulsions

during parturition at term, like a goat (Vast/imAra)

should be removed immediately by the Surgeon from the

womb

(by Caesarean Section)
its

;*

as a delay
10-:
i.

in extract-

ing the child ma\- leads to
*

death

Csecsarean Section means incision of the uterus through the abdomi-

nal walls and extrication of the foetus therefrom. a dead subject requires no skill of a
the

Operation like this upon

surgeon.

Any one can do
modern
times,
foetus

it

without
the

help of any
life is

anilomical

knowledge.

In

when

mother's

in peril,

and the expulsion of the
passage,

becomes nearly

impossible,

by the natural

owing

to an existenee of deformity

either in the parturient
to save both

canal or in the

forms and structures
is

of the foetus,

mother and child

this operation
in

principally undertaken.
is

The eviJence
in passages like

of similar attempts,
just

ancient India,

found

recorded

what we have
subjects,

translated
is

and that the operation was
it.

practised on living

there

not the least doubt about
it

This

custom

is still

preserved in Central Africa, and

is

possible that the

Egyp-

tians like

Hindu philosophy and

religion learnt this also from the Hindus.
p.

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

70 "saw a case of the

Central Africa performed by a man.

At one stroke

Chap. VIII.]

XIDAXA STHANAM.
bladder
is

^0
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

dyspnrea
her

and perspiration.
and stands
shall
in

She complains

of

cadaverous

breath

danger of imminent
the

death.
child
in

By

these

symptoms a physician
This portion
is

know

death of the

the

womb.

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 haemorrhage

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

and threads of bark.
from various
roots,

The wound was then
the

dressed with a

paste prepared

woman

placed quietly upon her

abdomen,

in order to favour

perfect drainage,
It

and the task of the African
first

Spencer Wells was
half unconscious
patient

finished.

appears that the patient was
wine.

rendered

with banana
well.

One hour

after the operation the

was doing

And

her

temperature never

rose above loi F.

nor her pulse above io8.
healed, and the

On

the eleventh day the

wound was completely
reminded of the opera-

woman

apparently as well as usual."

When we

read this evidence of Felkin,

we

are

tive steps as described in

our

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, subs-

titutions of false readings
try to

and dismal knowledge of grammar and rhetoric
evidence that in ancient India Cesarean

prove in the face of strong

Section was at'empted only on cases where one "might not perspire."
If

we

take r2fqiliqi: in the sense of "a
in the sense of

woman whose
is

life

is

in

great

danger" and not exactly

"a woman who

dead" as recom-

mended by Dalian
meaning
if

and Arundutla (and which

might have been the
in the text),

instead of

f^qg

a

word

like

sjiiqn
in

had been used

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

diflTerent

readings ^^ITI^ ^"<^ <?f%51'C
are impressed

betaken conthat in ancient

jointly into consideration

we

with

the

idea

6o

THE SUSriRUTA SAMHITA.

CChap. VIII.

India Cicsarean operations

were very frequently undertaken

in cases of

puerperal eclampsia, where the molher
tion of a goat sufTerin}^ from
of an accidental

had been

in

the deplorable condiin cases

cramps and convulsions as well as
that

death
in

not unlike

which

fell
is

to

the lot of the poor

molher
destroyer

of

him

whose nnme the operation

called.

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

q^ = goat»in = =a
in the parturient

tiger or wolf) or in cases

where the presence of deformity
of the
is

canal or of maUormalion
living child.

foetus

prevented the natural delivery of a

The

incision

not

to

be made anywhere else but exactly

in the place

where Kelkin saw the
selection
of !(f^' ({{^^

illiterate

Negro

successfully apply his

knife,

the
a

as

suggested

by some commentators
subject
is

being
grave.
is

tempest on a tea pot

especially

when

the

beyond the

In a living subject the selection of a very

proper

site for the o,"eration

of

course

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.

We

extract here the

two

dififerent

readings and

leave

our readers to judge whether

we

are

correct to

draw the above

inferences.
:

— Ed.
oi5?i«i%
ori: ai^.^

^r«fi^ ^^^^\^\: f,fg

H^^e^ qf?

qij^sc^^^-

r^?'^

I

Bagabhala S'arira S'.hanam.

ch. II. slo. 53.

^ft^^\K

U^^w.

ffg: v^^'H gf?

?i?igiii5^^*i%

«

m^fqc^;*?-

Thus ends the eighth Chapter

of the

Nidana Sthanam
labour and

in

the Sus'ruta
presenta-

Samhitd, which treats of Niddnam of
tions.

difficult

false

CHAPTER
Now
\vc

IX.
on
the

shall

discourse
I.

Nidanam

of

Vidradhi

(abscess etc.).

The blessed Dhanvantari, who for the promulgation
Ayurveda
and
for

the honoured of the

gods,
of the

of the

knowledge
proper

administering

medicines

(to the sick),

took his birth at Kasi, (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

the

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

the bone

and

flesh,

and
round

fat of

a person

properties),

gradually give
or

to

a

deep-seated,
is

painful,

extended
wise.

swelling which

called

Vidradhi by the
Pittaja
type, the

The
t\'pe,

disease admits of being divided into six

types

such as

the the

Vataj'a

t>-pe,

the

Kaphaja

Sannipatika type, the Kshataja type (traumatic),
i^which has
its

and the Asrija

seat in the vitiated

blood).
3-4,

Now we

shall describe their specific

symptoms.
abscess

The
is

Vsttaja

Type

:

— This

assumes a

black Or vermilion coKnir,
characterised

is felt

rough to the touch and

by a
of

sort of excruciating pain.

The

growth and suppuration of the abscess
about
in

are

brought

a

variety

forms (owing to the variable

and

irregular action
5.

of the

deranged Vayu inolvcd

in

these cases).

The Pittaja Type — This
:

abscess assumes a

blackish }clIow colour or one like that of a ripe

Audum6.

vara

fruit.

It is
is

attended with fever and
of rapid growth

a burning

sensation, and

and suppuration.

62

NIDANA STHANAM.

Chap. IX.]

The Kaphaja Type:— This
like

abscess

is

shaped
to

an Indian saucer (s'arava) and seems cold
It

the

touch.
ised

assumes a light yellow colour and
little
is

is

character-

by numbness, itching and

pain.

and suppuration of

this abscess

very
thin,

The growth slow. The
those from

secretions from a Vataja

abscess

are

a Pittaja type are yellow,

while the exudations from a
J.

Kaphaja abscess arc white.
the Sannipatika type

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,

augmented and conducted by the deranged Vayu and vitiates the blood and Pittam, thus giving rise to a kind
of abscess

which

is

(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
all

and pain attended with
the Pittaja type,
It
is

the

symptoms Of

peculiar to
disease.

mark

the present form of

the

called Raktaja Vidradhi.

external Vidradhis

or abscesses, those

of the Sannipatika type should 10

be

regarded as incurable.

1

1.

Antara-Vidradhi ;— Now

we

shall describe

the characteristic features of internal abscesses

(Antara-

[Chap. IX.

THE SUSHRUTA SAMHITA
The Vdyu, Pittam and Kaphah
eating
physical
or of
dr\-,

.

63

Vidradhi).

of the body,

deranged through
congenial (to the
articles

heav}-,

of food

incompatible and intemperament of the eater) putrid and decomposed sub-

stances, or

by excessive coition and fatiguing physical
or

by voluntary repression of any natural urging of the body or through the eating of food which
exercise,
is

followed

b\'

an acid reaction, either severally
a

or

collectively give rise to

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: — They
seated at the

are

generally found

to be

mouth (neck)
the
sides,

of the bladder, or about the

umbilicus, or in
regions), or
heart,

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
external abscess.
or

those

of the

The
on

symptoms
should

of their

suppurated
in

unsuppurated stages
of the chapter

be determined

the

light

Amapakvaishanyiam (Ch XVII

Sutra.). 14-15.
:

Their specific
me
ent
in

symptoms -Now
which
specifically

hear
these

describe the symptom.s

mark

internal abscesses according

to their

seats in the differ-

regions
the

of the

organism.
is

An

abscess appearing

restum (Guda)

marked by the suppression
in the

of the flatus (Vata).
to
difficulty

Seated

bladder,

it

gives rise

of urination

and scantiness
it

of

urine.

Appearing about the umbilicus
hic-cough and a
tines.

produces a distressing
in the
it

rumbling sound (Atopa)

intes-

Seated

in either of the sides

(Kukshi)
to

tends to

aggravate inordinately the vayu of the body.
ing
in

Appear-

the

inguinal region

it

gives rise
waist.

an extreme
in either

catching pain at the

back and

Seated

64
of the

NIDANA STHANAM

[Chap. IX.

Vrikkas it brings about a contraction of the sides. Appearing on the spleen, it produces symptoms of
gives rise to an excruciating

difficult
it

and obstructed respiration. 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
the

of unquenits

symptom which marks

seat on

Kloma.
part

16-17.
:

Prognosis
vital

— An

abscess

appearing

on

any
be

(Marma)

of the

organism, whether large
should

or small in size, suppurated or unsuppurated,

deemed' as
umbilicus

extremely hard to cure.

Discharge from an
the

abscess formed in the region of the organism above

and (spontaneously bursting),
region
of

will

flow out

through the mouth whereas similar secretions from down
the

umbilical
outlet

(the

abdomen), naturally find
the anus.
etc.)

an
•in

through the
the

fissure of

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

proves

fatal.

An

incision
internal

made

by surgeon

from the outside into an

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.

A

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 unhwholcsome food after parturition. The abscess in such a case, which is attended with extreme

Chap. IX.]

NIDANA STHANAM.
(Da hajvara)
origin to

65
considered
as

hyper-pyrexia

should

be

having had

its

the

vitiated

blood (Raktaja

Vidradhi) accumulated in the

organism.
(in

The

abscess,

which appears
a safely

Kukshi delivered woman owing
in

the

the iliac

region) of
of the
child-

to the

presence
after

unexpelled blood-clots
birth, should

in

those
as

regions a
is

be also diagnosed

case
called

of

Raktaja

abscess.

The unexpelled
abscess,
if

blood

Makkalla.

Such an
is

not absorbed

in the

course of a week,

sure to suppurate.

20

- 21.

Differentiating diag^nosis of

Gulma
how
is

and Vidradhi* :— Now
which distinguish a Gulma Vidradhi (internal abscess).
it

I

shall discuss the features

(internal
It

tumour; from a

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
?

22—

23.

The answer
(internal

is

that a

Gulma
not

(^internal

tumour', though
as

caused by the same deranged Doshas
abscess),

a

Vidradhi

does

resort

to
etc.,

any deranged
while, on the

organic matter, such as

flesh,

blood,

contrary, in a case of Vidradhi,

the diseased flesh and

blood

of a

locality are in

themselves transformed into

an abscess.

An

internal

tumour

(Gulma)

is

like

a

water bubble floating and moving about within a cavity
*

A Gulma according
(also)

!o

Sus'nm does
in
its

not supjniraU', bnl
a

ihc

term

"Api"
as

contemplates instances

which

Guln.a may suppurate
flesh etc. of the

in the case

where

it

has got

basis in the

dernnged
of the

locality.

Charaka

asserts that

retarded

digestion
pain,

ingested

food
!tver

followed by digestionnry acid

reaction, colic

insomnia with
etc.

and a non-relish

for food

and a sense of oppression,
in a

are the

symp-

toms which indicate
that
it

that suppuration has set

Gulmn, and he advises

(Gulma) should be treated with

poultices, etc.

ee
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
sets

tumour) does not

suppurate at
it

Suppuration
contains

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 to it. Hence, a Gulma does not
suppurate at
all.

24.
:

Incurable Types
abscess

— A case
the

of

an

internal

suppurating

about

heart,

bladder

or

umbilicus as well as one of the Tridosha type (appearing

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

(generally)

becomes

fatal.

The suppurating
affects

process in

an internal abscess, which generally lying bone, is sometimes found to

the

under-

affect the
find

marrow.

The suppurated marrow, failing
account
of the

to

an outlet on

compactness of the
a

local flesh
in

and bone,
locality

produces a sort of burning

sensation
like

the

which consumes the body
disease

blazing
a

fire.

The
dirt,

confined

to

the

bone,

like

piercing

torments the patient for a considerable length of time.

An

incision

(made into the affected bone)
fat-like, glossy,

is

followed

by the secretion of a
thick
pus.

white, cold and

Men,
Sastras,

learned

in

the

knowledge of the
abscess
as

Medicinal

designate
(abscess

such an
of

an

Asthighata-Vidradhi
involves
all

the

bone)

which
is

the three kinds of deranged Doshas, and

attended with various kinds of pain
respectively.

w hich

mark them

25-26.
ihe

Siimliiid

Thu'^ rnrls th' ninili Chapler of the Nidanasthanam in which treats o(the celiology of absccs.?.

Sii^'mta

CHAPTER
Now we
shall discourse

X.

on the Nidanam of
(sinus)

Visari.

pa

(erysipelas),

Nadi

and

Stana-roga
deranged and

(diseases affecting the

mammae

of a

womanl

Definition of Visarpa :— The
aggravated Doshas, (Vayu, Pittam and
recourse
blood,
to,

Kapham) having
flesh

and affecting the Tvaka (Skin),

and

speedily give
(

rise to a sort of shifting, elevated

swelling
of
to

Sotha) marked by the characteristic
in the case.

symptoms
is

any of them involved
extend
all

This swelling tends
disease
called

over

the body.

The

Visarpa from the

fact of its

extending or swiftly shifting
2.
is

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

The Vataja Type :— The
soft

swelling (Sotha)

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

(in

the affected locality).

It

is

further
fever.

marked

b}'

the usual!

symptoms

of the

Vatika

A

case

of
or

this type in

which uneven flame coloured

\esicles

bulbs appear on the affected part
vitiation (of the

through the extreme

Vayu and

Pittam) should be given

up

as incurable.

3.

The
Pittaja

Pittaja

and Kaphaja Types - The
:

Visarpa (erysipelas) rapidly extends
fever, a
(of

(over

the

body, attended with severe
suppuration

burning sensation,
skin
spot
of
.

and

cracking

the

A
this

large
as-

number sume a

of

vesicles

appears on
colour.

the
case

which

blood-red

A

t}'pe,

characterised

by the

destruction

of the local flesh and
of

veins owing to the excessively
the

aggravated condition

deranged Doshas (Kaphha and

Pittam)

and a

68
coll}'rium-likc

Tin: SUSllKUTA SAMIIITA.

[Chap. X.

black colour (of the

swelling), should be

regarded as incurable.
slowly
affected
is

and the process of suppuration
part
a slight

The Kaphaja Visarpa extends is tardy. The
and excessive
:

becomes white, glossy and swollen, and
\n\.\n

marked by

itching.

4-5.

The Sannipatika Type
the part

-The

Visarpa

of

Tridoshaja type

is

deep-seated

and the

affected
all sorts

assumes

all

colours

and

is

attended with

of piin

which are peculiar to the three aforesaid types

The

local flesh
(jf

and veins arc destroyed
disease and
6.

in the

suppurating
looked

stage

this

hence,

it

shouldbc

upon

as incurable

The Kshataja Type
wound
the
to a

(Erysipelas

due

to

a

or an ulccri:— 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 Erysipelas (Sopha— lit rash) which assumes a reddishbrown colour, with high fever with a burning sensation,
and suppuration
in
its

train,

and
the

it

is

found to be
of Kulattha

covered with black
pulse.
7.

vesicles

to

size

Prognosis ;— The
Visarpas
are

Vataja, Pittaja and

Kaphaja
indicate
or

curable

;

the

Sannipatika and Khataja
of Vataja

ones

being incurable.
unfavourable

The symptoms, which
in

an

prognosis

a

case

Pittaja Erysipelas,

have been described before
vital parts

Those,

which attack the

(Marmas) of the body, can
8.

be cured only with the greatest difficulty.f

Or through

the

extreme augmentation of

all

the

three

doshas

in

the ulcer (Sadyah kshata-Vrana) according to others.

+

Golden coljured (yellow)
is

Erysipelas

due to the action of the

(deranged) Tillam

incurable

(PiKatrni

A'anchana-vapuscha ia hA na

sydhyei.).—D. K.

Chap. X.]

NIDANA STHANAM.

69

The Nadi-Vrana :— The
swelling
neglects
it

pus of an abscess or
if

burrows into the affected part
in
its

a

person
its

fully suppurated stage, dubious of

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

a
is

abscess.

An
to

abscess

or swelling

called a Gati of pus,

Vrana owing
a large

an

excessive

infiltration

and

it is

also called a

presence of
its

Kadi-vrana owing to the number of recesses or cavities in
types
of Nddi-vrana

inside

There arc

five different

(sinuses) such as

the Vataja, Pittaja Kaphaja, Tridoshaja

and

Sah'aja.

9—10.
is

The Vataja, Kaphaja and Pittaja rough and shortTypes:— The Vataja Siiius
mouthed, characterised by an aching pain (in its inside) It exudes a sort of frothy secretion which becomes
greater
at

night and

is

attended with an aching pain.
affected

Thirst, lassitude, heat
locality) arc the

and a piercing pain(in the

usual

accompaniments of the Pittaja
of hot

types. Fever

is

present from the beginning and the Sinus

exudes a large quantity
secretion

and yellow coloured

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

secrete a

copious quantit>' of thick, shiny, white-coloured
it -13.
:

pus which becomes greater at night,

Dvandaja and Tridoshaja Types —
A
of

case

of

Nadi-Vrana involving the concerted action
of the

any two

deranged
exhibiting

Doshas (Vayu,

Pittam
to

and Kapham) and
both,
is

symptoms
one.

peculiar

called

a

Dvandaja*

There are

three

Gayadasa docs nol read the symploms of Dvi-doshaja
principles)

{i.e.,

due

10

iwo morbific

types

of

sinus

a

g vtn 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.

Vata-kaphaja

and

Pitta-kaphaja)

A

case

of

Natdi-

vrana, exhibiting symptoms of the three aforesaid types,

and attended with fever and a burning sensation,
cult

diffiis

breathing,

dryness

of the

mouth and syncope,
of
this

called

Tridoshaja.

An

attack

type should
the

be regarded as dreadful

and

fatal,

casting around

gloom

of death.

14-T5.

The ^alyaja Nadi-Vrana :— A
matter (such as
the
dirt,

foreign

bone, splinter

etc.),

lodged within

body and
etc,

invisible

to the eye, tends to burst open
its

the skin,
tion
ised

of the locality along
rise to

channel
It is

of insercharacter-

and gives

a type of Sinus.

by a constant pain, and suddenly
This type
called Salyaja.
16.

and rapidly

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

ThcStana-Roga: —These may be divided into
as

many

types

as

the aforesaid

Nadi-Vrana and are
the
last

caused by the same exciting factors as

named
the

malady.
breast
of-

The milk-carrying ducts remain
a nullipera

closed in

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
the the

and expand of

their

own

accord,

thus

making
to

advent of diseases possible that are peculiar

mamma.

17-19
:

-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 2o. with child) which is called milk.
Rasa (lymph
chyle)

The breast-milk

Its
lies

character :— The
and
invisible

breast milk,

like

semen,

hidden

in

the

organism, though

Chap.

X

]

NIDANA STHANAM.
it

7I

permeating
of semen.

in a subtle or essential form.

The
and

charac-

teristic features of

the breast-milk bear analogy to those
breast
sight

The
as

milk
or

is

secreted,

flows
in the

out

at

I

he 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

man

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

love of a

mother

for her children brings

about the secre-

tion of her breast-milk

Both semen and breast-milk are

the

product of the essence of digested food, this essence

being converted into milk in

women. 21 22. Its abnormal and normal Traits: The milk of a mother vitiated by the deranged Vayu

of

her system

has an
of a

astringent taste and

floats

on

water

The milk

mother vitiated

b}--

the deranged

Pittam has an

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

and

pungent taste and

mother vitiated by

the

concerted

and simultaneous

derangement of the three Doshas of the body is marked by the combination of all the preceding symptoms. An
external blow or hurt

too (Abhighata) sometimes
23.

pro-

duces vitiation of the mother's milk.

The milk
water., tastes

(of a mother),

which instantly mixes with
its

sweet and retains

natural

greyish

tint,

should be regarded as pure.

24.

The bodily Doshas
a

liaving recourse to the breasts of

woman whether

filled v^'ith

milk or not and

vitiating
diseases,

the local flesh and blood give rise to
*

mammary

The

paitick-

''Chn"'
cases.

in

the lext ir.c-icaffMhnI the colour

mny

turn

blue or pink in

some

72
(Stana-roga).

THE SUSHRUTA SAMHITA.
All

[Chap. X.

the
called

types
the

of

abscess

(Vidradhi)

excepting the one
types

Raktaja out of the six

described before are found to attack the

mammae,
identical

and

their

symptoms should be understood
25.

as

with those of external abscesses.
Thus ends the
Samhila

tenth Chapter of the Niflanam

Sthanam

in the Sus'rula

w ich treats of and mammary abscesses.

the oetiology and

symptoms

of Erysipelas, Sinus

CHAPTER
Now we
(Glands
shall discourse
etc.),

XI.

on the Nid^nam of Granthi
etc.),

Apachi (Scrofula
i.

Arvudi (Tumours)
etc.

and Galaganda (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
swell-

inflammation).

2.

The Dosha-Origincd Types :— The
ing

(Sopha) of the Vataja type seems as
into

if

it

were

drawn

and elevated or as
cleft

if

severed

or

pricked

with a needle,

two or drawn asunder or as if cut in two or pierced. The knotty growth assumes a black colour, and is rough and elongated like a bladder.
in

On
red

bursting a granthi of this type exudes clear

bright

blood.

The Pittaja Granthi

is

characterised by
(in its inside).

heat

and an excessive burning sensation

A

pain, like that of being boiled

by an

alkali

or

by

fire, is felt in

the inside.

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,
It
is

and

feels

hard
its

and compact as a stone
pus when
bursts.

slow or tardy in

growth and exudes a secretion of thick white-coloured
it

3-5.

The
thi is

lYIedaJa

Type :— The

fat origined

Gran-

and glossy and gains or loses in size with the gain or loss of flesh by the patient. It is marked
large

10


74

THE SUSHRUTA SAMHITA.
little

[Chap. XI.

by a

pain and an excessive itching sensation
fat

and
or

exudes a secretion of
a gruel,
in colour

resembling clarified

butter

and consistency, made of the levigated
bursting.
6.

paste of

sesamum on

^ira-Granthi — (aneurism
The bodily Vayu
exertion
or by
in

or varicose veins)

:

weak and enfeebled

persons, de-

ranged by over-fatiguing physical exercises, straining or
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

a

raised knotty formation which

called a

Sird-Granthi,

In the
it

event of

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
is

crop of such glandular
called

knots,

Apachif on account of the extensive nature of
8-9.

their growth.

* In several editions an additional line is to be found running as men well conversant with syirplonis (of Gtavihis) recognise a type of Granthi due 10 the action of the deranged flesh and blood, which exhibits symp{Afansjtasrayavi charvttda trms idenlical with those of a tumour But Jejjata has laskhanena tiilyani hi drish/amath lakshanajanih). rejected it as of questionable authority.
t These glandular formations appear about the root of the penis, about ihe 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 spontaneous!}- 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
(to

disease undoubtedly owes

its

origin

to

the deranged fat

and Kapham, and may only be made
with
lo.
etc.)
:

amenable

medicine)

the

greatest

difficulty

lasting for years at a time.

ArVUda— (tumour
of flesh

— The

large

vegetation

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

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
to

symptoms of an Arvuda
or
fat,

which owes

origin

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.
1 1

Raktaja— Arvuda :— The
(Vayu,

deranged Doshas

Pittam and

Kaphamo

contracting, compressing

They resemble spawns
of the

of fish in shape and size and are due (o the action deranged Vayu, Pittam and Kapham. The appearance ol such glands in the upper part of the body should be ailribuied lo the action They are ixtrenicly hard lo cuie of the deranged and aggravated \^ayu. in as much as their growth (foruiation) involves the concmed aciion of the morbific principles (Doshas) of the body. Bhoja-

Charaka,

who

designates

this

disease

as

Gandamala, describes

its

location in regions about the

jawbones alone,

* That they having recourse to the flesh, produce deep-s(attd vegetations (of flesh) is the reading adopted by Gayadasa and others.

76

THK SUSflRUTA
(^Sira)

SAMIIITA.

[Chap. XI.

and drawing the vessels
ted part^,
raise
is

and blood

(of the affec-

a

slightly

suppurated

and

exuding

tumour which
tubercles and
is

covered

with small warts and fleshy
This tumour
is

called a

Raktarvuda.

rapid

in

its

growth and exudes a constant flow of

(vitiated) blood.

The complexion
and
other
pale

of the patient owing

to

depletive

actions

concomitant
yellow.

evils

of

haemorrhage

becomes

and

The
its

type

should be considered incurable on account of
its

having

origin in the blood.*

12

13.

IVIanS^rvuda

:

— The

flesh

of

any part of the

body hurt by an external blow etc. (hurting it with a DR.) and vitiated in consequence, gives log of wood is called rise to a sort of swelling (tumour) which

Mdnsarvuda, which originates through the action of
the deranged
purating,

Vayu.
the

It

is

glossy,

painless,

non-sup-

hard

as a stone, immobile,

colour

as

surrounding

skin.

appearing

in

a

person addicted to

and of the same Such a tumour meat diet becomes
of the

deep seated owing to the
bodily
type.
flesh
14.
:

consequent vitiation

and soon lapses into one of an incurable

ProgTIOSiS
Arvudam

— Even

of

the

aforesaid

curable

types (such as the Vataja, ctc.^

the following

types of

(tumours) should be likewise regarded as incur-

able, those

which appear
,

in the cavity of

a Srota

chan-

any vulnerable joint of the body and are characterised by any sort of secretion and also imnel or an artery

or

movable, should be deemed incurable.

An

ir\rvudam
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 ^'ound in Raktdarvuda, while a dominant action of the deranged flesh marks the

Mdnsdrvuda

type.

Chap. XI.

NIDANA STHANAM.

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
i^with

as equally

incurable
(^tumour)
to

one of the foregoing types).

An Arvuda

of

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 Calaganda
deranged and aggravated Va}'u
deranged and augmented
lity affects the

(Goitre;:

-The

in

combination with the
fat of the loca-

Kapham and

gradually gives

two tendons of tne neck (Manyas) and rise to a swelling about that part of the

neck

characterised

by the

specific

symptoms
is

of

the
in-

deranged Doshas (Vayu or Kapham) and principles
volved
(Goitre).
in

the
17.

case.

The

swelling

called

Galganda

Symptoms of the Dosha-origined Types — The swelling or tumour in the Vataja goitre
:

is

characterised by a pricking pain

(in its inside)

marked

by the appearance of blue or dark coloured veins S'ird) on its surface. It assumes a \crmilion or tawny brown
hue.
in

The

goitre

course

of time,

becomes united with the and gains in size, giving
in

local

fat

rise to

a

sense

of burning

the throat, or
at
all.

is

characterised
is

by

the absence of

any pain
its

A

Vataja goitre

rough

to the touch, slow in

growth,

and never or but rarely
in

suppurates.
palate
as
this

A
well

sense of dryness
as

the throat and the

a

bad taste
swelling

in the
in

mouth

likewise

marks

type.

The

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). and
the patient feels
It is

but slight pain

an
in

irresistible inclination to scratch
its

the part.
rare

slow

progress and suppuration
is felt
if

is

and tardy.

A

sweet taste

in the

mouth and
sort

the throat and the palate seem as
of sticky

smeared with a

mucous.

i<S-2o.

Symptoms
The
swelling
It
is

of

the IVIedaJa Type:—
soft

glossy,

(heavy

— D.R)
is

and paleshort
at

coloured.

emits a fetid smell and

characterised by
It is

excessive itching and an absence of pain.
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

A
a

case

of

goitre

attended

vvith

respiration,

softening

of the

whole

bod}-,

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

as

one which

is

more than

of a year's standing should
22.

be abandoned by the physician as incurable,

large

Text : A pendent swelling whether and occurring about the region of the throat and resembling the scrotum in shape is called
IVIetrical
or

small

a Gala-Ganda.
Thus ends
the

23.
eleventh

Chapter

of

the

Nidana

Sthanam

in

the
etc.

Snsruta Samhita which treats of the

Nidanam

of Granlhi, Scrofula,

CHAPTER
Now we shall discourse
(disease of
phantiasis).

XII

on the Nidanamof

Vriddhi
vele-

(hydrocele, hernia, scrotal tumours etc),

Upadatisa.

the
i

genital

organ, and

^Ifpada

Classes
Vriddhi such
the

:

-There

are

seven

different

types of

as the

Vataja, Pittaja,

Kaphaja, Raktaja,

Medaja, Mutraja and the Antra-vriddhi.

Of

these both

Mutraja-vriddhi (h\-drocele or extra vagation

of the

and Antra-vriddhi types, though owing their origin to the deranged condition of the bodily Vayu, have
urine),

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

i

lying

in the

nether regions of the body

may
rise

resort

to the spermatic cords

(Dhamani) and give
(scrotal

to

a

swelling and inflammation

of Phalacosha (scrotal sac)

which
in

is

called

Vriddhi
of the

tumour
and
the

etc.).

A
of

pain
(Kati)

the bladder,

scrotum, penis

the

waist

incarceration

Vayu and
premonitory

swelling

the

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. Vriddhi,

The
assumes

swollen
the

scrotum,
colour
of

of
a

the
ripe

8o

THE SUSHRUTA SAMHITA.
fruit and and heat
is

[Ch*p. XII.

Audumvara
sensation

attended with fever, a burning
the affected
part.
It
is

in

of a

marked rapid growth and speedy suppuration
scrotum).

(of the

The swollen organ in the Kaphaja Vriddhi becomes hard and cold to the touch accompanied byIn the little pain, and itching (in the affected part'.
Raktaja type the swollen scrotum is covered over with black vesicles, all other symptoms of the type being
identical with those of the Pittaja

one.
like

In the

Medaja

type the swollen

scrotum looks
glossy

a ripe Tdla fruit
painful.

and becomes

soft,

and slightly

The
part.

patient feels a constant inclination to

scratch
its

the

The

Mutr.iji- vriddhi (hydrocele) owes
its

origin

to

a habit of voluntary retention of urine,

characteristic

symptoms being

softness

and

fluctuation on the surface
filled

of the swollen scrotum like

a skin-bladder

with

water, painful urination, pain in the testes and of the scrotum.
5.

swelling

Antra-vriddhi (Inguinal hernia):— The local Vayu enraged and unusually aggravated by lifting a
great
load,

wrestling
or

with
fall

a .stronger

person,

violent
like

physical

strain

a

from a

tree

and such
regions

physical labour doubles up a part of the small intestine

and presses
there

it

down
in

into

the

inguinal

lying

strangulated
is

the

form

of a

knot

(Granthi)
hernia).

which

known
not

as

Antra-vriddhi (inguinal
attended
to
at

The

part

properly

the

outset

descends into the
elongated

scrotum which becomes ultimately
looks
like

and intensely swollen and
It (hernia)

an

inflated air-bladder.

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.

Si

TheUpadansam: —An
of

the

genital,

inflammatory swelling whether ulcerated or not is called
disease

Upadans'a*.
action

The

owes

its

origin

to

the

of the local Doshas, aggravated
intercourse,
;

and excessive sexual
nence in sexual

by promiscuous or by entire absti-

matter

or

by

visiting a

woman, who

had observed a vow of lifelong continence or one who has not long 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
;

whose partturient canal
entire length
;

is

studded with hairs along
a

its

or by visiting

woman

not amorously
;

disposed towards the visitor and vice versa

or

by know-

ing a

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
is

naturally foul

;

or by going unto a

woman

in

any of

the natural fissures of her

copulation (Vi yoni)
finger nails, or biting

;

or
it

body by pricking the
teeth, or

other than the organ of
genital with

with the

through poisonthe
(penis

ous contact, or through practice

of getting
the)
;

abnormally

elongated

by pricking
its

bristles

of

a

water parasite {Suka) into
*

body
to

or

by

practising
types
of

Upadans'a

is

not

syphilis

whole

whole.

Certain

Upadans'a such as the Raklaja and S^nnipdtika types which
destruction of the organs concerned
exhibit
certain

entail the

symptoms which are
eruptions and
tertiary

common
used
the
to

to

syphilis

as

well.

The secondary
mentioned by

symptoms of
treat

syphilis
it

are

not

ihe A') urvedic Rishis
this
fact

who

only
that

with
the

vegetable

medicines and

intimates

probability

secondary
efficient

and

tertiary

symptoms
from

of syphilis
the

might not arise by their
beginning,

and

able
the

treatment
poison

very

preventing
of

the absorption of
so

into

the

system.

The
taken

practice
into

ablution,
as

common among
the
it

the Hindus,

might be
factors.

consideration

one of

important
the

preventive

Maharshi Caaraka has
Impotency'.

comprised

within

chapter

on

'Senile

— Ed.
II

82
masturbation,

THE SUSHRUTA SAMHITA.
or

[Chap. Xtt.

any unnatural offence
or through

with female

quadrupeds

;

or by washing the
;

genitals with filthy or

poisonous water

neglect to

wash

the parts

after coition, or voluntary

suppression of a natural flow

of

semen
the

or

urine
etc.
is

or through

any hurt

or pressure

on

organ

The

inflammation of the genital
Upadans'a.
five

thus

engendered
Vataja,

called
into

The

disease

admits of bsin^ divided
as, the

distinct

types, such

Pittaja,

Kaphaja, Tridoshaja and the

Raktaja.

7—8.

The symptoms
The
ness and

of different

Types:—
cracking
etc.,
is

roughness of the genitals, the bursting or

of the integuments of the penis and prepuce

numb-

swelling of the affected part

which

perceived

rough to the touch and the presence of a varied sort of
pain peculiar to the deranged
indications of the

Vayu

are the characteristic
the

Vataja type.

In

Pittaja type

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

becomes

swollen and assumes the colour of a ripe Indian fig (reddish-yellow), attended with a sort of intolerable

burning sensation

The

process of suppuration

is

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
t}-pes

Symptoms
the

each

of the Vataja, Pittaja and Kaphaja

concurrently
t>T3e of

manifest themselves in

Sannipatika

Upa-

Chap. XII.]

NIDANA STHANAM.

"

83

dansa.

The organ

cracks, the ulcers or cancers

become

infested with parasites
to the suffering of
its

and death comes
wretched victim.

in to

put a stop

9 —13.
in

^lipadam (Elephantiasis) :- The disease
the deranged Vayu, Pittam and

which

Kapham, taking

a down-

ward course, are lodged in the thighs, knee-joints, legs and the inguinal regions and spread to the feet in course
of time
is

and gradually give

rise

to

a swelling therein,

called Slipadam.

There are three types of Slipada
deranged

severally

due to the actions of the

Vayu,

Pittam and Kapham.

14—

15.

The symptoms
Types: —The
the
touch.

of

the

different
in

swollen

parts
felt

assume a black colour

Vataja type and are

rough and
the

uneven to the

A
is

sort of

spasmodic pain without any apparent
in

reason

felt (at

intervals
to

seat of the

disease),

which largely begins
type
is

crack

or burst.
softness

The Pittaja
and yellowish
attended with
type the
painful,

characterised

by a

little

hue (of the diseased localities) and often
fever,

and a burning sensation.

In the

Kaphaja

affected localities

become

white, glossy, slightly

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
the

preponderance of
three types
of the
(of

deranged
in as

Kapham marks
much
as,

the

disease,

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

tChap. XII.

rain-water
(lit.- all

remain
seasons)
in
all

stagnant
of

the year

making them damp and
is

humid

seasons.

18-91

The

disease

usually found to be confined to the legs

and hands of men but cases are on record in which it has extended to the ear, nose, lips and the regions of the
eyes.

(Penis

—Madhaba-Nidjinam).
twelfth Chapter of the

20.
in the

Thus ends
Samhila which

ihe

Nidanastbanam

Sus'ruta

treats of the

Nidanam

of scrotal

tumours,

hernia,

Upa-

dans'am and elephansiasis.

CHAPTER
Now
we
shall

XIII.
on
the

discourse
(diseases

Kshudrarogam
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
Vivrita,

;

— Ajagallika,
Kachchapika,

Yavaprakshya,
Valmika,
Jala-garddabha,

Andhdlaji,

Indravriddha, Panasiki,

Pashana-garddabha,
Agni-rohini,

Kaksha,

Vishphota,

Chippam.

Kunakha,
Pamd,,

Anus'aye,

Vidarika,

Sarkara-

Arbudam,
Kadara,

Vicharchika.
Indralupta,

Rakasa,

Pd,dadarika,

Alasa,

Darunaka,

Arunshika,

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

Yatumani, Mas'aka, Charmakila,Tilakalaka, Nyachchya,

Vyanga,

Parivartika,

Avapatika,

Niruddha-prakas'a,

Niruddha-guda,
Guda-bhrans'a *

Ahiputanam, Vrishana-kachchu,
2,
:

and

Metrical Texts
eruptions which are
are
glossy,
are

-The

species of pimples or

shaped like the
painless
is

Mudga
the

pulse

and

knotty and
of the

called Ajagallikai.

They
skin)

same colour
is

(as

surrounding

and their origin

usually ascribed to the action

of the deranged

Kapham and Vayu.
Yatvaiprakshya^
:

The

disease

is

peculiar to

infants,-]-

— The

eruptions

*

Brahmadeva comprising
list

Garddavika,

h-vfUika,

GandhapidikA and
species.

Tilakdlaka in the

reads

it

as consisting of thirty-four different

Jejjata does not hold the four forms of disease

commencing wiih Garddain of

vika,
all

etc.

as included within the

list.

Gayadasa, finding them included
within the
the
list

the recensions

reads 6'arfWo3A/-fa', etc. as included
etc. as

list

Kshudra Roga, and Pama Kushtham.
t They
afflict

included

within

of

Kshudra

certain infants

— Dallana.

:

86

THE SUSHRUTA SAMHITA.
like the barley-corns,

[Chap. XIII.

which arc shaped
thick

extremely hard,
(lit

at the middle,

knotty and affect

— confined to)

the flesh are called Yavaprakshya.

action of the deranged

They are due to the Vayu and Kapham. Andhjilaji
eruptions
a

— The

dense,

raised, slender-topped

which
pus

appear in

circular

patches

and
are

exude

slight

are called Andhdlaji.

the deranged
or eruptions,

They Vdyu and Kapham.

due to the action of
Vivritai:

— Pustules
fruit

which are coloured

like a ripe

fig.

and

are flat-topped and appear in
intolerable burning

circular

patches with an
Vivrita
3

sensation, are called

They
6.

are due to the action of the deranged Pittam.

Kachchapika :— A
shape of a
face
tortoise

group of

five or

six

hard,
in the

elevated, nodular eruptions (Granthis), arranged

(which

may

appear on the surcalled

of

any part of the body), are
to

Kachchapikd.

They

are due

the
:

action

of the

deranged

Kapham
erupsoles,

and Vdyu.

Valmika

— The

knotty undurated

tions (Granthis) which

gradually

appear on the

palms, joints, neck and on the

regions

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

The disease is due to the action of the Kapham, Pittam and Vaiyu. 7 8. deranged I ndravr idd h2t :— Pimples or eruptions ^Pidaka)
(Granthis).

arising (on the surface of the body), arranged in the
circular array as
in

same
the

marks the
disease

distribution of the seed (sacks)

a lotus

flower are

called
is

Indravriddhai

by

physicians.

The

caused by the action

of the

deranged Vdyu
(Pidaka)
over
the
of a

and Pittam.
sort

Panasika :— Eruptions
painful

of extremely

pustules

all

back

or

the

ears

which

resemble

the

Chap. XIII.]

NIDANA STHANAM.
in

8^

Kumuda
Vayu.
of the

bulb

shape,

are

called

Panasika.

They
and

are due to the

action

of the

deranged

Kapham and

Pashana-Garddabha :— A
jawbones, (Hanu-sandhi;

slightly painful

non-shifting hard swelling,

which appears on the joint
is

called

Pashanaderanged
thin
is

Garddabha.
superficial

The

disease

is

the effect of the
:

Kapham and Vayu.
swelling,

Jala-Garddabha
which
like

—A

and
of a

erysipelas
is

shifting or progressive character

and

further attended

with fever and

a burning

sensation and
is

which

is

but

rarely found to suppurate,

called

Jala-Garddabha.*
deranged
Pittam.

The disease Kaksha — The

results

from

the

disease characterised

by the eruptions of
is

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

and on the region about the arm-pits,

called

Kakshd.
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

*

The
Piitaui.

circular raised spots studded with vesicles are

called

Gardda-

bha.

They are reddish and

painful
it

and produced by ihe action of Vayu

and

Gayadasa reads

so.

+
in

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
pain,

breaking open the flesh at the
fever

waibt,

attended with extreme

high

and an insufferable burning sensation which, if not properly remedied,
on diath within a fortnight, or ten days
(vesicles) are called
of

bring

their

first

appearance.

These

Vahni- Rohini.
to

And
the

again from another work
action
of the

he cites that a case

oiVahni Kohini due

deranged-

88

THE SUSHRUTA SAMHITA.
bursting
the
local
flesh,

[Chap. XIII.

(KakshA) by
is

and
if

which
blazing

attended with fever and a sensation

as

a

fire is

burning in the inside
Agni-Rohini.

(of

the affected part), are
is

called

The
It is

disease

caused

by the
the

concerted action of the three

deranged Doshas .;Vdyu,
incurable and ends
in

Pittam and Kapham).

death of the patient either
fifteenth

on the seventh*, tenth or
.

day

(of

its
:

first

appearance

15.

Chippam —^Thc
vitiating the
flesh
is

deranged Vdyu and
finger-nails,

Pittam
to

of the

give

rise

a

disease which

characterised

by pain, burning and
is

suppuration.

denominated

The disease called Chippam, Upanakha and Kshataroga.
nails

also

Kunadry,

kham

:

— The
It

of

fingers

becoming

rough,

black, and injured

through the action
effect of a blow,

of the

Doshas

enraged through the
(bad
nails).
is

are called

also

called

Kulviam.

Kunakha Aiiusayi :—
is

A

small swelling (on the surface of the

body) which
skin),
is

of the

same colour

(as

the

surrounding
its

but

is

deep-seated, and suppurates in

deeper strata,

called

Anusayi by the physicians. The disease is the effect A round reddish of the deranged Kapham. Vidarika
:

swelling rising either on the auxiliary or inguinal regions
in the

shape

of a

gourd
is

(

Viddrikandd)

is

known

as

Vidarika.
of
is

The

disease

due to the concerted action
Pittam

the

deranged

Vayu,

and

Kapham and
to

characterised

by

symptoms

peculiar

each of

them.

16-19,

Kapham
*

proves

faial

within a fortnight, that due to the deranged Pillatn,

wiihin 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 Vdyu, on the tenth day in a case

marked by the dominant

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

Chap. XIII.]

NIDANA STHANAM.

89

^arkararbudam :— The
Kapham
(Sira),

deranged 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

Vayu, when aggravated

through excessive secretion, dries and gathers the flesh

up again

in the

shape of

(a large

number
is

of)

gravel-like

concretions (Sarkara)

known accordingly

as Sarkararbu-

dam.

A

fetid secretion of varied colour

secreted from

the veins (Sira) in these Granthis which are sometimes

found to bleed suddenly.
disease called

The

three varieties of the skin

Pama (Eczema), Vicharchika (Psoriasis) and Rakasa have already been discussed under the head
of

Kushtham

(Chapter. V.).

20 soles

2

r.

Padadarika :— The
of extremely pedestrian
their natural

and

feet of a

person
lose

habits

become dry (and

serous
gives

moisture).
rise

The

local

Vayu

thus

aggravated
(Dari
darika.
in

to

peculiar

painful

cracks

the

affected
:

parts)

which are

called Pada-

Kadara

— The
shape),

knotty

(Granthi),

a

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)
etc.

of a person as an outcome

produced

condition of the local blood and fat by the deranged Doshas incidental to the
or of gravel
affection,
is

pricking of a thorn
(corns).

called a

Kadara

Alasa

:

— An

caused by contact of

poisonous mire
is

characterised

and appearing between the toes, which by pains, burning, itching and exuda22

tion, is called Alasa.

25.

Indralupta:— The

deranged Vayu and Pittam
12

having recourse to the roots of the hairs bring about their

$0
gradual

THE SUSHRUTA SAMHITA.
falling
off,

[Chap, Xlll.

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 Khatlitya (Alo-

Darunaka:— The

disease

which the

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

naka.

The

disease

is

due to the action of the deranged

Kapham and Vayu.
a

Arunshika
or
outlets
result

:

— Ulcers (A runshi)
the

at-

tended with mucopurulent discharges and furnished with

number
of

of mouths

and appearing on the
action
of local
(of

scalps

men

as

the

of

parasites

and of the deranged blood and

Kapham
:

the

locality)

heat

are called Arunshik^. Palitam The and Pittam of the body having recourse to the
of the head

region

owing

to overwork, fatigue,

and expremathe

cessive grief or anger, tend to

make
of the
is

the
hair

hair

turely grey, and .such silvering

ibefore

natural

period

of
:

senile

decay)
yellow

called

Palitam.

Masurika
,

(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
:

Yauvana-pidakai— (Mukhadushikski — The pimples like the thorns of a Salmali tree, which arefound on the face of young men through the deranged condition of the blood, Vayu and Kapham, are called YauvanaMasurikl
pidaka
or

pimples

of

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
to

of vitiated blood and at the
exercise,

same time
is

their

undergoing no physical
the
bodily

and hence there

little

chance

of

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 Vayu and Kapham. Yatucircular,

mani (mole)
less,

:

— The reddish, glossy,

and pain-

congenital marks CSahajam) 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 Fittam.

26—33.
:

IVIasaka
black

(Lichen)
pulse
of the

-The
shape,

hard,

painless,
(skin) re-

and elevated eruptions on the body
in

sembling the Masha
aggravated
condition

caused

by

the

bodily

Vayu
painless

are

called

Mas'aka
the
level

Tilakalaka:
about the
the

— The
of
are

black
a

spots on

skin

size

sesamum

seed

and
This

with
is

skin

called

Tilakalaka.

disease

caused

through the aggravated condition of

the Vayu, Fittam

ana

Kapham .-f
arc

Nyachcham

:

— The
skin,

congenital, painless,

circular,

white or brown (Sydva)
found to be restricted
of the

patches on the skin, which

to a small or comparatively diffused area
are
called
:

the skin)

Nyachcham. Charmakila (hypertrophy of The causes and symptoms of the disease
have
been
already
described
:

known

as

Charmakila
of the

Vyang'a The Vdyu being aggravated through wrath and overfatiguing physical exercise, and surcharged with Fittam,
and suddenly appearing on the face of a person, causes thin, circular, painless and brown-coloured patches or
stains.

(under the head

Ars'a-Nidanam).

They

are

known by

the
it

name
is

of

Vyanga

*

34-38.

*

According

to certain authorities

due

to the

absorption of blood

by Vayu and Pitlam.

+
is

According

to

others

the

spot

goes by the name of iV//j/iaw,

if it

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

92

THE SUSHRUTA SAMHITA.

[Chap. XIII.

The Parivartika :— The
of the

vital

Vayu (Vydna)
integuments
affected

aggravated by such causes as excessive massage (masturbation), pressure, or local trauma, attacks the

penis (prepuce) which being

thus

by
and

the deranged

Vayu forms

into a knot-like structure

hangs down from the glans penis.
as

The

disease

known
factor.

Parivartika or Phymosis

is

due to the action of the

deranged Vayu aggravated by any extraneous
It is

times suppurates.

marked by pain and burning sensation; and someWhen the knotty growth becomes hard and is accompanied by itching, then it is caused by

the aggravated

Kapham.
:

39.

Avapatika
prepuce
is

— When

the

integuments

of

the

abnormally and forcibly turned back by such
girl

causes as coition under excitement, with a

(before

menstruation and before the rupture of the h}'men and
consequently with a narrow external
or
orifice of the

vagina)

masturbation or pressure or a blow on the penis,

or a voluntary retention of a flow of

semen or
called
:

forcible

opening of the prepuce, the disease
or

is

Avapatika
prepuce

paraphymosis.

Niruddha-prakas'a

— The
covers

affected

by the deranged Vayu

entirely

up the
orifice

glans penis and thus obstructs and covers up the
of the urethra.
jet

In cases of partial

obstruction

a

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 Xiruddha-prakas'a

which
pain

due

the deranged
39-41.

Vayu and

is

marked by

(in

the glans pcnis\

Niruddhaguda :— The
ed by the repression
fecation stuffs the
of
its

Vayu (Apana) obstructurging towards de-

of a

natural

rectum, thus producing constriction

passage and

consequent

difficulty

of

defeca-

Chap. XIII.]

NIDAKA STHANAM.
is

93
as
is

tion.

This dreadful disease
(stricture

known
sort

Niruddhaextremely
itch-like

gudam
difficult

of the

rectum) which
.

to

cure.

Ahiputana

—A

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

cleansing

that

The

which are the

effects of the

deranged blood

and

Kapham

soon assume

an

Eczematous character
spreads,

and exude a purulent discharge on account of constant
scratching.

The Eczema (Vranaj 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)

—A
in a

prolapse or falling out

weak and

lean patient
in

through straining, urging or flow of stool as
is

dysentery

called Guda-Bhrans'a or prolapsus ani.
Thus ends
the

42

— 45.
in

thirteenth

Chapter of the Nidana Sthanam
Nidanani of minor ailments.

the

Sus'ruta Samhita

which

treats of the

CHAPTER
Now we
disease
shall

XIV.
the

discourse

on

Nidanam
i.

of the

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 — Diseases, which result from — Sarshapika, Ashthisuch malpractices, are knonwn
as,

Hka, Grathitam, Kumbhika, Alaji, Mriditam,
pidaka, Avamantha, Pushkarika,

SammudhaUttam^,

Spars'ahani,

Satoponaka, Tvakapaka, Sonitarvudam, Mansarvudam,

Mdnsapaka. Vidradhi and Tilakalak.

2.

IVIetrical
shape and
size,

Texts :— The

tiny herpetic eruptions
in

(Pidaka) which resemble the seeds of white mustard

(and are found to crop up on the male

organ of generation) on account of a deranged condition
of the blood and

Kapham,

as the result of

an injudicious

application

of Suka

plasters

are

called

Sarshapika
pimples,

by

the

wise.

Eruptions of

hard

stone-like

(Pidaka) irregular at their sides or edges and which are

caused by the aggravation of the local

Vayu by
the

the

use

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

The knotty Granthis
to
its

(nodules)
stuffed

on

penis

owing
caused

being

frequently

with the

bristles of a
is

Suka by

insect are called

Grathitam.
or

This type

the deranged action of the

Kapham,
This type

A
is

black wart
fruit

resembling the stone

seed

of a jambolin

in

shape

is

called

Kumbhika(.

due
3

to

the

deranged condition of the blood and Pittam.

— 5.

Chap. XIV.]

KIDANA 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.

A

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
(^It

Suka)
is

in its

dorsum

called

Sammudha(in-

pidaka.

the

outcome of the aggravated Vayu*).
Suka
to

A

large

number

of elongated pustules on the penis the
partj
is

cidental to an application of

which
called

burst at the middle, causing pain

and shivering,

Avamantha
The
one

(epithelioma*.

6 — lo.
type of the disease
is

Pushkarika
has
its

marked

by the eruptions of small pimples around the principal

The type

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

complete anes-

owing to the vitiated blood by the injudicious application of a Suka is called Spars'aPustules
of the

haklli-

appearing on the penis
local

through the

vitiation

blood and Pittam

by such consuppuration of

stant applications are called

Uttama.
is

A

the prepuce under the circumstance

called

Tvakapakh.
the
affected

There
organ.

is

fever with a burning sensation in

The

disease

is

due to the vitiated condition
ii

of the blood and Pittam.

15.
is

The type

of the disease in which the penis
of black

marked

by the eruption

vesicles

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

96

THE SUSIIRUTA SAMHITA.

[Chap. XIV.

an excruciating pain
is

in the ulcerated region of the

organ
fleshy

called

SonitaLrvudam.

The

vegetation

of a

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 Mainsairvudam.

A

puration as well as sloughing of the penis attended with
different kinds

of pain

which severally mark the deis

ranged
pSLka.

Vayu, Pittam and Kapham
This type
is

called

Matnsa-

caused

by the concerted action

of the deranged Vayu, Pittam and

Kapham.
the one

15-18.

The

specific

symptoms

of a

Tridoshaja Vidradhi

as described before (Chap.ix.)

mark

which

affects

the penis (owing to an

injudicious application of the

highly
disease

poisonous
is

irritant

Suka

to the organs)

The

called

Vidradhi.

A

process of general sup-

puration

and sloughing of the organ marks the type
produced by the application of a black Suka or
species.

which

is

one of a variegated coloured insect of the same

The type
as

is

called Tilakailaka,

and should be regarded

Tridoshaja one.

19-21.
above

Prognosis: — Of the

enumerated malig-

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 Bhag"na.m (fractures and dislocations etc. of bones),
i

Various kinds of fracture
variety

may

be caused from a
fall,

of causes,

such as

by a

pressure,

blow,
etc.

violent jerking or

by

the bites of ferocious

beasts

These cases
divisions

may

be grouped under the two main sub-

such as

Sandhi-Muktam

(dislocation)
2.

and

KsLnda-Bhagnam

(fracture of a kanda).

Cases of Sandhi-muktam (dislocation)
into six different types, such
as

maybe

divided
Vis'-

the

UtplisJitam,

lishtam, Vivartitam, AdhaJi-Kshiptam, Ati-ksJiiptam

and

Tiryak-kshiptam.

3

General features of a dislocation :—
Incapability of extension, flexion,

movement, circumin respect

duction

and rotation (immobility, considered

of the natural

movements

of the joint), of the dislocated
painful

limb,

which becomes

extremely

and cannot
the

bear the least touch.

These are
4.

said to

be

general

symptoms

of a dislocation.

Diagnostic
tion
:

symptoms

of a dislocaby two
to
articular
is

— In case of a
at

friction of a joint

extremeties (Utplishtam) a swelling

found

appear

on either side of the articulation attended with a variety
of pain
night.

A

little

swelling accompanied

by

a constant pain and disordered function of the dislocated
joint,

of the articulation
joint

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

distinguish a case of

Vivartitam

(lateral displacement).

An

excruciating pain, and

looseness

of the dislocated
13

98

THE SUSHRUTA SAMHITA.

[Chap.

XV.

bone arc the symptoms which characterise a case in which a dislodged bone is seen to drop or hang down
from
its

joint

(Adhah-kshiptam).

In a

case of abnor-

mal projection (Ati-kshiptam\ the dislocated bone is removed away from its joint which becomes extremely
painful.
is

A case of oblique dislocation
projection
or

(Tiryak-kshiptam)

marked by the
5.

displacement of the
sort of intolerable

bone on one side accompanied by a
pain.

Different

kinds
Fractures

of
may

Kanda BhagKdnda-Bhagnam
into twelve

nam — Now
:

we

shall describe the

(fracture

etc.)-

be divided
as,

different kinds

which are known

Karkatakam, As'va-

karnam.Churnitam,Pichchitam,Asthi-chchalitam, Kdnda-

bhagnam, Majjagatam, Atipdtitam, Vakram, Chchinnam, Pdtitam and Sphutitam. 6.

General symptoms of Kanda-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
generally

in

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 tvvo

articular

the middle so as to resemble

the shape

of a

knot (Granthi),
a horse

The

case

where the fractured
of
is is

bone projects
into

like the ear

called

Karkatam. upward As'vakarnam. The
called

fractured bone

found to be
or

shattered

fragments

in a case of the

Chumitam
both

comminuted kind which
crepitation.

can

be

detected

by palpation and
of the

A

smashed condition

fractured

bone marks a

Chap, XV.]

NIDANA STHANAM.
often

99
found to

PicUoMtim kind which is be marked by a great swelling. The
case of the

case

where the
is

covering or skin
splintered
off
is

of the
called

bone (periosteum)
the

cast

or

Asthi-chchalUtatn.
severed
is

The

case where the completely broken or

bone? are

found to project through

the local skin,

called Killda-

bhag^nam (compound).
the
fractured or

The

case where a fragment
is
is

of

broken bone

found to pierce into the
called JVEljjaaugatam,

bone and dig out the marrow,
(Impacted
fracture).

The
is

case where the fractured bone

droops or hangs

down

called Ati-patitam.
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

Chhinnan.

The

case where the bone

slightly fractured
is

and pierced with a large number
Patitam, an excruciating pain being

of holes,

called

the leading indication.

The
insect

case where the bone largely
if

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,
difficulty in

are effected with extreme

a

case

Churnitam, Chhinnam,
kind.
in a

Ati-pdtitam
or

or

Majjanugatam
occurring

A

casa

of displacement

laxation
in

child or in

an old or weak patient or

one

suffer-

ing from

asthma (Svasa) or from any cutaneous
Kshata-Kshina disease
is

affec-

tion (Kushtha^ or
cure.
8.

difficult

to

Memorable verses
are
to

:

—The

following

cases

b3 given

up

a^

h^p^leis
that
are


;

;y/.3.

fracture of the description,

pelvic bone (or of bones

of this

wherever they
pelvic joints
;

may
;

be

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.
;

[Chap.

XV\

simple fracture of the bone or its dislocation back-bone and temporal and cranial bones. breast-bones,
If

the

dislocations

and fractures be

improperly

set

from the outset (Adito)* or if the union be anyhow 9— ii. disturbed there is no hope for recovery.
If fractures

happen
life

at

any time of the

first

three

stages

of adalt

which has been described before

(vide Sutrasthana Chap.

XXXV.) and if they are set up by an able surgeon they have a great chance of being
united.
12.

A
called

bending of a
its

gristle

or

cartilage

(Taruna)

is
is

fracture.

A

Nalaka

(long

bone)

bone
is

usually found to

be severed.

A

Kapatla bone
(tooth)
is

found
be

to be cracked, while a

Ruchakaf

found to

splintered
*

off.

13.
A.ii/o

The word

may be taken

inlo

the

sense

of congenital mal-

formation which

is

beyond remedy.
of the particle 'cha' denotes

t

The presence

Valya-asthiin the Sus'ruta

Thus ends

the fifteenth Chapter of the
treats of the

Nidana Sthanam
dislocations

amhita which

Nidanam

of

and

fractures.

CHAPTER
Now
the

XVI.
on
the
afifect

wc

shall

discourse
(diseases
r.

Nidanam
the cavity

of

Mukharog^am
mouth

which

of

in general),

General Classifications:— Sixty
ferent

five* dif-

forms of mouth disease are known
are found to attack seven different

in practice.
viz.

They
the

localities

lips,

the

gums
;

of the teeth, tongue, palate, throat

and
;

the entire cavity
fifteen, to
five

of these eight are peculiar to the lips

the roots

of the
;

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

patika,

Raktaja,
4.

Mans'aja,

Medaja

Abhighataja

(Traumatic).

The Vataja Type :— The
part seems as
if
it

lips

become dry,
pulled

rough,numbed, black, extremely painful and the affected
were smashed and
out or
In the

cracked by the action of the aggravated Vjiyu. 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

ab.sent in this

type

and the patient
the parts.
*

an irresistible inclination to scratch
lips

In the

Sannipaitaja type, the

change
this.

According

to others sixty-seven

— but Dalian does not support

102
colour,

THE SUSHRUTA SAMHITA.

[Chap. XVI.

becoming black, yellow, or ash-colourcd (white)
and are found
to

at intervals

be

studded with various

sorts of eruptions.

5—8,
:

The Raktaja type
condition
of the

—(Produced by the

vitiated

blood) the affected lips look as red as

blood and profusely bleed

and crops of date coloured

(chocolatecoloured) eruptions appear on their surface. In
the

Ma^usaja type (due to the vitiated condition of the

become heavy, thick and gathered up in the form of a lump of flesh. The angles of the 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,

heavy and marked by an

skin of the inflamed surface

become numbed, sensation. The becomes glossy and looks
itching

like the surface layer of clarified butter

exuding a thin
In
the

crystal-like

(transparent)

watery

discharge.

Abhighataja (Traumatic) type, the lips become red, knotty and marked by an itching sensation and seem as into or cut open with an axe and (become if .pierced
cracked and fissured).
9

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, Dantathe five sorts of

Saushira,

Maha-Saushira,

vaidarbha,

Vardhana,

Adhimansa and

NAdi

(sinus). 13.

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

disease has
local

origin

in

the deranged

condition

of the

blood and

Kapham.

Danta pupputaka
violent swelling

(crum boil):— The disease in

which the roots of two or
and

three teeth at a time

is

marked by a

Chap. XVI.]

NIDANA STHANAM.
Danta-pupputaka.
condition
of the

1

03

pain
to

is

called

The

disease

is

due

the vitiated

blood and Kapham.

Danta-veshtaka: The teeth become loose in the gums, which exude a discharge of blood and pus. This disease
is

due

to the vitiated blood of the locality.

SausMra:


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
Sausliira:
the palate
fied,

and

Kapham

of the locality.

Mahai-

— The disease in which the teeth become loose,
marked by sinuses
cavity
or fissures, the

and the whole

of the

gums putrimouth inflamed, is
14

called Mahas'aushira, the

outcome of the concerted action

of the deranged Doshas of the body.

18.

Paridara.
come
putrificd,

:

— The disease
off

in

which the gums beis

wear

and bleed
disease

called

Paridara
in

(bleeding

gums\

The

has

its

origin

the

deranged condition of the blood,

Kapham and

Pittam.

Upakus'a:— 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
Upakus'a,
of the
this

least

shaking,

is

called

There

is

a

slight pain,

and the

entire cavity
fetid

mouth becomes swollen and emits a
is

smell
of

;

disease

due to the vitiated condition
19.

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 become loose and can be
is

moved
the

about,

called

Danta-vaidarbha which

is

due to
:

an extraneous cause such as a blow etc
disease

Vardhana

which

is

marked by the advent of an
last

additional

tooth (the

molar) through the action

104

THE SUSHRUTA SAMHITA.
Vayu with
a specific

[Chap. XVI.

of the deranged of
its

excruciating pain

is called Vardhana or eruption of the Wisdom The pain subsides with the cutting of the tooth. AdhimaLDsa :— The disease in which a violent and

own,

tooth.

extremely painful tumour appears about the root of the
tooth,

and

is

situated in the farthest end of the cavity of

the
is

cheek-bone accompanied by a copious flow of saliva
called

deranged

Adhimansa or Kapham, The
the
roots

Epulis,
five

It

is

due
Na'di

to

the

sorts

of

(sinus)

which

affect

of the teeth

(are either Vataja,

Pittaja,

Kaphaja,

Sannipataja or

Abhighataja),

their

symptoms being

respectively identical with those of the

types of Ncidi-vrana.

20 - 24.

Diseases to the teeth proper:— Diseases
which are
restricted

to

the

teeth proper are

named
25.

as,

D^lana, Krimi-dantaka,Danta harsha,Bhanjaka,Sarkara,
Kapalika, Syava-dantaka and Hanu-moksha.

Dalana
as
if

:

— The disease in

which the teeth seem
is

being

cleft

asunder with a violent pain
is

called

Dalana or toothache, the origin of which

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

accompanied by a copious flow of

saliva.

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

specific

features.

Danta-harsha

:

— The

disease
is

which the teeth cannot bear the
It is

heat, cold or touch

called Danta-harsha.
tion

due to the deranged condi:

of Vayu.
is

Bhanjaka
is

— The

disease in which the

face

distorted, the teeth break,
severe,

and the accompanying

pain

is

called

Bhanjaka (degeneration of the

Chap.

XV7

]

NIDANA STHANAM.

I05
condition of
disease,
in

teeth\
the

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

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
functions of the teeth.

to destroy the healthy

growth and

Kapalika

:

— The disease in which

the preceding crystallised deposits get cemented together

of their coating (enamel)

and aftenvards separate from the teeth taking away a part is called Kapalika (calcareous
deposit)

which naturalh' makes an

erosion into

and
in

destroys the teeth

Syava-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-mokslia The disease in which the \'ayu 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.

26 -33.
five

Diseases of the tongue :— The
of diseases

Kinds
the

which
of

affect

the organ

of

taste

are

three

sorts

Kantakas due to the
Pittaja

three

deranged
Alasa

Doshas

(Vataja
34.

and

Kaphaja),

and

Upa-jihvika.

The three Kantaks :— In
taka
sense

the

Vataja Kanloses

type
of

the

tongue

becomes

cracked,
like

the

taste

and

becomes rough

a teak leaf

(giving the organ a warty appearance).

In the Pitta ja

Kantakaform
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

Kantaka

type the

tongue becomes heavy, thick and
fleshy warts in the

grown over with vegetation of slender

H


I06

THE SUSHRUTA SAMHITA.
:

[Cliap.

XVI.

Alasa —The severe inflammaiory swelling about the under surface of the tongue is called Alasa, which if allowed to grow on unchecked gives rise to numbness and immobility of the organ
shape o{ S'dlinali thorns

and tends

to a

process of rapid suppuration
is

at

its

base.

The disease Kapham. The Upa-jihva
(cystic)

caused

by the
:

deranged blood and
disease
tip
in

-The
the

which a

swelling

shaped

like

of the tongue

appears about the under-surface of that organ by raising
it

a

little

is

called Upa-jihvika (Ranula).

The accom-

panying symptoms
sensations
in

are salivation, burning and itching
affected

the

organ

;

these are due to the
T)7.

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

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-paka.

Gala-SUndika
sw^elling,

:

— The
it

diffused

and elongated

caused by the deranged blood and
appears

Kapham,

which
goes

first

about the root of the palate and
till

on
is

extending
called

looks

like

an inflated skin-

bladder

Gala-s'undika (tonsilitis) by physicians.
the indications
of

Thirst, cough, difficult breathing are

the disease.

Tundikeri

:

—A

thick swelling resembling
in

the fruit of the

Tundikoi ^^Xdini
pain

shape and appearing

about the root of the
piercing
or

palate attended with a burning,

pricking

and suppuration
:

is

called
red,

Tundikeri (abscess of the

numbed
the

swelling

Adhrusha appearing about the same
tonsil).

—A

region,

as

effect

of the vitiated blood of the locality, attended
fever

with severe

and

pain,

is

known by
like

the

name

of

Adhrusha, Mansa-kachchapa:— A brownish and slightly
painful

swelling

somewhat shaped
about
the

the back of a
of the
soft

tortoise (and

appearing

region

Chap. XVI.]

NIDANA STHANAM.
called

I07

palate^

is

M^nsa-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
lih'

:

—A

swelling shaped like
in

and appearing
called

of the soft palate as an
dition

outcome of the aggravated conis

of the
is

local blood

Arvudam.

The

swelling
before.
flesh

identical

with the

Raktarvuda described
vegetation
of morbid
soft
is

Macsa-Sangliata :~ A
the

at

edge

or

extremit}'

of the

palate
called
:

through the action of the deranged

Kapham

Mansa-Sanghata.
painless
fruit

It

is

painless.

Talu-pnpputa

permanent swelling to the shape of the Kola (plum") caused by the deranged fat and Kapham
is

at the region of the soft palate

called
soft

Talu-pupputa.
in

Talu-sosha :— The disease of the
the

palate

which
with

patient

feels

a

sort

of

parched
pain

sensation
in

dyspncea and a
part
is

severe

piercing

the
origin

affected
in

called Talu-sosha,

which has
the

its

the
in

aggravated

condition

of

bodily

Vayu

acting

concert with the

deranged

Pitlam.

disease in which the deranged

Pittam
soft

Talu-paka sets up
palate
is

— The
a

very
called

severe suppurative process in the

Talu-paka.

39-47-

The diseases
larynx
larynx
the
five
:

of
in

the throat and
the throat and the are

— The diseases peculiar to
seventeen
of

are

number and

known

as

types

Rohini,

Kantha-Saluka,
Svaraghna,

Adhijihva,

Valaya. Valasa, Eka-vrinda, Vrinda,
Gala-vidradhi,
Vidari.
48.

Sataghni, Gilayu,

Galaugha,

Mansatana, and

General features of Rohinis :— The
aggravated
ni

Vayu, Pittam, Kapham,

either severall}' or

combination, or blood

may

affect

the

mucous

of

the throat and give rise to vegetations of fleshy papillae.

I08

THE SUSIIRUTA SAMHITA.
the

[Chap. XVI.

which gradually obstruct

channel
is

of the
called

throat

and

bring on

death.
49.

The

disease

Rohini

(Diphtheria").

The Vataja Rohini: -A
the tongue which tend to

vegetation of exall

tremely painful fleshy Ankuras (nodules), crops up
obstruct

over

the

passage of the

throat and are usually accompanied

by other distressing
Vayu.
Pittaja-

symptoms
Rohini
:

characteristic of the deranged

— The

Ankuras (nodules)

in the

present type are

marked by

speedy growth and

suppuration,

and are
fever,

accompanied by a burning sensation and high

Kaphaja
heavy,

Rohini —The
:

Ankuras
by

(nodules)

become
50-52.

hard

and

characterised

slow

suppuration

gradually obstructing the passage of the throat.

The Sannjpatika Type :— Suppuration
takes place in the deeper strata of

companied by
amenable to
characteristic

all

the dangerous

the membrane acsymptoms peculiar to
disease.
It
:

I the three aforesaid

types

of the

is

rarely

treatment
of

Riktaji

Typ8

-Symptoms
in the throat,

the
fleshy

Pittaja

type of the disease are
This type

present and the
is is

outgrowth formed

found to be covered with small
incurable.*

vesicles.

53~54
:

Kantha-^'alukam —The

disease in which a

hard rough nodular growth (Granthi) in the

shape of a
if it

plum-stone crops up in the throat, which seems as
has

been stuffed with the bristle of a S'uka insect or
is

been pricked by thorns
disease
It is
is

called

Kantha-Salukam.

due

to the action of the deranged

The Kapham.
:

amenable

to surgical

treatment only. Adhijiliva

A

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

printed editions
(incurable)
is

Madhab's Nidanam

in

lieu

Asadhya

not to our

mind

correct.

Chap. XVI.]

NIDANA STHANAM.

I09

deranged blood and
is

Kapham

over the root of the tongue

called Adhijihva,
in.

which should be given up as soon as

suppuration sets

Valaya :-

A

circular or ring-shaped

raised swelling obstructing or closing

up the upper end
is

of

the oesophagus (structure of oesophagus)
It

called Valaya.
It is

cannot be cured and hence should be given up.
to

due

the

deranged
:

action

of the

Kapham

in

the

locality.

Valsisa

—The
is

disease in which the

unusually

aggravated
in

Vayu and Kapham

give rise to a swelling

the throat, which

extremely painful and causes a

difficulty of respiration,

ultimately producing symptoms
is

of

complete

asphyxia
is

called

Valasa
55

by

learned

physicians and

vcr\' difficult to cure.

— 58.
disease in

Eka-vrinda and Vrinda*:— The
which a
appears
circular, raised,
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.

A

piercing pain in the swelling

points to

Vataja origin.

59
:

— 60.
disease
in

^ataghni — The
concerted
action
of the

which, through the

deranged Vayu, Pittam and
fjagged

Kapham, a hard

throat obstructing Varti

mem-

brane; edged like
fleshy excrescences
*

a Sataghni-f and densely beset with
is

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 Ek£-vtinda, and not a separate disease.
+ Salaghni
is

a kind of

weapon used

in ancient warfare.

iro
that pipe
is

THE

.-^USIIRUTA

SAMHITA

[Chap.

XVI.

denominated as Sataghni.

Various kinds

of pains, (characteristics of each

of the deranged Vayu,
in

Pittam and

Kapham)
:

are

present

this

type which
6i.

should be necessarily considered as irremediable.

Gllayu
Kapham and
painful
in

-— The disease in

which the aggravated
to

blood

give

rise

a hard and slightly

(D.

R

extremely painfull glandular swelling
to

the
is

thrvmt
called

the

slzz of the stone of the

Amalaka
or

fruit

Gilayu.
is

A

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: — Thediscasein
sive swelling occurs along the

whichan exten-

whole inner lining of the
action of the deranged
called Gala-vidradhi
in

throat,

owing

to the

concerted
is

V^yu, 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.

Svaraghua: -The
owing
to

disease in which the

patient faints

the

choking of the larynx by the deranged

Kapham

which is marked by stertorous breathing, hoarse-

ness, dryness

and paralysed condition of the throat
which has
its

is

called Svaraghna

origin in the deranged

Vayu.

63

— 65.
:

IVIanSatana
spreading and
the

— The

disease in which a pendent,

extremely painful

swelling appears in
is is

throat which gradually obstructs the pipe
It

called

Mansatana.

invariably proves fatal

and

caused

by the deranged Vayu, Pittam and Kapham

66

Chap. XVI.]

XIDANA STIIANAM.
:

til

ViCiari

-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.

67.

The disease
Cases which are found

in
to

the entire cavity: —
invade the entire cavity of
restricted
to

the mouth (without being

any particular
Vataja,
Pittaja,

part

thereof)

may

be

either

due

to

Kaphaja or Raktaja type and are known by the general

name
is

SaVra-Sara.
with

68.

In the Vataja type the entire

cavity

of the

mouth
a
large

studded

vesicles
inside.

attended

with

a

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
of the

lining 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 itaktaja
it

type

is

nothing but a modification of the Pittaja one

(giving rise to similar
called

symptoms)

;

is

also

by others

Mukha-paka.

69-72.
Nidana Sthanani
in the Sui'ruta

Thus ends

the sixteenth Chapter of the
treats of the

Samhita which

Nidanam

of the diseases of the mouth.

Here ends the Nidana Sthanam.

THE

SUSRUTA SAMHITA
S'ARIRA STHANAM.
(Section on Anatomy).
: :

CHAPTER
Now we
shall discourse

I.

on the S^riram which treats
general
i.

of the science of Being in

(Sarva-Bhuta

Chlnta ^ariram).
The
is

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

Mahan

(intellection),

Avyakta (unAhamkara (Egoism) and
and
evo-

the five
is

Tanmdtras

or elementals (proper sensibles)

the sole and primary factor in working

out the

lution of the universe.

The one
all

absolute

and original
out

nature

is

the fundamental stone house of materials
self-conscious

of which the bodies of

(Karma-Purusha)

working agents (agents who come into being through the
dynamical energy of
their acts or
all

Karmas) have been
water,

evolved in the same manner as
fined
in

whether con-

a

tank or a reservoir, or coursing free through

the channels of streams and of mighty rivers, have been

welled up from the one and shoreless primordial ocean.

2.

Out

of that latent unmanifest (Avyakta)

or original
units

nature (impregnated by the atoms or elemental
15

of

114

THE SUSIIRUTA SAMHITA.
Purushas)
Intellection

[Chap.

I.

consciousness or

or

been evolved, and out of

MahAn

egoism.

This
as

Mahdn has Mahdn or
partaking
Rajas, and

intellection should be likewise considered

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
or

these foregoing organs the

first

are

intellectual

sense

organs (Vuddhi Indriya)

the next five being

operative

(Karma-Indriya\
the

The

mind (Manah)
intellectual

par-

takes

of

character of
4-5.

both the

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,
etc.

have been evolved out of the

Bhutadi

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

these five
smell.

Tanmatras are sound, touch,
the

taste, sight

and
five

From

combination of the aforesaid

Tanmatras (Bhutadi) taken one at a time, have successively emanated the five gross matters of space such as
* Sattva,
in the

Rajas and
;

Tamas

:

— Adhesion,

cohesion and
in the

disintegration
;

Physical plane

affection, love

and hate

moral

emancipa-

tion, spiritual affinity

and

sin in the Psychic.

Simply phenomenal or the simple outcome of the phenomenal evolution
without being by other specific attributes of matter and hence Sattvika or
jlluir.inating or qi'asi-spiritual,

Chap.

I.]

SARIRA STHANAM.
heat,
(fire,)

115

ether,

air,

fluid

(water),

and earth
four

(solid).
is

These twenty four categories combinedly form what
technically

(Tattvas).

known as Thus we have

the

twenty

elements

discoursed on the twenty four
6.

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.

five

operative (Karma-Indriya)

The original nature (Avyakta), Mahan* (intellection). Egoism (Ahamkara),the five sensibles (Tanmatras),
and the
five gross

material

principles
is

in

their

nascent

stage in evolution form what
categories of

included within the eight

Nature

(Prakriti), the

remaining sixteen

categories being her modifications (Vikara).

The objects

of intellection (Mahan) and Egoism (Ahamkara) as well as of the sense organs of knowledge and actions are the material principles (Adibhautika) though they are spiritual in

themselves and in their nature.

The tutelary god of intellection (Buddhi) is Brahma. The god Is'vara is the presiding deity of the sense of egoism (Ahamkara) the moon god is that of the mind
;

(Manah)
eyes

;

the quarters of the
is

heaven,
;

of the ears

;

the

wind god
;

that of the
is

skin

the
;

sun

is

that of the
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

is

that of

the hands the

Vishnu
and
7.

is

Mitra
the

is

that

of
of

anus

Prajapati

that

of

organs

generations.
*

Mahan, Ahamkara and
Nature
in

the five Tanmatras, though but modifications

of the original

themselves,

have been included within the

category of Nature (Prakriti) in asmuch as they form the immediately prior
or antecedent conditions of the evolution of the

phenomenal universe.

Il6
All the

THE SUSHRUTA SAMHITA.
aforesaid
(twenty-four)

[Chap.

I,

categories
are

or of
the
are

elementals

(Chaturvins'ati-Tanmdtras)
Similarly
of Prakriti
the

devoid
of
etc.

consciousness.

modifications

primal
all

cause

such as the Mahat
in

bereft of consciousness

as

much

as
is

the

cause

itself,
it.

the Avyakta The Purusha

or the original nature
or

devoid of

the

self-conscious

subjectivity,

enters into the primal cause

(Mula-Prakriti
effect

or

original

Nature)

and

its

necessary

(the

evolved
his

out

phenomena) and makes them
essence or self-consciousness.

endued with

own
holy

The

preceptors and

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'
in

material

(elementals),
to

though unconscious

themselves, tend

contribute
self or

towards the making of the self-conscious
universal individual (the aggregate of limited
tional
selves)
for

the

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 un-

disembodied, without a
second,
all

beginning or origin,

— pervading

and omni-

present.

Chap.

I.]

SARIRA STHANAM.
the

tl7

Traits of diversity :— Of
the
Prakriti,

Pumsha and
and
of Sattva,

only

the

latter

is

non-conscious
qualities

possesses

the three fundamental

Rajas and

Tamas.
in

Prakriti

performs the
she
lies

function
the

of the seed or

otherwords

inherent as

seed

or the

primary cause

evolution of the

Mahat

etc.

in the latter phenomenal and contributes the maternal

element in the conception, development and
the

birth

of

primordial

cosmic matter (phenomenal

universe\

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

and miseries of
though
10
is

and do not participate
the

in their

enjoyment
ganism.

imprisoned

human
its

or-

Since an effect

uniform

in virtue to

producing
Pra-

cause, the evolutionised 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
other words, these Mahat,

Prakriti.

Ahamkara,

etc,

are

but the

modifications
Sattva, Rajas

of the

three

fundamental qualities of
of self-consciousness,
their

and Tamas. Moreover, certain authorities
are
units

hold that the Purushas

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 SUSHRUTA SAMHITA.

[Chap.

I.

IVIetrical Text (Vaidyakc.) :— 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 (Svabhaba), God (Is'varaV* 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 Tamas, and all created
same.
disease
In
is

qualities
things,

of

Sattva,

Rajas and

whether mobile or imthe

mobile, should be considered as alike exponented by the
the

Science
sole

of

medicine

cause of a

the one

aim

to be achieved

by means of
and
subject
further,

administering proper medicinal remedies (matter),

hence the properties of matter are
to be dealt with in a

the

only

fit

book on pharmacy.
prior

And
of the

because the

immediately
a proper and

cause

human

organism

is

congenial

admixture of the

sperm and ovum (matter), the sense organs are the
resultants of objects

phenomenal

— evolution of matter,
are

and the
or

of sense

perception

equally

material

phenomenal
organ of his

in their nature.

12 —14,

IVIemorable verse

particular : -A man by a 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,
of the central, primordial Sun, out of

was hid

in the

burning disc
solar

which the

different

systems

have come into being.

Chap.

I.]

SARIRA STHANAM.

Up
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

of medicine does not lay

down

that

the

self-conscious Selves
it

(Kshctrajna) are

all

pervading, but

asserts that they are real

and eternal
or

and are born

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
in

extremely subtle
self is

their
infinite

essence.

The

self-conscious
is

possessed

of

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
that

corroborated by a dictum of the Sruti which

holds

Parusha

is

nothing but a combination of
five

a self-conscious self

and the

kinds of matter (Maha-

bhutas) formed into an organic body.
individual,

This Purusha or

which
falls

is

called Individual of action

(Karmaart

Purusha),

within the scope of the science and
16

of medicine.*
*

17.

Here

lies

the difference
in

between Sankhya and Ayurveda. While the
of the soul, the
latter

former discourses on

material character

comin

mences

to

discuss
is

on the questions how the material environment
inhabit
is

which the soul

said to

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,
of
life

in

the

strictest
at

sense of the

word molecular and

his

science

an attempt

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

materialistic

standpoint,

which

modern westein

science.

Intellect

according to

material and belongs to the
its

same category which the Sankhya
enumerates
originr.lly

system of philosophy in
as seven.
is

explanation of evolution
to Sus'ruta,
is is

The soul, according
is

an independent existence and

often associated with what

called

life.

soul,

and

it

not everywhere the same.

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

I20

THE SUSHRUTA SAMHITA.

[Chap.

I.

The attributes
vidual
enemity,
:

of

an organic indishunning of pain,
respiration

— Longing

for pleasure,

energetic

undertaking

of work,

(Prana\ emission of flatus (Apana), closing and opening
of the
eytfids,
intellect

(Vuddhi), sentiment (Manah),

deliberation,

discretion,

memory,
i8.

knowledge of

art,

perseverance, sensation and perception, are the attributes
of an organic individual.

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
qualities

memory, comprehension, and the doing
irrespective

deeds

of

consequences,

are

the

which
non-

grace the mind of a person of a Satttvika temperament.

Feeling of

much

pain and misery, a
vanity,

roving

spirit,

comprehension,
pride,

untruthfulness,

nonclemency,

an over winning confidence in one's own excelanger and hilarity are the attributes which
of the Rajashika
in

lence, lust,

mark a mind
stupidity,

cast.

Despondency,
impiety,

disbelief
.

the existence

of God,

stupification

and perversity

of intellect,
qualities
19,

lethargy in

action

and sleepiness are the

which mark a

mind

of a

TatmasMka stamp.

The distinctive traits of the five material of Elements of the world :—
The
properties of Akas'a (ether) are sound, the

sense of
veins,

•hearing, porosity

and

differentia evolution of the

ligaments
tifsi'T

etc. into their

characterised species (Viviktatd.)
of

g^^; ^"^ takes cognisance
with the body
(

sorrow,

disease

and death by
)•

its

union

q<

JTfliJ^ aflft ^J^Wfq:

^^^ ?gi'^%
it

Hence

the living frame together with the soul that ia said to inhabit

forms the

subject-matter of Ayurvedic medical treatment.

Ed.

Chap. I]

SARIRA STHANAM.
Vatyu
(ethcriii) are touch, the

121
skin,
all

The

properties

functional

activities

of the organism,
lightness.

throbbing of the

whole body (Spandana) and
of

The

properties

Teji

(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

The

properties or

or

modifications of

Pritllivi

earth

matter

solid)

are smell, the nose,

Of
the

these the

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

of

Sattvika stamp, the

Vayu

or etherin

in

Rajashika,
in

the Teja in Sattvika

and Rajashika, the water
in

Sattvika

and Tamashika and the earth

Tamasha

attributes. 21.
:

There are IVIemorable Verses
qualities are

—These
The
in

found tu characterise and enter into the suc-

cessive elements in the order of their enumeration.
specific attributes of these

elements are manifest

the

substances v\^hich are respectively originated from them.

The term

Prakrit! 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 Purusha forms
in

the

twenty fifth principle. These twenty five fundamental principles of

cosmogony have been dealt with
^Salya-Tantram) as well as

the present
treatise

treatise

in the other

(Salaky-Tantram and Sdnkhya Philosophy).
Thus ends
the
first

22

— 23.
Samhiia

Chapter of the S'arira Sihanan
of Being in general.

in the Sus'ruta

which deals with the science

16

CHAPTER
Now
treats
fluid

11.

\vc

shall

discourse
of

on

the

Sariiam

\\liic!ii

of
etc.

the

purification

semen

and

cataminal

(^ukra-^onita-^uddhirnama
i.
is

^ariram).

A man
seminal
fluid,

incapable

ol

begetting children, whose

affected

by the aggravated Vdyu, Pittam or
smell, or

Kapham, emits
a
clotted

a cadaverous

has acquired
like

or
or
2.

shreddy character or which looks
has become
thin,

putrid pus,
or
stool,

or smells like

urine

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
time

etc.)

which

Vayu

the

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).

of the

deranged

Kapham
(at

by the action (white) colour and prohas a
vitiated
etc.)
its

Semen

duces the pain (itching sensation

peculiar to
outflow).

the

deranged

Kapham
all

the
is

time of
tinged

The

semen

vitiated

by blood

with a bloody hue,
to

produces

kinds

of pain

peculiar

the

deranged

Sonita (Pittam).

The semen
in

smells like a putrid corpse

and

is

emitted
character
to

large

quantities.
fluid

The shreddy
should

or

clotted

of the

(Grautliila)

be

ascribed

the
If

action

of

the

deranged

Vayu and
pus
(Puti-

Kapham.
puya).

vitiated

by the action of the deranged
it

Pittam and

Kapham
is

looks

like

putrid

Thin semen

caused by the deranged

Vayu and

Chap.

II.]

SARIRA STHANAM.

1

23

Pittam as described before.

A

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

are curable.

3,

Deranged Artavam
(

:— The catamenial
either

fluid

Artavam) of a

woman
or

vitiated

by the deranged V^yu,
severally

Pittam,

Kapham,
as
unfit

blood,

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 deranged
roots).

Doshas
several

or

blood
(of

(underlying

its

Of
is

the

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

matter, should be

deemed
4.

as

being beyond remedy, the rest being amenable.

lYIemorable Verses :— The
of seminal

first

three types

derangements or defects should be corrected
physican with

by
etc*

an

intelligent
oil etc.

an application of
measures

medicated
or

iSneha-karma), diaphoric
injections ^Uttara-vasti\

uretheral

A

medi-

cated
of)

Ghrita

prepared with a (decoction and
flowers,

Kalka

DJiataki

Khadira,
to

barks should

be given

drink

semen em:ts a cadaverous smell
native, a

Dddima and Arjiina to a man whose (Kunapa\ As an alter(a

medicated Ghrita prepared with

decoction

and levigated paste or Kalka of) the drugs forming the S'dlasdrddi group should be given to him. In a case of
*

The word " A:U"

in ihe text

includes emelicSj

purgatives,

Anuva-

sanam and Asthapanam measures according

to their specific

Doshas.

124
clotted

THE SUSHRUTA SAMHITA.

[Chap

II.

and shreddy semen (Granthi), the patient should
to drink a

be

made

medicated
of) S'athi,

Ghrita prepared with a
or with an alcaline solu-

(decoction and

Kalka

tion prepared from the ashes of the burnt

Paids'ha

wood.

In

the

case

of a pus-like appearance

of the fluid the

patient should

be treated with the
(a

medicated Ghrita
of)

prepared
included

with

decoction and Kalka

the

drugs

within the groups of Paruskakddi and Vatddi

(Nyagrodhadij
measures
laid

Ganas.

In the

a

case

of

thin

semen,

down under
medicated
ofj

same head
prepared

before, as well
to.

as those to be hereafter described should be resorted

Similarly a
coction

Ghrita,

with

(a

de-

and Kalka
or
as
fecal

Chitrakk roots. Ushira roots and
in a

Hincru, should be
like

drunk
as

case of the In
all

semen smelling
of seminal

urine

matter.
in

cases

disorders

well

menstrual

anomalies, Uttara-

Vssti (uretheral or
after
oil

vaginal

injection) should

be

made

having recourse to the application

of medicated

etc.

(Sneha-karma

,

purgatives,
5

emetics,

Asthapana

and Anuvasana measures.

— 12
deranged

Treatment
all

of
(by

deranged Artava:— In
the catamenial blood would be
the

the four cases

when

found to be vitiated

Vayu,

Pittam,

Kaphah
should

or Sonita), the preliminary remedial measures of
oil etc,

the application of

purgatives

etc.

(Pancha-karma)
the

be

first

employed
be

and

then
viz.

following
of

measures

should

undertaken

application

Kalka, (levigated paste of drugs),

Ficliu

(medicated

plugs— pecharies

etc/),

Pathya
as

(diet)

and

Achamana
treat-

(washes with decoctions)

described under the
etc.

ment of
clots

Gyontiecological

cases
in

Appearance

of

of blood
fluid

(Granthi)

place of the healthy

men-

strual

would
of Path^,

indicate,

decoction

or a pulverised

compound

Trushuna and Vrikshaka (Kutaja).

Chap.

II.]

NIDANA STIIANAM.
Chandaiiani
is

12$
indica-

A decoction o^ B/ia:^ras'rlj'a,vr' 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

Vayu, Pittam and Kaphah
individual

according to the requirements of each

case

under

treatment.

Sali-rice,

barley,

wine and meat
be deemed
as

with cholagogue

properties

should
13

a

wholesome

diet in these cases.


:

16.

Traits of pure and

healthy semen
which
is

and menstrual
transparent
the smell
like
crystal,
;

blood — Semen
fluid, glossy,
oil

sweet and
in

emits

of honey

or like

or

honey

appearance
healthy.

according to others, should

be considered as
is

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

ma}'

be washed

off"

by

simply soaking them
health}-.

water) should

be considered as

17—18.
(Menorrhagia) :—
of the

Asrig'dara
excessive

An
the

abnormal
blood

or

discharge

menstrual
after

(Artava),

or
or

its

long

persistence
at

even

wonted time,
properties)

its

appearance
as

a
in

premature or unnatural period
its

(as well

contrarit}'

colour or

is

called Asrig'dara.

All types of the disease (Asrigdara)

arc attended with

an aching

in

the

limbs and a
In

painful

flow (of

the

catamenial
'^from

fluid).

case of exce.ssive
as

hcemorrhage

the uterus),

symptoms such

weakvis'on,

ness, vertigo, loss of consciousness,

darkness of

or

difficult

breathing,

thirst,

burning (sensation of the

bod}'), delirium,
*

palour,
is

somnolence and other Vataja
according
to

Blndrab'riyam

S'richandanain

Dallana

or

white

Sandal wood according Gayadasa.

126
troubles

THE SUSriRUTA SAMFHTA.
(convulsion,
hysteria
etc.)

[Chap.

II.

may

set

in.

A
with

physician

should

treat

a

case

of

Asrigdara

measures and remedies as laid down under the head of

Rakta-pittam (hoemorrhage) in patient is young (of sixteen year.s),
and the
tions.

a

case
in

when

the

careful

her diet,

disease

unattended

with .severe

complica-

19

— 21.
:

Amcnorrhoe
menstruation
of
(

—In

a

case

of

suppression

of

Ainenorrhoe)

caused by the obstruction
in the
fish,

the

deranged
the

Doshas (Vayu and Kapham)
should
pulse,

passage,

patient

be advised

to

take

Kulaitha pulse,
gru 4
etc.),

Masha
wine

Kanjikam fermented sour
cow's
urine,

Tila,

(Sura),

whey, half

diluted

Takm, curd and

S^ukfam

for

her diet.

The

.symptoms and treatment
tion have been described

of thin and scanty
before.
Still

menstrua-

in

such a case

measures

laid

down
ma}'

for the treatment of

(amenorrhce)

be

adopted.
the

treatment described as before,

Nashta-Rakta Under a course of semen or the cataresorted
to their

msnial blood

of a

person would

be

healthy and normal condition.

22

-23.

A woman
forego the bed

with (healthy)
of her

catamenial

flow
first

should
three

husband during the
as

days of
coUyrium.

her

uncleanness,
shall

well

as

day sleep and
nor bathe,
etc.),

She

not shed

tears

nor

smear her person (with sandal
her bod}% nor pare her nail,

paste

nor anoint
in

nor run, nor indulge
talk,

loud and

excessive

laughter and

nor should she
herself

hear loud noise, nor
to
if

comb

her hair,

nor expose
all
;

droughts^ nor do any fatiguing work at a

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

(during those days\ gives

Chap.

II.]

SARIRA STHANAM.
a

1

27

birth

to

blind child gives

;

by shedding tears (during her

period) a
sight
;

woman
a

birth to a child of defective eye-

by bathing or smearing her body (with sandal
miserable
;

paste etc.)

one

;

by anointing her body
a child with bad
in

a leper (Kushthi)
nails
;

by paring
restless

her, nails
;

by running a
or tongue

one

by indulging

ex-

cessive laughter, a child

with brown (S)ava) teeth or

palate

;

by excessive talking a garrulous
;

child or

one of incoherent speech
;

by hearing loud
hair, a bald

sounds, a deaf child

by combing her
to

one

;

whereas
fatiguing

by

exposure

the
first

wind
three

or

by

doing
her

work (during
birth
it).

the
to

days of

period) she gives

an

insane

child Cconceived

immediately after
are to be avoided.

Hence

these acts (^day sleep etc)

24.

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

on a matress made of Kus'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 tray." 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 da)- she should
take

ceremonial

ablution,

put on

a new

(untorn)
after 25.

garment and ornaments and then visit her husband having uttered the words of necessary benediction.

Metrical Text :— A child period resembles the man whom
ablution on the fourth day
of her

conceived
she
first
;

after

the
after

sees

menses

hence she

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

may

resemble

his

father).

After

that

the

perform the

rites

(Garbhadhana ceremony),
at the

In the case of the hu&band being abscnat the suD.

time, sh^ should look

128.

THE SUSHRUTA SAMHITA.
a

[Chap.

II.

to help the conception of

male child

and

after

the

ceremony a wise husband should observe the
rules of conduct,

following

26

— 27.
Husband :— A
day of the next
husbaud wishher

Conduct
for a

of

ing to beget a son by his wife, should not visit

bed

month

(before the

flow).

Then on

the fourth

day of her uncleanness, he should anoint or

body with Ghrita, should partake of a food in the afternoon or evening composed of boiled S'dli rice, milk and clarified butter, and then visit the bed of his
lubricate his

wife

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 her body with oil, partake of food largely composed of oil and MasJia pulse, and then meet her husband
at night.

priate
in

The husband then having uttered the approVeda Mantras and having awakened confidence
wife,

the

should

go unto her on the fourth,

sixth,

eighth, tenth or

on the twelfth night of her menses for
28.

the progenation of a male child.

IVIctrical
of these nights

Text ;— A
leads
to the

vislc to

the

wife

on

any

continual

increase of the

wealth, progeny, and the duration of the

husband's

life.

On

the other

h?i,nd,

a visit

to

one's

wife

on the
to

fifth,

seventh, ninth, or eleventh da)^ of her flow leads

the

conception of a female

child

The

thirteenth

and the

remaining days

(till

the next

cour.se)

are

condemned
going unto

as regards intercourse.

29

—30

Prohibited Period etc. :— A
one's wife

on the

first

day of her monthly course tends to

shorten one's life
diately after
l>y
its

and a child born of the act dies imme-

delivery.

The same
biith

result

is

produced

a

visit
i.e.

on the second day, or the child dies lying-in
its
;

loom

ten days of

A

visit

on the third day

Chap. II.]

SARIRA STHANAM.
deformed and
and remain
in the

1

29

leads to the child's being
child

short-lived.

A
lives

which

is

the fruit of a visit on the

fourth

day

long, will be well developed

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 manneras a thing thrown into a stream does
not go against

away with the current. Hence a husband should foreswear the company of his wife during the first three days of her un cleanness, when she also should observe a vow of sexual abstinence the husband should not visit his wife within the month after
but
is

carried

;

the twelfth

day of her menses).
(of

31.

After the impregnation on
or four drops

any

of these nights,

three

the

following

drugs

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

S'ahadevd or

Vis'vadevd,
right

mixed with milk should be
of

poured into the
conception
of

nostril

the

enceinte for

the

a

male
it

child

and care should be taken
32.

that she does

not spit

away.

Metrical Text :— A
factors

co-ordination of
(Ritu),

ihe

four

of

menstrual

period
i.e.

healthy
of

womb

(Kshetra), nutrient

liquid

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
and

(Kshetra),

water (containing nutrient
strong

matter)

vigorous seeds (Vija) together with proper

care, help

the

germination of

and undiseased
generous,
of
its

sprouts.
is

A

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,

II.

Causes of different colours of the Child:— The ficiy principle (Tejadliatu) of the
organism, which
is

the originator of

all

colours of the

skin (complexion), happening to mix largely with the watery principle of the body at the time of conception,
serves
to

make
;

the

child

a fair
a

complexioned

one

(Gaiira-varna)

mixed

with

large
it

quantity of the
the chiid a

earth principle (Kshiti) of the body,

makes

dark

complexioned

one

(Krishna-varna).
earth

In

combiethereal

nation with a large quantity of
principles of the organism,
it

and

imparts a dusky (Krishnafull

s'yama) complexion

(^to

the

developed

fcetus).

A

similar combination of watery and ethereal principles

serves

to

make

the

child

dusky yellow (Gaura-s'yama).
of

Others on the contrary aver that the complexion of the
child
is

determined by the colours
born blind
the

the

food
34.

taken

by

its

mother during the period of gestation.
child
is

A

in

failure

of

the

fiery

principle

(Teja-dhatu)
its
still
;

of the organism in reaching the

region of

undeveloped eyes (part
so
also

—where
it

the

eyes

would be)
of the

a penetration
for

by the same
blood-shot

(Teja-dhatu) into

its

blood accounts

the

eyes

child.

Entered

into the Pittam

makes

the child a yellow-pupiled one
into
its

(Pingalaksha).

Entered

bodily

Kapham
its

and mixed with
eyesight.
35.

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

IVIemorable verses:— As
densed
clarified
fire,

a

butter melts and
so the

expands

lump of con* if placed by

the side of a

ovum
in

(Artava) of a

woman

is

dis-

lodged and glides away
*

contact with an adult male*
occurs about
the

Sub'iula's theory

is

that

ovulation

same lime

as

uienstfuation

and rather

initiates the latter,
is

and the shed ova are washed
on

out

Nviili

the menstrual flow, hence there

a possibility of conception

Chap.

II,]

SARIRA STHANAM.
divided
into

131

A

seed

two by the deranged Vayii 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 *
att

A

born of
feels

scanty paternal

sperm becomes

Asekya and

no sexual desire
and)
child begotten

(erection) without previously (sucking the genitals

drinking the semen of another man.
in

A

a sordid

vagina

is

called

a

Sougandhika, whose
be-

organ does not

respond to the sexual desire without

smelling the genitals of others.

The man who

first

comes a passive member of an act of sodomy and then again commits sodomy with the woman (he visits) is
called

a

Kumbhika

(or

Guda-yoni
^,6

and
a

is

included

within the category of a Kliva).

— 40.
woman
without

The man who cannot copulate with
is

previously seeing the sexual intercourse of another couple
called Irshaka.

A

child born of

an act of fecund-

ation foolishly or ignorantly effected

during the menses
her on
his

of

its

mother by

its

progenitor by
is

holding

bosom during the act
born of a

called a

Shauda and

invariably

exhibits effeminate traits in his character.

A

daughter

woman
41
the

riding on her husband
will

during the act
traits
in

of sexual intercourse

develop masculine

her character.
connexion
stops
of

—43.
period of
flow.

during
itself

But when the menstruation
day,
to
it

by the

end of the
no ovum
is

third
left

also

indicates

that

ovulation has ceased and question arises
fourth
is

be

fertilized,

hence

the

how can
ovulating

there be
?

conception

then

on connexion on the

day and
the

thereafter

The explanation

(as in the following verse)

that

organ though quiescent

at

the

time

is

again

stimulated to activity

by intercourse with a male and new ova are shed
fertilized

which are ready

to

be

by the semen.

— Ed.
to

Gayi interprets the term "Dharmelara"

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

T?2

THE SUSHRUTA SAMHITA

[Chap.

II.

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

Shanda

is

devoid

of

that

fluid
etc.

(Sukra).

The semen carrying ducts
which helps the erection of

of an

Asekya
as

are

ex-

panded by the drinking of the semen

above described

his reproductive organ. 44-45

The conduct and character
its
(/.

of a child

and

its

incliof

nation to particular dietary are determined
parents during the
e.

by those

act

of fecundation.

A

boneless
is

with cartilaginous

bones)

monstrosity

the

outcome of the sexual

act in

which both the

parties are

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
in its

paternal
sities

elements*
serpents,

development.
or

Such monstrofcetus

as

scorpions,
of a

gourd shaped

delivered from the

womb

woman
46-49.

should be ascribed

as the effects of deadly sins.

The
and
born

child of a

mother whose wishes are not honoured
pregnancy stands
lame,
in

gratified during

danger of being

palmless,

hunchbacked,

dumb

or

nasal
of

voiced through the deranged condition of the
its

Vayu
its

mother's body.

The malformation

of a child in

the

womb; should
*

be ascribed to the atheism of

parents,

or to the effects of their misdeeds in a prior existence, or
Hair, beard, nails, leeth, arteries, veins,
paternal

ligaments and

semen are

called

elements
father

inasmuch

as

these are said to be inherited by

the child irom

its

Chap.

II.]

SARIRA STHANAM.
condition
of the

133

to

the

aggravated
50

Vayu, Pittam and
faeces

Kapham.

— 5r.
excrete
or
,

A
owing

fcetus 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.
as its

A

child

the

womb

does not cry inasmuch
the sheath
its

mouth remains covered with

of the placenta
is

i.e.fcetalinemhrams (Yarau) and

throat

stuffed with

Kapham. The processes movement of the foetus in
those of
its

of respiration,

sleeping

and

the

womb

are effected through

mother.

52 of

— 53.
the
in

The adjustment
of

different

limbs and organs
at their proper

the

body of a

child

the

womb
its

places, the

non-development of hair on
according
species.

palms and

soles

and the subsequent cutting and
spontaneously effected
after the

falling off of its teeth are

to the laws of nature

model of
in

its

own
prior
traits

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

Sattvika
his

too

and
Acts

also

remembers
to

prior births

(Jatismara).

similar

those,

which a man

performs in a prior existence, overtake him also in the
next.

Similarly

the

traits

and the temperament which
existence
54 — 55.
Sthanam
in

he had developed in a previous
sure to be patent in the next.
Thus ends

are

likewise

ihe second Chapter of the S'arira
treats of the purification of

the

Sus'ruta

Samhita which

sperm and ovum.

CHAPTER
Now we
pregnancy,
shall discourse
etc.

III.

on the Sariram which treats of
.i.

(Garbha Vakranti Sariram
clement (Sukra)
is
(i.e
,

The male
element
therefore

reproductive

endowed
is

with Soma-guna
Artava)

thermolytic properties) the female
the opposite property and

presents
(i

Agni-guna

e.,

thermogcnetic 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

adjustment

the

way

of supplying
2.

nutrition

and

in

way

of the adding to their bulk.

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

aggravates

the
in

heat

generated
of

b}'

the friction of the sexual organs
tion.

an act

copulato
dis-

The Vayu and heat
its

thus aggravated tend
sac

lodge the semen from

or

receptacle

in

a

man

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

and

secreted

by similar causes.
subsequently conAfter that,

The combined ovum and semen
fined in the
is

are

uterus

(Garbhas'aya).

He who
smeller,

known by
hearer,

the epithet; of Self-conscious, impressioner

(creator of sensations
seer,

and perceptions), toucher,
eternal,

taster, Self or

Ego, creator, wanderer, witunmanifested
takes

ness,

ordainer,

speaker, though
in his real

and incomprehensible

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. Ill]

SARIRA STHANAM.

135

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
its

of

semen
of a
ele-

over

the

ovum

(in

conception)

;

the

birth

daughter shows the preponderance of the maternal
ment.

A

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,
secreted.

as

being the time during which the ova are

Certain authorities hold that there are
to all

women

who never menstruate
(lit

appearances

4

5.

Memorable verses :— The
:

face of a

woman
becomes
is

a

woman
lively.

of

undetected

menstruation)

full

and
for

A

moist and clumsy deposit
teeth

found
a

on the body,
desire

face,

and

gums.

She

feels

sexual
hair,

intercourse

and speaks sweet words.
droop down.

Her

eyes,

and

belly

A

sort

of

distinct throbbing

is felt

m

her

aims, thighs, mamma;,

umbilicus,

perineum and buttocks.
its

Her sexual

desire

grows intense and prominent, and
her

gratification gives
will at

utmost joy and pleasure.
indicate
6.

These symptoms
has

once

that

a

woman
full

menstruated

(inter-

nally).

Just as the petals of a

blown

lotus

flower

are

gathered up during ths 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 SUSIIRUTA
uterus (Yonij
7.

SAMIIITA.
flows

L^hap. Ill,

whence

it

out

odourless

and

blackish.

Period of IVIcnstruation :— The
(menstruation)

process

commences

at the twelfth
till

year,

flowing

once

in
it

every month, and continues

the fiftieth* year

when

disappears with the sensible decay of the body. 8
wife on even days during the
in all

A

visiti* to one's

cata-

menial period (twelve days
an intercourse on odd
daughter.

from the cessation of male child while
in

the flow) leads to the conception of a

days

results

the birth of a

Hence

a man, seeking a

male-issue,

should

approach

his wife for the

purpose

in

a

clean

body and
9.

with a quiet and calm

spirit

on an even date.
physical

A
flow

sense

of

fatigue
in

and

languor,

thirst,

lassitude and weariness

the thighs, suppression of the
secretion

of

semen and menstrual
coition)

(Sukra
in

and
the

Sonita) out of the uterus (Yoni), and

throbbing

organ

Cafter
lO.

are

symptoms

of a recent fecun-

dation.

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

hence a son
;

the sexual intercourse

be made on

days

whereas menstrual secretion
is

daughter

born
to

if

becomes more on odd days, so a the intercourse be made on odd days.
is

According
a daughter
is

Bhoja, a son

born from intercourse on

even

days and
is

born from that on odd days.
virile

The

birth

of a

male issue
is

due

to the

preponderance of semen

and that of a female sex
If
is

due
be

lo the

preponderance of menstrual secretion.
(in quality

both

the

secretions

equal

and quantity)

a

hermaphrodite

issued.

Chap. III.]

SARIRA STHANAM.

I37

brash,

and a sense of general lassitude are the indications
ri.

of pregnancy,

Prohibited conducts during gestation
:

— Immediately
woman

on

the

ascertainment
all

of

her

pregnancy, a

should avoid

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
cation
of

her haunches, excessive applietc.,

Sneha-karmas
{i.e
,

and venesection

an

improper time

after the eighth

month

of gestation),

and voluntary retention of any natural
body.
12.

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
mouth
formed
of
(in

of the Foetus:— in
gelatinous
;

the first
is

gestation
the

a

substance

only

womb)

the

molecules of the primary
earth, water,

elements (Mahabhuta

air, fire,

and

ether)

being acted upon by cold (Kapham), heat
air

(Pittam) and
the second

(Vayu

or

nerve-force) are condensed in

month.
matter)

A

lump-like
the

appearance

(of

that

confused

indicates

male-sex (of the

embryo).

An
the

elongated-like
foetus

shape of the matter
;

denotes that
its

belong to the opposite sex
(like
e.

whereas

tumour-

like

shape
(/

a Salmali-bud) predicts the absence of

any sex
five

a hermaphrodite).

In

the

third month,

lump-like protuberances appear at the places where

the five organs

—namely the two hands, two

legs

and the

head
the

would be and the minor limbs and members of body are formed in the shape of extremely small

138
papillae.
(of

THE SUSHRUTA
In the fourth
of

SAMIIITA.
all

[Chap. III.

the limbs and organs become more potent and the foetus is endowed with consciousness owing to the As heart is the seat formation of viscus of the heart. of consciousness, so as the heart becomes potent, it is endowed with consciousness and hence it expresses its the

month

body

the embryo)

desire

for

things
its

of

taste,

smell

etc.
is

(through the
called

longings of hearted
desires
birth

mother).

The

enciente
time,

double-

(Dauhrida) at the
a

whose wishes and

—not being
of the

honoured and

gratified

— lead to the
Hence
long-

of

paralysed,

hump-backed,
should

crooked-armed,

lame, dwarfed,
the
desires

defect-eyed, and a blind child. enciente

be gratified, which

would ensure the birth of a strong, vigorous and
lived son.
14.

Memorable Verses :— A
cause the longings
to be
gratified

physician should

of a

pregnant

woman (Dauhrida)
gratifications
;

inasmuch as such
birth of

would
and

alleviate
fulfilled

the discomforts of gestation

her desires being
long-lived,

ensure the
son.

a

strong,

virtuous

A

non-fulfilment

of her

desires during

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
affect

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)
to
fine

gives

of a

who

is

sure to be

rich and
for

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 STHAN-AM.
to

139

for

a

viiit

a

hermitage.

The

desire of a pregnant
idol, predicts

woman
of

to see a divine

image or an
in
life.

the

birth of a child in her

womb who

would grace the council
Similarly,

an

august assembly

a desire to

see a

savage animal on the part of a pregnant
presence of a
in her

woman

signifies the

child

of savage

and cruel

temperament

womb.

A

desire for

the flesh of a

Godha
in

indicates the presence of a sleepy,

drowsy person

her

womb who
in
life.

would be tenaciously fond of good

things

part of the

Similarly a longing for beef on the mother (during gestation) indicates the birth
vigorous
child

of a

strong and

capable of sustaining

any amount of fatigue and physical pain
for

A

longing

buffalo-meat of the mother indicates the
valiant

birth of

a
a

hairy,

and red-eyed
a

child (in

her wombj;

longing for boar-flesh
child

indicates the

birth of a

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
character
desires

such stature
in
life

and would
are peculiar

develop such
to

traits of

as

that

animal.

The

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 Foetus :— In
fifth

the

mouth

the fcetus

is

endowed with mind
its

(IVIanah^

and wakes up from the sleep of
tence.
in.

sub-conscious exis-

In the sixth

In the

month cognition (Buddhi) cornes seventh month all the limbs and members

140
of
its

THE SUSHRUTA SAMHITA.
body are more markedly developed.
(in the heart of the foetus)

[Chap.

III.

The Ojosilent

dhdtu
in the

does not remain

eighth month
dies for

*

A

child born at that time (eighth
after
its

month)

want of Ojo-dhdtu soon

birth,

a fact which

may

be equally ascribed to the agency of

the malignant monsters
gestation) offerings of

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

and monsters

(for

the

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
of

the analogy of percolation

transudation
of

the

completion

the
its

fecundation, the vessels

(Dhamani) of

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 tiansudation womb. 17.

through

its

Different opinions on the formation
of

the
is

foetal

body

:-Saiinaka
foetus
is

says

that

probably the
since head

head of the
possible.

first

developed

the only organ

that

of

all

other organs
is first

makes the functions Kritaviryya says, it is
siiace

the heart that

developed

heart

is

the

seat

of Manah and Buddhi (mind and
* Sometimes
it

intellect).
child

The son
to

of

passes

from

the body of the

that of the

mother and vice vtna.

Chap. III.]

SARIRA STHANAM.

14!
re-

Paras'ara says that the development of the umbilical

gion of foetus must necessarily precede (that of any other
part of
its

body) inasmuch as

it

is

through umbilical

chord that an
body.

embryo draws

its

substance from mother's
feet

Mat:ka,udeya says that the hands and
be developed since they are
in

of a

foetus are first te

the

only

means of movements
point of time since

the

womb.

Sabhuti Gautama
is

says that the development of the trunk
all

the earliest
lie

in

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
;

Dhanvantari holds that the of the body of an embryo
be perceived
the

goes on simultaneously

and they can not
attenuated

or detected in their earlier stages of development in

womb owing
mango
pith
etc.

to their extremely

size

like

a

fruit or sprouts of

of a

ripe

bamboo. As the stone, marrow, and matured mango-fruit or the

bamboo, cannot be separately perceived in the earlier stage of their growth but are quite distinsprouts of

guishable in the course of their development,
in the early stage

likewise

of pregnancy the limbs

and organs of
extremely
they
therefore

the

body

(foetus)

are not perceptible for their

attenuated stage but become potent (and
are distinctly perceived)
in

the course of time

for their

development.

18.

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

describe
fcetus

the

parts

and

principles

of the

body of a

which are respectively contributed by
maternal
factor,

paternal

element,

the

serum
hairs

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

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
of

steady
a
in

and
arc

hard

substances

(in

organism

child)

contributed by the
;

paternal element
flesh,

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

(Mdtrija)

strength, complexion, growth, rotundity

maternal element and

decay of the body are due to the serum (Rasaja). The sensual organs, conciousness, knowledge, wisdom,
duration
of
life

(longivity),

pleasure

and pain
in

etc.

are

the outcome of the spiritual element

man

(Atmaja).

We shall
the

describe the Sattvaja features of the

body

in

next chapter.
are

Valour, healthfulncss, strength, glow
the

and memory
born
with
(Satmyaja).

products

of

a

child

naturally

physiological
19.

conditions of

the

parents

Signs of male and female conception
is
:

— An cncicnte,
detected,

in

whose
lifts

right

mammaethe milk
at the

first

who

first

up her right leg

time of locomotion, whose

right

eye looks larger, or

who
and

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

of 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

pre-assumed
cations.

from

the

contriety

of the foregoing indi-

An

enciente whose sides become
of whose

raised

and

the

forepart

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.

Chap. Ill-]

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 pregnancy are sure to be
virtuous

blest

with good,

and generous children
during
the
fruits.
etc.

;

whereas a contrary
sure
to

conduct
with

period

is

be

attended

contrary

The development
qualities

of the limbs
is

and the members

of a foetus in the

womb
and

natural

and spontaneous, and the

conditions

which mark these organs are determined by the acts of the child which are anterior to its genesis and wcrri
done
in its prior existence.

21-22.
in

Thus ends the
Samhila which

third

Chapter of the S'arira Sihanam

the

Su

'ruta

treats of the generation

and pregnancy.

CHAPTER
Now we
treats
shall

IV.
the
foetus

discourse

on

Sdriram
in

which

of the

devclopiTient

of a

the

womb,

as well as of the factors

which contribute to the growth
and principles
r.

of

its

different bodily organs

^GarbhaSleshma

Vyakaranam-aariram).
The Fittam
(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

(Pranah) of the Foetus,

2.
:

Folds of Skin
ing

—Seven

folds or layers of cover-

(Tvaka — skin) are formed and deposited on the
transforming
product of
Sonita
the

rapidly

combination of

(semen) Sukra and

(fertilized

ovum)
individual
(of

which
Soul

have been

thus

charged

with
as

the
layers

or Self in the

same manner
first

cream) are

formed and deposited on the surface of

(boiling) milk.

Of

these

the

fold

or layer
all

is

called Avabhaisini
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
The complexion
is

Sidhma, Padma;

*

of a person
is

is

due

to

this first layer

and

as the
its

colour of an opaque body
surface, this layer

due

to the rays

that

are

reflected

from

rightly

named Avabbas'ini

or reflecting layer.
(or for

**

The

text runs

"Vriherashtadashabhaga," which means eighteen
;

so mr.ny) 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

Lohita
is

it

measures a
seat

sixteen-twentieth

of a

Vrihi and

the

of such (cutaneous affections; as

Tilakalaka, Nyachcha and
or layer
is

Vyanga

etc.

The

third fold
in

called

Sv^ta^,

which measures
a Vrihi,

thick-

and forms the seat of such diseases as Ajagalli, Charmadala, and Mas'aka
ness, a twelve-twentieth of
etc.

The

fourth

fold

or

layer

is

called

Taimr^
forms

measuring an eight-twentieth

of a

Vrihi and
kinds
or

the seat of such diseases as the various

of Kilasa
called

and Kushtha

etc.

The

fifth

fold

la\-cr is

Vedini, measuring in

thickness

a

five-twentieth
etc.

of

a

Vrihi and forms the seat of Kushtha, Visarpa,
sixth fold or layer
is

The

called

Rohiui,

which

is

of equal

thickness as a Vrihi (grain),

and

is

the seat of Granthi,
etc.

Apachi,

Arvuda,
or

Slipada
is

and
called
is

Gala-ganda
seat

The

seventh fold
Vrihi in

layer

Mansa-dhara' twice a
of

thickness

and

the

l^hagandara,

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 about the tips of the fingers, inasmuch as there is a surgical dictum to the effect that an incision as deep as
the

thickness of the

thumb
the

may
help

be

made

into

the

region of the

abdomen with
3

of a

Vrihi-mukha

(instrument).

The Kalas too number seven
at the

in all

and are situated

extreme borders (forming encasement and support) of the different fundamental principles (Dhatus) of the
organism.
4.
:

Memorable Verses — x^s
core of a piece of

the

duramen

or

wood

or stem

becomes exposed

to view

by cutting into

it,

so the root principles (Dbattus) of the
la}ers

body may be seen by removing the successive

or

19

146
tissues of

THE SUSHRUTA SAMHITA.
its flesh.

Chap. IV.]

These Kalds are extensively supplied
tissues),

with Sndyus (fibrous
encased
in a

bathed

in
5-6.

mucous, and
Kalds.the

membranous

covering.

IVIansacIhara-Kala:- Of these
is

first

named Maasadhara
tissues),

(^fascia),

in

the

contained

flesh

(bodily substance of the Kala) of
(fibrous

the Sira (veins),

Snayu

Dhamani

(arteries)

and other Srotas
7.

(channels) are found to spread and branch out.

IVIcmorable Verse — As
:

the roots and stems

of a

lotus

plant

respectively

situated in the ooze

and

water (of a tank), do simultaneously grow and
so

expand,

the

veins
8.

etc.

situated

in

the

flesh,

grow and

ramify.

Raktadhara- Kala -The
:

second

KaU

is

called
etc.X

Rakta-dhara (Vascular

tissue of the blood vessels

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

Memorable Verse:— As
latex
in
its

a plant containing
or

tissues,

when

injured

pricked, exudes

milky
flesh

juice,

so blood oozes out instantaneously on the

of the

body (supplied with the Raktadhard-kala)
10.

being injured.

IVIedadhara-Kala :— The
Medadharat (adipose
in the
tissue).

third

Kald

is

called

Meda

(fat) is

present (chiefly)

abdomen
is

of

all

animals, as well as in the cartilafatty substance present in large
11.
is

ges (small bones).

The

bones

called Majjai (marrow).

IVIemorable Verse :— Marrow
large

found inside

bones, whereas a substance similar in appearance
inside other

and found
present
in

bony

structures (cartilages should
i

be considered as

Meda, mixed with blood.
12-13.

The

fats,

purely

muscular structures, go by the name

of Vassi (muscle-fat).

[Chap. IV.

SARIRA STHANAM.
fourth

147

^leshmadharaC-Kala :— The
called Sieshmsidharai (Synovial tissues)

KaU

is

and

is

present

about

all

the bone-joints of animals.
:

14.

IVIemOrable Verse
upon mucous (Sleshma) contained movements, i'.
called

-As

a wheel easily turns

a well greased axle, so the joints moistened
in these

by the

sacs

admit of easy
kala

Purishadhara-Kala :— The
Purishadhara and being situated (abdomen) serves to separate the faecal

fifth

is

in

the Kostha
in

refuse

the
16.

(Pakvds'aya) lower gut (from other ingested matters).
IVI

em Orable Verse
and keeps the
is

:— This Kald extends about
lower intestines (Un-

the

liver,

upper and lower intestines and other abdominal
foeces in the

viscera

dukam) separate and hence
Pittaphara-kala
it

called

MaladharA-kald
sixth Kala
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 (Amas'aya
to

Grahani-Nadi) and on

its

way

the

(Pakas'aya)

intestines (for the proper

action

of the

digestive juices

upon

it)

18.

IVIemorable Verse :— The
viz.

four kinds of food,

those that are chewed, swallowed, drunk,

or licked,
are

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

proper

time through the heating agency
19.

(action") of the

Pittam

^Ukradhara-Kala :— The
called

seventh

KalA
20,

is

Sikradhiia

(semen-bearing),
all
:

which
physician

extends

throughout the entire body of

living creatures.

IVIemorable Verse
know
that
like
fat

-The

should

(Sarpi) in the milk, or sugar in the
of)

expressed juice of sugar-cane, the (seat
extensive with the whole organism of a

semen

is

co-

man

(or animal).

148

THE SUSHRUTA SAMHITA.

tChap. IV.

The semen
fingers'

passes through the ducts situated about two
deferens) and just
finally flows out

breadth on either side (vas

below the neck of the

bladder and

through the canal. The semen of a man during an act of sexual intercourse with a female under exhilaration
.

comes down from

all

parts

of his

body owing
act).

to the

extreme excitement (engendered by the

21-33.
(vessels

The

orifices of the

Artava— carrying channels
of a

of the uterine mucosa)

pregnant

woman

are

ob-

structed by the foetus during pregnancy and hence there
is

no show of menses (during gestation). The menstrual
in
it

blood thus obstructed

its

downward

course

ascends

upwards

;

a

part

of

accumulates and
the
is

goes to the
rest

formation of placenta

(

Apara\ while
;

ascends
reason

higher up and reaches the breasts

this

the

why

the breasts of a pregnant
24.

woman become
foetus are

full

and

plump.

The
of blood

spleen
;

and
lungs

liver

of the

formed out
of

the

are

made
25,

of

the

froth

the

blood

;

and the Unduka

or faecal receptacle, of the refuge

matter (Mala) of the blood.

IVIetrical Texts :— The

intestines (Antra),

the

bladder (Vasti), 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. As fire fed by draughts of air refines the dregs of
cfolden

and transforms it into pure metal, so blood and Kapham acted upon by the heat of the Pittam
ore

are

transformed

into

the shape

of the

intestines etc.

in the

abdomen.
flesh,

of the

blood

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

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

forms them into muscles (Pes'i\ The Vayu, by taking

off

Chap. IV.]

SARIRA STHANAM.
transforms them

149
into

the oily principles of fat (Meda).
(Sira-

and

^fibrous tissues) Snaiyu.the

underbaked (Mridu)
internal cavities

ones being

converted
into

into

the Sira and the overbaked

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

the

Snayu.

The

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. The heart essence of the blood, flesh, Kapham and fat.
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
left side,

situated

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 (Chetana)

in all

creatures.

Sleep

sets in

when

this viscus
effects

heart) of a person

becomes
of

enveloped by the

of the

Tamas

(principles

illusion or nescience).

30-31.

heart which is of bud hangs with its apex downward, folding itself up during sleep and expanding with the return of wakening or consciousness. 32.
the shape of a lotus

IVIcmorabIC Verse :— The

Sleep and
sive

its

virtues

;

— Sleep

is

the

illu-

energy of
has

God
its

naturally

all-pervading deity) and ^lit. -the sway over all created beings. The

kind of sleep which sets in

when

the sensation-carrying

channels (Snayu) of the

which abounds
Tamasi-nidra.
of

in the
It is

body are choked by Sleshma, of Tamas, is known as this sleep which produces unconquality

sciousness at the time of dissolution or death.

A man
day and
in

Tamisika-tempsrament
;

sleeps both in the

night

one of the Rsijasika-teiiiperament sleeps either
the

the day or in

night

;

while sleep never visits the

I50
eyelids of a
night.

THE SUSIIRUTA SAMHITA. man
of

Chap. IV.]

Sattvika-temperament before midenfeebled Kapham and aggravated Vayu, or suffering from bodily and mental troubles, get little sleep, and if at all, their sleep is of the VaikaPersons

with

rika or delirious type {ie.

much
:

disturbed)*.
!

33-34. the heart
is

Memorable Verses — O Sus'ruta
said to
h?.

the primary seat of consciousness (Chetana) in

the animated beings.

Sleep overcomes a

man whenever
of Tamas.
quality
of

the

heart
is

is

enveloped

in the illusive effects

Sleep

the offspring of

Tamas and
The

it is

the
is

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

deeds

done

by

him

therein.

Dreams are but the embodiment of these recollections,

The

self or

Jivatmat,

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,
of infants,

summer and

case

old

men,

and persons enfeebled by sexual excesses, or in Kshatakshina diseases and in case of habitual tipplers. A sleep
in

the

day may be enjoyed
or

after the fatigue of a long

journey, riding,

physical

labour,

or
to

on

an empty
suffering
to those

stomach.

It

may
of

be allowed as well
fat,

men

from the
*

loss

Kapham

or

blood,

of

Such persons

may

get sleep only,

when being

tired

and exhausted

they

case
f.

to think of thf-ir affairs,

G

Charaka :— When the

active

self

of a person,

tired in

body and

rnind, loses tovich with his worldly affairs, sleep

comes

to him.

Chap. IV,]

SARIRA STHANAM.
or parched

151

scanty perspiration, or of dry

constitution

;

and also to those who have been sufifering from indigestion and who may sleep for a Muhurta (48 minutes) Those who have kept late hours in in the day time. 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
the

and

all

the

Doshas of
bringing
couL,h,

body are aggravated by a sleep

in the day,

on

many

a

troublesome complaints

such

as

asthma, catarrh,heaviness of the body, aching or lassitude
in the limbs, fever, loss of

appetite etc.

On

the

other

hand, the

keeping of late

hours in the night develops
are peculiar to the deranged

symptoms (Upadrava) which

Vayu and

Pittam,

^6.

lYIcmorable 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

A

conformity to the preceding

conduct

rewarded with health, good

humour,

strength,

healthful
is

complexion,

frame which

neither too fat

and beauty, a nor too thin, and a long life
virility

of a hundred years).
to those
late

who

hours at

day sleep may not prove injurious it and conversely keeping night may not tell upon the health of those
are habituated to

A

to

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

the

bodily

Vayu

or

Pittam,

an aggrieved state of the mind,

loss of vital

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

those which destroy sleep.
useful in cases of

The

following measures
as

are

sleeplessness
oil

-such
soft

anointing the

body, rubbing of

on the head,

massages of the
;

body (with cleansing paste) and shampooing a diet consisting of cakes and pastiy made up of S'dli-rice and

152

THE SUSHRUTA SAMHITA.

Chap. IV.]

wheat prepared with sugar or other derivatives of sugarcane, sweet or soothing articles with milk or
or
flesh

meat

juice

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
advise

motion.

Hence, a wise physician should
should
be

those

and similar other measures
Excessive sleep

to allay insomnia.

40-41.

remedied

Sans'odhana

measures,

fastings,

by emetics, bleeding, and works
equanimity
of

which tend

to disturb the at night
is

mental

man.

Keeping up
in the

beneficial to persons afflicted with

obesity, poison or the

deranged

Kapham

;

so also a

nap

day

is

beneficial to people troubled with hiccough,

colic pain, dysentery, indigestion, or thirst.

42-43.

Somnolence or Drowsiness etc. :— In
this

kind of light sleep, or
the

in

the

i)roliminary

stage

of

sleep,

sense

organs-

are

overpowered and remain
objects

only partially cognisant of their respective
all

and

(subjective

and

objective)

symptoms

of

a

sleepy

person such as, yawning, sense off atigue and heaviness
ol

the limbs, present themselves in succession

;

these are

the special features of Tandra.
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.

A

sense of fatigue without any physical labour which
res-

comes upon a person unaccompanied by hurried
piration
is

called

Klama.

It

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 apath}' to
*

sorts of

Hand,

leg, anus,

and generative organ

etc.

Chap, IV.]

SARIRA STHANAM.
of

1

53
is

work even with the capacity
called

carrying them through

Alasyam

(laziness)

Nausea, without vomiting of
salivation

invested

food, attended with

and formation

of sputum,

and cardiac

distress

are the

symptoms of
drowsiness,

Utklesham.
a beating

A
pain

sweet
in the

taste in

the mouth,

heart, dizziness,

and non-relish

for food are the signs of
if

Glaiii (languor).
in a

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 (Murchchaj

due

to

an excess

of the deranged Pittam. and to the quality of the
vertigo

Tamas

;

(Bhrama)

is

due to an

aggravated state of the

V^yu, Pittam, and to the quality of tne Rajas; drowsiness (Taudra) is due to a similar condition of the V^yu, Kapham and to the quality of the Tamas while sleep
;

(Nidra;

is

produced by the predominance of

Kapham and
51.

to the quality of the

Tamas

in the

organism.
is

The growth
the serum

of a foetus in the

womb
Vayu
it

effected

by

(Rasa) prepared out of the food (assimilated
in

by

its

mother) incarcerated by the
its

the internal

passage of

body.

52.

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

clearly

under-

or heat(Jyoti) in the umbilical
is

which

fanned by

its its

bodily

Vayu and thus The same Vayu
generated),

contributes
in

to the

growth of

body.

combination with the heat (thus
lateral

expands the upward, downward, and
the
foetus.

channels
to the

(in

body of the embryo) and thus

leads

growth of the
sight)

The

eyes

(Dristi— aper-

ture of
*

and
we

the
the

hair-follicles of a

man do
refers

not
both

lo the text

find

word "Indriya" which

to

Jnanendriya (sensory
the body.

functions)

and Karmendriya (motor functions) of

20

1.54

THE SUSHRUTA SAMHITA.
all (in

[Chap. IV.

participate at

the general expansion of the body).
is

This

is

a law of nature, and
the the

the opinion of Dhanvantari.

On

the other hand

growth of hair and finger nails

continue even

when

body

enters the stage of decay. 53-56.

This also

is

a law of nature.

The Temperaments :— The
(Prakriti) of persons

temperaments

may

be of seyen 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
temparamciit
contact,
is

:— A man of VdHkaand
cold

wakeful,

averse

to bathing

unshapely, thievish,
;

vain,
feet,

dishonest and fond

of music

the

soles

of

his
;

and the palms of

his

hands are much fissured
beard

has often

a rough and grisly
in

and moustache, finger nails and hairs
hot-tempered and
is

him

;

he

is

given to biting his

finger

nails
is

and grinding
his

his teeth

(when

asleep).

Morally he

impulsive, unsteady in
;

his friendship, ungrateful, lean,

body is marked with a large number of he is incoherent in his prominent veins (Dhamani) He is a fast walker habit and vacillating in his temper.
and rough
;

and dreams
are

of scaling the skies in

his
is

sleep.

His eyes

always moving.
friends,
is

His mind
capable

never steady.

He
of

makes few
little

of

accumulating very

money

and talks incoherently.

The

traits

his character etc,

seem

to

resemble those of

a

goat,

jackal, hare,
ass.

mouse, camel, dog, vulture, crow, and of an

59-60.

Chap. IV.]

SARIRA STHANAM.

1

55

Pittvaja-Tcmpcramcnt :— A
smell.

man

of

Pittvaja temperament perspires copiously emitting a fetid

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 cats much,
is

warmth and
v-ery soon.

irritable
is

in

temper, though he
of middling strength
is

cools

down
lives

He

a

man

and

up to middle
a

age.

He

intelligent

and
to

possesses

good
the

retentive

memory

and

loves

monopolise
speaker
is

conversation

(by pulling

down

any

that

may

be

present).
in

simply

irresistible

battle.

He is vigorous and He dreams in his
lightning-flashes,
fire,

sleep of such things

as

meteors,

Nageshvara, Palas'a or Karnikara plants.

He
is

is

never

overpowered
antagonist
afflicted
;

with

fear

nor bends

before

a powerful

he protects the suppliant and
the

very

often

with suppuration in

cavity of the
of a

mouth.
serpent,
cat,

The

traits of his

character resemble those

Gandharba (heavenly musician), Yaksha, monkey, tiger, bear, and of a mongoose. 61-64.
an owl,
a
:

Kaphaja Temperament —The complexion
of

a

man

of

5 leshmd temperament
blade
of
grass,

resembles
lotus,

either

the colour

of a

blue

polished

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

He

is

prosperous in

life.

His voice resembles the
lion,

rumblings of a rain-cloud, the roar of a

or

the

sound of a Mridanga.
lakes or pools decked
flowers,

He dreams

in his sleep of
full

large
lotus

with myriads of

blown

swans and Chakravakas.

His eyes are slightly


156

THE SUSIIRUTA 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 SAstras

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 to
character

his preceptors.

The

traits of his

resemble

those

of

Brahma, Rudra,
bull,

Varuna, a Hon, horse, 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 Sannipatika one.

69.

The temperament
does
it

of a

man

is

never altered, nor
or
in

suffer

any

deterioration

abatement.

A

change, abatement or deterioration
case

any particular
death.

should be

regarded

as

the

harbinger of

worm, bred in poison, is not troubled with it, so the temperament of a person however painful to no inconvenience to himself. Several others does authorities hold that the temperaments of persons have

As

a

their origin in the material

elements of the

body and

accordingly they classify them as the Vatika Prakriti,
the

Taijasa Prakriti, and the

Apya

(watery) Prakriti,

the characteristic traits of
to the
first

which respectively correspond
y\.
in
is

three temperaments described above. 70
of the

A man
his stature,

PartMva temperament
firm, strong

large

and

is

and muscular

in his limbs.

A man

of the

long-lived, has

Nabhasa temperament is pious and large aural cavities. The mental temperaaccording to their qualities.
72.

ments are

classified

Chap. IV.]

SARIRA STHANAM.
features

157
of a

Sattvika Features :— The
duct, belief in the existence of

Bralima-kaya person are cleanliness of person and conGod, a constant reader of
Vedas, a

the

worship

and reverence of

elders

and

preceptors,
sacrifices.

hospitality
a

and celebration
of the

of

religious

Those of
of

Maheudra-k^ya person

are valour,

command, constant discussion
tenance

Sastras,

main-

servants and dependents and magnanimity.

The

features of a

Karuna-kaya person
hair

are a liking for

exposure to cold, forbearance, a brown hue of the pupils,
golden
colour
of the

and sweet speech.
are,

The

features of
of disputes,

a

Kouvera-kaya person

arbitration

capacity of bearing hardships, earning and

accumulation of wealth,
or fertility.
are love

and capacity of propagation

The

features of a

Gandharva-kaya person
features of a

of garlands

and perfumes, fondness of songs

and music, and love making.

The

Yamyaabsence

Sattva person are
of
action,

sense

of duty, promptness, firmness
purity,

courage,

memory,
are

and

of anger, illusion,

fear

and malice.
divine

The

features of a

Rishi-Sattva
of

man

contemplation,

obser-

vance of vows, complete sexual abstinence, performance

Homas, celebration of religious wisdom and cultivation of divine
of.

sacrifices,

knowledge,
science. as

or spiritual

These seven types
belonging to the

men

should

be

considered

Sattvika group (of Sattvika mental

temperament).

Now

hear
(of

me

describe the

features

of

men

of Rajasika

stamp

Rajasika
jealous of other

Features

mind\ Tl. :—Asura-Sattva

men

arc affluent in circumstances, dreadful, valorous, irascible,

men's excellence, gluttonous and fond
sharing with any one
irritable,
else.

uf eating alone without

A

Sarpa-Sattva

man

is

laborious,
in

cowardly,

angry, double-dealing,

and hasty

eating

and sexual

158
intercourse.

THE SUSHRUTA SAMHITA.

[Chai.. IV.

A
in

Sa.kuna-Sattva
sexual

man

is

gluttonous,

intemperate

matters, irritable and fickle.
is

A

Rakshasa-Sattva man
vain and ignorant.

solitary in his

habits, fierce,

jealous of others excellence, externally pious, extremely

The

characteristics of a Paisachairri-

Sattva man are eating food partaken of by another,
tability of

temper, rashness, shamelessness, and covetous-

ness of female possessions.
are utter

want
to

of

Those of Preta-Sattva man knowledge as regards duty, laziness,

miserableness, envy, covetousness, niggardliness.
six belong

These
hear
the
of

the Rajasika

cast

of mind. of

Now
men

me

describe

the

characteristic
74.

traits

Tamasika temperaments.

Tamasika Features:— The
anything.

features

of

a

Pasava-Sattva man are perverseness of intellect, parsimoniousness, frequent sexual dreams and incapacity of
ascertaining
or

discerning

The

features of

Matsya-Sattva man
dice,

are unsteadiness^

stupidity, cowar-

fond of intermissive quarrel and oppression and a

longing for water.

The

features of a

Vanaspati-Sattva

man

arc fondness of staying at the same place, constant

eating

and

absence of truthfulness, piety, riches 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 should coolly deliberate upon the etc. A physician
different types

of

temperament described herein and
75-/6.
Slhanam

their characteristic features.

Thus ends

the fourth Chapter of the S'arira
treats of fcetal

in the S'us'ruta

Samhild which

development

etc.

CHAPTER
Now we
of
shall discourse

V.

on the Sari ram which treats

the

anatom}-

of

the

human
i.

body

(Sarira:

^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
is

in
as)

as)

b}'

the

Atma
is

(self-consicous
in
it

self),

called

the

foBtus.

There
limbs,
in

consciousness

the
into

embryo.

The Vayu

(or the vital force") divides
etc.,

Dosha, Dhatu, Mala,

and organs,
the

etc.

The

Teja (or the heat latent
rise to

the fecundated matter) gives
tissues
;

the metabolism of the
it

Apa
is

(water)

keeps
in

in a liquid state
its

;

the Kshiti (earth)
;

embodied
developed

the shape of
its

species

and the Akasa

(ether) contri-

butes to
foetus

growth and development.
all
its

A

full}'

with

parts, such as the hands, feet, tongue,

nose, ears, buttocks etc.

and the sense-organs,

is

called

The body is composed of six Sariram or body. main parts, namely, the four extremities (upper and
lower), the trunk or

middle body, and the head.
:

2.

Different
we
shall describe

members of the body
the

-Now
of the

Pratyangas

or

members

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 SAMIIITA.
which number twenty
likewise
in
all,

[CliapV.

and

the

interior

channels (Srdtas) 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 c?ecum (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),
bones, the

the

Sanghatas

Simanta, the
the
Pes'i

joints, the

Sndyu

(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

Srotasf,

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 (Kalas).

The

are

The
number.

root principles (Dhatu) of the

body

are seven in
(veins),
five

There
Pes'i

are

seven

hundred Sira
nine

hundred

Snayu
(vital

(ligaments),

three

hundred hundred bones, two hundred
(muscles),

and ten Sandhi
parts),

(joints^,

one hundred and seven Marmas

twenty-four

Dhamanis
as

(arteries etc.), three

Doshas (morbific principle— such
*

the

Vdyu, Pittam,
as
at

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

the

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

Chap, v.]

SARIRA STHANAM.

l6l

and Kapham), three kinds of Mala
nine Srota (canals) in
all in

(excrements) and

the

human organism, which
5.

will be described in detail later on.

The

skin,

Kala, the
morbific

root

principles

of the

body,

(Dhatus) the

principles
liver,

(Doshas) such as the
lungs,

Vdyu

etc

,

of the

body,

spleen,

Unduka

(colons),

heart

and the Vrikkas (kidneys) have been
6.

already described (in the preceding chapter).

The Asayas
named
Vayu),
Pittats'aya

(cavities
(the

or

viscera)

:

— They

are

as the Vaitasaya
(the

receptacle

of the bodily

receptacle

of

the
or

Pittam),

Sleshma^saya (the receptacle

of Sleshma

Kapham),
Amzisaya
MutratAs'aya the

Raktasaya
(stomach),
s'aya

(the

receptacle

of

the

blood),

Pakvas'aya
addition
(uterus).

(intestines \

and

the

(bladder).
in

Females
to

have

another
is

(receptacle)

these which
intestines

called

Garbhasaya
in length,

The

(of

an

adult)

male, measure fourteen cubits (three and a half Vya'mas)

while those of an adult female
7

measure only
nine

twelve cubits.

8.

The Srotas or Channels :— The
canals
(Srotas)

of the body,

such as the ears, the eyes,

the mouth, the nostrils, the anus

and the urethra, open Females have three more such ducts or canals as the two breasts (milk channels") and the
on the outside.
one which carries off the menstrual blood.
9.

The Kandaras :— The
teen
in
all,

Kandar^is

number
back.

six-

of

which four are

in the legs, four in the
in

hands, four in the neck,

and four

the

The
of

Kandaras of the four extremeties extend
the nails of the fingers and toes.

to the roots

The
at

four

Kandards of

the neck, connecting
the penis.

it

with the heart, extend

down

to

The
the

four

Kandards

the back and in the
to

region

of

Sroni

extend down

the buttocks

21

l62

THE SUSHRUTA SAMHITA.
These Kandards terminate above
(i.e.

[Chap. V.

(Vimba).

in the head,

the thighs, the
respectively

breast and in the balls of the shoulders

the

Kandaras of the neck terminate
chest,

above
of the

in the head, those of the legs in the thighs, those

dorsum

in the
lo.

and those of the arms

in the

shoulders).

The Jala or Plexuses :— The
plexuses
uses,

Jala

or

are of four kinds, such as the

muscular plexthe

the

Vascular
is

plexuses,

ligamentous plexuses,
of
four

and bony plexuses.
of plexuses,
(wrists)

One of each
(ankles).

kinds

found about each of the Manibandda

and Gulfa
intermingle

These

four

kinds
in

of
the

plexuses

and

cross

one another
is

form of a net-work.
of plexuses,
ii.
;

The whole body

a chain-work

The kurchas — There
of

are six Kurchas*in
feet,

all

;

which two are
and one
cords or
of

in the

hands, two in the

one

in the

neck,
cular
side

in the penis.

There are four great musoriginate

Kajjus which
for the

from either
inwards

the

spinal

column, one pair

going

and another outwards 12—13. muscles together.f
seven in number,

purpose of binding the

The Sevanis or Sutures
e. g. five in

:—tThey

are

the head, one in the tongue
incision
14.

and one

in

the

genital.

An

should not be

made
dtas
*

into

any of these

sevanis.

The Asthi-Sanghatas :— The
(collection of a

Asthi-sanghfourteen in
of muscles,

number
or

of bones) are

The Kurchas

(clusters

groups)

may be made up

bones, vessels and ligamentous s'ructure
t

— Dallana.
on each side of
all.

According

to

Gayaddsa

four such cords are found

the spinal column and thus totalling eight in

J

Sevani

evidently

means the

central tendinous

band which looks

)ike a suture

from which the muscles on either side

arise,

Chap, v.]

SARIRA STHANAM.

163

number.

Of
of the

these one

is

found

in

each of the following

positions, viz. the

two ankles, the two knees and the two
of

groins
similar

;

remaining eight, six are to be found in
the

positions

upper

extremities,
;

namely
is

one
the

in

each of the wrists, elbows and axillas
in the regions

one

in

cranium and another

of the Trika*

(thus

making up fourteen
all,

in all).

15.

The SimantaS ;— The
teen in

Simantas number fourSeveral

and are respectively situated about the place
autho16.

of each of the aforesaid Asthi-sanghata.

rities assert that there are eighteen Sanghata.s.-f-

The Bones
Ayurveda
bones
in

:

—According
medicine),
is

to the followers of the

(general
the

the

entire

number

of
;

human body
Of
these,

three hundred

and sixty

whereas Salya-Tantram (the present work) counts only
three hundred.

one hundred and

twenty are

to be found in the (four)

extremities,
(Sroni),

one hundred and
(Pars'va),

seventeen in the pelvis
chest

sides

back,

(Urah) and

the region of the

abdomen
17,

(Udara),
;

and sixty-three

in the

neck and the regions above
in the aggregate,]:

thus

numbering three hundred
*

"Trika"
it

generally
the

means

the

sacral region,

but Dallanan says

that here

refers to

meeting of

the

two

clavicles with the breast-

bone.
t

According

to

them
the

four

more Asihi-sangatas are
mentioned
at
;

to

be

found over

and above the

fourteen

already

these are

—one

above the

sacrum, one above

chest,

one

the junction

of the

thorax and

abdomen, and one
t

at the acromial

end (of the Scapula).
in

Pundita Gargddhara Kaviratna of Murshidabad

his

famous
chapter

commentary, known as the
of Sarira

Tikd-jalpa-kalpa-tarii, in the
states
:

7th.

Sthanam
body

in the

Charaka Samhita
of

"In the

surgical text-book
is

Sus'ruta

the

number of bones
all.

in

the

human
hundred

given

to

be three hundred in
in

Of
;

these,

one

and eight bones are

the

four

extremeties

one hundred

and twenty-six

in the pelvic cavity (S'roni), sides (Pars'va),

back (Prishlha),
in

(Aksha^ collar-bones and

breast (Urah)

;

and

sixty-six

the region

l64

THE SUSHRUTA SAMHITA.

tChap. V.

Bones of the four Extremities:— There
are three bones in
fifteen

each toe of the

foot,

thus

bones altogether (in the toes of each

leg).

making Ten

the Tala (sole), Kurcha (cluster), constitute and Gulpha (ankle) of each leg, and one forms the two bones are found in the Jangha P^shni (heel)

bones

;

(leg)

;

one
;

in

(thigh)

thus

extremity.
the other leg

Jdnu (knee), and one in the Uru making thirty bones in one lower The same number holds good in the case of as well as in that of the two upper limbs.
the
in the four extremities arc

(Thus the bones

one hundred
bones form

and twenty
the the

in

all).

i8.

Bones
Guda

of the

Trunk :— Five
;

Sroni (pelvic cavity)
(anus),

of these four are found about
(pubis),

Bhaga

and

the

Nitamva
is

upward the neck.

Thus the

total

number

of three hundred
feet
;

made

up.

Now

there are three bones in

each toe of the

this

makes

fifteen

altogether.

Seven bones constitute the sole (Tala), cluaer (Kurcha),

and the ankle (Gulfa).
in

There

is

one bone

in

the heel (Pashni), two
in

the

leg

(Jangha),
there

one in the knee (Janu), and one
bones
in

the

thigh

(Uru).

Thus Thus

are twenty-seven
to the other

one lower limb.

The

same number applies
limbs.

lower limb as well as to the two upper
eight
;

a total
five

number
in

of

one hundred and
pelvic cavity

bones

is

made

up.

There are
the

bones

the

(S'roni)

of these there

are twi in

hips

(Nitamba),
is

and the
with

pubes (Bhaga),

anus (Guda)

and

sacrum (Trika)

constituted

one bone each.

There are

thirty-six

bones in one side (Pars' va) and the same count applies to the
thirty
;

other.

There are

bones in the back (Prishtha)
seventeen
in

;

two
;

in the

collar-

bone (Akshasanjna)
neck (Griva)
(Hanu).
;

the breast (Ura)
;

eleven in the
in the

four in the wind-pipe (Kantha-nadi)
teeth.

and two
three
in

jaws

There are thirty-two
;

There are
;

bones in the
either

nose (Nasa)

two

in

the

palate

(Talu)

one each

cheek

(Ganda), ear (Kama) and temple (S'ankha),
six
is

making

six

together;
sixty-six

and

in

the cranium
up.

(Sira).
total

Thus a

total

number
totals).

of

bones

made

(Hence) the
total
is

number of
iliree

three hundred

bones

is

made
list

(with the grand

of

the

foregoing

Thus

the

of

bones of a skeleton

described."

Chap, v.]

SARIRA StHANAM.
fifth

16$
or triangular

(hips),

and the
(the

one

is

the Trika

bone

sacrum).
(side),

There are

thirty-six

bones

in
;

one Parjsva

and the same number
eight in the

in the

other

thirty in the Prishtha (back),

Urah

(chest)

;

and (Thus
all).

two

more

known
one

making
19.

Akshaka (collar-bone). seventeen in hundred and
as

Bones above the Clavicles :— There
nine bones in
(wind-pipe)
;

are

the GrlvA (neck)

;

four in the Kantha-nadi*

two

in the

Hanu
;

(Jaws).

The
in

teeth

numnose
;

ber thirty-two.

There are three bones
(palate)

the

one

in the

Talu

also one in each

Kama

(ear),

S'ankha (temple), and
in all)
;

Ganda
all].

(check),
Sira

(thus

making

six

six bones

form the
20.

(cranium).

[Thus

making

sixty-three in

Different kinds of Bones and their situations —These bones may be divided into five
:

classes (according to their character), such as the

Kapala,
bones,
hips

Ruchaka, Taruna, Vailaya and the Nalaka.
situated
in

The

the

knee-joints,

shoulders

(Ansa-f),

(Nitamvas), cheeks (Ganda\ palate, temples, and the

cranium belong to the Kap£fcla kind
teeth belong to the Rucliaka, class.
nose,
ears, throat (trachea)
)

(flat

bones).
in

The
the

The bones
(cartilages)

and the socket of the eyes

(Akshi-koshaf

are called

Tarana
palm

;

while

those which are found
sides

in the

(wrist), foot (ankle),

back, chest and regions of the abdomen, belong to
(irregular or curved) class.
and
Kantha-nadi are

the
*

Valaya
Tala,

The remaining
with Charak's

Kurcha,

identical

Salaka, Sthana and Jalru respectively.

t

Though
of

it is

asserted here that

there

exist
is

Taruna bones
no mention
is

in

the

sockets of the
text,

eyes (Akshi-kosha) but
of

there

at all in the

the

presence

any such therein.
it

There

no mention of the

shoulder-blade (Ansa) here though

is

a part of the skeleton.

l66

THK SUSHRUTA SAMHITA.

[diap.

V.

bones belong to Nalaka class (long-bones, lit.— recd-likc
or cylindrical).
21.
:

IVIcmorablc Verses
by the hard core inside
found
pith
in its inside).

— As trees
trunks,

arc supported

their

so

the

body

is

supported (and kept erect) by the firm bones (which are

And

since

these

bones form the
they are not desoff

(Sara) of the

human organism,
etc.

troyed even after the destruction and falling

of the

attached

flesh,

skin,

of the

body.

Muscles are
of the
veins
in

attached strongly to the bones by means
(Siras)

and ligaments (Snayus), and are thus kept
fall off.

position and do not

22.

The Sandhis or Jomts-(IVI.
joints

T.) :— The
(diar-

ma\' be

divided

into

two

kinds according as

they are immovable
throsis).
ties

(synarthrosis)

and movable
at the four

Those which are situated
the others are

extremi-

as well as in the Kati (waist)
;

movable
learned.

known
body.
;

to

and Hanus (jaws^ are be unmovable by the

There are two hundred and ten articulations
in

(Sandhis)
-re
in

the

human

Of
the

these
in

sixty-eight

the

four

extremities

fifty-nine
in

the

trunk
in the

^Koshtha);

and eighty-three
it.

neck

and

region above

23.

Sandhis of the four Extremities :—
Three
great
is

joints are
toe,

found

in

each toe, two only
fourteen
in

in
;

the

thus
in

making

each leg

one

placed

each ankle, knee-joint and groin, thus

making seventeen Sandhis in each leg or thirty-four in A similar number is to be the two lower extremities.
found

m each of the two upper extremities. 24-25. Sandhis of the koshtha and Clavi:

cles
bone

— There are three Sandhis about the Kapala or flat
Kati (waist, hence pelvis)
;
;

in the

twenty-four
;

in the

vertibral

column

twenty-four

in the sides

eight in the

Chap, v.]

SARIRA STHANAM.
;

1

6/

chest

;

eight in the Griva (neck)
;

three in

the

Kanthas

(windpipe)
the the

eighteen in the cords or bands (Nadi) binding
the heart
;

Kloma and
teeth,
in the

thirty-two about the roots of

one
nose

in the region of the thyroid
;

(Kakalaka)

one

two

in the eyes

;

one

in

each of the two
all)
;

ears,

temples and cheeks (thus making six in
the
;

two
e}'e-

about

joints of the jaw-bones
;

;

two over the
in

brows

two above the temples

five

the

Kapala

bone of the fore-head and one

in the

head.

26-27.

Their forms, distinctions, and locations — These joints may be divided into eight
:

different classes

(named

after

the

objects

which they

respectively resemble in or

shape),
(ball

namely Kora (hinged
and
socket),

lap-shaped),
of

Udukhala
palm),
dove-tailed),

Samudga

(back

the
or

Pratara

(raft),

Tunna-sevani
i^crow-beak),

(seam-like

Vayasa-tunda
the

Mandala

(circular),

and Sankha-vartah (involutions of
fingers,

conch-shell).

The
in

joints in

wrists,

ankles

knee-joints and

elbows (Karpura) belong to the Kora
the axilla or shoulder-joint

group.
teeth,

Those

(Kaksha).

and hip (Vankshana) arc of the Udukhala type.
anus,

The

joints in the region of the

vagina,

shoulders

(Ansa-pitha

— i.e

glenoid

cavity) and hips, belong to the

Ssiimudga form.

The
the

joints in the

neck and the spinal
;

columns, belong to the Pratara (irregular) type
those

while

found

in

Kapala bones of the
side

pelvis (Kati)

and the forehead, arc of Tunna-sevani (suture) form.

The

joints

on

either

of

the

cheek-bones

(tem-

poromandibular) belong to the Vayasa-tunda type.

The

Mandala
heart,

joints

occur in
eyes

the

encircling

Nadi of the
nostrils.

throat,

and Kloma.

Sankh£l-varta joints
the

occur in the bones of the ears and
peculiar
features of

The
joints

these different

kinds
28,

of

(Sandhis) are evident from their names.

l68

THE SUSHRUTA SAMHITA.

[Chap. V.

IVIetrical Text :— Only the bone-joints have the joints of muscles been enumerated and described
;

ligaments and veins are innumerable.

29.

The Ligaments (Snayu) :— There
hundred ligaments (Snayus)
in

are nine

the
four

human body,
extremities
;

of

which
in the

six

hundred occur
in the

in

the

two

hundred and thirty

trunk (Koshtha) and

seventy

neck and upwards. (Of the six hundred ligaments
ligaments are situated
;

in the four extremities), six

in

each toe making thirty
in the

(in

the toes of each foot)
(ankles),

thirty

Tala

(soles),
;

Gulpha
in

and the Kurcha
;

(ankle-joint)

thirty
;

the

leg

(Jangha)

ten

in
;

the

knee-joints (Janu)

Udara (abdomen) ten thus making one hundred in the groin (Vankshana) and fifty in each leg. The same number is found in
forty in the
;

the other lower limb and
extremities.
in

in

each of the two upper

(Of the two hundred and thirty ligaments
there

the trunk\
;

are

sixty
;

in

the

lumbar region
the sides
;

(Kati)

eighty in

the

back

sixty in

and

thirty in the chest.

(Of the seventy ligaments to be above the
clavicles)

found
six in

in the region

there are thirty
in

the

neck (Grivd) and thirty-four

the

head.

Thus
is

the total

number
30

of ligaments in

a

human body

nine hundred.

— 33.
hear

IVIemorable Verses :— Now
the ligaments (Snayus).
four
distinct

me

describe

They may be grouped under
viz.,

heads,

Pratanavati
or

(ramifying

or

branching),

Vrltta

(ring-shaped

circular),

Prithu
liga-

(thick or broad),

and Sushira

(perforated^.
in

The

ments (Snayus) which present

the

four

extremities

and the joints belong to the Pratainavati type. The Kandards or large ligaments are of the Vritta type while those which arc found in the stomach (Amds'aya"^ or in the intestines ^Pakvds'aya), and in the bladder belong
;

Chap, v.]

SARIRA STHANAM.

169
back,

to the
sides

Sushira type.
a boat

The h'gaments

of the chest,

and head are

of the

Prithu type.

34

— 35.
;

As
is

together

made of planks and timber fastened by means of a large number of bindings
on the water and to carry cargo
being bound

enabled to float

so the

human frame
or
is

and fastened

at

the

Sandhis
(Snayu)
diseases

joints

by a large

number

of ligaments
injury
to,

enabled to bear pressure.

An
if

or

of,

the bones, veins, joints or muscles are not so
to the system as
in
is

detrimental
are
affected

the case

the

Snayus

Only the physician, who is acquainted with the internal and external ligaments
any way.
is

(Sndyus) of the body,

qualified to

extract a hidden
etc.)

and imbedded Salyam (extraneous matter
part of the body.
36.

from any

The
number
are
in

IVIuSCleS (Pes is) :— The muscles
five

(Pes'is)

hundred
four

in

all,

of
;

which four hundred
Sixty-six*
in

the

extremities

the

trunk (Koshtha) and thirty-four
clavicles.

in the

region above the

37.

lYluscIes 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^i

and the same number
ten
in

attached to the Kurchcha

;

the sole and the ankle-bone (Gulpha,
in the region
five in

— malledi)

;

twenty
joint
;

between the Gulpha and the knee;

the knee-joint (Janu)
in the groin
in

twenty
;

in the thigh

(Uru)

;

and ten

(Vankshana)
in

thus

one hundred

muscles

all

each

leg.

making The same
;

number is found in each of the other three extremities (thus making four hundred in all). 38.

Muscles
six

in

the Koshtha
and
forty

:

-(Of the

sixty-

muscles

in the trunk), three are in the region of the
sixty in the trunks

Gayadasa reads

above the

clavicles,

22

170

THE SUSHRUTA
;

SAMIIITA.
in

Chap. V.]

anus (PaaO
(Sevan i)
bladder
;

o;ic in the
in

penis; one

the
in

perineum
of the the

two

the
;

scrotum
in

;

five

each

haunches
;

(Sphik)
five in
;

two

the

top or head of
;

the

abdomen (Udara)

one about the

umbilicus

five

along each side (of the spinal column),
in all)
;

on the upper part of the back (making ten
in the sides
;

six

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.

Muscles Of the Head and Neck :— (Of
the thirty-four muscles found in this region), four are in
the throat (Grivd)
;

eight in the

two jaw-bones (Hanu)
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
hundred

and

distribu-

of the

muscles

(Pes'is)

have been
bones

described.

40.
:

Metrical Text
and
joints
etc.,

— The
body,

ligaments, veins,
derive
their

of a

human

strength

from the

fact of their 41.

being supported by or covered over

by the muscles.

Extra Muscles
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 Garbhdsaya or uterus is situated in the space
bounded by the
Pittas'aya (small intestine)

and Pakvds'aya

Chap, v.]

SARIRA STHANAM.
and the
foetus lies
in
tliis

171

(large intestine)

during the

period of gestation.*

42-43.
position
in

According

to

their

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 —The
:

muscles which

are found in the penis

and scrotum of a man as desthe
to

cribed before correspond to
in

covering
the

of the uterus

the case of a
in her

woman owing

absence of those

organs
of the

body.

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

conch-shell in shape and

possessed of three

involuted

turns (Avartas) like

the interior of mollusc

The

uterus

(Garbhas'aya

-foiital

bed)

is

situated at the third posterior

involuted turn.

The shape
The

of the uterus resembles

the

mouth
in the

of aRohit-fish (narrow at the

mouth and expanded
in

upper end).

fcetus

lies

a

crouched

or

doubled up posture
the

in the uterus
its

and thus naturalh" at
is

time of parturition

head

presented

at

the

entrance to the vagina.

47-48.

Superiority of ^alya-Tantram
different parts or

'.—The

members
even

of the

body
cannot

as

mentioned
correctly

before

including

the skin
is

be
in

described

Hence,

by any one who any one desirous

not versed

Anatomy.
thorough

of

acquiring a
a

knowledge of

anatomy should prepare
it)

dead body

and carefully observe (by dissecting
If

and examine
it

wc

read Mutrcis'aya (bladder) in

place

of

Pillac'aya

ixplains

the

anatomy beUtr.

— Ed.

172
its

THE SUSHRUTA SAMHITA.

Chap. V.]

different parts.

For a thorough knowledge can only
the

be acquired by comparing
Sdstras

accounts given

in

the

(books
49.

on

the

subject)

by

direct

personal

observation.

IVIOde 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

be

first

be

left to

removed from the entrails and the body should decompose in the w'ater of a solitary and still
in a

pool,

and securely placed

cage (so that

it

may

not be

eaten
it

away by

fish

nor drift away), after having covered

eiitireh^

with the outer sheaths of Mwija grass, Kns'a
with rope
etc.

grass, hemp or

After seven days the body
observer

would be thoroughly decomposed, when the
should slowly scrape off the decomposed skin

etc.

with a
a

whisk made of grass-roots,
strip of split

hair, Kus'a blade

or with

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

IVlemorabSe Verses: -The
or invisible

Self,

the

Lord of the body cannot be detected except
He, who human body
subjects

with the psychic eye or with that of the mind.
has observed the internal mechanism of the

and

is

well read in the
all his

works bearing on these
his

and has thus

doubts expelled from
the

alone qualified

in

science of

mind is Ayurveda and has a
57.

rightful claim to practise the art of healing.

Thus ends the
Samhita w hich

fifth

Chapter

of the

S'arira-slhanam in the Sus'ruta

treats of the

anatomy of the human body.

CHAPTER
Now we
shall discourse
fically treats of the

VI.

on the Sariram which specior vital parts of the

Marmas*

body
i.

(Pratycka-marma-nirdesa Sariram.)
Classification of IVIarmas :— There
one hundred and seven
ism),

arc

Marmas

t^in

the

human
classes,

organ-

which may be divided into

five

such as

the

Mansa-Marmas, Sira-Marmas, Snayu-Marmas, AsthiMarmas and the Sandhi-Marmas. Indeed there are no
other
in the

Marmas

(vulnerable or vital

parts)
2.
:

to

be

found

body than the preceding

ones.

Their different numbers
eleven

—There
;

are

Mansa-Marmas

(vulnerable muscle-joints)
;

forty-

one Sira-Marmas (similar veins, anastomosis)
seven

twenty;

Snayu-Marmas (vital ligament-unions) eight Asthi-Marmas (bone-unions) and twenty Sandhi-Marmas
(^vulnerable joints).
3.

Their Locations :~Of
one
leg,

these,

eleven

are

in

thus

tremities

making twenty-two in the two lower exThe same number counts in the two hands.
twelve

There
chest

are

Marmas
;

in

the

regions

of the

and the abdomen (Udara)
in

fourteen in

the

back

;

and thirty-seven

the region of the neck

(Griva)

and

above

it.

4.

— The Marmas which are situated
as Kshipra,

Names and distributions of Marmas:
in

each leg are known

Tala-Hridaya, Kurchcha, Kurchcha-S'irah,
Ani,
Urvi,

Gulpha, Indravasti, Janu,
Vitapa.

Lohitaksha and
the.
unite

The twelve Marmas which
which proves generally

are situated in
joints

Places where veins, arteries, ligaments,

and

mu.clcs

and an

injury to

fatal.

1^4

THE SUSHRUTA SAMHITA.

Chap. VI.]

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

Nabhi
roots

(umbilicus),
of

Hridaya

(heart),

Stana-

mula

(the

two

breasts),

the Stana-Rohita,

(muscles of the breasts^ the two Apalaps

and the two
be

Apastambhas,
waist', the

The

fourteen

Marmas

to

found

in

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
the two Ansa-phal:ikas

two 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, Lohitakshaand 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,thc twoKrikatikas, the two Vidhuras, the two Phanas, the two Apingas, the two

Avartas, the
five

two Utkshepas, the two Sankhas, one Sthapani
Simantas, four Sringatakas and one Adhipati.

5—9.
Talaare

The
the

different heads of IVIarmas :— Of
Marmas, Those
those

aforesaid

known
as

as

the

Hridaya,

Indravasti,

Mans a- Marmas.

Guda and known

Stana-rohita,

Nila-dhamani,

Matrika, Sringataka, Apanga, Sthapani,

Phana,

Stana-

mula, Apalapa, Apastambha, Hridaya,

Nabhi, Pars'va-

Sandhi, Vrihati, LohitAksha and Urvi, are Sira-Marmas.

Those

known

as

the

Ani,

Vitapa, Kakshadhara,
Kshipra,

Kurchcha,

Kurchcha-Sirah,

Vasti,

Ansas,

(shoulders), Vidhura and Utkshepa, are Snayu-Marmas.

Those known
phalaka,

as

the

Katika-taruna, Nitamva, Ansa-

Sankha,

are

Asthi-Marmas.
Adhipati,
the

The Janu,
the

the

Kurpara, the Simanta, the

Gulpha, the

Manivandha,

the

Kukundara,

Avarta and the

Krikatika arc Saudhi-Marmas.

10—14.

Chip. VI.]

SARIRA STIIANAM.
:

1

75

Qualitative classes
(vital

— Again

these

Marmas
heads,

unions of the body) arc under

five distinct

namel}',

Sadya-Pranahara,

(fatal

within

twenty-four
a
fortnight

hours), Kalantara-Pranahara,

(fatal

within

or a month), Vis'alyaghna (fatal as soon as a dart or any

other imbedded foreign matter

is

extracted

therefrom),

Vaikalyakara,

(maiming
effects].

or

deforming) and
respectively

Rujakar
produces

(painful) [according as

an injury

the

aforesaid

Of

these,

nineteen
;

Marmas
to

belong to the Sadya-Pranahara group
the Kalantara-Pranahara group
;

thirty-three

three to the

Vis'alya;

ghna group;

forty-four to the

Vaikalyakara group
15.

and

eight to the Rujakara group.

IVIemorable Verses :— To
hara group
Sankhas,
(fatal in

the
if

Sadya-Pranaanywa}' hurt)
the

the course of a

day

belong the four Sringatakas,
the
eight

one Adhipati,
the

two
the

Kantha-Siras,

Guda,

Hridaya, the Vasti and the Nabhi.

To
if

the Kalsintara-

Pranahara group
the four
four

(fatal

later

on,

any way
five

hurt)

belong the eight Vaksha-Marmas, the

Simantas,

Tala-Marmas, the four Kshipra-Marmas, the
the the
the

Indra-vastis,

two

Katika-tarunas, the two
Vrihatis,
class

Pars'va-Sandhis,

two

and

the

two

Nitamvas.

To

Visalyaghna

belong the two

Utkshepas and the one Sthapani. To the Vaikalyakara (deforming) group belong the Marmas, known as the
four

Lohitakshas,

the four

An is,

the

two Jdnus, the

four Urvis, the four

Kurchchas,

the

two Vitapas, the

two Kurparas, the two Kukundaras, the two Kakshadharas, the two Vidhuras, the two Krikatikas, the two Ansas (shoulder), the two Ansa-phalakas, (shoulderblades), the

the two Man}'as, the two Phanas

A

two Nials, and the two Avartas. learned physician should know that the two Gulphas,
(tips of eyes), the

two Apangas

176

THE SUSHRUTA SAMHITA.

[Chap. VI.

the two Mani-vandhas and

the four Kurchcha-Sirah (of

the

hands and
if

legs)

belong to the Rujakara group
piercing
;

(painful

hurt).

A
16-2

of

the

Kshipra-Marma

ends

in

an instantaneous death
f.

or

death

may

follow

at a later tinic.

Firm unions of Mdnsa
(ligaments),

(muscles), Sira

(veins),

Snayu
specifi-

bones

or bone-joints

are

called

Marmas

(or vital parts of the

body) which naturally and
life

and hence a hurt to any one of the Marmas invariably produces such symptoms as arise from the hurt of a certain Marma * 22. The Marmas belonging to the Sadya-Pranahara group
cally form the seats of
(Praina),

are

possessed

of

fiery

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 Kdlantara-Pranahara group are
(cool)
in

and

lunar

their

properties.

And
so,

as the fiery virtues are enfeebled easily
virtues

and the cooling
being
the

take
of

a
this

considerable

time

in

Marmas
like

group prove

fatal in the
if

long run (in

the event of being any
the

way

hurt,

not instantaneously

preceding 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
and they

possessed

Saumya
owing

(lunar properties)
to their steady

retain the vital fluid
virtues,
*

and cooling

and hence tend only to deform the organism
are of opinion that hallucination, delirium, death, stupor
in

Some
Mar

and

coma
thes

as described
as.

the

Sutrast

anam

are

the

results

of

injuries to

Chap. VI.]

SARIRA STHANAM.
hurt,

1

77

in

the event of their being

instead

of

bringing

on death.
properties
of

The Rujakara Marmas of fiery and Vataja become extremely painful inasmuch as both
are

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-bhautikaV

Different Opinions on the
Some
and
hara)
in

Marmas: —

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-Prana-

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

which there

one

in

smaller quantity, will prove fatal

in the

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

(Kalintara-Pranahara).*

Those, which are the junction

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

group
*

;

those
Marmas,

of the
such

two belong
as

to the

Vaikalyakara

^

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,
class, are

Talahridaya,

Kshipra,

and

Indravasti, belonging to the
^

same

devoid of Asthi (bones\
to

The
is

Ulkshepa marma,

belonging

the

Vis'alyapianahara

Mansa (muscles) and Sandhi (joint). Sthapani- Marma, belonging to the Vaikalyakara class, is J The devoid of Mansa (muscle), S'ira and Snayu the Lohitaksha-marma
group,

devoid of

;

(of the

same group)
(of the

is

devoid of Snayu, Sandhi
is

and Asthi (bones)
S'ira

;

the

Janu-marma
the

same group)

devoid of
is

Mansa,

and

Snayu:
;

Urvi-marma

(of the said

group)

devoid of Asthi, Mansa and Snayu
is

the

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
S'ira,

Krikatika-marma
(of the

devoid of Mansa,
is

dnd Sandhi;

the

Ansa-marma
;

same

group)

devoid of Mansa, Snayu and Sandhi

the

Anba-phalaka-marma

178

THE SUSHRUTA SAMHITA.
;

[Chap. VI.

group

and those
last

in

which only one
not

of

them

exists

belongs to the

or pain-generating type (Rujdkara)*
is

But the

fore going theory
is

a sound

one, inas-

much
vein,

as blood

found to exude from an injured joint
in the

which would be an impossibility
ligament
(Snayu) and
it.

absence of any

muscle being intimately
should

connected with

Hence every Marma
or
veins,

be
five

understood as a junction

meeting place of the
muscles,

organic principles of ligaments,

bones

and

joints.

24-25.

IVIetrical
by the
are

text:— This
Vdyu,
into

is

further corroborated

fact that the four classes of Sird. or vessels

(which

respectively carry the

Pitta,

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
to

organism.f

The

Vayu, aggravated by an
(those four
classes

injury

a

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,
set in.

and symptoms of syncope are found to careful examination of the affected
(of

Hence a
should
;

Marma

the said

group)

is

devoid of Mansa, Snayu and Sandhi
(of the

the Nila,

Manya and Phana Marmas
Sandhi and Asthi
;

same group) are devoid of Mansa, the Avarta-marma is devoid of S'ita, Sniyu and
(of the said class) is

Mansa;
*
to the

the

Apanga-marma

devoid of Mansa, Snayu

and Sandhi.

The Gulpha,
is

Manibandha, and Kurchcha-s'ira Marmas, belonging
S'ira,

Rujakara group, are devoid of Mansa,
present in these.

Snayu and Asthi,

i.e.

Sandhi alone
t

Hence

the piercing of a

bone

is

attended with bleeding.

Chap. VI.]

SARIRA STHANAM,

1

79

precede
its

all

the foregoing acts of extricating a Salya from

actions of the Pitta
in

and and the Kapha should be presumed the event of a Marma being any way injured or
inside.

From

that similar aggravated conditions

pierced into.

26

— 29.
the
of the

A Marma
perforated at
its

Sadyah-Prdnahara type being edge brings on death at a later time
of

(within seven days), whereas a deformity

organ

follows

from the piercing

of

a

Kalantara-Mdraka*
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 Visalyaghna-j*
Rujakara*:
class

group.

And

a

Marma

pro-

duces an excruciating
the event of
its

pain (instead of a sharp one) in
30.

being pierced at the fringe.

An

injured
in

Marma

of the

terminates

death within seven

Sadyah-Pranahara type days of the injury,
or a

while one of the Kalantara type, within a fortnight

A

month from the date of hurt (according to circumstances). case of injured Kshipra-Marma seldom proves fatal

before that time (seven days).

An

injured

Vis'alyaghna or Vaikalyakara group
in the

Marma of the may prove fatal
31.

event of

its

being severely injured.

Marmas of the Extremities :— Now
shall

describe
any of the
perforated,
{i.e.
it

the

situation
of

of

every

Marma.

we The
be

"

If

Marmas
act
like

the

Kalantara-Pranahara
is

group

deeply
a

then

this perforation

sure to bring

on death within
of the Sadyah-

day

will

a

slightly

injured

Marma

Pranahara group).
t

Any Mnrma

of

the

Vis'alyaghna-group,

being deeply

perforated,
a slightly

brings on death within seven
injured

days

(i, e.

it

will

behave

like

Marma of the Kalantara-Pranahara class), J Any Marma of the Rujakara class, being deeply
bring
excruciating

perforated (injured),
like

is

sure to

pain etc,

(i.e.,

it

will act

a

slightly

injured

Marma

of the Vis'alyaghna group).

l8o

THE SUSHRUTA SAMHITA.
as

[Chap.

VI.

Maima, known
region

the
first

Kshipra*,

is

situated

in

the

between

the

and the second
injured

toes (Tarsal

articulation),

which, being

or

pierced,

brings
as the

on death from convulsions.
Tala-Hridayai",
is

The Marma, known
the

situated in

middle of the sole
root
of

of the foot in a straight line

drawn from the

the

middle

toe.

An

injury to this
in death.

Marma

gives rise to

extreme pain which cuds
as

The Marma, known

the

above
foot.

from

Kurchchat, is situated two fingers' width 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
injur\-

situated
foot

under the ankle-joints,
(Gulpha-Sandhi)
;

one on each side of the
to
it

an

gives

rise

to

pain

and swelling of the

affected

part.
is

A

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 known as the Indravasti-Marma..1 results in excessive haemorrhage which ends in death. 38.
• It

is

a

Snayu-Marma (ligament)

to

the width

of half a

finger,

and

belongs to the Kalantara group.
t
It is

a

Mansa-Marma
a

to the

widlh of half a finger and belongs

to the

Kaianlara group.
*
It
is

Snayu-Marma
Snayu-Marma,

lo

the

length

of four

fingers'

widlh, and

belongs to the Vaikalyakara group.
§
It
is

a

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.

^

Indravasii measures (wo fingers in length according to

Bhoja and

Chap. VI.]

SARIRA ST HAN AM.
to

l8l

An
in

injury

or

piercing

of

the

Jainu-Marma*
results

situated at the union of the thigh

and the knee,

lameness of the patient.

39.

A
sides

piercing of the Aui-Marma,1* situated on both the

above three

brings
leg.

fingers' width from the Janu (knee-joint), on swelling and paralysis (numbness"! of the

40.

A

perforation

of the

Urvi-Marma,^ situated
results
in

in the

middle of the Uru
of the leg, owing
injury to the
a
little

(thigh),

the

atrophy

to

the incidental heemorrhage.
'

An
the

Lohitaksha-Marma,
below the
(groin-joint),

situated respectively

above and

Urvi-Marma and

Vankshana

and placed near the thigh, is attended with excessive haemorrhage and causes paralysis [p{ the leg).

41-42.

An
the

injury to the

Vitapa-Marma,^

situated between
region), brings

Scrotum and the Vankshana (inguinal

on loss of
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
in the

preceding ones.

The Marmas
Kurpara and
in

hands arc almost

identical with those of the legs, with the exception that

Manivandha,

Kakshadhara
according
to

Marmas
It
is

Gayddasa, though half a finger

width

oihers.

a

Minsa-Marma and belongs
*
It is

to the

Kalantata group.
fingers
in

a joinl-Marma,

thiee

length

and belongs to the

Vaikalyakara group.
t
It is

a

li^am-nt-Marma,
is

half

a

finger

in

length,

(three

fingers

according to Gayadasa) and

of the Vaikalyakara class.
in length

X

It

is

a

S'ira-Marma, half a finger

and of the Vaikalya-

kara group.
y

It is

a S'ira-Marma,

halfa finger

in

length

and of the Vaikalya-

kara group.
IT

It

is

a

Snayu-Marma

to

the

length

of

one finger and of the

Vaikalyakara group.

l82
occur
in

THE SUSHRUTA SAMHITA.
the place
of
the

[Chap. VI.

Gulpha,
the

Jdnu

and

Vitapa-Marma is situated between the scrotum and the 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)
results

Vitapa Marmas respectively.

As

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

hemiplegia.

Thus the

forty-four
ties

Marmas

of the upper

and

the

lower extremi-

have been described.

43-46.

IVIarmas on the
shall

Thorax

etc. :— Now we
in

describe

the

Marmas, situated
the

the region of

the the

thorax

and

abdomen
which
is

(trunk).

A
to

hurt to
large
flatus,

Guda-Marma*,
and serves
to

attached

the

intestine

as the passage of

stool

and
the

ends fatally (within

twenty-four

hours of

hurt).

Vasti-Marma,t situated inside the cavity of the pelvic region and the bladder and composed of small muscles and blood (and which
injury

An

the

serves
in

as

the

receptacle

of
the

urine),

proves fatal withof

the

day,

except in
the

cases
to

extracting

the

gravel,

only when

injury
of

the

organ
its

is

short

of complete

perforation

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 medical treatment.
*
It is

An

the

a

Mansa-Marma

to the

length of four fingers'

width and be-

long? to the Sadyo-maraka class.

t

It is

a

ligament combination (Snayu marma) to the length of four
class,

fingers,

belonging to the Sadyah-Pranhara

Chap. VI.]

SARIRA STHANAM.
root of
all

183

Na^bhi-Marma * the

the

Siras

and situated

between the Amas'aya (stomach) and the Pakv^saya
(intestines) ends in death within the day.

47-50.
is

A
in

hurt to the

Hridaya-Marma,t which

situated

the

thorax between the two breasts and above the

pit of the

Amas'aya and forms the seat of
Rajas
injury

the

qualities

of Sattva,

and Tamas,
to the

proves fatal within

the

day.

An

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
two

injury

to

any of the Stanathe
nipples
of
fills

Rohita-Marmas,§
breasts about

situated

above

fingers in width,

the cavity

of the
of

Koshtha (thorax) with blood, producing symptoms
fatally.

cough and asthma, and ends

An

injury

to

the

(balls

Apalapa-Marmas,' situated below the Ansa-kuta of the shoulders) and above the sides (meeting
different

of the
axilla',

branches of the sub-clavicle veins

i.e.

transforms the blood
fatal thereby.

of the organism into pus

and proves

51-54.
vessels,

An
as the

injury to

any of the Vayu-carrying
bronchi
lying

known

Apastambha-Marma^
of

(meeting of the bifurcated

branches
"

the

on

both the sides
belonging to the

It is

a S'ira-Marma to the length of four
class.

fingers,

Sadyah-Pranahara
t
It is

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

Sadyah-

Pranahara
X
class.
It is

a S'ira.Marma, two

fingeri

in

length

and of the Kalantara
and uf
class).

§ It

is

a

Mansa-Marma about
S'ira-Marma,

half a

finger

in

length

the

Kalantara
II

class,

(according to Vgabhata,
half a finger

of the

Sadyo-Maraka

It is

a

in length,

and of the Kalantara

class.
IT

It is

a

S'ira-Marma,

half

a

finger

in

length

and belongs

to the

Kalantara

class.


I84
of the
breast),

THE SUSHRUTA SAMHITA.
fills

[Chap. VI.

Koshtha with the deranged V&yu (tympanites) accomapanied by cough and dysthe

pepsia,

and terminates
situated
55-56.
in

in

death.

Thus the

twelve
are

Marmas
described.

the

thorax and

abdomen

PriShthalVIarmaS :— 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 (sacrum)

on

both

sides of the spinal column,

gives

rise

to

an

excessive
in death.
\

haemorrhage and consequent pallor and ends

A

hurt to

any of the Kukundara Marmas
sacro-sciatic notch), situated

(lit

:

a

hollow
sides

—the great
the

on both
complete

of the

spinal

column and
the
loins),

in

the region slightly
in

below

waist

(in

results

anaesthesia and inoperativeness of the lower extremities.

A

hurt

to

the

Nitamva-Marmas,^ attached
attached

to

the side above the Sroni (pelvis) and

inside to

the muscles of the waists, gives rise to
in the

Sosha (atrophia)

lower extremities, weakness and ultimately brings

on death.
(caelic

An

injury to the

PatrsVa-SandM-Marmas
at

§

axes) which are situated just
of the
sides

the middle below

the extremities

(Parsva)

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

A

hurt to the

Vrihati-Marmas
and of
the

|l

It is

an Aslhi-Marma, half a

finger in length

Kalantara-

maraka
t

class.

They
a

are Joint-marmas (Sandhi), half a finger in length

and

of

the

Vaikalyakara group.

t

It is
is

bone Marma, half a

finger in length,

and of the Kalantara
a
finger

class.

§ It

a S'ira-Marma to the length of

half

and belongs

to

the Kalantara class.
II

They

are

S'ira-Marmas
to the

(arterial

anestomsis)

to the lengt

of half

a finger

and belong

Kalantara

class.

Chap. VI.]

SARIRA StHANAM.
from
the
of
roots

185
of

which
course

commencing
round

the breast

both the

sides

the

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

spinal column and the patient

as

supervening symptoms arise from an excessive

loss of blood.

An

injury to

any of the two Amsa-phalaka-

Marmas*

situated on either side of the vertebral

column

and connected with the scapula brings on anesthesia

There are two Marmas known as Amsa-Marmasf which are situated on cither side midway between the neck and the head of the arms
or atrophy (So?ha) of the arms.

and connect the Amsa-Pitha (glenoid cavity) and the

Skandha
is

(shoulder).

An

injury to any of these
of

Marmas
been

attended with an

incapacity
in

moving the hands. back
iiave

Thus the fourteen Marmas
described. 57-65.

the

The Jatrugata-IYIarmas -Now
:

wc

shall

describe

the

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

arc

known
(i.e

as Nila,

the other two as Manyai.

One

Nila and one
,

Manya

situated on either side of the larynx,

anterior

posterior side of the larynx\

An

injury to

and any of them
injury
to

produces dumbness, and

change of voice (hoarseness),
^

and also the

loss of the faculty of taste.
(arteries), four

An

any of the eight Siras
of

being on each side
as

the

neck
)

(Griva),

and

known
in

Sira'-Ma'trika-

Marmas §
* t
It is

ends fatally within the day.
Snayu Marmas,

66-69.
is

an Asthi-Marma, half a finger
are
half

length and
finger
in

Vaikalyakara.

They They They

a

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-

Maran

class.

24


1

86

THE SUSHRUTA SAMHITA.
injury to

[Chap. VI,

An

junction of the head and

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

Krikattik^* (transverse process of the arch of the
results in a free

movement
attached

of the head.

A

hurt to of an
as

any
ear
the

of the

Marmas

to

the

lower end

(posterior

extrensic

ligament)

and

known

Vidhurai*
injury to

Marma results in the loss of hearing. An the Phana-Marmas^ attached to the interior
nostrils, results in the loss of the

channels of both the
faculty of smell.

An

injury to

the

Apanga-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
vision.

the eye-brows, brings on blindness

and impaired

An

injury to the Sankha- Marmas"^

(meeting or suture
Pterion),

of the temporal, frontal and sphenoid bones
situated over the tips of the eye-brows ears

and between the

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
a
finger
in

They
It is

are

Sandhi-Marmas,

length,

and of the

Vaikalyakara group.
t
a

S'nayu-Marma, and

is

of the Vaikalyakara class.

X They are S'ird-Marmas Vaikalyakara class,
§

to the length of

half a

finger

and

of

the

They They
They

are S'ita
class.

Marmas

to the length of half a

finger

and

of

the

Vaikalyakara
il

are

Sandhi-Marmas,

to the length of half a finger

and

of

the

Vaikalyakara
IT

class.

are

Asthi-Marmas

to the

length of half a finger.
finger
in

$

They

are

S'nayu-Marmas, half a

length

and of the

Vib'alyaghna class.

Chap. V/.J

SARIRA STHANAM.
thing

lil^

extraneous pointed

lodged

into

these

Marmas,
or

results in the death of the patient,
lives as
if

who, on the contrary,

long as the shaft

is

allowed to remain inside

the shaft

comes out
veins),

itself (after putrefaction).

70-75,

An
the

injury to the

Sthapani-Marma*
situated
in

(nasal arch

of

frontal

the

middle of the eyeone.

brows, ends in the
injury
Co

manner

of

the preceding

An

any

of the five joints of the head which are

Simanta-Marmasf, results in fear, insensiand madness of the patient and terminates in An injury to any of the four Sringatakadeath.
as the
bility

known

Marmas]: which forms the junction of the four Siris
(nerves), (branches

of the facial artery) ears

and soothes the
fatal
§

nose, the eyes, the

and the tongue, proves
the

within the day.
(the vertical
in

An

injury to

Adhipati- Marmas
is

groove on the frontal bone) which

marked

the inner side of the roof of the cranium by the Sira(superior

Sannipata
exterior

longitudinal
ringlet

sinus),

and on the

side

by the

of the hair (Romavarta)

proves fatal within the
the

day.

Thus we have described
in the region

thirty-seven

Marmas, situated

above
should

the clavicles (Urddhva-Jatru).

76-80.
incision

IVIcmorabIc Verses :— An
be

made

at

the

spot

a finger's width remote from the

Urvi,

Kurchcha-Sird,
;

Vitapa,
clear

Kaksha and a

Pars'va-

Marma
*

whereas, a

space of two fingers should
of
half
a

They

are S'ira-Marmas to the length
class.

finger

and of the

Visalyaghna

+ They are Sandhi-Marmas to the length of

four

fingers

and of the

Kalantara-Pranahara
X They are

class.

S'ira-Marmas to the length of four fingers and of the
class.

Sadyah-Pranahara
§
It is

a Sandhi-Marma, half a finger
class.

in

length

and of the Sadyah-

Pranahara

l88

THE SUSIIRUTA SAMIIITA.
its

[Chap. VI.

be avoided from

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

in the science of surgery,

have laid
should

down
be
first

rule that, in a case of surgical operation, the

situation

and dimension of each
and the

local

Marma

taken into account

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

become

contracted in the case of a cut in the leg or in the hand
of a man, and hence the incidental bleeding
tively scantier.
is comparaany of these

Therefore

it is

that a cut in

parts of the body,

however
the

painful, does not

necessarily

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
are of opinion that a surgical

Some

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 Manivandbas.

Chap. VI.]

SARIRA STHANAM.

1

89

haemorrhage (from the affected part) and attended with an excruciating pain, owing to the derangement of the

Vayu, and meets
of injury
to

his

doom
Hence,

like
in

a tree whose roots
case
of piercing or
leg

have been severed.

a

any of these Marmas, the hand or the
82.

should be immediately amputated at the wrist or at
the ankle (respectively).

The medical
to

authorities have described the
in

Marmas

have covered half
dies

the

scope of
hurt

Salya Tantra
in

(Surgery), inasmuch as

a

person

any of the
result
if

Marmas
hurt).

presently

(i. e.,

within seven days of the
is

A

deformity of the organ

sure to

from

an injury to one of these Marmas,
averted by
treatment.

even

death be

a course of judicious and
83.

skillful

medical

The
in

life

of the patient

is

not to be despaired of even
crushing of a bone of the

the case

of fracture

or

Koshtha, Sirah and Kapala 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,

Pad a

and

Kara

any other part of the body and even where a whole leg or hand is found to be severed and carried
or in

away

if

the
84.

Marmas

are

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-Pranahara. 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

190
(intellect)
,

THE SUSHRUTA SAMHITA.
and various kinds of pain.
K4ldntara group
(of

[Chap VI.

An

injury
is

to

a

Marma

of the

a person)

sure to

be attended with the loss of Dhatus (blood
various kindsof supervening

etc.)

and

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

medical treatment

;

but

a deformity
injury to
for

affected

organ

is

inevitable.

An
in

any
ths

of

the

Vis'alyaghna

Marmas ends

death
to

reasons

mentioned above.

An
to

injury

any of the

Rujdkara Marmas gives
in the affected organ,

rise

various kinds of pain

which may ultimately bring about
if

a deformity of the same,

placed under the treatment

of an ignorant and unskillful

An

injury to

Vaidya (Surgeon). 86. the adjacent part of a Marma, whether
cut,

incidental to

a

incision,

blow (Abhighata), burn,

puncture, or to
series of

injury

any other cause exhibits the same symptom? as an actually affected one. An to a Marma, whether it be severe or slight, is
87.
in

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

difiiculty.

88-89.

Gayaddsa 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
* (

YII.
treats

shall discourse

on the Sariram which

of the description

and

classification

of Sira or vascular

^ira-Varnana-Vibhaktinama
seven

Sariram).
There
are

hundred Siras
attenuated

(vessels)

in

the

human organism
for

(except those which cannot be counted
size).

their

extremely
their

The

vessels

(Siras)

by

contractibility

and expansibility &c
in

sustain
as

and nourish the organism
and canals serve
and
fruitful.

the

same manner
field

streamlets

to

keep a

or a

garden
tral

moist

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 from
the
all

the Siras (vessels)
beings,
ori-

that arc found in the organisms of created

umbilical region (Nabhi)+ and thence
bodies.
in

they spread

over their
is

The

life

of an

orits

ganic animal

seated

the vessels surrounding
point.

navel which forms their starting
its

The
it)

navel

in

turn

rests

on

or

is

attached to the Franas
attached to
in

(the life-

carrying vessels
*
lie

— nerves
Some

the

same

The

Sanskrita term S'ira denotes veins, nerves, arteries and lymphaas

vessels

well.

read S'ird- Varna (different

colours

of the

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

t Most probably the idea
in their fcetal state.

is

derive

\

from the appearance of the S'iras

192

THE SUSHRUTA SAMHITA.
as the

[Cbap. VII.

manner

nave of a wheel supports the spokes, and
3-4.

the spokes in their turn support the nave.

Principal ^iras:— Of

these

Siras

(vessels),

forty are principal ones, of which ten arc Vayu-carrying

Siras (nerves), ten are Pitta-carrying Siras

(veins),

ten

convey Kapha (lymphatic vessels?) and ten arc bloodOf these the Vayu-carrying carrying Sirds (arteries).
Sirds, situated in the specific

receptacle

of that

bodily
in

principle (Vata), are again found to branch out

one

hundred and seventy
carrying

five

smaller branches (ramifications).

Similarly, each of the remaining Pitta-carrying,

Kapha-

and blood-carrying vessels
spleen and
in

(Siras) situated in

their specific receptacles, {ie, in the receptacles of Pitta,

Kapha and
branch out

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
twenty-five Vayu-carrying Siras

:- There

(nerves) in one leg
other.

and
of

the

same count applies

to the

Similarly there

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

the hands.
in the

There are thirty-four Vayu-carrying
.trunk)
;

v?issel5

Koshtha

of these eight occur in the pelvic
the

regions attached with the anus and

penis

;

two

in

each of the
(cavity of the
chest.
sels)

sides,

six

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 hundred and seventy-five Siras that carry Vayu. 6. one
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
with the
cases,
Pitta,
in

193 the resthat
)

Pitta-carrying

pective regions of the bDcly),
in

exception

these

three

(

Kapha and blood
ears
in
lieu

ten

occur in the eyes and two in the

of eight

and four respectively, as
Siras (vessels).

in the case of

V^yu-carrying
hu.i-

Thus we have described the seven
7.

dred Siras with their branches,

Memorable
Siras
:

Verses— The
in
its

Vayu-carrying

—The Vayu
its

normal

state

and coursing
unobstructed

through

specific Siras (vessels) helps the

performance

of

its

specific

functions viz., expansion,

contraction, speech,
non-illusivenesi

of

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

organs, whereas a coursing of the

said

Vayu

in

a de-

ranged condition through the aforesaid Siras
gives
rise to

(vessels),

a

host

of such diseases as are due to the
8.

derangement of V^yu.

The Pitta carrying ^iras :— The
its

Pitta in

normal state and coursing through
produces
the

its

specific Siras

(vessels)

healthy glow
the

of

complexion,
healthfulnnss

relish for food,

kindling of

appetite,

and other good

which however being aggravated and coursing through them
gives rise to a host of Pittaja diseases.
9.

effects, characteristic of the Pitta,

The
Kapha

Kapha-conveying ^iras:-The
normal state and coursing through
itsspecific

in its

Sirds (vessels)

smoothes and contributes

to the firmnes5

of the limbi and joints, improves the strength and

proit,

duces

all

other go 3d

effects

specially belonging to
in

whereas the same Kapha, flowing through them
aggravated condition, ushers
in a large
10.

an
the

number
:

of

Kaphaja distempers of the body.

The Rakta-carrying
in its

^i ras
its

—The
25

blood

normal state and flowing through

specific Siras

194

THE SUSIIRUTA
-i

SAMIIITA.

[Chap. VII.

(vessels) strengthen

the

other

fundamental
the

principles

(Dhdtus) of the body,
the organ
of touch
in

improves
the

complexion, aids performance of
its

proper

functions and produces other functions characteristic
it

of

in

the

body.
it

Flowing through them

in

a vitiated

condition,

begets diseases which are
1

due to the de-

rangement of the blood.
There
is

1.

not

a

single

which

carries

cither

the

Sira (vessel) in the body Vdyu, or the Pitta or the of the
vessels

Kapha

alone.

Hence each

should be

regarded as affording an opportunity for conveying all kinds of the Doshas of the body, for as soon as they are

deranged and aggravated they seem to flow through
the
S'iras

all

promiscuously.
12.

Hence they

are called Sai'va-

vahah.
vessels

Specific colours of the ^iras:-The
vermilion (yellowish

which carry the bodily Vayu (nerves) have a red) hue and seem to be stuffed

with

Vdyu.

The
are

Pitta-carrying

vessels

(veins)

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
shall

and

neither too hot, nor too cold.

Now we
surgeon
result
in

describe

the

Siras (veins)

which a
it

should not pierce or open, inasmuch as
death,
or bodily deformity.
in

may

An

intelligent

surgeon shall

always bear

mind

that sixteen out of

the four hundred vessels in

the

extremeties,

thirty-two

out of the

hundred and thirty-six vessels
should
not

in the

trunk

and
the

fifty

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

Jdladhara (which

attached

to the connective tissue

Chap. VII.]

SARIRA STHANAM.
as

195
three
internal

of the Kurchcha-Sirah)
ones, of

well

as

the

which two are known
the

as the Urvi-veins

and the

other as the Lohitdksha, together with
ing

the

correspond-

ones in

other

making sixteen

in all,

leg and in the two hands, thus which are situated in the upper
unfit for

and lower extremeties, should be held

opening.
eight

Of

the thirty-two veins

in

the pelvic region

(^Sroni),

such,

known

as the four)Vitapas (two on

each side of the

testicles)

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

on each side) should be considered unfit for bleeding or
opening.
sides, the

Of
is

the sixteen veins (eight on each side) at the

one which courses upward from each of the two
attached to the

sides

and

Marma known

as the Pa'rsVa-

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
side)

any

of the two

Siras

(on

each

be made known as

the Vrihati and
of
in
it

which run upward along either side
Similarly of the twenty-four Siras

(spinal column).

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
Siras

each of the xApastambhas and Apalapas, making fourteen
in all,

should not be opened.
of

Thus thirty-two
e.,

in

the

regions

the b.ick

[i

the sides and the pelvic

regions), the

abdomen and

the chest should be

regarded

as unfit for

opening or other surgical purposes.

16—21.
in

There are one hundred and sixty-four Siras
region above the clavicles.

the

Of

these the eight and four

(making twelve and
Matrikas,
the

rcspcctivch^

known
the

as

the

eight

two Nilas and the two Manyas)
throat,

out

of the fifty-six in the neck and

should

be

196

THE SUSMRUTA SAMHITA.
opening.

[Chap. Vlt.

regarded as unfit for
in

Similarly the two veins
in

the

two Krikdtikds and two
all in

the two Vidhuras,
;

should be held unfit for similar purposes
sixteen in
the neck.

thus

making
about

Of

the sixteen vessels (eight

on each
opened.

side' of the

Hanus

(Jaws), the

two Siras

each of the joint of
22.

the jaw-bones

should never be

Of
in the

the thiity-six* vessels in the tongue, sixteen are

situated in the under-surface of that organ

and twenty
for

upper surface

;

of these the

two speech-carrying
unfit

and the two taste-carrying ones should be held
venesection.

Of

the

twenty-four

vessels

in

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,
not be
the sound-

one situated

each

Apanga

should
ears,

opened.

the ten vessels in the two
in

carrying one
the
sixty

either

ear

should not be opened.

Of

vessels

of

the

nose

and eyes
the

coursing
vessels

through the region of
adjacent
to the

the

forehead^

four

sculp proper and the
unfit

Avarta-Marma

should

be held

for

opening or bleeding.

One

vessel (Sira) in each of the

the

two Avartas and the one in Sthapani-marma should not be opened (on any

account\

Of

the

ten

vessels

in

the

temple, the one
unfit for

about each temple-joint should be held
or
bleeding.

opening

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'ira's

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
situate
text.

In the counting of the

in

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

from the

Chap. Vli.]

SARIRA STHANAM.
in

ig^

in

each of the two Utkshepa-Marmas, one

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.

IVIemorable verses :— As
etc.,

the stem and leaves
its

of a lotus plant,

originated

from

bulb,
(lit
:

spread
water),

over the whole surface of a pool
so the vessels

or tank

emanating from the umbilicus of a man
32.
the
S'arira

spread over his whole organism.
Thus ends
the

seventh

Chapter
of

of

Slhanam
and

in

the

Sus ruta Samhiia which
S'irds (vessels).

treats

the

description

classificrition 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
or

up with excessive drinking or sexual
tired

enjoyments
with

with the troubles of long journey,

an intoxicated person, a patient who has been treated purgatives, emetics or with Anubasana and

Asthapana 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
even
if

be properly ligatured or
raised up.
2.

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
is

suppurated or unsuppurated,

if

such a proceeding

deemed necessary and after the application of Sneha and
Sveda.

Venesection should be made even
it

in

the

cases

declared unfit for

(such as in an infant

etc.) in

cases of

Chap, VIII.]

^

SARIRA STHANAM.
etc.)

1

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) and anointed (Sneha) with oily

A

liquid* food or diet consisting of articles

which are antidotal to the bodily principles iDoshas)
which engendered the disease or Yavagu
be given to him at
first.

(gruelj

should
(i.e.,

Then

at the proper season
etc.)

not in the rainy or winter season be brought near the surgeon and

the patient should
to sit or
lie

made

down

and the part to be incised upon should be bound, neither
too
{e.g.^

loosely
in the

{eg

,

in the extremities etc.)

nor too tightly

head
to

etc.),

with any of the accessories, such as
etc.,

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

so as

not

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\
in

5

Metrical text :— Venesection
performed
day.
It is

should not

be

an extremely cold or hot, cloudy or windy
vein

forbidden to open a

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
vein
is

:— The

whose

to be operated

to the height of an Aratni (distance of

upon should be seated on a stool the elbow from with
his

the

tip of the small finger)

his face turned
in

towards

the sun.

He

should keep his
resting

legs

a

drawn up or
his

contracted

posture

elbows (Kurpara) on
his

knee-joints and the hands with
in

two thumbs closed
ofy his

his

fists

placed

on

(the

upper ends

Manyds

(sterno mastoid muscles),
*

Then having
for

cast the binding
o(

A

liquid food

is

recommended

blood so as to bleed easily.

....

the

purpose

liquefying

the

200

THE SUSHRUTA SAMHITA.
fists

[Chap. VIII.

linen on the two closed

thus placed on the neck, the

surgeon should ask another
the patient
to

man from
of the

the

back

side

of

take

hold

two ends of the cloth
upward, and

with his
then

left

hand having the palm turned
to tie

ask

him

up with
to
raise

his right

hand the bandage
nor

round the
too

part, neither too diffusely

nor too tightly

loosely,

so as

the
for

vein

and

to press the

bandage
blood.
in

round

the

back

a

good out-flow of
previously

Then he
sit

(surgeon) should perform the operation

the desired spot, the patient having been

asked to
confine
pleted).

with

his

mouth
till

full

of

air

(i.e.,

he should
is

his

breathing

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.
In
7.

the

case of opening a vein (Sira) in the leg, the
level

affected leg should be placed on a

ground, while

the other leg should be held in a
posture, at a little higher place.

somewhat contracted
aff"ected leg

The

should

be bound with a piece of linen below its knee-joint and pressed with the hands down to the ankle. A ligature of the above kind should then be tied
four
fingers

above the region to be incised upon,
vein sh©uld be opened.
8.

after

which the
the

In the case of opening the
patient

a

vein

(Sira)
sit

in

arms,

should

be caused to
closed
in

easily
fists

and fixedly
',as

with his two thumbs

his

above).
etc.,)

A

ligature

ol

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.
in

The

knee-joint

and the elbow should be held
of

a

contracted or drawn up posture at the time

opening
Vis'vachi,

a vein

in

a case of Gridhrasi (Sciatica^

and

respectively.

The

patient

should hold

his

back raised

Chap. VIII.]

SARIRA STIIANAM,

201

up and expanded and his head (and shoulders) bent down at the time of opening a vein in the back, shoulders 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

own body with his arms in his sides. The penis
in

should

downward
to the roof

{i.e.,

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 tims 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
according

the nature of the banda^^'e to be used therein
to the exigencies
{i.e.,

the health and the kind of diseases
i

of the patient\ of each case,

Z-'^J.

An

incision to the depth of a barley-corn should be

made with

a

Vrihimukha

instrument

(Into

a

vein

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

instrument should
the depth of a
signifies

be thrust oily half that depth or to
in

VrUii seed

other places (Vrihi here

S'ukadhdtiya as well
a

as Rakta-s'ili\

An
a

inci-

sion

over

bone should be made with the Kutharika
axe)
to

(small
corn.

surgical
18-19.

the

half

depth of

barle}--

IVIcmorabIc Verses :— An
be effected
be devoid
the cold
in

opening
season
as

should

such a day

in the

rain}'

would

of the rumblings of a thunder-cloud, during
in the fourth)
in

{i.e.,

part of the

day

in

summer,
These

and

at

noon

the winter season (Hemanta).

are the only three

times

of

opening a vein.
26

A

well

203

THE SUSHRUTA

SAMIIITA.
in

[Chap. VI tr.

and successfully pierced vein bleeds
simultaneously with
the
thrusting

streams (almost
the
knife)

of

and

spontaneously stops after a
vitiated

Muhurta
to

(a little while).

The

blood

is

seen

first

flow out of an opened
first

vein, like the

drop of yellow pigment

coming out of
in-

a Kusunihha flower.
cision

Blood does not flow out from an

made

into a vein of

an unconscious (Murchchhita),

much

frightened, or a thirsty patient.

An

incision of a
is

vein without proper bandaging and raising up

attend-

ed with a similar result.

20-23.
affected

A

weak person,

or one

with the unusual
or one fainted

derangement of the bodily
of continuous

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

(Sams'amana) for the purification of the diseased remnant.

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
of
in

Vrihimukha
as

instru-

a

distance

two

fingers

above the seat

Kshipra-marma

such diseases

Padadaha,

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

Vata-kantaka, Vicharchika, Padadari
of opening a vein in the
*

etc.

The mode

case of Slipada (Elephantiasis)
a

In

medicinal

preparations,

four seers in the casj of liquids, but in cases
piLjgalive

thirteen Palas

measures and and a half only.

measure is understood to be of excreta due to emetic and of blood-letting, a Prastha U meant to be

Prastha

[Chap. VIII.

SARIRA STIIANAM.

203
disease.

would b2 described under the treatment of that
In

Vata-rogas,

such as

Kroshtuka-s'irah (Synovites),
S'iia

maimedness (Pangu)
(vein) of the

and lameness (Khanja\ the
leg-calf),

Jangha (lower
be

four

fingers

above

the

Gulpha, should

opened.

In

cases

of Apachi

(scrofula"),

the vein should be opened simultaneously with
disease

the appearance of the

two
of

fingers

below the
or
the

Indravasti-marma.

In

a

case

Gridhrasi (sciatica^

the vein should be opened four fingers the Jdnu (knee-joint).

above

below
veins

In a
of the

case

of goitre, (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 other, as well as
in

the

case

cases

of those situated in
is

the
that

two upper extremities (hands), but the speciality
in a case of

enlarged spleen, the vein near the Kurparaleft

sandhi (elbow-joint) of the
fourth
in

hand or that inside the
Similarly

and the
vein

fifth

fingers should be opened.

a case of Yakriddalyodara or Kaphodara, the corresin

ponding
cases

the

right

hand

should

be

opened.
vein

Several authorities advise the opening of the same
in

of cough

and asthma* due
27-35.

to the action of the

deranged Kapha.

In a case of Vis'vachi, the
(four

fingers

same argument holds good above or below the Kurpara-sandhi) as in
In a case of Pravahika (diarrhoea)
(colic),

a case of Gridhrasi.

attended with Sula

the vein
(Sroni)

within two fingers

width around of the

Pelvis

should be opened.
in

The

vein of the

penis should be

opened

a

case

of

Parikartika (D.R.-Parivartika),

Upadans'a,
vein

S'uka-dosha
side of

and seminal disorders.

The

on

either

Gayi holds Ihat

in cases

of asthma and cough venesection

should

be hal recourse to only

when they

are in a mild form.

2Cl\

TllK SUSIIRUTA SAMIIITA.
b::^

Chap. VIII.]

the scrotum should

opened

in

a

case

of

hydrocele

(Mutra-Vriddhi).

36-39.

Th2
left

vein four finders below

the

navel

and on the
opened
of
in

side of the Sevani (suture) of

should
In

be
case

a

case

Dakodara
)lic

(ascites).

a

internal
in

abscess and c
the

in the sides (Pleurodynia), the vein
left

region

between th3 breast and the

armpit
in

should be opened.
case of

Several authorities assert that

a

Avavahuka and Vahus'osha (atrophy
between
the

of the hand),

the

vein

Amsas

(shoulders) should

be

opened.

In a ca?c of Tritiyaka (Tertian) fever, the vein

inside the Trika-Sandhi should be

opened.

In

a

case

of Chatiirthaka fever, a vein joined

with either side of

and below the shoulder-joint should be opened. In a case of Apasmara, the middle vein adjacent to the joint In of the jaw-bones (Hanu-Sandhi) should be opened.
a case of insanity and hysteria* (Apasmara), the vein between the temple and the edge of the sculp or those
in the

Ap'inga (tips of the eyes), the forehead or the
In cases of the diseases of the

chest should be opened.

tongue and the teeth, the veins on the under-surface In (Adho-Jihva) of the tongue should be opened.
the case of a disease of the palate, the local
vein should
in

be opened.

In diseases of the ears and specially

a case of 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 loss of the smelling faculty, the vein at the tip of the nose

should be opened.

In

cases

of eye-diseases,

such as
on the

D.xllana, however, differs here

frooi

the

text.

He

says,

authority of Vagbhata, that the opening of a vein
iho edgi- of the sculp or those in the
in

between the temple and
and not

Apdnga, ihe forehead and the chest
in the case

should be recommended

cases of insanity only,

of

of .Apatmara as well (as in the text).

Chap. VIII.]

SARIRA STIIANAM.
etc.,

205
as well

Timira (blindness), Akshipdka (ophthalmia)
as in diseases of the

head and

in

Adhimantha, the veins
and
the

about the nose,

the

forehead

Apdnga
40-51.

(the

outer canthus of the eyes), should be opened.

Defective Venesection :— Now we
describe the

shall

twenty kinds of defects

relating

to
:

an

opened vein (Dushta-vyadhanas
Durviddha, Atividdha,
Aprasruta,

They

are as follows

Kunchita, Pichchita,
Ante-abhihata,

Kuttita,

Atyudirna,

Paris'ushka,

Kunita, Vepita,
viddha,

Anutthita-viddha, SdStrahata,

Tiryag-

Apaviddha,

Avyddhyd,

Vidruta,
i.e.,

Dhcnuka,
about

Punhpunarviddha and Marmaviddha,
the Sira-marma, the

incised

Snayu-marma, the Asthi-marma and the Sandhi-marma. 52-53. Their definitions :— The vein in which an
act

of

venesection

is

unattended with a satisfactory
its

outflow of blood owing to

being

incised
is

with an

extremely slender

instrument
in

and

marked by an
is

extremely painful swelling
called

consequence thereof,

Durviddhat (badly incised).
an
internal
is

The

vein in

which
the

the incision becomes excessive

and no blood comes out
channel

properly or enters

owing

to

largeness of the incision,
cised).

An
in a

opened vein

in

Atividdha which the incision has been
called
is

(over-in-

made
going

curving manner and
is

attended with the foreor contracted).

results,

called

Kunchita (crooked
its
is

An

incised vein presenting a flattened or

thrashed

ap-

pearance on account of
knife

being
called

opened

with a blunt

(^Kantha-Sastra)
vein at
the
sides

Pichchita (thrashed).
incisions
its

The

of which of
in

have been
is

successively

made,

instead

body,

called

Kuttita

(lacerated).

An
is

incised vein, unattended with
patient's fright,

any bleeding owing to the
loss of consciousness,

coldness or

called Aprasrulai (unbleeding).

2o6

THE SUSIIRUTA
larg'c

SAMIIITA.
its
is

[Chap. VIII.

A

vein with a

incision in

body made with
called

a sharp and flat-edged instrument,

Atyudirna
Antevein

(improperly
blood
oozes

wide-incised).

An opened
quantity
is

vein in which
called

out

in
in

small
the

abhihata
in

(struck

interior).

An opened
total
(lit.,

an

anaemic patient (marked

by a

absence
as
if

of

bleeding
has

and) stuffed with Vayu
dried

the

flow

been

up

Paris'ashka (dried up).
part
of the

A

by the Vayu), is called vein opened but to a quarter
(partially incised).

proper length and attended with a scanty
is

outflow of blood,

called

Kuuita

A

vein which trembles owing to its being bandaged at a wrong place and from which blood does not flow out A vein in consequence, is called Vepita (quivering
i.

incised without being previously properly raised up

and
is

attended with a similar result
called

(i e.,

absence of blood),
cut

Amitthita-viddhai.

A

vein

into

two and

attended with excessive bleeding and
of the organ
incis:d
is

inoperativeness

called

Sastrahata
is

(knife-cut).

A

vein

with

an

instrument applied

slantingly

and

(consequently) not fully opened,
(obliquely
incised).

called Tiryag'-viddliai

A

vein

incised

several

times

and (every time) with an improper instrument, is called A vein unfit for opening Apaviddhjfc (wrongly incised)
{i.t\,

whose opening has been forbidden

in

the

Sastras\

AvyadhySk (unfit for opening). A vein opened and hastily is called Vidrutai (erratic). A vein bleeding continuously owing to its being repeatedly pressed and successively opened, is called Dhenuka'. A vein variously cut owing to its being pierced into
is

called

carelessly

the

same part with an extremely slender-pointed
is

instru-

ment,

called

If a vein in the

Panah-punarvidaha^ Snayu-marmas, the Asthi-marma.'', the
(repeatedly incised).
it is

SirA-marmas or the Sandhi-marmas be opened,

Clap. VIII.]

SARIRA STHANAM.
in

20/

called

Marma-viddha and
54.

such cases severe pain,

emaciation i^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

like fishes.

greatest

unsteady and changing Hence a vein should be opened with the care. An opening into the body, made by an
as they are naturally

ignorant and

unskilful

surgeon,

is

attended with

the

aforesaid dangers and

many

other distressing symptoms.

An

act of \enesection, properly performed, gives
relief
oil

more
of

speedy

than that derived from the

application

medicated

&c

,

or of plaster
is

as

well.

Venesection

(bleeding) properly performed

half of the

treatment
of
55.

described

in

surgery like

the

application

Vasti-

karmas (enematic measures)

in therapeutics.

A man
riscd

medically

anointed

(Sneha-karma), diapho-

(Sveda\ vomited (Vamana), purged (Virechana),
Vasti-karmas (Anuvasana and
physical
time,

or treated with both the

Asthapana) or bled
sexual
intercourse,

shall forego anger,

labour,

sleep

in

the

da}'

excessive

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

on his haunches, frequent ramblings, exposure to

cold,

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-chikits^. ch.

39").

56.

lYIemorable Verses :— The
incarcerated in

vitiated

any

part of the

body should be abstractby cupping it with a by the opening
to the density of the
in

ed therefrom

by scarifying

it,

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

of a

vein respectively, according

blood.

(Others assert thatj leeches should be applied

208
the
case
of

THE SUSHRUTA SAMHITA.
the
(vitiated)

[Chap. VlII.

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 throughin
in

out the
case of
skin.

body and with a horn or a gourd
the

the the

deranged blood having been seated

57-58.

Thus ends
Samhila which

the

eighth Chipter of the 5'arira
venesection.

Sthanam

in the Sub'rula

treats of

CHAPTER
Now we
shall discourse

IX.

on the Sariram which treats

of the description of the arteries, nerves

and ducts,
i.

etc.*

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

inducts) 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),

and the Srotas, (channels), since
are

Dhamanis (arteries), Dhamanis and Srotas
of

modifications

one
is

original

kind

of Sira

But

this opinion

not a sound one
natures,
in the

inasmuch

as

they have got

different

origins

and functions and as being described so

Ayurveda.

But owing to their adjacent positions, the existence
of several authoritative

dicta

(Apta-vak) regarding the

oneness of their character, similarit}' of their functions,

and the minute nature of
be homologous in
diversities in their

their shape, they appear to

their

action,

even
2.

amidst

the

real

work and
in

office.

Of
have

the

twenty-four Dhamanis,
roots

which
region

(originally)

have their

the

naval

(Nabhi), ten
course,

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
as in foetal

be

filled

wilh

air,

so

called

from the

fact

of their being distended with air after death.
t

So

far,

life,

allantoic

arteries

and
,

the

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
touch, taste, sight,
sneezing, laughter, speech, and weeping,

body, as sound,

smell, inspiration, sighing, yawning,
etc.,

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

as the channels of the bodily

two serve Vayu, two of the Pitta,
blood,
of

two of the Kapha, two of

the

and two of the
remaining
ones

Rasa (lymph
carry
taste.

chyle).

Eight

the

(twenty), serve the following functions, vis.,

two of them

sound, two

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 instrumentalit}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
and members of the body) above
as

integrity (of the limbs

the (line of) the back the

umbilicus, such
chest,

the the

Udara, the
shoulders

sides,

the

neck,

and the

arms.

4.

nis

IVIcmorabIC Verse: — The up-coursing Dhamaduly perform the offices stated above. Now I
specific

shall describe the
office,

functions,

etc.,

{i.e.,

nature,
5.

and

situations, etc..) of the

down-coursing ones.

Functions
:

of the

down -coursing
Dhamanis resdownward conveyance
catamenial

Dhamanis — The
of

down-coursing

pectively form the channels for the

Vayu

(flatus),

urine,

stool,

semen, and

Chap. IX.]

SARIRA STHANAM.

211

fluid,

etc.

These Dhamanis reaching down into the
the food
Pitta) separate the serum and drink through the agency

Pittasaya (receptacle of the

prepared out of
of the local heat

and

pitta),

and carry

it

to the remotest

parts

of

the

organism maintaining
(ultimately) conveying

their

healthy

moisture,

supplying them with the necessary principles

of nutrition

and

them

to the up-

coursing and lateral
to the parts traversed

Dhamanis,

in

order to be conveyed

by them

respectively.

Thus they
its

indirectly

serve

to

supply the heart with

quota of

healthy Rasa (serus
the}-

fluid), if

not in a direct wa}'. Moreover

tend to separate the efifetematter (urine, stool
f'-om

and

sweat)

the

fully

transformed

lymph-chyle

in the

abdomen, the stomach and the small
and Pakvas'aya).
is

intestines (Amas'aya

Each

of the down-coursing

Dhamanis

found to ramify into three branches at a place midway

between the Amas'aya (stomach)
(intcstines\

and the
thirty
in

Pakvds'aya
all.

Thus they number
ten

The

functions of the
follows,
vi::.,

out of these (thirty vessels) are as
carr\-

Pitta, two Kapha, two blood, and two Rasa (lymph-chyle). Two of these Dhamanis, running into the intestines, carry the

two serve to

Vdyu, two

food, another

two carry the Toya* (watery)
serve
to

part,

another
out
the

two, running into the bladder,

carry
the

urine (from the bladder), another two

carry

semen

and another two serve as the channels of transmission and emission of the same fluid and serve to carry the
ovarian discharge
in

women. The two Dhamanis, attached
the

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

of

liEcal

matter, while

remaining

eight

convey

perspiration to the lateral-coursing Dhamanis,

Thus we

have finished describing these thirty Dhamanis with their ramifications. These sustain and maintain the
*

This watery part reaching the bladder

is

transformed into urine.

212
integrity of

THE SUSHRUTA SAMHITA.
the
parts
of

[Chap. IX.

the

body below
urine,

the

naval

region, such as the Pakvas'aya (Intestine), the waist, the

organic principles

of

stool

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

I

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
baffle

Dhamanis,

ramifying

themselves

hundreds and
counting.

thousands of

branches,
these

simply

The

net-work of

Dhamanis spreads over
its

the whole
exterior

orgnism and maintain
skin) through

integrity.

Their

orifices are attached to the roots of hairs (pores

of the

which they convey the perspiration and
body,
soothing

the Rasa (serum), thus supplying the

both

inter-

nally

and externally,
of healthy
of the

with

the

nutritions
effects

(moisture
potencies

lymph-chyle).
of

The

and

articles

anointment, .sprinkling,

immersion, and plasters, enter through these orifices
into the internal organism

through the

agency of the
a pleasant
or

heat

in

the

skin,

and sensations of
experienced

painful contact

are

through their instruthe four

mentality.

lateral-coursing

Thus we have Dhamanis

finished describing

with
8.

their

ramifications

throughout the whole organism,

Memorable Verses :— The
got
the pores
in

Dhamanis have

their

sides

through which they carry

Rasa (lymph-chyle) throughout the organism, like The.'^e the filaments and fibres of water-lily and lotus. Dhamanis furnish the self-conscious Ego, confined in

Chap. IX.]

SARIRA STHANAM.
is

21

the material body, which

the resultant

of the

combidistinct

nation of the

five

material
to

elements,

with

a

sensation* peculiar

each of the

five

sensc-organs-jfive

and break

up the combination
9
shall

(of the

material

elements) at the time of death.

— 10.
its

Now we
point.

describe the

symptoms produced by a
root
or
starting

Srota (duct or channel) pierced at

The ducts

or

channels

respectively conveying

the the
the

life,

the food, the water, (the
(serum),

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

Surgeiy (Salya-tantra).
the
Srotas
(vessels)

Several

authorities assert that

are

innumerable^, and

perform

different functions in their different aspects.

The two Srotas
nis

(channels) of

Praaa
injury

(bronchi) have

their roots in the heart

and the Rasa-carrying Dhama-

(pulmonary
body,

arteries).

An

to

any of these

Srotas (vessels)
the
loss

produces groaning, bending
of

down
The

of

consciousness

(Moha), illusion, and
food-

shivering,

or

may

ultimately prove fatal.

carrying"

Srotas

(^Esophagus) have
in the

their roots in the

Amasaya (stomach) and
(intestines).

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

even end

in death.

There are two water-carrying"

(Udaka-vaha) ducts or channels which have their roots
the
palate

and the Kloma, and a piecing of any
taste,

*

Hearing, touch, smell,

and

sight.

t Eyes, ears, nose, tongue and skin.

X But

this

science

does

not
of,

take any cognisance of them, since the
or an injury to,
its

pain incidental to a piercing

any of these

extremely

attenuated channels, must be slight in

character.

214
of these

THE SUSIIRUTA SAMHITA.
makes
tlic
(/.

[Chap. IX,

patient thirsty and ends in his instanf
,

taneous death

within seven days).
arc

The serumnuinljer

carrying (Rasa-vaha) ducts
seru^n-carrying

two
the

in

and
or

have their roots in (the viscus

of)

heart

and the
to

Dhamanis

(vessels).

An

injury

piercing of any of these ducts gives rise to Sosha (consumption) and sym.pt oms identical with those developed by a hurt to the Prana-vaha channels of the body,

The blood-carrying" Srotas (channels) number and have their roots in the spleen and the liver, and the blood-carrying Dhamanis (capillaries An injury to any of these channels is in general).
ending
in death.

arc two in

attended with

pallor,

bluishness

of complexion, fever,

burning sensations, excessive haemorrhage, and
of the eyes.

redness

The two muscle-carrying Srotas
their

(ducts or

channels)

have

roots

in

the

(Snayu),

nerves

Tvak

(serum\

and
injury

the
to

blood-carrying

Dhamanis
is

(capillaries).

An

any of these channels

characterised by swelling, loss or atrophy of the muscles,

appearance of varicose veins or
in death.

may

(ultimately)

resu't
in

The fat-Cirrying Srotas (ducts) number and have their roots in the region
(waist) and the Vrikkas
of these bring in
(a

are two

of the Kati
to

(kidneys).

An

injury

any

copious

flow

of)

perspiration, oily

gloss

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
b}-

An

injur}-

any of these

is

marked

constipation or epistaxis

in the bladder, retention of urine,

and numbness of the

genitals.

their

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

(intestines)

an injuiy to any of these
of stool
(in

is

characterised

by complete retention

the bowels), accom-

Chap. IX.]

SARIRA STHANAM.
foul smell

21

panicd

by a distention of the abdomen,

and

intussusception of the intestiiie (as in a case of enterites).

The
roots

two semen-carrying
in

Srotas (ducts)
testes.

have their
to

the breasts and the
leads
to
loss

An

injury

any
that

of of

them

of

manhood,

dela>'ed

emission
of

semen,

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
to

product).

An

injury of

any

of

these

brings

on
for

sterility,

suppression

the menses and
to the Sevani

incapacity

copulation.

A

cutting

(median raphe of the perineum) exhibits
with those
of a
case of

symptoms

identical

injured

bladder or anus, described before.

A

ph\sician

may

take in hand the medical ticatmcnt 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
duct,

end

A

case
or

of

pierced
like

from which the
matter)

dart

(Salya,

the

piercing

has been

extricated,

may

be medically treated (without holdingto

out

any prospect of recovery
according to the

the

friends

of the

patient),

direction

laid

down under

the head of ulcer ^Vrana).

11-12,

IVIctrical
(arteries),

Text

:

— The ducts emanating from the
Dhamanis
through the whole body,
13.

cavity of the heart, other than the Siras(veins),

and found
(lit.

to course

are called Srotas

channels or current?).
Chapter
of

Thu
Sus'ruta
ciicts

ends

the

ninth

the

S'arira

Slhanam
of

in

the

Samhita which

treats

of

the

descriptions

the

arteries,

ard nerve?.

CHAPTER
Now
of
vvc shall discourse

X.
treats

on the Sariram which
etc.,
till

the

nursing
the

and

management,
conception

of pregnant

women from

day of

parturition
i

(Garbhini -Vyakarana-^ariram). General Rules :— An encicntc, from
day of conception, should
ful spirit in

the

first

always cherish a clear joy-

a

clem body.

She should wear clean

and
in

white garments, or.iamcnts, &c., engage

herself in the

doing of peace-giving and benedictory
devotion to the gods, the Brahmins and
superiors.

rites

and

live

her elders and She should not touch nor come into contact

with unclean, deformed or
forego
sights

maimed

persons, and

should

the

use

of fetid smelling things, avoid dreadful

and painful or agitating sounds and the use of
stale

dry,

and dirty food

as

well

as

that

prepared

overnight.

Long and

distant walks from home, resorts
solitary
retreat,

to cremation-grounds or to a

or

tt)

a

Chaitya*, and sitting under the shadow of a tree should

be absolutely forbidden
gestation).

(to

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 other

load,

talk

in

a

loud voice

and
from.

things which

might occasion injury to the
should be refrained
the

foetus, (sexual intercourse, &c.)

The

practice of constant anointment and

cleansing

of the

body,

&c,, (with

Amalaki, Haridra,
up.

etc. —lit. cos-

metics) should

be given

All

fatiguing

exercises
for
to

should be discontinued and the rules laid
*

down

the
a

Chaitya

is

a haunted or

diefied

tree,

or

according

others

Budhistic monastery.

Chap. X.]

SARIRA STHANAM.
of a
to.

217
strictly

guidance

u'oman

in her

menses should be
the

adhered

The couch and

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, prein

pared with appetising drugs and abounding
substances.
delivery.
2.

fluid
till

These

rules

should

be followed

up

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
fourth,

thmi
sixth

month
in

of gestation, with curd in the
fifth

with milk
the

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 jdui^ala (wild) animals

her
in

the

fourth, food with

milk

and
of

clarified

butter

the

fifth,

adequate quantity
decoction
;

clarified

butter

prepared

with (the
in the sixth

of)

Svadamshtra, or gruel (Yavagu)
butter

and

clarified

prepared
in

with

(the

decoction

of)

the Prithak-

parnyddi group

adequate quantities in the seventh

month

of gestation.

These help the
restoring

foetal

development.
of her

For the purpose of
for

the

Vayu

body

(nervous system) to the normal course and condition and
the

cleansing of the bowels, the enciente should be

given an
tion of

AsthApana (enema), composed of a decocVadara mixed with Vala, Ativala, Satapushpa, Palala (flesh), milk, cream of curd, oil, Saindhava salt,

"Hridya" here means the diet

in

which there

is

an abundance of

Ojo- producing (albuminous) properties.

2a

2l8

THE SUSHRUTA SAMHITA.
fruit,

[Chap. X.

honey and clarified butter. After that she should have an Anuvdsana (enema) made up of the drugs oil prepared with milk and decoction of

Madana

known

as the Madhurddi-gana.

This restores the

Vayu

to its normal course and condition, which brings on an easy and natural parturition unattended with any

puerperal
delivery

disorders.

Henceforth up to the time of

the

enciente should have liquid food (Yavagu)
of the

made up
flesh of

of emollient substances (fatsy and soup
(deer, etc.).
If treated

Jangala animals
enciente

on these

lines

the

remains

healthy

and strong,
with
the
enter

and
evils.

parturition becomes easy

and

unattended
to

An
under

enciente
in

should

be

made

lying-in

chamber

the

ninth month of her pregnancy and of happy stars and propitious auspices
the

lunar conditions.
o-riha)

The chamber

of confinement (Sutika-

in

respect of a Brahmin, Kshatriya, Vais'ya and

Sudra mother should be raised on grounds respectively possessed of white, red, yellov/ and black soils, and

made
in

of Vilva, Vata,

Tinduka

and Bhallataka wood.

Couches should be made of these woods respectively
cases
of

the

different

social orders.

The
the

walls of
furniture

the

room should be well-plastered and
should

(necessary accessories)

be

placed

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— (MT.) — 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-

X

J

SARIRA STHANAM.
pain
at

2I9
indicate

characteristic

the

waist

would

the

approach of the time
severe pain at the

of delivery.

A

constant and
(in-

waist

and the back, constant

voluntary) motions of the bowels

and micturition and mucous discharge from the vulva arc the symptoms which are manifest at the time {i.e.^ a little before) of
parturition.
4-5.

Preliminary Measures :— Rites
diction

of beneof

should be
in

performed

for

the

safety

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

masculine name

should be given

hand.

Her body should be
a gruel

anointed with
she should be

oil

and washed with warm water and
to drink largely

made

(Yavagu)
at

made
time).

of articles (which exert a beneficial

virtue

the
soft

Then she should be

laid

on her back on a
her

and sufficiently spacious

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."
umbilical

an untying of the
enciente should

the

gently

make
in

such

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

22C

THE SUSHKUTA SAMHITA.
the
exit

Chap. X.]

made on
and
the

of

the

foetus

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
real

the

absence

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
or cephalic one

A

case of abnormal presentainto

tion (Pratiloma) should be

converted

the

normal

(Anuloma) by version*.

8-9.

In the case of protracted delivery,
tion of the child at the vagina,

e.g.,

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 HiranyapusJipi (Kantakari)
should be tied (round the neck or the waist) or
chala {Atasi) or Vis'alj'd (Patala) should
the

Suvar-

be tied round
the
parturient

hand

(wrist)
10.

and leg (ankle)

of

woman.
or

Post-parturient IVIcasu res :— 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 of the new-born

applied on the head
umbilical

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
been

The

various forms of (Pratiloma) abnormal presentations have

described

under MuJha-Garbha
is

Nidanam

(Nidan-Sthana— Chap. IX.)

and

their treatment

to

be found in Chikitsa-Slhana

— Chap.

XV.

t

Drahmadcva recommends Vahi-Taila

instead of clarified butler.

Chap. X.]

SARIRA StllANA^t
round
its

221

v( the string" being tied
bilical cord

neck

;

then the um-

should be

severed

immediately above the

ligature,

ii.
:

Natal Rites
of;

— Then

having sprayed (the face
should

the baby with cold water, the post-natal rites
it.

be performed unto

After that the

baby should be
clarified

made

to lick an electuary

composed
juice

of honey,

butter and the expressed

of Brdhini leaves
of)

and

Ananid, mixed with (half a Rati weight
given with the ring-finger of the feeder.
of the
it

gold dust and
the

Then
of the

body
of

child

should

be anointed with Vala-taila and
in

should

be

bathed
the

an

infusion

barks

Kshiri

trees, or in

washings (decoctions) of drugs
in

known
in

as the

Sarvagandha (Eladi group), or
silver

water

which red-hot gold or
in

bar has

been
leaves,

immersed,
according

or

a tepid decoction

of KapittJia

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

milk

in

newly parturient
parturition

woman

sets in three or

four days after
orifices of the

owing

to the dilation of the

milk ducts (galactoferous ducts).
fed
thrice

Hence
clarified
ofj

the

baby should be

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 day and on the second and third days the child
;

should

be fed
^root).

on

clarified

butter

prepared with the

Lakshand
butter

On
its
(/.

the following (fourth) day the child

.should be fed

on

handful
in

of

honey and

clarified

only twice

fc\,

the

morning and

at

noon).

(From the evening
first

of

fourth

day) the mother should

squeeze

off a

quantity of her milk

and then give

222
the child her

THE SUSHRUTA SAMHITA.
breast.

[Chap. X.

(This

rule

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
a

be

anointed (after
treated

parturition)

with the Vala-Taila and
externally) with

iboth internally

decoction of Vayu-subduing drugs
etc.). If still

(such as the Bhach'a-Ddrvddi grow^,

there be
(the

any abnormality
should

in

the

condition
i c,

of the
lochia),

Doshas
the
solution

discharge of vitiated

blood

mother
of

be given to

drink a luke-warm

treacle mixed with powders of Pippali, Pippali roots,

Hasti-pippali,
cine

Chitraka and S'ringavem, and the medibe continued
for

should
(if

two or three
disappearance

days or
of

longer,

necessary),

till

the

the

vitiated blood (lochia).
{i e.,

When

the discharge gets normal

on the appearance of healthy lochia), the mother for three days a gruel should be made to take
drugs

(Yavdgu) prepared with the decoction of the
constituting the Viddri-Gandhddi Gaiia and
(a

good quantity

ofj clarified

butter or a

mixed with Yavagu prepared
animals

in milk.

After that a

meal of boiled Sali-rice and a

broth

made
for

from the

meats
into

of

Jangala

boiled with barley,

Kola and KulattJui pulse, should be
taking
consideration
appetite

prescribed

her,

the

strength and

the

condition

of her

(Agni or
this

digesting

power).

regimen of diet
fafter

The mother should observe and conduct for one month and a
After this period
she

half
at

delivery).

may
and
to

be

liberty to

to

choose

any food
a

to

her

liking

revert

her natural

mode

of living.

According
does not
till

several

authorities,

however,

woman

regain

her

natural

temperament of body
strong but

the reappearance of
15.

the healthy menstruation (after parturition).

A

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 Gatia.

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
the
last

Yavagu

(gruel) as described

para.

Thenceforth a diet of demulcent probe
prescribed
for

perties .should

her and

her

body
should

should

be regularly washed with a copious quantity
water.

of tepid

A

mother, after parturition,
time)
in

forego

(for

a

considerable

sexual
irascible

intercourse,

physical labour and indulgence
etc.
1

emotions^*

Memorable Verses :— Any
by a newly delivered mother
conduct of
life
;

disease acquired

(^Sutika)

by her injudicious
a
difficult
if it

soon lapses into one of

type

(hard to cure)

and

it

becomes incurable

be

due to

too

much

fasting.

Hence

a wise physician should treat

her with such measures as are natural her temperament, the
time,

and congenial

to

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
should

bowels

and
in

distention

of

the

abdomen (tympanites).
throat
hair
;

Hence

such

a case

her

be tickled with a finger covered with
orifice

or the exterior

of the

vagina should

be

fumigated with the fumes of the cast-off skin of

a snake,

Katuka, Aldvu, KritavedJiana and mustard seeds
with mustard
oil.

mixed

In the alternative, a plaster of Ldn^ali

* Fifteen kinds of emotions as described in the thirty-ninth chapter of
the Chikitsa-sthanam.


224

THE SUSHRUTA

SAMIIITA.

[Chap. X.

roots should be applied to the

palms and soles of hcf
of

hands and

feet

;

or

the

milky juice
;

Snuhi

tree

should be applied over her scalp
of pasted Ldngali roots

compound made and Knshtha mixed with either
or a

wine or the

cow''s

urine
of

should
roots

be given her for drink.
or of

A

Kalka

either

S'dli

the

drugs con-

stituting the Pippalyddi

Gana mixed with wine (Sur^)
purpose
of

should be given her for the
tive,

In the

alterna-

an Asthapana (enema)

white

mustard

seeds

KusJitha (Kuda), Ldngali, and the milky juice of
vrikiha,

Mahd-

mixed with Sura-manda should be
fail)

prescribed.

(Iftheaboxe measures
mustard
should be

an

Uttara-Vasti (uterine
in

douche) prepared with the aforesaid drugs and boiled
oil

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

and

its

Treatment :— The
woman whose organism
account of profuse
use

of a

newly delivered
or deranged

has become excessively dry on
of absorbants

by any other causes,
its

— the

lochia being obstructed in

exit

by the
which

local

Vayu,
appear

gives

rise

to

Granthis

(nodules)

may

below the navel, on the sides
about

of the

pelvis

about the

region of the bladder or of the pubis.

Severe piercing

pain

(Sula)

is

felt

the

region of the navel, the

stomach and the bladder and a sensation of pricking
with
needle

and cutting

pain

in

the

intestines.

At the same time the abdomen becomes distended with the retention of urine. Theic arc the symptoms
of

Makkalla.

In such a case, a decoction

of the drugs

of the Virataj-oddi

6^rt/z<^ mixed with a powdered compound of the Ushakddi Gana should be given her. In the

alternative, a potion of carbonate of potash

[Yavakshdrd)
;

dissolved

in

tepid water or in clarified butter

of rock-

Chap. X.]

SARIRA STHANAM.
decoction
of the
;

22 5

salt dissolved in the

>f

the Pippalyddi

Gana
latter

of a conipound

made

powdered drugs of the powders
the
of
in
;

Gana with Sura-manda
drugs of the

of the

cardamom
of
the

and PanchiZ-kolas dissolved

decoction

Varunddi Gana
dissolved

of the
in

powders of pepper
decoction
of the
T^'ikafu,
;

and

Bhadraddru

the

Prithakparnyddi
Chaturjdtaka and

Gana

;

or

of

pulverized

Kiistumbuni mixed with old treacle
19.

or of simple Arishta, should be prescribed.

IVIanagcment of the Child: -The
with a
silken

baby

being wrapped up in silk should be laid on a bed covered
sheet
;

it

should

be fanned

with the
tree.

branches of a Pilu,

Nimha, Vadari, or Parushaka
in oil

A

(thin")

pad (Pichu) soaked

should be
its
{e,g.,

constantly

kept on the head of the child, and

fumigated with the fumes of drugs
etc.)

body should be Vacha, mustard,

potent enough

to

keep

off

the (evil) influences of

demons and
the floor

evil spirits. The same drugs should be tied round the neck, hands, legs and head of the infant and

of the lying-in

room should be kept strewn

over with pounded sesamum, mastard, linseed [Atasi).
fire

A

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

present case as well.

20.

Then on

the tenth

day of its
rites

birth the parents having

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 weta

nurse
its

:

-For

the healthy grovth of the child

wetof

nurse should be selected

from among the matrons
of the

own

caste

(Varna\ and possessed

following

29

226
necessary

THE SUSHRUTA
qualifications.

SAMIIITA.
sliould

[Chap. X.

She

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

pure milk

in

her

breasts

which should neither be too
up.
It

much pendulent nor drawn
observed that her skin
is

should

be carefully

healthy and unmarked by any

moles or stains, she being free from any sort of
(such
as

crime

gambling, day-sleep, debauchery,
affectionate
heart,

etc.).

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
the

exuof

berance of milk

in

her breasts, and not in

habit

doing anything that degrades
girl

woman

in life.

A

"SyAma"
a

possessed of the aforesaid

qualities

makes
of a
is

good
be

wet-nurse,

A

child nursed at the

breast

woman

with upturned

or

unprominent nipples
in features,

apt to

deformed (Karala)

while

extremely pendusuffocate

lous (large and flabby) breasts

may

the

child

by covering
wet-nurse of

its

mouth and nostrils. Having chosen a the commendable type, the child with its
laid
in

head well-washed should, on an auspicious day, be

on her lap wrapped

a clean

and untorn
towards
to

linen.

The
north,

face of the child should

be
look

turned

the the

while the nurse should

the east

at

time.

Then, after

first

having a small quantity of the milk
consecrated with

pressed out and the breast washed and

the following Mantras (incantations) the child should be

made

to suck her right breast.

22.

IVIetrical

Texts :— "O,
of the

thou beautiful damsel,

may

the

four

oceans

earth contribute to the

secretion of milk in thy breasts for the

purpose

of im-

Chap. X.]

SARTRA STHANAM.

22^
O, thou with

proving the bodily strength of the child.
a beautiful face,
attain a long

may
like

the the
22.

child,

reared

on your milk,

life,

gods made immortal with
of any and every commendable type,

drinks of ambrosia".

A

child

nursed

at

the

breast
of

woman for want may fall an easy
its

of a nurse

the

prey to disease, owing to the fact of the

promiscuous nature of the milk proving incongenial to
physical

temperament.

The milk
off

of a nurse

not

being pressed out and spelled

at

the

outset

may

produce cough,
milk into

difficulty of breathing, or

vomiting of

the child, owing to the sudden rush of the
its

accumulated

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
Sili-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,
garlic, fish, Kas'enika^ S'ringdtaka, lotus-

sesamum-paste,

stalk, Viddri-kandi,

MadJuika
etc.,

flower, S'atdzari, Nalikd,
24.

Aldvu, and Kdla-S'dka,

should be prescribed.

Exams nation,
it

etc., of
is

milk

:— The

breast-

milk of a nurse or a mother should be tested by casting
in water.

The milk which
with
water,

thin,

cold,
is

clear,

and
to

tinged like the
easily froths

hue of a conch-shell,
does
floats

found to be
give
rise

miscible

not

and shreds, and neither

nor sinks in water,

should be regarded as pure and healthy.

A
to

child

fed

on such milk
health.

is

sure to thrive and gain in

strentgh and

A

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

228

TPIE

SUSHRUTA SAMHITA
is

.

[Chap. X.

whom

the assimilated food

followed by

an acid reac-

tion, or of

one who

is

fond of incongcnial and unhealthy
principles

dietary, or

whose fundamental
is

are

vitiated.

A

child should not be given the breast until

an adminislest this

tered medicine

assimilated in

its

organism,

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.
:

lYIcmorabIC Verses
Pitta

— The

Doshas iVayu,

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

A

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 derang-

ed Doshas which account for such vitiation (inasmuch as
the medication of the child alone will not
satisfactory effect).

produce any

26-27.

Infantile diseases and their Diagnosis —-A child constantly couches its diseased part or
:

organ and
part of
its

cries for the least

touch (by another of that
be
its

body).

If the seat of disease

head, the

child cannot raise nor
its

move

that organ

and remains with
in
its

eyes closely shut.

A

disease seated

bladder

gives rise to retention
sional fainting
fits.

of urine, thirst,
retention

pain
urine

and occa-

A

of

and

stool,

discolouring of complexion, vomiting, distention of the

abdomen, and gurgling
seat of

in

the intestines
its

indicate
(colon).

the

the

disease

to

be

Koshtha

A

constant crying (and the child's refusal to

be consoled)

Chap. X.]

SARIRA STHANAM.
principle

229
(morbiferous
28.
laid

would signify that the diseased
diathesis) extends all through
its

organism.

Treatment
down
child or an infant

of Infants :— Medicines
of
its

under the head of a particular disease should like-

wise be prescribed in the case
;

appearance

in

a

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

in

adequate

age, etc.) as mentioned hereand administered through the vehicle of milk and

(according

clarified butter, to a child living

nurse also

is

on milk alone, while the to take the same medicines as well.* In

the case of a child fed both

on milk and
i

(boiled)

rice

{KshirdnnddaX.c, living on both solid an
wet-nurse.

liquid food) the

medicine should be administered both to the child and
its

In the case of a child living on solid food

only, decoctions (Kashaya) etc. should be
child

given

to

the

and not to the nurse. Medicines

to the quantity of

a

small pinchful

may

be prescribed for a suckling

who

has completed

its first

month

pastes) should be given to
rice to the size of a

Kalkas (medicated a child fed on both milk and
of
life.

stone of a plum-fruit (Kola), and the
rice (solid food)

dose for a child fed on
the size of a
*

only being to

plum (Kola).t
clarified

29.
to

Milk and

bulter

being congenial

the

constitution

of

infants

should be

used

as vehicles for drugs in their cases but, these are

not necessary in the case of the nurse.
j-

According
is

to several other

authoriiic.=,
:

the

dosage

in the

case

of

children

to

be regulated as follows

In the case of a child, one n:\onth 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)
increased by a Rati a month,
till it

at

first,

and gradually

completes one year. After this time the
grains) for each

dose

is

to

be one

Masha (about twenty

year

of age

till

he

is fifteen.

This dosage, however, does not apply

in the present

age.— Ed.

230

THE SUSHRUTA SAMHITA.
IVIetrical

[Chap. X.

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 Vata-

jvara (fever due to the derangement of the bodily

Vayu\
fever,
fever.

within the

first

and within the

two days of an attack of Pittaja first three days of that of Kaphaja
clarified

But the use of

butter

may
rice,

be prescribed for
or on

an infant fed on milk and boiled
alone, according to requirements.

boiled

rice

30-31.

In case of fever a child should be given
all, lest

no suck

at

the

symptoms

of thirst

might develop.
in

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 (Mastulunga), bends
child

Vdyu aggravated by 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

well

be treated with spray of cold water (to

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.

etc.,

possessed of the

of subduing the

A

suppuration of the anal region (Guda-palia) of
(Pitta-destroyintereffica-

a child should be treated with Pittaghna
ing) measures and medicines.

Rasanjana used
very

nally and externally (as an unguent) proves
cious in these cases.
33-35-

Chap. X.]

SARIRA STHANAM.

23
butter

Infantile

Elixirs :— Clarified
of)

cooked
seeds,

with (the decoction and Kalka

white mustard

Vachd, Mdnsi, Payasyd, Apdnidrga^ S'atdvari,

Sdrivd,
salt

Brdhni, Pippali^ Haridrd^ Ktishtha and Samdhava
should be given to an
infant
fed

exclusively

on milk.

Clarified butter prepared with (the docoction
of)

and Kalka

Madhuka (Yashtimadhu), Vacha,
(^boiled) rice (solid

Chitraka, Pippali

and Triphald should be given to an infant fed both on
milk and
butter boiled with (the decoction

and liquid food). Clarified and Kalka of) Das'amula,
MaricJia,

milk, Tagara^

Bhadraddru,
the two sorts of

honey,

Vidanga,

Drdkshd and
to

Brdhmis should be given

an infant fed on (boiled)
intellect

rice (solid food)

By

these the
child

health, strength,
is

and

longivity of

the

improved.

Z^-Z7'

A

child

should

be

so

handled or

lifted as

not to

cause any discomfort.

baby should not be scolded, nor suddenly roused up (from sleep), lest it might get
It

A

awfully frightened.

should not

be

suddenly drawn
attempt to seat

up nor suddenly laid down,

lest this

should result in the

derangement of
it

its

bodily V^yu.
to
sit

An

(before

it

has learnt

steadily),

may
a

lead to
child

haunch-back
be

(Kyphosis).

Lovingly should

amused with toys and play-things. A child unruffled by any of the above ways becomes healthy, cheerful and intelligent as it grows older. An infant should be guarded against any exposure to the
fondled and
rains, the

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 (cavesl

and

it

should be protected
evil stars

from the malignant influences of
38.

and occult powers.
:

Metrical Texts
(alone) in an unclean

—A

child should not

be

left

and unholy place, nor under the sky

232

THE SUSHRUTA

SAMIIITA.

[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 a
in

child,

it

its

proper food

Hence

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

A

child should

always be kept

an

inner apartment

of the
its

house,

and

religious rites

should be performed on

behalf for

the propitiation of evil deities,

and

it

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

and

becomes unconscious
nurse with
its

wounds

himself or

its

teeth

gnashes

its teeth,

crooks, yawns, or

and finger-nails, moves its eye-brows
its

with upturned eyes, vomits frothy matter, bites

lips,

mixed with shreds cries in an agonised voice, becomes dull in of mucus, complexion, becomes weak, does not sleep in the night,
becomes
cross,

passes

loose

stool

does not suck the breast as before,
bug-like the
or

or

emits

a

fishy,

mxole-Hke smell from

its

body

—these
will

are

general

symptoms exhibited by
or

a child under the

influence of a malignant star
specifically described later

planet

which

be
41.

on

in the

Uttara-Tantra.
:

Education and lYIarriage
tion of a child should be

-The

educaage

commenced

at

a

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 rules,

marry a
is

A

conformity to
satisfaction,

sure to

crown him with health,

progeny and a capacity for
rites

fully discharging the religious

and paying

off his parental debts.

42.

Chap. X,J

SARIRA STHANAM.

233

lYIetrical
the

Texts :— An

offspring of a girl below

age of

sixteen by a

usually found to die in the

man below twenty-five is womb. Such a child, in the
Hence
agirl
all.

event of

its

being born alive, dies a premature death

or else becomes

weak

in

organs (Indriyas).

of extremely tender age should not be fecundated at

An

extremely old woman, or one suffering from

a

chronic affection (of the generative organ), 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.

A

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^
its

for

soothing

and making

it

steady in

place. 45.

A
in the

foetus

being displaced

from

its
,

normal position
pain
or

produces the following symptoms, viz

spasms

back and the

sides (Pars'va), burning

sensation,

excessive discharge of blood and retention of urine and
foeces

A
to

fcetus

changing place or shifting from one
swells

place

another,

up

the

abdomen 'Koshtha).
in

Cooling and soothing measures should be adopted

such cases. 46.
* Jivaniya drugs

two Tolas, milk iixteen Tolas and water sixty-four
to

Tolas, to be boiled and reduced to sixteen Tolas, ie.^
tnilk.

weight

of the

30

'234

Tllli

SUSHRUTA SAMIilTA.
:

[Chap. X.

lYIedical

Treatment — in
MadJiuka
the

a

case

of pain

under the circumstances, the encientc should be made
to drink a potion consisting of milk boiled

with Mahd-

saha, Kshudrasahd,

flower,

S'vadansttd and
In the case of

Kantakdri, mixed with sugar and honey.
retention
of
urine,

patient

should

drink a potion of milk boiled with drugs

be made to known as the
In

Ddrvddi Gana (mixed with sugar and honey). case of A'ndha (retention of stool attended with
tion

the

disten-

of

the

abdomen),

a

potion

consisting
garlic

of

milk

boiled with asafetida, Sativarchala

salt,

and Vacha
In

(mixed with honey and sugar) should be given.
cases of excessive bleeding, linctus

made

of the
*
,

powdered

chamber
jana, or

of

a

Koshthagarika insect

Samangd^
and Rasdn-

DJidtaki flowers,

Navamdlikd, Gairika,

resin

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
enciente
Sali
rice

S'aluka, S'ringataka and Kas'cru

mixed with

boiled milk should be given.

As

a further alternative, the

may

be

made

to eat

cakes
of

with the decoction

made of powdered Udumbara fruit and
sugar.

Audaka-kanda, mixed with honey and
of linen or a plug

A

piece

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

a

case

unattended

with

bleeding, the

enciente should be

made

lo drink a potion

composed of

milk-boiled with Ji/«rt7/^//^<2(Yashtimadhu), Devaddru and
*

There

is

a

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'matitaka, Satdvari and

Payasyd

;

or with the drugs of the group of Viddrigandhddi or with Vrihati, Kantakdri, Utpala, S'atdvari,

Gana

;

Sdrivd,

Payasyd and Madhuka (Yashtimadhu).
foetus steady in the

These remedies

speedily applied tend to alleviate the pain and

make

the

womb.

48.

After the fcetus has been steadied

by the aforesaid
cow's
of Udiimvara^
the

mesaures, a diet

consisting

of

(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

Yavagu

(gruel) of the

Udddlaka

rice, &c.,

cooked with

the decoction of the Pachaniya group (Pippalyadi) and

devoid of

all

saline

and

fatty matter, for a

number

of

days

corresponding to that of the month of gestation.
treacle

Old

mixed
etc.),

with the

powdered drugs of the
be
given,
pelvis,
in

Dipaniya group (Pancha-kola), or simply some Arishta
(Abhaydrishta,
of

should
in

the

event

there

being
49.

pain

the

bladder

and

abdomen.

The

internal ducts

and channels (Srotas)
continues,
leads
treated
etc

stuffed with

aggravated

Vayu

lead to the weakening (Laya) of the
state
it

fcetus and, if the

even to
with

its

death.

Hence the case should be
etc.,

mild

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
*

As an alternative, Kulmasha sesamum and pieces of dried with Masha,
be given to her.
Vilva
be
fruit

boiled
(tender)

should be given her, after which she should

made

to drink, for a week,

honey and Maddhvika

(a

kind of weak wine).
• ''Kulmdsha"
barley, etc.

At

the non-delivery of the child
half boiled

may mean

either Kulattha pulse or

wheat,

236 even
after

THE SUSHRUTA SAMHITA.
the
lapse of the
full

[Chap. X.

term of gestation, the

encientc should be

made

to thrash corn with a pestle in

an Udukhala or mortar (husking apparatus) or should be made to|sit or move (on legs or by conveyance), on an
uneven ground.
50. foetus in the

Atrophy of a
to

womb

should be ascribed

the

action of the deranged

Vjlyu.

This

is

detected

by the comparatively lesser fulness of the abdomen of the enciente and slow movement of the foetus in
the

womb.

In

such a case,

the

enciente should be
(of

treated with milk, with the

Vrimhaniya

restorative

and
soup.*

constructive
51.

properties)

drugs, and with

meat-

A

combination of

deranged

Vayu

in

ovum and semen affected by the the womb, may not give rise to a
matter),

successful fecundation (living impregnated

but

leads to a distention of the

abdomen

(as in

pregnancy),
itself.

which again,
this
is

at

any time, 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
should
the

the

uterus,

is

be

treated with

the

remedies laid

down under
52.

head of

Lina-Garbha

(weak

foetus).

Now

we

shall

discourse on

the

management

of

pregnancy according to the months (period) of gestation.
Metrical Texts
(i)
:

— The

following receipes, such as,
S'akavija,

Madhuka (Yashtimadhu),
;

Payasya, and
pippali,

Devadaru

(2)

As'mantaka,

black

sesamum,
;

Manjishth^, Tdmra-valli and Satavari

(3)

Vrikshadani,
;

Payasya, Latd, (Durvd), Utpala and Sariva
Sdriva, Rdsnd,
*

(4)

Ananta,
;

Padma,
in

and Madhuka (Yashtimadhu)
ihe
text
signifies

The panicle "cha"

the

use

of

any other

.constructive tonic.

Chap. X.]

SARIRA STIIANAM.

237

(5)

Vrihati,

Kantakdri, Kas'mari, sprouts (Sunga) and
(as,

barks of milk-exuding trees
butterf
;

Vata,

etc.),

and
Visa

clarified

(6)

Pris'ni-parni, Vala,
;

Sigru,

S'vadanshtra
(stalks

and Madhuparnika
of
lotus),

and

(7)

S'ring'taka,

Draksha,
;

Kas'aru,

Madhuka (Yashtimadhu),
month
of

and sugar

should successively be given with milk* to
first

an enciente, from the
gestation,
in
53.

to the seventh

her

the case

of a threatened

miscarraige or

abortion.

An
Ikshu

enciente should be
roots of

made
(in

to

drink

milk

boiled
Patola,

with the

Kapittha, Vrihati, Vilva,
case

and

Kantakari,
miscarraige)
In the

of impending

or

threatened

in

the eighth

month

of

her

pregnancy.

ninth

conditions), the

potion should be

month (and under similar made up of Madhuka
In
similar conditions), a potion

(Yashtimadhu),
the tenth
consisting
is

Ananta-mula, Payasha and Sariva.
boiled

month (and under
of milk

with

Sunthi and

Payasya

beneficial, or, in the alternative,

may

be given a potion
(Liquorice; and

made up
foetus

of milk with Sunthi,

Madhuka
would

Devadaru.

The

severe

pain

vanish and

the

would continue to develop
child born of a
for

safely- in the

womb,
sterile

under the aforesaid mode of treatment.

54-57.

A

woman, who had remained
a

(not-conceived)
prasava;* after
lived one.
*

period of

six

years (Niviitta-

a

previous child-birth, becomes a short-

58.

Chakradatta reads "Visam" (stalks of

lotus)

instead

of

"Ghritam"

(clarified butler).

t If a conception does no', occur in a
five

woman

for a

period of more than

years
*

a'^ter

a child-birth, she

is

called
of

Nivrittaprasava.
these

Sivadasa also says that
milk, but

powders

drugs should

be given

with boiled

he adds that some authorities recommend theae

drugs to be boiled in rnilk according to Kshira-paka-vidhi.

23S

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

A

diet consisting of sweet
for

and acid things should
bring
the

be prescribed

her,

so as to
state
;

deranged

Doshas

to

the

normal

mild

Sams'amaniya
mild in their

(soothing and pacifying)

medicines should be applied
articles

and food and drink consisting of
potency, predominently
to

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
linctus (Prds'a\
viz.,

compounds, used as
Matsyakshaka*

(i)

well-powdered gold, Kushtha,
;

honey, clarified butter and Vacha
(Brdhmi),

(2)

Sankhapuspi, powdered gold, clarified butter clarified butter and honey (3) Arkapuspi, honey, powdered gold and Vacha and (4) powdered gold,
; ;

Kaitaryyah

(Maha-Nimba),
60.
of

white

Durba,t clarified

butter and honey.

Thus ends the tenth Chapter
Samhita,

the S'drira

Sthanam

in

ihc

Sus'iula

which

treats

of

the nursing and

management

etc. of

pregnant

women.
*

Some, however, explain Matsyakshaka
a kind of red-flowered shrub

to

be Dhuslura; others again

say
*

it is

grown
Text,

in the

Anupa
either

country.

The word "S'veta," in "Durva" and mean "white"
Aparajita or white Durvgi.

the
or
it

may

be adjective to
or

may mean white Vacha

white

Here ends the ^arira Sthanam.

THE

SUSRUTA SAMHITA
GHIKITSA-STUANAM.
(Section of Therapeutics).

CHAPTER
Now we
of the two
shall

I.

discourse

on the medical treatment
ulcers

kinds

of inflamed
i.

(Dvivraniya

Chlkitsitam).
Ulcers

may

be grouped under two head? 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
their

of the

blood or the several deranged conditions
Pitta

Vayu,

and

Kapha, or
while

are

due

to

concerted

action (Sannipata),

the

second group embraces
bites

those which are
birds, ferocious
fall,

caused
animals,

by the
reptiles

of

men, beasts,
or

or

lizards,
alkali,

by a
or

pressure and

blow, or by

fire,

poison,

irritant drugs,

or through injuries inflicted

by pointed
axes,

wood,

skeletal

bones*
(a

horns,

discus, arrows,

tridents, or Kiintas

kind

of shovel\ or

such other

weapons.

Although both these classes of ulcers possess
in

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,
of

and the variation

their

Fragments

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

clarified butter

should be

on the wounded locality
parts,

for

the

adhesion
pacifica-

(Sandhdna) of the lacerated
tion,
i

[and for the

e, restoration to normal state, of the

local

blood

and Vdyu aggravated through an obstruction of their
passage].

Hence

arises

the

necessity

of

making the
(a

tw^o-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
Pras'na
ities,

the Chapter on Vrana-

(Sutra

Sthanam. Ch. XXI).
of the

Several authorulcers

by adding the simple uncomplicated
Pitta, &c.)

(un-

associated with any

morbific principles of the
to

deranged Vayu,
of

the

list,

hold the number

types

to

be

sixteen.

(Practically

they are in-

numerable, according to the combinations made of the

deranged Vayu,
system).
4.

etc.

and the different Dh£itus 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),

24 [
are

(of all

forms of

while the .symptoms, which

exhibited in each case

according to the

virtue

of the

deranged Vayu,
Specific ones.
(the

Pitta, etc, involved therein, are called the

A

Vrana

is

so

named from

its

etymology

term being derived from the root Vrana
signifies a

— to

break)
skin

and

cracked or broken condition
afflicted part) of the

^of the
5.

and flesh of the

body.
ulcer

The Vataja- Ulcer :— The

assumes a

brown or vermilion colour and exudes a thin, slimy and cold secretion, largely attended with tension, throbbing and a sort of pricking and piercing pain (in
its

inside),

which seems

as

if

being

expanded and

extended.

This type of ulcer

does not extend
destruction
rapid in
its

much
of the

and

is

characterised by a

complete
ulcer
is

tissue (flesh).
It

The Pittaja

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

be extended

and raised around

margin and
It

irresistible itching sensation.
(in its

is

thick

accompanied by an and compact

depth), covered with

a

large

number of

vessels
in

and

membranous

tissues

(Sira-snd.yu-jala),

grey

colour, slightly painful, hard
thick, cold, white

and heavy, and exudes a
secretion.

and slimy

The Raktaja
is

ulcer (resulting

from a vitiated condition of the blood)
coral.
It

looks
to

lump of red be surrounded by black
like

a

often

found

vesicles

to smell like a strong

alkali.
if

produces a sensation, as
(of
it).

and pustules and It becomes painful and fumes were escaping out
and
are

Bleeding
of

(is

present)

the

specific

sympto

toms

the

Pittaja

type

likewise

found

supervene.

6

— 9.
31

242

THE SUSHRUTA SAMHITA.

Chap.

I.]

The Vata-Pittaja Type :— An
the concerted action of the
is

ulcer due to
Pitta

deranged Vayu and

marked by a pricking and burning pain and a red

or vermilion colour. of
it

A

sensation of fumes arising

out

(is

also

felt)

and the ulcer exudes a secretion
characteristic colours of both
Pitta.

which partakes of the
deranged
pain

the

Vayu and
in the ulcer

An
to the

itching

and piercing
type),

is felt

due

combined action of
constantly disulcer
resulting

the deranged

Vayu and Kapha (Kapha-Vataja
indurated,

which becomes heavy and

charging a cold, slimy secretion.

An

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

(Vata-Raktaja type)
attended

is

dry and thin and
pain

with
or

a a

piercing

and

anaesthesia.

exudes blood

vermil-coloured

secretion

and

marked by the combined hues respectively peculiar to An ulcer due to the the deranged Vayu and blood. combined action of the deranged Pitta and blood (Kakta-Pittaja type) is marked by a colour which
resembles the
surface

cream of
a hot

clarified

butter.

It

smells like the washing of
pelatous),
ulcer

fish, is soft,

spreading (erysimatter.

and

secretes

blackish

An

due to the combined
glossy

action

of the
is

deranged

Kapha and
heavy,

blood (Kapha-Raktaja type)

red-coloured,
is

slimy,

and indurated.
exudes a

It

usually

marked by itching
secretion.

and

yellowish

bloody

An

ulcer

due to the concerted action of the

deranged Vciyu, Pitta and blood (Vata-Pitta-Raktaja type) i'^ maikcd by a .sort of throbbing, pricking and
burning pain.
It

discharges a

flow

of thin

yellowish

Chap.

I.]

CHIKITSA STHANAM.
produces a sensation,
its

243
if fumes were due to the con-

blood

and

as

escaping (out of
certed

cavity).

An
is

ulcer

action of the deranged Vdyu,

Kapha and

blood

(Va^ta-Sleslima-Raktaja type)
itching, throbbing

usually

attended with
thick, grey,

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

concerted

of

the
is

marked by the deranged Vayu, Pitta and
ulcer

An

Kapha
of pain,

(Sa'nnipatika)
secretion,

attended with diverse
&c.,

kinds

colour,

peculiar

to

each of

these types.

An

ulcer

associated
Pitta,

with the

combined

action of the deranged Vayu,

Kapha and blood
is

(Vaita-Pitta-Kapha-Raktaja type)
sensation, as
largely
if it

attended with a
It
is

were being burnt and lacerated.

accompanied by throbbing, itching sensation,
of

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
of

the

back of the tongue, soft, glossy,
shaped and marked
secretion whatsoever,

smooth, painless, well-

by the absence
is

any kind of
(Saddha-

called

a

clean

ulcer

Vrana).

21.
:

Therapeutics
treatment of a
into

— The
factors,

medical

(and surgical)

Vrana
different
diet),

(ulcer)

admits of being divided
such
as,

sixty *

— Apatarpana
Parisheka

(fasting or low
(irrigating
*

Alepa

(plastering),

or

spraying),

Abhyanga
differ in

(anointing),

Sveda
factors,

N. B-

Authorities, however,

enumerating these

although every one of them sticks to the

total

number

of sixty.


244
(fomentations,

THfi

SOSHRUTA SAMHITA.
Vimldpana
(resolution

[Chap.

1.

etc.),

by mass-

age or rubbing), Upandha (poultice),

Pdchana (inducing
Sneha

suppuration), Visravana (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),

applications),

Ddrana (bursting Lekhana (scraping), Aharana

Eshana

(probing),

Vyadhana (puncturing
re-union
or adhesion),

opening a
(suturing),

vein),

Vidrdvana (inducing discharge), Sivana
(helping

Sandhana
(cooling

Pidana

(pressing),

SonitasthApana (arrest of bleeding),
application),

Nirvdpana
poultices),
(lint

Utkarika

(massive

or

Kashaya (washing with decoctions), Varti plug), Kalka (paste), Ghrita (application of
clarified

medicated

butter),

Taila

(application

of

medicated oil\ Rasa-kriya (application of drug-extracts),

Avachurnana (dusting with medicinal powders), VranaDhupana (fumigation of an ulcer), Utsadana (raising of the margins or bed of an ulcer), Avasadana (destruction
of

Mridu-Karma (softening), Daruna-Karma (hardening of soft parts), Kshara-Karma (application of caustics), Agni-Karma (cauterization), Krishna-Karma (blackening), Pandu-Karma (making
exuberant
granulation),

yellow-coloured

cicatrices),

Pratisarana (rubbing

with

medicinal powders), Roma-sanjanana (growing of hairs),

Lomapaharana
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.

I.]

CHIKITSA STHANAM.

245

or vapouring), Madhu-sarpih (honey and clarified butter),

Yantra

(mechanical
(diet)

contrivances,

eg., pulleys, &c.),
(protection
22.

Ahara

and

Raksha-Vidhana
spirits).

from

the influence of malicious

Of these, Kashaya, Varti, Kalka,
(Sodhana) of an ulcer and for
(Ropana).
are surgical

Ghrita, Taila, Rasa-

kriya and Avachurnana are the measures for the cleansing

helping

its

granulation

The
as

eight

acts

(from Chhedana to Sivana)

operations.

We

have already spoken

of

such

acts

Sonitasthapana,

Kshara-karma, Agni-

karma, Yantra, Ahira, Raksha-vidhana and

Vandhashall

Vidhana

(in

the

Sutra-sthana).

Later on, we

discourse on Sneha, Sveda,

Uttara-vasti, Siro-virechana, Nasya,

dharana.
in

Of

the

Vamana, Virechana, Vasti, Dhuma, and Kavalaremaining measures we shall speak
23.

the present chapter.

There are six kinds of swellings (Sophas),as described
before,

and the following eleven
ending
in

measures, commencing

with Apatarpana and
regarded as their cure.
a swelling and

Virechana, should

be

These are the proper remedies for
to be efficacious in, nor) prove

do not (cease
other

hostile to cases of swelling
ulcers.

which are transformed into
be

The

measures should

deemed

as

remedial
general

to ulcers but Apatarpana is the first, and principal remedy in all types of swellings

(Sophas). 24.

Memorable Verses :— Apatarpana
should

(fasting)
full

be prescribed

in

the
in

case

of a patient,
his

of

enraged Doshas, as well
principles

as,

one having
purpose

organic

(Dhatus) and refuse matters (Malas) of the
of bringing

system, deranged by them, for the

them
to

to

their

normal

condition,
to

with a regard

both

their

nature

and

the

strength, age, &c., of the

patient.

Persons

afflicted

with diseases which result

246

THE SUSHRUTA SAMHITA.

[Chap.

I.

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

women

should never
ulcer

A

swelling and an

extremely painful

should be respectively treated

with a proper medicated plaster at the very outset.
pain in such a case will yield to
as a blazing

The

the medicinal

plaster

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).

25

— 28.
oil,

In the case of a swelling brought on by the deranged

Vayu, the affected part should be washed or sprinkled
(Parisheka) with a

warm

lotion

of clarified butter, or

Dhanyamla and
of

essence of meat

with
the

a

decoction

the

drugs that tend to pacify
relieve the pain.

enraged Vayu
the
or

and to
the a

A
or

swelling due to the action of

deranged

Pitta

blood
be

or to

effect

of

blow

or

poison

should

washed

sprinkled

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 (Kakolyadi-gana) and the Kshira-Vrikshas. A Kaphaja
swelling on the

body should be

washed or sprinkled

with a luke-warm lotion of oil, cow's urine, alkaline solution, wine (Surd), Sukta and with a decoction of

drugs that destroy the deranged Kapha.

29

— 31.
jets of

Metrical Text —As
:

a

fire is

put out by

water, so the

fire

of the deranged

morbific

principles

(Doshdgni) of the body are speedily 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.

IVIetrical Texts: An application of an anointment (Abhyanga) should precede the measures of fomentation, resolution,

&c while
,

it

should follow

all

evacuating
swell-

measures, &c.

A

painful,

extended and indurated

ing, as well as an

ulcer
act

of a similar nature,

should be

fomented, while an
gentle

of

Vimlapana
in

(resolution by

massage) should be done

respect of a fixed or
little

unfluctuating swelling attended with

or
first

no pain
annoint

whatsoever,

A

wise

physician

should

and foment the part and then
it

gentl}'

and slowly press
his

with a bamboo-reed or with the
palm.

back of
or

thumb
is

or

A

non-suppurated

swelling

one that

partially

suppurated should

be
to

treated
its

with poultice

(Upanaha\ which would lead
ration, as the case

resolution or suppu-

might

be.

A

swelling, not resolved

or not subsiding even after the adoption of the

measures

beginning with
(in

Apatarpana and ending
list),

in

Virechana

the

given

should

be caused to suppurate
chapter of Mis'raka,

with the drugs enumerated in the

such as curd, whey, wine (Sura), Sukta and Dhanyamla
(a

kind of fermented

paddy

gruel).

They should be
and
be

formed into a paste and the paste should be cooked into
an
efficacious poultice-like composition (Utkarika),
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.
{i
e.,

The

should be allowed to take a wholesome

which does

not produce Kapha) diet as soon as suppuration would
set in (in the swelling).

34-39.

.

248

THE SUSHRUTA SAMHITA

[Chap.

I.

Blood-letting"
sorted
to
in

:

— Blood-letting
formed

should

be

re-

a

case

of newly

swelling

for

Bleeding its resolution and for alleviating the pain. (Visravana) is recomnmended in the case of an ulcer

which

is

indurated,

marked by
is

a considerable

swelling

and inflammation and
extended at

reddish black or red-coloured,
its

extremely painful, gagged in
its

shape and

considerably

base (congested), specially in the case pain and

of a poisonous ulcer, for the subsidence of the

for warding off a process of suppuratiou therein, either by applying leeches or by opening (a vein in the

by means of an instrument. of a dry or parched temperament
locality)

An

ulcer-patient
dis-

affected with

tressing supervenients or ulcer-cachixia or

who

is

weak

should be made

to

drink
of)

an

emulsive potion cooked

with

(a

decoction

appropriate drugs.

A

patient

afflicted

with an ulcer with an elevated

margin and by the
flow of

attended
presence
blackish

with swelling and specially marked
of

the

deranged

Kapha and by
be treated with
purgatives
to

a

red

blood should

emetics.
a

Ulcer-experts
afflicted

recommend
old

patient

with an

or

long-standing ulcer, attended
the

with a

deranged condition of

Vayu and
which

Pitta.

An

excision should be

made
is

into an ulcer

refuses

to suppurate

and which

of

a

hard and indurated

character attended with sloughing of the local nerves and

ligaments (Snayu).
should be

An

opening^ or excision
in the

(Bhedana)
inside of

made

into

an ulcer (Vrana)

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.]

CHIKITSA 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

with

all

its

pus gathered
be

to

a

head

;

substance

should

applied

on
the

its

surface

and a

bursting should be effected
to be just aggravated

when

Doshas are found

by the incarcerated pus. 47, ulcer which is indurated, whose edges are thick An and rounded, which has been repeatedly burst open,
and the
an
flesh

of

whose cavity
b}-

is
;

hard
or,

and elevated,
other words,

should be scarified

a surgeon

in

indurated

ulcer

should

be

deeply scarified, one

with thick
scarified,

and rounded edges should be excessively
the

while

one

which has

been
off.

repeatedly

burst open should

be

entirely

scraped

An

ulcer

with a hard and elevated bed should be scraped

evenly
In

and longitudinally along the length of
performed with a piece of
fibres of

its

cavity.

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

in its inside,

which takes

a

crooked or round about direction, as well as
its

of the one formed into cavities within

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

mentioned hereafter.

32

250

THE SUSHRUTA

SAMIIITA.

[Chap.

t.

be probed by gently introducing the tender

fibres

of

bamboo

sprouts (Karira), a (lock of) hair, a finger, or an
its

indicator into

inside.
in

The

course of a sinus occurring
ot

about the anus or
should

the

region

the

eyes (Netra-

fibres Vartma) Upodika, or Karira, in the event of of Chuchchu, their mouths being narrow and attended with bleeding.

be probed

with

the

slender

The Salya

(incarcerated pus,

etc.)
is

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 puncturinserted
into

ing (Vyadhana), the knife should be
seat of the disease to a proper

the

depth and extent, to be
in

determined

by

its

situation

the
as

body, and
stated

the

Doshas

(pus, etc.)

should be

let out,

before.

Ulcers with a wide mouth, unattended with any symptoms
of suppuration,

and occurring
sutured
up,

in a fleshy

part of the

body, should

be

and the adhesion (San-

dhdna) of the edges should likewise be effected, as directed before.

A

plaster

composed of drugs (capable of
ulcer

drawing out and secreting the pus), as described before,
should be applied around the mouth of an
in

seated

any of the Marmas (vulnerable parts), or full of pus inside, with a narrow-mouthed aperture. its The should be removed when dry, and should not plaster
in

be applied on the orifice of the ulcer, as
case,

it

would, in that
of pus

interfere

with the

spontaneous secretion

(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 (Sonitasthapana).

*

Styptic measures are of four

kinds— Sandhana,Skandana, Pachana,

and Dahana.

See Sutra-Slhanam, Chap. XIV.

Chap.

I.J

CIIIKITSA

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
with com(of the

medicinal

remedies.

It

should be allayed

pounds made up of the proper cooling drugs
clarified butter.

Mis'raka chapter), pasted with milk and lubricated with

Cooling plasters (Lepa) should then be
55-56.
flesh
is
is

applied as well.

An
and
is

ulcer

whose

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
of

be fomented with a poultice-like efficacious preparation
(Utkarikai )cooked

with the drugs

Vayu-subduing

properties, those included within the

Amla-varga, and

those which belong to the
the
oily

Kdkolyadi group, and with
linseed,

seeds

(such

as

sesamum,

mustard,

castor,

etc.).

An

indurated,

slimy ulcer should

be

painful, faetid, moist and washed with a disinfectant or

purifying lotion consisting of a decoction

of the drugs

mentioned before
Plugs or

for the

purpose.

57"58.

lints plastered

with a paste of the purifying be
inserted
into

drugs (enumerated before) should
ulcer with
in
it,

an

any foreign matter (e.g., pus) lying embedded or into one with a deep but narrow opening, or into
in a fleshy part of the

one situated

body.

An

ulcer

full

and marked by the action of the highly deranged Doshas (Vayu and Kapha) should be purified
of putrid flesh

with a paste of the aforesaid available drugs making
the
plug.

up

seated

which is deepand attended with a burning sensation and with
ulcer of a Pittaja origin,

An

suppuration, should be purified with

the

application of

a medicated clarified butter, prepared with the purifying

252

THE SUSHRUTA SAMHITA.
with
an

[Chap.

I.

drugs

admixture of
dry

Karpdsa-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
before
in

decoction

of

the drugs

enumerated

(Sutra, chap.

38,— the Salas^radi group) and prepared

the

following

manner

of Rasa-kriyai.

A

decoction of

the said drugs duly prepared

should be saturated with

an after-throw of Hatitdla^ Manahs'ild^ Kdsisa and
Sattrdshtra earth, and well

preparation
juice of

compounded together the mixed with the expressed Mdtidunga and with honey. The medicine thus
;

should

also be

prepared should
or fourth day.
Deep-j*

be
59.

applied to the ulcer on every third

and foul-smelling ulcers covered with layers (phlegmonous
purifying
ulcer)

of deranged fat

should be purified

by

the learned physician with the

powders of the drugs
or

with which the

plug

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
of

surgeon (Vaidya) after

had been found to have been

thoroughly purified.

Medicated plugs,
as,

composed

drugs possessing healing properties (such

Sotna,Amritd,

As'vagandhd,

etc)

should be inserted

in

deep-seated ulcers,
60-62.
of

when cleansed and unattended with pain.
*

The

total weight of the purifying

drugs should be equal

to

that

the Karpasa-phala alone and they should be boiled together with four times
their qnantity of clarified butter
1

and with sixteen times of water.

There

is

a different reading of

"Agambhira"

in place of

"Gabhira,"

but Gayi thinks the emendation undesirable.

Chap.

I.]

CHIKITSA STIIANAM.

2<\$

A
applied
in

Kalka or
for

a

levigated

paste

of

sesamum and
be

honey (mentioned
the

in the

Mis'raka

Chapter) should

purpose of healing up
all

.an ulcer situated

a

muscular part from which
off

putrid

flesh

has

been removed or sloughed
cavity.

and which exhibited a clear
sweet
;

This paste (of sesamum) tends to allay the
its

deranged Vayu through
Pitta through

taste,

oleaginous-

ness 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

sesamum mixed with

the drugs of purifying and
heal

healing properties tends to purify and

up an

ulcer.

An

application of the levigated paste of

sesamum mixed

with honey and NzMda-lectves leads to the purification
of sores
(j'e
,

an application of the same paste sesamum, honey and leaves of Nhnbd), mixed with
;

whereas

clarified

butter

tends

to

heal

up the
to

ulcer.

Several

authorities atribute the

same

virtue

a

barley-paste.*

Levigated pastes of barley and of sesamum (or a paste of
barley

mixed with sesamum) contribute
is

to the resolution

or subsidence of a non-suppurated swelling, fully suppurate

one which

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,which 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
before)

(Ropaniya— enumerated
m.arked

and milk.

An

ulcer

by an aggravated condition of the deranged
to

Jejjada and Gayadasa interpret the term mixed with sesamum."

mean "barley-paste

254

THE SUSIIRUTA SAMHITA.

[Chap.

I.

Yiyu and Kapha
tion

should be healed up with the applicaboiled

of an

oil,

and

prepared with the proper

purifying drugs mentioned before,

66 6y.

Rasa-kriya* with the two kinds of Haridrd should be resorted to for the purpose of healing up an ulcer, in which bandaging is forbidden (such as those due to the
deranged Pitta or blood, or to blow,
of poison), and
joints,

&c.,

or to the effects

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 granulation-f*.

Healing medicinal powders
of

should be used in the case
fined to the skin,

an ulcer which
shape

is

con-

and

is

firm-fleshed
its

and marked
[i.e.,

by
not

the absence

of

any

irregularity in

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

and

efficacious

of

ulcers

in

general

with regard to their

Doshas (both idiopathic and traumatic).
of these measures has been
cases

The

success

witnessed

in

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
of the

employ

the

drugs,

mentioned

before,

any

seven forms (either in the
*

shape of a decoction, or a

The

decoction of Iripkald and the drugs of the Nyagrodhadi group

should be duly prepared, filtered and then condensed to the consistency of
treacle.

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-kriyiC.

Several editions read "though cleansed yet ungranulating ulcers,"

Chap.

I.]

CHIKITSA STHANAM.

255
of

plug, or a paste, or through the

medium

medicated

oils

and

clarified butter, or in the

shape of Rasa-kriyd, 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 Vaiyu

in

any

of the

seven

— decoction,
be used in

etc.

Similarly the drugs which are included

within the groups of Nyagrodhadi or Kakolyadi should

any of those seven forms,
Pitta
(for

in the case of

an

ulcer due to the aggravated

the

purification

and healing

thereof).

Drugs which form the group of
as

Aragvadhadi, as well

those

which have been desbe used
of two
in the case of

cribed as heat-making in their potency, should
in

any of those seven aforesaid forms,
of those groups,

an ulcer due to the deranged Kapha.
or three
in

The drugs
connection

should
in

be combinedly used

any of those seven forms,

with an

ulcer

marked by

the aggravated condition of

any two
pain

or three of the deranged Doshas respectively. 71-74.

Fumig'atfon
Kshauma,
S'ala tree)].

:

—Vataja ulcers with

severe

and secretion should be fumigated with the fumes of
barley, clarified butter

and other proper fumi-

gating substances
75.

[such as turpentine and resin

(gum

of

Utsadana-Kriya
plasters (consisting of

(Elevation)
(prepared

:— Medicated
etc.)

Apdtndrga, As'vagandhd,
butter

medicated

clarified

with

the

and same

drugs should be used in ulcers (due to the aggravated Vayu

and marked by the absence of any
a

secretion,

and

affecting

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

Infilling

up) the beds or cavities thereof.

Meat

of carni-


256

THE SUSHRUTA SAMHITA.

tChap.

1.

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.

^6.

Avasadana
etc.)

(destruction

of

super-growths)

:

Proper drugs or 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.
lYI

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

78.

Daruna-karma:— The
ning measures (Daruna-karma)
nection with soft
ner.

employment of hardeis

efficacious

in

con-

ulcers

and

in

the

following

man-

Barks

of

Dhava,

Priyangu,

As' oka,

Rohini,

Triphala, DJidtaki flowers, LodJira and Sarjarasa, taken
in equal parts

and pounded into
i.e.,

fine

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-lettinT should be resorted

the

event
;

of

any

vitiated

blood being found to have been involved in
a similar participation of any deranged

the case
oils

but in the event of
lotions

Kapha,

and

composed

of the Vayu-dcstroying drugs should be

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. So.

Agni- Karma

(actual cauterization)

:— An

ulcer

incidental to an act of lithotomic operation allowing the

urine to dribble out through

by excessive bleeding, or
ised

in

its fissure, or one marked which the connecting ends

have been completely severed, should be actually cauter-

with

fire.

8i
:

Krishna- Karma -The
white cicatrix,

blackening

of a

which

is

the result of a bad
(after the

or defective

granulation, should be

made
first

complete healing

up of the
taka (and

ulcer) in the following

manner. Several Bhalld'
in the urine of a

seeds

should be
dried
in

soaked
sun,

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

Another pitcher should be
thin

buried in the ground

and perforated

lid

placed

over

its

mouth, and the pitcher containing the
it

seeds should be placed upon
(so that the

with

its

mouth downward
joined
(with
lit

mouths of the two pitchers might meet), and
should

then the meeting place
clay).

be

firmly
fire

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 (An upas — such as buffaloes, etc.) should be burnt and pounded together into extremely fine powder. The oil (of the
horses, etc.)

and those which

in

Bhallataka seeds collected

as

above) should

then

be

33

i258

THE SUSHRUTA SAMHITA.
with
this

tChap.

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

some kinds

of

fruit

{Phala-snehd) prepared in the

manner

of the Bhalldtaka

(and mixed with the powdered ashes of hoofs) should
82-83.

be used for the blackening of a cicatrix.

PandU-karana
colour (Pdndu) of the

:

—The

natural

and healthy
black colour
in

surrounding skin should be ima

parted to a cicatrix which has assumed

owing to the defective or faulty healing up of the sore
the following manner.

The

fruit of the J?6'/^/;22*

should be

immersed
finely

in goat's

milk

for seven nights and, afterwards

pasted
skin.

with the same milk, should be applied

to

the

This

measure
or

is

called

Pandu-karana
to

(imparting
cicatrix).

a

yellow

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 Madhiika (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 Kdsisa (Sulphate of iron), Rochand, Tuttham

(Sulphate of copper).
of

Hariidla,

Manahs'ild, scrapings

Prapunnada (seeds of Chakunde), and Rasanjana and buried a month beneath the roots of an Arjuna tree after which it should be taken out
skin,

raw bamboo

and applied to the black
egg, Kataka,
crystals-j- (pearls

cicatrix.

The

shell of a

hen's

Madhuka, (Yashti-madhu),

sea-oysters and

according to Jejjata and Brahmadeva)

taken

in

equal parts should be pounded and pasted with

• Rohini, according to some cornmentators, means a kind of Plaritaki according to others,
it

;

means Katu-tumbi.
etc.,

t Burnt ashes of sea-oysters and pearls

should be used.

Chap.

I.]

CHIKITSA STHANAM.

259

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
(JLomotpatti)
to
is

the

spot

where the appearance of hair

desired.

An

application of this

plaster

would lead to the appearance of hair even on the palms
of

the

hands.

Another alternative
of the

is

a

pulverised

compound
nails,

consisting
skin,

burnt ashes of the bones, horns of any quadruped,

hair,

hoofs and

over a part of the

body, previously
to the

anointed (rubbed)
in

with

oil,

which would lead

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 same result.

Kapittha,

would be attended with
hair

88

90.

Hair-depilators :— The
ated part of the
factory

of

an
the

ulcersatis-

body found

to interfere with

healing up of the ulcer, should be shaved with

a razor or clipped with scissors, or rooted out

with the

help of forceps.

As an

alternative,

an application of a

plaster consisting of
of)

two parts of pulverised (burnt ashes
arsenic)

conch-shell and one part of Haritdla (yellow orpiment

or

yellow

oxide

of

pasted
spot,

with Sukta (an

acid gruel) over

the

desired

would be attended
of the oil of of Snuhi,

with the same result

A

compound made

Bhalla^taka mixed with the milky exudation
should be used by an intelligent physician as
tory measure.

a depila-

As an

alternative, the burnt ashes of the

stems of

plantain leaves and
rock-salt,

Dirghavrinta (Syonaka)

mixed with
*

Haritdla and the seeds of Sami,

This also

is

a remedy for giving a natural colour to the skin.

26o

THE SUSHRUTA SAMHITA.
deemed
a

[Chap.

1.

pasted with cold water, should be
depilatory.*
tail of

good

hair-

A

plaster
lizard,

composed of the ashes of the
plantain,

a domestic

Haritala

(oxide of

arsenic),

and the seeds of
oil

Ingudi burnt together and
in the

pasted

with

and water, and baked

sun

may

also be used for the eradicating of hair
locality.

in

the

affected

94-95-

Vast! -Karma :— A

medicated Vasti (enema)
in the case of

should be applied to the rectum

an ulcer
with an

marked by an aggravated condition of the deranged

Vayu which
of the body.

is

extremely dry and

is

attended

excruciating pain occurring specially in the lower region

A

measure of Uttara-vastishould

(Vaginal or

Urethral
strictures

syringe)

be adopted in the cases of
urine,
ot
is

and other disorders connected with
menstruation,
as

.semen
gravel

and
"f

well

as

in

cases
ulcer

in case

these are due to an ulcer.

An

purified, softened

and healed up by bandaging leaving
apprehension of a relapse.
96-98.

no room
bandaging

for
is

the

Hence

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
the Eranda, Bhurja, Putika, or Haridrd
as

leaves
as

of

plants

well

with those of

the

Upodikd and

Gdmbhdri.
*
i

An
to

ulcer

marked by an aggravated condition
may be used
internally for the purpose.

According

seme
read

this

D. K.

Some

"Tatha^nile"

in place of

"As'mari-vrane."

."Taihanilt" means and in cases of (aggravated) Vayu.

Chap.

I.j

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

trees),

and aquatic

plants.

An

ulcer due to the
tied

deranged and aggravated Kapha, should be
with the leaves of
indchi,

over

the Pdthd,

Haridrd or

of the S'ukandsd.

Murvd, Only those

Gudiichi,

Kdkaleaves

which are not rough, nor putrid, nor old and decomposed,
nor worm-eaten and which are
soft

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
the

in

an

ulcer

is

attended with various kinds of
in case the

extreme pain, swelling and bleeding
eat

up the

flesh.

A

decoction of

the

drugs of

Surasddi gana proves
medicine in such a

efficacious as a

wash and healing

case.

The
bark

ulcer should be plastered

with such drugs as the

of

Saptaparna, Karanja,

Arka, 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

brought out of the ulcer by placing a small piece of raw
flesh

ulcer.

These vermin may be divided into

twenty groups or
later on.

classes,

which

will be fully dealt

with

(Uttara-Tantram—
kinds

ch. 54).

103.

Vrinhanam
tonics)
:

(use of restorative

and constructive
and constructive
of a
patient
of the

— All
leaf

of tone-giving
in

measures should be adopted
*

the

case

The

which does not poison the Sneha and the

essence

medicinal drugs placed in a folded piece of linen (and applied
ulcer
is

over

an

the proper leaf and) should be used for tying over the paste.

562

THE SUSHRUTA SAMHITA.

[Chap.

I.

weak and emaciated with
sore, taking
full

the troubles of a long-stand ins

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.
:

104-105.

^iro-vircchana and Nasya — s'iro-virechana measures
skilful

(errhines)
in

shou d

be

resorted
situated

to
in

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-CJharana
of decoctions
virtues either

— Medicated
(according
case of an

gargles (con-

of drugs) of purifying or healing

hot

or

cold *
in

to

requirein

ments) should be used

the

ulcer

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 :— inhaling of smoke or vapours
(of

medicated

drug.s)

should be prescribed

in cases of ulcers

of the

deranged Vayu and Kapha attended with swelling,

secretion and pain and situated in the region
clavicles.

above the

Application of honey and clarified butter, se-

parately or

mixed together should be prescribed
(Sadyo-Vrana)
bringing
for

in cases

of extended or elongated ulcers which are
incidental in their character

traumatic

or

allaying
its

the heat of the ulcer and
sion.

for

about
in

adhe-

Surgical instruments should be used

conncc-

* 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.]

CIIIKITSA

STHANAM.
is

263
but

tion with an ulcer

which

deep-seated
is

provided

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 m.ajor
stars and spirits with and the minor duties (Yama and Niyama)

enjoined to be practised on his behalf.
;

112-113.

The causes of ulcers are six-}* their seats in the body number eighty in all the features which characterise them are five $. The medicinal measures and
;

remedies

in

respect of

ulcers

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

chapter)

from fear of

may

be increased in combination with other

drugs or substances of similar virtue, (digestionary trans-

formation
*

and potency,

etc.)

without any apprehension

."^ee

Chap. XIX,

— Sulra-Sthanam.
an ulcer are Vayu,
Pitta,

t

The
The The

six causes of

Kapha, Sannip^ta,
Snayu, Sandhi,

S'onita aud Agantu.

X
Asthi,
§

eight seats of an ulcer are Tvak,

Mansa,

S'ird,

Koshiha and Marma.
five

symptoms

of

an ulcer are dae
to

to

Vata,

Pitta,

Kapha,

Sannipata and Agantu,
with those due
II

The symptoms due

S'onita

being identical

to Pitta, are

not separately counted,

The

sixty

medicinal measures and

remedies are

those

described

before in the present chapter.


264
of

THE SUSHRUTA
doing any mischief
or

SAMIIITA.

[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
mentioned
parti-

the

absence of

of them, as

in the present

work,

A
if

drug belonging to any
separately
disease,

cular

Gana

or

group

described as non-

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.

Upa.Clra.va. : 'The distressing supervening symptoms which are found to attend a case of ulcer, are quite
different

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 manidiarrhoea,
to
food,

patient are fever,
fits,

hiccup, vomit-

ing,

fainting

aversion

cough,

difficult

breathing,

indigestion

and

thirst.

The medical

treat-

ment

of ulcers though described in detail in the present
will

chapter,

be

further dealt with in the next chapter

on Sadyo-Vrana.
Thus ends the
first

118-120.
in

Chapter of the Chikitsita-Sthanam

the
ulcer.

Sus'ruta

Samhita which deals with the treatment of the two kinds of

CHAPTER
Now we
shall discourse

11.

on the medical
or sores

treatment of

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

Sus'ruta,

the

son

of

Vis'vdmitra.

Different Shapes of Sores :— I
scribe the shapes of the various
or wounds) caused
in

shall

de-

kinds

of

Vrana

(sores

by weapons of variously shaped edges
parts of the

the

different

ulcers

have a variety of
others
are

shapes.

human body. Traumatic 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 a

and

lastly

some have she shapes
at

barley corn
or a

(bulged

out

the

middle).

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.

A

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 a complete severance of a part or

member

of the

body

is

also

designated

by that name.

A
the
or

perforation

of any
tip of a

of the

cavities or receptacles of

body by the
is

Kunta, spear, Rishti, or a sword
little

by a horn, attended with a
called

discharge, constitutes
or ulcer.

what

a

Bhinna (punctured) wound
the

The AmAs'aya (stomachy
Agnyasa}'a

the Pakvds'aya (intestines),

the

(gall-bladder ?\

Mutr^s'aya

(urinary

bladder), the Raktas'aya (receptacle of blood), the heart,

the

Unduka and
(viscus).

the lungs constitute

what
filled

is

called the

Koshtha
which
is

A

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

(Vdta) with an
a

perspiration,

redness of the eyes,
feted

bloody smell

in

the
in

mouth, and
the heart

one

in the

body

and an aching pain

and

in the sides. 7

10.

Now

hear

me

discourse on (their) detailed symptoms.

A

perforation of the wall of the Amas'aya

(stomach)

is

marked

by

constant

vomiting

of

blood,

excessive

tympanites and an excruciating pain.
the Pakvatsaya
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

any

perforation,

the

Antras

(intestines) are filled with

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),

and

a sense of heaviness

also perceived in their inside, ri-13.

Chap.

II.]

CHIKITSA STHANAM.
or
in

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^.

A

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
friction

any part of the body suffering abrasion through or from any other such like causes and attended
is

with heat and a secretion
or lacerated)

called a
14-17.

Ghrishta (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
or aggravated

Vayu enraged
of

by the incidental bleeding,
Potions
as

or haemorrhage will occasion excruciating pain.

Sneha

foily or fatty liquids)

and using the same
and

a

washing
cases.

(in a

lukewarm
of

state)

should be advised in such
other Kris'aras

Preparation

Ves'avaras

mixed with oil or clarified butter should be used as poultices and fomentations with the Masha pulse, ungents and emulsive Vastis etc., and the use of oily
largely

(enematas)* prepared with decoctions of Vayu-subduing
drugs should be applied.
or

A

crushed or thrashed

wound

abrasion

is

not attended wi':h any excessive bleeding
;^on

an absolute absence whereof,
to

the contrary) gives rise
in

an excessive burning sensation and suppuration
affected part.

the

Cold washes

and

cooling

plasters

should

be

used in these cases for the alleviation of the
is

Snehapana

recommended when

the ulcer
is in

is

in a

region above Uie

umbilicus and Vasli-karma

when

the ulcer

a subumbilical region.

268

THE SUSHRUTA SAMHITA.
for

[Chap.

If.

burning and suppuration as well as
the
said

the

cooling

of

(incarcerated)
of these six

heat.

What

has

been specifically

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

off

be sutured

in

the proper

way and

position and
cut

should be poured into

cavity.

A

Chhinna

on

the Krikatika (lying on the posterior side of the junction
of the neck

and the head) and
to

even
its

if

it

allow

the

Vayu

"f*

(air)

escape through

cavity

should be

brought together

and
to

duly sutured and bandaged in a
leave

manner
between-.

(so

as

not

any

intervening

space

The

part thus adhesioned should be sprinkled
butter

with

clarified

prepared from goat's
to take
his

milk.

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
(sword-cut,
etc.)

lateral

and wide-mouthed wound
extremeties,

on

the

the

bone-joints

should

be duly set and joined together as instructed

before and the

bandaged
* Several

in

wound should be the manner of a

sutured

and speedily

Vellitaka bandage, or

commenlators explain those that are situated either on the
sides.

head or on the
t

The dictum
is

that a hurt on
to

any of the wind-carrying sounding chanto

nels

pronounced

be incurable, should not be supposed

hold good

in the present case.

Chap.

II.]

CHIKITSA STHANAM.
01*

269
or

with a piece of skin

hide

in

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, Priyangu, Haridrd,

most efficacious healing (Ropana) agents
the
thirteen

Madhuka, (Vasthimadhu) and milk, forms one of the A Kalka of
drugs

— Chandana, Karkatdkhya,
Aniritd,

the

two

kinds of

Sahd (Mugani and Mashani), Mdnsi,
Somahva),
Harenu,
should
oil)

(D.R.

Mashahva,
Triphald,
oil

Mrindla
in

Padmaka and Utpala
(lard,
oil

be cooked

mixed with milk
and
this

(four times that of

and the three
clarified

other kinds of oily matter
butter)

marrow and
should
be

medicated

used

for

sprinkling

over a

wound
28.

of this type for the purpose of

healing (Ropana).

Medical
of

Treatment
with the

of

Bhinna —
:

Henceforth we shall deal

medical

treatment

Bhinna

(excised) wounds.

A
up

case of an excised eye
as

(Bhinna) should

be given

incurable.

But

in

the case where an eye (ball) instead of being completely

separated would be
*

found

to

be dangling out (of
i.e.,

its

For the complete elimination of ihe deranged Doiha

pus,

elc

,

of the

wound

invloved in the case

—Jejjata.
back should be
breast
laid

He who
he

has got a

wound on
on

his

on

his

face

and

who

has got an

ulcer

his

should

be

laid

on his back

Differeut

Reading Gayi.

2/0

THE SUSHRUTA SAMHITA.
be
as

[Chap.

II.

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

following (D.R,— Ajena in place of

'Anena"
clarified

i.e.,

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

Jivaka

and

Rishavaka taken

should

be pasted together, and
cow's
use
of

cooked with sixteen seers of
clarified

milk and four seers of
the

butter.*

The

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

by the discharge of lumps or rope-like Varti (fat) through the wound, the emitted or ejected fat-lump
should be dusted with the burnt ashes (D. R. — powders)
of astringent

woods (such

as

Manu,

Arjtina, etc.)

and

black clay (pounded

together).

A

ligature

of thread

should then be bou'id 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 16 seers of cow's milk and with the
But Gayi recommends only four seers of
goat's milk a Kalka.

four drugs as a

Kalka.
from
as

clarified butter

prepared

cooked wilh i6 seers of cow's

milk

and the four drugs

Chap. II]

CHIKITSA STHANAM.
and

2'J\

medicinally with Yashti maddu, Ldkshd

Gokshura,

mixed with
(as

(a proper quantity of) sugar
is

Prakshepa)*

equally

and castor oil commendable for the alleburning sensation,
(pariental
fat)
(in

viation of the pain and the

the

wound

or

ulcer).

The fat-lump

afore-

said causes a rumbling sound with pain in the

abdomen

and may prove even fatal in the event of its being left uncut. The medicated oil to be mentioned hereafter
in

connection with

Medaja-Granthi

should

be

applied

in

such cases.

30-32
piercing
into

Foreign

bodies (^Salya)

any
etc

of

the
ofj

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). The blood (of the affected chamber or receptacle) in such case lies
incarcerated therein in the event of
outlet
its

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

cold, the eyes red-coloured, the

bowels consti-

pated and the abdomen

distended.

The manifestation
character of

of these symptt)ms 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 milk

— one

with

Yashti-madhu and
other

mixed

with sugar

and castor

oil

as a

Prakshepa and
oil as a

with

Gokshura and mixed with Laksha and castor

Prakshepa.

A
oil

thiid in'erprjtation

would make three preparations of milk prepared

separately with Yashli-madhu,

Laksha and Gokshura
Prak.hepa)

— sugar
oil

and castor
in

being mixed in the

first

(as

and

castor

alone

the

second and third.

A

fourth preparation

would be

to

prepare
in the

the

milk

separately

wiih

Yasblimadhu, Laksha and Gokshura as
addition of castor
oil (as

preceding case

— without the

Prakshepa).

272

THE SUSHRUTA SAMHITA.
Emesis
is

[Chap,

II.

beneficial
to

in

the

case

where the blood
in

would
scribed

be

found

be

confined

the

Amas'aya
be
pre-

(stomach).

Purgatives

should

unhesitatingly

where the blood would be found to have been lodged in the Pakvds'aya (intestines) and Asthapana measures without oil should be employed with hot,
as

purifying i^Sodhana) substances (such
etc.)

the

cow-urine,

The

patient

should

be made to drink a Yavagu

(gruel) with

Saindhava

of boiled rice

salt and his diet should consist mixed with the soup of barley, Kola and
oil.

Kulalttha pulse divested of

35-36.

In a case of a perforation or piercing of any of the

bodily Koshthas attended

with excessive haemorrhage be caused to drink
(a

or bleeding, the patient should

potion of animal) blood and such a case

marked by the
and tympanites

passage of

stool, urine, etc.,

through their proper channels
of fever

of outlet and by the absence

and other dangerous symptoms, (Upadrava),
in the ultimate

may

end

recovery of the palient.

37-38.

In a case of a perforation of the Koshtha (abdomen)

where the intestines have protruded or bulged out
untorn condition, they should
into the cavity

in

an

be gently
their to

re-introduced
position,

and placed

in

original
others,

and not otherwise.

According

however,

large black ants should be applied even

to the perforat-

ed intestines in such a case and their bodies should
separated from their heads after they had
the perforated parts with
their

be

firmly

bitten the

claws.

Aftei-

that
to

intestines with the heads of the ants

attached
the

them
re-

should be gently pushed back

into

cavity

and

instated in their original situation therein.

The bulged
and
clari-

out intestines should be
dust,
fied

rinsed

with grass, blood
lubricated

washed with milk and

with
the

butter and gently re-introduced into

cavity of

Chap.

II.]

CHIKITSA STHANAM.
the

273
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.
partially

In a case w^hers the intestines could be but

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
the
full

vomiting thus

engendered, would help

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) Kala
In
tines

42-43.
intes-

a
into

ca.se

where the re-introduction of the abdominal

the

cavity would be found to be

difficult
orifice

owing to the narrowness or largeness of the
of the wound,
it

should be extended or widened

with a small or slight incisiona ccording to requirements,

and the intestines re-introduced into their proper place.

The

orifice or

mouth

of the

wound should be
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

THE SUSIIRUTA SAMHITA.
clarified

[Chap.

11.

butter,

and the patient should be given a
R. tepid milk) with

draught of tepid

clarified butter (D.

castor oil for an easy passage of the stool

and downward
flatus).
oil,

coursing of the

Vdyu

(spontaneous emission of the

Then,

for its healing

up (Ropana), a medicated

pre-

pared with the bark of the Asvakarna, Dhava, S'dlmali,
Mesha-s'ringi, S'allaki, Arjima, Viddri, and Kshiri trees

and Vald
and forego

roots should be applied to the
life

wound.
47

For a

year the patient should live a
all

of strictest conticence

kinds of physical exercise.

—48.
of the
intro-

The

legs

and the eyes of the patient should be

barsting" out of the

washed and sprinkled with water in the event testicles which should be
sewn up

duced into their proper place within the scrotum, and
in the manner of a Tunna-sevani (raised seam;. The scrotum should be bandaged in the shape of a Gophana-Vandha and a restraining apparatus (Ghatta-

Yantra)

placed
against

round the waist of
its

the

patient

(to

guard

it

oscillations or

hanging down).
with

The

wound should not be
oil

lubricated
it

any kind of
a

or

Ghrita

inasmuch as
prepared

would make the wound

moist and slimy.

The wound should be healed with

medicated

oil

with Kdldnusdri, Aguru, Eld,

Jdtl flower, Chanda?ia, Padtnaka, Manahs'ild, Devaddru,

Amrita and sulphate of copper (pounded

together). 49-50.

A

plug of hair should

be inserted into a

wound on
matter
of the

the head, after having extracted the foreign

therefrom, with a

view to arrest the exuding

brain matter (Mastulunga) which invariably proves fatal
to the patient through the aggravation of

the

deranged

Vayu

in

consequence thereof.

The
the

hairs of the plug

should b3 taken out one by one as
progresses
;

healing

process

granulation).

An

oleaginous medicated plug
a

or lint should be inserted into

wound on any

other

Chap.

II

]

CHIKITSA STHANAM.
body,

2/5

part

of the

which should be treated with the
laid

measures and remedial agents
with a traumatic
ulcer
after

down
first

in

connection
the

having

allowed

vitiated blood to escape.

51-52.

The medicated
should

oil

known

as

the

Chakra-taila*
deep-seated
vitiated

be poured (frequently applied) by means of a
is

slender pipe into an ulcer (wound) which

but narrow-mouthed, after
blood"!-,
-^ri oil

first

letting

out the

duly prepared and boiled with Samangd,
Tuttha,
Vidang-a, Katuka,

Haridtd, Padmd^ Trharga\

Patkyd, Gtiduchi and Karanja acts as a good healing

(Ropana) agent

(in

these

cases).

The

use

of an

oil

prepared with Tdlis'a,Padmaka, Mdnsi, Harenu, Agufu,

Chandana, and the two kinds of Haridrd, Padma-vija,
Us'ira and Yashti-madhu acts as a
in cases of traumatic ulcers.

good healing remedy
treated with
a

53"55its

A
own

cut

wound (Kshata) should be
measures and
treated (to

specific

remedies, while
all

bruised

one (Pichchita) should be
purposes) as a case of

intents

and
first

Bhagna

(bone-fracture).

The

treatment of a mangled or contused
is

wound (Ghrishta)
should be dusted

to extinguish

pain, after

which

it

with the powder

of proper

medicinal
56-57.

drugs (such as

S'dla^ Sarja, Arjima, etc.).

In the case of a dislocation of any part of the body,

caused by a

fall

(from a tree), or in the event

of having

been run over or trampled down (Mathita
or

— by a
a

carriage
etc.),

by a
*

beast),

or of being

wounded

i^b}-

blow,

chips of
to

The oil just pressed out of an old oil-mill or squeezed out of ihe wood belonging to an old one, in ihe manner of the Anutaila be described hereafter, is called the Ohakra-taila The vitiated blood should first be let out for fear of putrefaction t
+

of the ulcer,

Triphala, Trikatu

and Trimada

are called

Trivarga.

2/6
the
patient

THE
should

SUSIIllUTA SAMIIITA.

[Chap.

II.

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

A man
or hurt at

fatigued

(from

the

a journey^
likewise
58.

any

of the

Marmas,
preceding

should

be

treated

with

the

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-

A

physician

should

wash a

traumatic ulcer
Vala-oil

attended with an aching pain either with a
tepid clarified
butter

or

(according to the

nature of
59

the

season and the temperament of the patient).*

— 61.

An
Pathyd,

oil

cookcdwhh Saman^d, Rajanz, Fa^imd (Bhivgi), sulphate of copper, Suvanhald, Padmaka,
Vidanga, Haremika, Tdlis'a(red)

Lodhra, Yashti-ntadhuka,
patra,
kes'ara,

Nalada {/atdmdnsi),
Manjishthd,

Ckandana,

Padma-

Us'ira,

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.
sweet,
for

Applications

of astringent,

cooling

and

oily

medicines should be

used

a

wxek

in

a case of a

traumatic ulcer (Sadyo-vrana), after which those mentioned
before, in

the

Chapter of Divraniya, should be

adopted
*

62—63.
oil in

With

aulumn and

in

the

case

of a

patient

of Rakta-pitta

tempeiament, and

wi'li Vala-oil in

winter and in the case of one of a Vdla-

k.npha temperament.

Chap.

II.]

CIIIKITSA

STHANAM.

2^7
the

Treatment of Dushta-Vrana:— In
case
of

a

malignant ulcer (Dushta-Vrana)

emetics,
sorts

errhines,
of diet

purgatives,

Aslhapana, fasting, specific
bitter,

(composed of

pungent and

astringent

things)

and blood-letting, should be prescribed (accordrequirements of each
be
case).

ing to the
sore

The

ulcer

or
the

should

washed with the decoctions of
of

drugs of both the Aragvadhadi and the Surasadi ganas,

and
drugs

an

oil

cooked with a decoction
be
applied
to

the

said

should

the

wound

for tthe

purification (Sodhana) thereof.

As an

alternative, an oil

boiled
(four

and prepared
times

in

an alkaline water or solution

that of oil) with a
as

Kalka of alkaline subsPalas'a,
etc.)

tances (such

Ghantaparuli,

should

be

used

for

that

end
to

Oil

cocked

with

Dravanti

(Satamuli, according

certain

authorities,

MushikaChit-

parni

according to others), Chiravilva, DaJiti,
Ximba-lcavcs,
the

raka, Prithvikd
Tejovaii,

Kas
two

isa,

Tuttha, Trivrit,

Nili (indigo),
salt,

kinds of

Haridrd^

Saindhava
khyd,

Tila,

Bhiimi-Kadamba, Stivahd, S'ukdNaipdli^
Jdlini,

Ldngaldhvd,
Siidhd^

Madayanti^

Mrigddani,

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.
In the case of a

malignant

ulcer,

due

to

the

aggravated
of a

Vayu, the purifying remedy should consist
of

Kalka

Saindhava
of a In

salt,

Trivrit and castor leaves.
Pittaja sore,

In the case of a (malignant)

the remedy

should

consist

Kalka
the

of Trivrit, Haridrd, Yashti-

madhii and Tila.

case

of

a

malignant

ulcer,

caused by the aggravated Kapha, the purifying remedial

278
agent should

THE SUSflRUTA SAMHITA.
consist of Tila,
roots.

[Chap. H.

Tejohvd, Danti, Svarjikd

and Chitraka

presence of the virus

An ulcer brought on owing to the of Meha or Kushtha in the system,
64

measures and remedies mentioned under the treatment
of Dushta-vrana should be adopted and used.

— 68.

The
list,

recognised school of physicians, which recognises

these six types of traumatic sores, does not
herein

add to the
whereas

mentioned, other types of
it

ulcers,

vain

pedagogues try to swell
of the aforesaid six.
so,

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

since

other types

that

they can devise are but single instances and can be
to
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

(Bhagnas).
fracture

IVIetrical

Texts :— A
in a

or dislocation

(Bhagna) occurring
in his diet, or

person

of

a
in

Vatika temperaone who
is

ment, or of intemperate habits, or
is

sparing

affected with such supervening disorders

(as fever, tympanites, suppression of the stool

and

urine,

&c.)

is

hard

to

cure.*

A

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 and parchiarticles

fying (devoid of oleaginous)
consisting
butter,

of

food.
f

A

diet

of

boiled

rice,

meat-soup,
all

milk,

clarified

soup of Satiiia pulse and

other nutritive

and

constructive food

and drink, should be discriminately

given to a

The barks of Udumbara, Madlmka, As'vattha, Palds'a, Kakubha, Bamboo, Vata
fracture-patient.

or

Sdla trees should be used

as

splints (Kus'a).

Manji-

shthd,

Madhuka,

red sandal
clarified

wood and
butter
(i.e.,

Sdli-ncQ mixed
clarified

with S'ata-Dhauta

butter

* Jejjata does not read the first verse, but

Gayi does.
be
prescribed
to

t

As

a

general

rule,

milk should

not
;

a

patient

suffering from an ulcer (Vrana) in general

but a case
that

of fracture

forms

an exception

thereto.

Some
if

authorities

hold

tepid

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
fracture-patient for fear of suppuration

a

and the
to

setting in of pus.

Others, however, take
explain the term to

"Kshuasarpih"
the
clarified

be a compound
prepared

word and
milk
(as

mean

butter

from

distinguished from that prepared from curd).

But experience
tiun,

tells us that in

cases of excessive weakness

or

emacia-

milk may be given without any hesitation— Ed.

28o

THE SUSHRUTA SAMHITA.
in 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

{i.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

rise

to

swelling
in

and suppuration
of fractures,
tight nor

local

skin, &c.

Hence
is

cases

experts prefer a bandage which
too loose.
7-8.

neither too

Washing's :— A
affected
part),

cold decoction of the

drugs of

the Nyagrodhddi group should be used in

washing (the
of (excessive)

whereas

in

the

presence

pain, (the part) should be

washed with milk boiled with

the drugs of the (minor) Pancha-mula, or simply with the

known as the Chakra-taila made lukewarm*. Cold (or warm) lotions and medicinal plasters (Pradehas)ofDoshaoil

subduing drugs should be prescribed with due regard to
the nature of the season

and the Doshas involved

in

each case.

9-10.
f

A
first

preparation of milk

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.
is

In
due

a
to

case of
Vayu and

* In winter

and where the aching

pain

present

Kapha.
t Consisting of the drugs of the Kakolyadi group weighing two Tolas,

milk

si^iteen Tolas,

water sixty-four Tolas, boiled together with

the water

entirely evaporated.

Ch»p.

III.]

CHIKITSA STHANAM.
on the
part, an

28
astringent

fracture attended with ulcer

plaster plentifully mixed with honey and

clarified butter

should be applied

;

and the

rest (diet

and regimen of
a (simple)

conduct) should be as laid
fracture.

down

in the case of

11-12.
:

PrOgTIOSiS
youth or a
winter,
is

-A

case of fracture occurring in

a
in

person with slightly

deranged Doshas or
fractured

held to b2 easily curable (with the help of the

aforesaid medicines

and

diet}.

A
in

bone

in

a

youth
of a

is

joined by the aforesaid
in

treatment

in the course

month,

two months

the case of a middle13-14.

aged

man and
it

in three

months

in

one of old age.

An
set

elevated and fractured joint should be reduced by

pressing

down, while one hanging down should be
it

by raising

up,

by pulling

it

in

the
it

case
its

of

its

being pushed aiide, and by reinstating
(proper) position in the event of
its

in

upward
(Rhagna)

being lowered down.

An intelligent physician should
joints,

set all dislocated

whether fixed or movable, by

the

mode

of

reduction, known as Anchhana, Pidana, (pressure), Sankshepa and Vandhana (^bandaging). 15-16.

Treatment :—A
should not be shaken
cold lotions or washes
{i.e.,

crushed

or

dislocated joint
at
rest)

should be kept

and

and medicated
normal

plasters (Pradeha)
is

should be applied to the part.
reset to its natural or

A joint

spontaneously
the

state or position after

correction of

its

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 of fractures in particular
limbs :^Now
be adopted
in

we

shall discourse

on the measures to
each particular

fractures

occurring in

36

282
limb.

THE SUSHRUTA
In the case of a

SAMIIITA.

[Chap. III.

nail-joint,

being

in

any way
be
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

should be plastered with a paste of Sdli-rice.

A

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
out
splint

linen.

In case of the fracture projecting

a thigh-bone should be reset with the help of a

circular

and bandaged.
in

In the case of Sphutita
thigh-bone, the part
20-24,
it

(cracked)

or

Pichchita (bruised)

should be also bandaged

the aforesaid manner.
the

In a case of a fracture in

Kati (Ilium-bone),

should

be reduced

by the fractured bone being
(as the case

raised

up or pressed down
or
Ghritas*}.

may

be)

and the patient
fracture

should then be treated with Vasti (enematas of medicated
oils

In

the

case

of a

of one

of the rib-bones (Pars'aka), the patient should

be lubribe lifted
rib

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
is

or
a

pad
case

In the Nidana-Sthana— Chap. XV.,

9—

it

stated

that
Jejjata,

of

fracture in the

Kati should be given up (Varjjayet).

however,

explains "Varjjayet" as "hard to cure."

Chap.

III.]

CHIKITSA STHANAM.
placed
a

283

(Kavalikaj should ba

over

it

and the patient
full

should be carefully laid in
oil

tank or cauldron
duly tied

of

with the

bamboo
case

splint

up with straps
of the of the

of hide.

In the

of

a dislocation the

Sandhi

(shoulder-joint),

region

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 elbow-joint

should

be

first

rubbed with

the

thumb, after which
it

it

should be

pressed with a view

to set

in its right place

by fixing and expanding the
sprinkled

same.

After that the affected part should be

over with any oleaginous substance.

The same measures
a

should be adopted

in

the

case of
the

dislocation

of

the knee-joint (Janu-sandhi),

wrist-joint (Gulpha25-29.

sandhi) and the ankle-joint (Mani-vandha).
In
the
case
of fractured

bones

in the

palms of the

hands, the two palms* should be

made even and opposed,

and then bandaged together and the affected parts should be sprinkled with raw and unmedicated oil (Ama-taila).

The
in

patient should be

made

later first to hold a 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.

A

of
to

fractured

arm-bone should be
given
in

treated

according
a fractured

the

directions
30-32,
''Ubhe

the

case of

thigh-bone.

The

text has

tale

same kriivd." Jejjata explains "Ubhe

tale"

to
it

mean "palms of
to

the hands and soles of the feet ;"

Gaya Dasa

explains

n>ean "the palms of both the hands."

284

THE SUSHRUTA SAMHITA.
Li thi cas3 of a bending
(twisting) or

t^hap. III.

intussuscep-

tion 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

the part should be bandaged with a piece

of linen

after having evenly put the splint (Kus'a round the neck).

The
back

patient
for a

should

be

caused to

lie

constantly on his

week.

In a case of a dislocation of the joints

of the

jaw-bones (Hanu\ the jaw-bones should be foment-

ed and duly set in their right position, bandaged in the manner of a Panchangi-vandha, and a Ghrita boiled

and prepared with (the Kalka and a decoction of) the Madhura (Kakolyadi) and V^yu-subduing (Chavyadi)
groups should be used as errhines by the patient,

^y^

{.

A
after
root.

tooth of a young

person,

not

broken

but
its

loose,

should be plastered with a cooling paste on

outside
at

having pressed out the accumulated

blood

the

The tooth should be
The

sprinkled

or

washed with
caused

cold water and treated
(adhesive) properties
to
-f

with drugs having Sandhaniya
patient

should be

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 or
be straightened
in

director,
of simple

while

should

a

case

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
According
to Gayi, the lifting

should
of the

be rubbed with
fingers
in

up

h3ad by putting
in

ihe Avalti and in the

Hanns should be made

cases of bending

and

intussusception of the neck respectively.

t

Honey,

clarifisd butter,

and drugs of the Nyagrodhddi group.

Chap. III.]

CHIKITSA STilANAM
straightened, and

285
set
in
its

clarified butter

evenly

right position

and bandaged.
in

Measures and remedial
with
Sadyo-vrana,
in the

agents

mentioned

connection

should be likewise adopted and employed
instance.
37.

present

In a

case

of a fracture of the bone of the

forehead

unattended

by

any oozing out of brain matter, the
rubbed with honey and

affected part should be simply
clarified butter

and then duly bandaged.
38.

The

patient

should take clarified butter for a vveek *

Cooling plasters and washes should be applied to a
part of the body, swollen but not in any

way

ulcerated

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

should
five

down on
or

a

plank or board and bound to
places for the
of
his

pegs in

five different

purpose

of preventing

any

movements

limbs.

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
In the second case (fracture of knee-joint) two on
side of the ankle-joints

the

exterior side of the enguinal region of the affected side.

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

columa, the
long-standing

chest and the shouldersi*.
lardaceous

In

cases

of

dislocations, the joint should be lubricated

with oily or
(with

applications,

fomented and softened
a

In the case of such an emission or oozing out
hiir as described in the preceding chapter
in

plug

of bristles or
laid

and remedial agents

down

connection therewith, should be
t

used.

The

principle

of

splintering
in

and bandaging

may be

profllably

compared with those followed

Agnur'a 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 union of a (fractured) lying between two
joints

bone

should be again disjointed,

(Kaada-bhagna), the union and the fractured bone should
as

again be set right and treated
fracture.

a case of ordinary

In the case where a fractured bone
ulcerated the

would be
part

found to have protruded out of the
dried,
it

and

should be carefully cut off near

margin of

the (incidental) ulcer, (so as not to create a fresh ulcer on

any other spot
in the

of the

affected

part)

and subsequently
fracture occurring

treated as a case of fractural ulcer.

A

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.

Potions of

clarified

butter,*

errhines

and Anuvdsana
in

(enematas) should be prescribed in cases of fractures
the extremeties.

41-43.
:

Gandha-Taila — Now
the
recipe

we

shall

discourse of

on

of a

medicated

oil,

capable

bringing

about the union of fractured bones.

A

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).
(at night
It

sun

(for

seven conse-

should then be saturated with cow's milk
in the sun,

and dried

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
s

the fourth week)

should be again saturated with cow

milk and dried and
*

powdered.

The

sesamum-

According to

Jejjata, not, only

Anuvasnnaenematas but potions of
in cases of fractures

clarified butter

and errhines also should be prescribed

in the extremeties.

Chap.

III.]

CHIKITSA STHANAM.
and

287
constituting

powder

powder of the drugs,

the

Kakolyddi Gana

as well as Yasthi-madhu, ManjisJithd,
(red)

Sdrivd, Kushtha, Sarja-rasa^ Mdnsi, Deva-ddru,

Chandana^ and S'atapusJipd 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 pulv^erised
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'dlpami, Tejapatra, Jivaka,

Tagara, Rodhra,

Prapaimdarika^ Kdldnusdri, (Tagara),
S'ringd-

Saireyaka, Kshira-Viddri, Anantd, Madhulikd,
iaka,

and those of the aforesaid
Yasthi-madhu,
etc.,

list

(Kakolyadi

group
pasted
over
a
oil

and
gentle

up

to

S'atapushpd)

together.
fire

The
and

oil
is

should be

duly

cooked

called the

Gandha-Taila.
results

This

should be administered

with good

in possible

ways

(e.g.,

as potions, liniments, unguents
Its efficacy is

and
or as

errhines)

to a fracture-patient.

witnessed in

cases

of convulsions,
the palate,
in

hemiplegia, parchedness
Ardita
(facial

atrophy of
well
as
in

paralysis)

Manyd-stambha
in diseases

(Paralysis

or

stiffness

of the

neck),
in in

of the head
in

(cephalagia),

in

ear-ache

Hanu-graha,

deafness

and

in

blindness

and

emaciation due to sexual

excesses.

Administered

in

food or drink, or employed as a liniment, in Vasti-karma

(enemata
sovereign

measures)
restorative.
it

or

as an

errhine,

it

acts

as

a

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

and

a

full-blown

and

imparts a sweet
part of

There should be three Dasa says

parts of

sesamum powder and one
Manjishtha,
etc.

(he powders of Kakolyadi,

Yashti-madhu,

(combined).

But

s'iva

that four parts of

sesanium-powders should be taken.

288

THE SUSHRUTA SAMHITA.
It is

[Chap. IIL

fragrance to the breath.

one of the most powerful
of the

remedial agents
(diseases

in

disorders

aggravated
It

Vdyu
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 (Okolyddi 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
Vasti-karma
union
of

a potion for anointing, and as an

errhine,

and

washes,

it

speedily brings
46.

about the

fractured bones.

A

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.

A

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)^

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

Sihanam

in the Sus'ruta
dis-

Samhita which deals with the medical treatment of fractures and

CHAPTER
Now we
nervous disorders

IV.

shaH discourse on the medical treatment of

(Vata-vyadhl).
;

r.

IVIetrical

Texts
in

— The
the

patient

having been

made

to

vomit

in the

event of the deranged

Vayu being

incarcerated
pulverised
(a

(lodged)

Amas'aya (stomach), a

compound known as the Shad-Dharana-yoga compound of six Dharanas or twenty-four MashA
seven
days.

weight) with tepid water should be administered to him

compound made up of Chitraka, Indra-yava^ Pdthd, Katiika, Ativishd, Abhavd (taken in is known as the Shadequal parts) together Dharana-yoga* and contains the properties of subfor

A

duing an attack of Vdta-vyadhi.
In the event of the

2-3.

aggravated Va} u being incar-

cerated in the Pakvas'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
salt*}*

fatty matters)

and

diet (Pras'a)

abounding
in

or saline articles should be prescribed.

In the case

of the aggravated

Vayu

being incarcerated
(lit.

the Vasti

(urinary

bladder),

diuretic

bladder-cleansing)

measures and

remedial

agents should
oils,

be resorted

to.

Anointing with medicated
of poultices

Ghritas, etc., application

drugs,

massage,

(Upanaha) compounded of Vayu-subduing and plasters (Alepa) of similar procases where

perties are the remedies in

the

aggravated

Vayu
*

is

lodged

in the

internal ducts or channels such

One Dharana

is

equal to four Mashas.
elc.

t

Sneha-Lavana and Kanda-Lavana,

17

290
as the
ears,
is

THE SUSHRUTA SAMHITA.
etc,

[Chap.

IV.

of

the

body.

Blood-letting
the
in

(vene-

section)

the

rem edy where
(Sirds).

aggravated
the
skin,

Vayu
flesh,

would
matters

be

found to be

confined

blood or veins

Similarly, application

of

fatty

iSneha),

actual

cauterization, massage, appli-

cation of poultices and binding of ligatures should be the

remedies where the aggravated
to have

Vdyu would be found
Saaiyu (ligaments), joints

become involved

in the

and boaes
found to
flesh of

Where

the

aggravated

Vayu would

be

have become situated in the bone, the skin and 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
tube.

his

Vayu from out of the affected bone by mouth to the exteiior open end of the V^yu having contamindis-

4-9.

In the case of the aggravatd

ated the semen, measures and remedies for seminal
orders (Sukra-dosha)* should be employed.
(physician)

The

intelligent
as

would take recourse to measures, such
immersion or bath
in a vessel (full of

blood-letting,

Vayuin

subduing decoctions), fomentation with heated stones, as
well as in the

manner of Karshu-Sveda, vapour-bath
(Kuti sveda),

a

closed

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, the purification of the

Treatments, such
-s

semen, etc, and the use
for

ol meiiicin

for

making Aphrodisia (Vaji-karana) and
(Mutra-dosha)
should

the

remedy
and

of

ihe dibordereil urinary organ
^

be adopted

employed.

Chap. IV.]

CIIIKITSA STIIANAM,
to have been confined in 10-12.

291

would be found

any

parti u'ar

part of the body,*

In the event of the aggravated
either with the Pitta or the

Vayu being connected

Kapha, such a course of treatment should be adopted as would not be hostile to the two other Doshas. Blood-letting (in small quantities)
should

be

resorted

to

several

times

in

a

case of

complete genesthesia (Supta-Vata) and the
be

body should
chamber-dust

anointed with

oil

mixed with

salt

and

(Agara-dhuma)
meat-soup
or

Milk boiled with a decDction of the
soup of
(well-cooked)
beneficial
in

drugs of the Pancha-mula group, acid-fruits (Phalamla),
corn
cases

(Dhanya)
of

with clarified butter are
roga,
13-15.

Vata-

^alvana-Upanaha :— A
of the

poultice

composed
Vayu-subVidarias,

drugs of the
(those

K^.kolyadi
of
all

group,

the

duing drugs

Bhadra-darvddi

and

gandhadi groups), and
Kanjika,

kinds of acid articlesf (such
etc.),

Sauvira, fermented rice-gruel,
in

the flesh of
in

animals which live
(Audaka)l,
oil,

swamps (Anupa)
butter

or

water
of

clarified

and

all

kinds

lardaceous substances, mixed together and saturated with a profuse quantity of salt and then slightly heated is known by the name of Salvana. A person suffering from any form of Vata roga should be always treated

with such Salvana poultices (Upanaha).
should

The

poultice
is

be

applied to

such part
measures
should

of

the

body as
laid

"

It

is

to

be

understood
of

that

and remedies
be used

down
Vayu

under

the

head
to

Sarvanga-gata

when

the

would be found

be diffused throughout the whole

organism instead of

being confined to any specific part.
t

According

to others

it

means

all

kinds of acid-

fruits, etc.

X
of

Chakradatta reads "^IT^qfliH: fln^^:" (well-cooked with the
in place of

fle.h

"Anupa" animals)

^|T<ft^^*ltQ^

I

292

TJ'E

SUSHRUTA SAMIllTA.
or

[Chap. IV.

numbed, painful

contracted

and the affected part
a
piece of

should be firmly ban daged

thereafter with

Kshauma*

linen

(

r

woollen cloth.

As an

alternative,

the affected part should be plastered (and well

rubbed)

with the ingredients of the Sdlvana-Upanaha and inserted
into a

bag made

of cat or
i6.

mungoosc skin
if

or

that of a

camel or deer hide.

The aggravated Vayu,
chest, the

located in the shoulders, the

sacrum

i^Trika) or the

Manya, should be subdued

by emetics and errhincs judiciously employed. Siro-Vasti
should be applied to the head of the patient as long as
it

would take one to utter a thousand Matras
sound),

(a short

vowel

more or
head,

less, as

the case

may

require,

where the
itsellf

aggravated
in

Vayu would be found
(if

to have

located

the

necessary)
is

blood-letting should

be

resorted to.

As

a

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

Vtiyu whether
or
is

it

extends throughout the whole system
17-19

confined to a single part.

Measures beneficial to Vata-Vyadhl:

— An application 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

lukewarm

washes, gentle

massage, the use of saffron, Agttra^ Patra, Kushtha, Eld^
Tagara, the wearing of

woollen, silken, cotton or any

other thick kind of garments, living in a
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,
lead
it

these
i.e.,

and such
made up

like

other

things

Some

as Valka,

bark.

Chap. IV

]

CIIIKITSA 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

i^Kaika) of

Suvarna-kshiri,

Saptald,

S amkhini,
each

TripJiald
tolas\

and Vidatiga, each weighand
curd,

ing

an

Aksha \two
of

Tilvaka- roots and
tolas),

Kampillaka,
decoction
Patras
'-'

weighing a Vilva (eight
and

a

Triphala and

each weighing two

(^thirty-two seers)

clarified butter,

weighing

sixteen seers,
authorities

should be duly cooked together.
this

Medical
as

recommend
in

Tiivaka Ghiila
in the

an oily

purgative

cases

of

Vata-roga.

As'oka-Ghrita and

Ramyaka-Ghrita aie prepared
b}'

same manner,

(viz.,

substituting As'oka
21.

and Ramyaka respectively

for

Tilvaka).

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 the

hand or with a saucer.
as
in

skimmed The oil

off either

thus

collected

should then be cooked with the Kalka of Va}ai-subduing

drugs
oil is

the preparation of a medicated
as the Aliu-Taila

oil.

This
has

known
This

The

use of this
in

oil

been advised by medical authorities
roga.
oil
is

cases

of
its

Vatabeing

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

group of

Maha-pancha-mula
and burnt on a

should be collected

in large quantities

Patra me.ins 64 Palas,

i

e.,

8

seer.=,

but

in

cases

of liquids

the

weight should be doubled,

294
plot

THE SUSHRUTA SAMHITA.
of land, so
as to

fCliap IV.

make

the soil

black.
;

The

fire

should

be

kept

burning

one whole night
fire

on the

following morning on the extinction of the

the ashes

should be removed and the ground, be soaked with one hundred Ghatas
four

when
(six

cool,

should

thousand and

hundred

seers)

of

oil

the

Viddri-gandJiddi group
and kept
in that

cooked with the drugs of and with the same quantity
condition for one night more.
up,

of milk

On
to

the next

morning the earth should be dug
should then be dissolved in
for

down
oil

the

stratum found to have been soaked with the
soil

and the

warm water
oil

in

large cauldrons

the

purpose.

The

that will be

found floating on

the

surface

of the water

should

be

skimmed off with both hands and kept in a safe basin. Then the decoction of the Vayu-subduing drugs (the
Bhadra-darvadi group), meat-juice, milk, fermented
gruel
rice-

(each taken in

a

quantity

measuring a quarter

part of that oil) should be taken

one thousand times
oil.

and each time should be boiled with the
subduing and aromatic drugs and
be thrown

Vayu-

spices, in the northern

i^trans-Himalaya) and southern (Deccan) countries, should
into
it

and boiled with the

oil.

The

boiling
it

should be completed within the period during which
could be properly done.
tne cooking, conch-shells

Then

after

the

completion of

should be

blown, Dundubhis

should

be

sounded,
should
be

umbrellas

should
it

be held

open,

chowries

blown into

and a thousand

BrAhmins should be treated with
silver

repasts.

The
in

oil

so

sacredly prepared should be stored carefully
or earthen
pitchers.
is

golden,
the

This

oil

is

called

Sahasrapaka-Taila and
fit

of irresistible potency

and
also

even for the use of kings.
in the

Satapatka-Taila

is

prepared
dients)

above manner (with the aforesaid ingreit

by cooking

one hundred times only.

23.

Chap. IV.]

CIIIKITSA STIIANAM.

295

The Patra-Lavana :— The green leaves of the
Eranda
plants and those of the trees

known

as

Mush-

kaka, Naktamdla, Atarushaka, Puiika,

Aragvadha and
equal quantity)

Chiiraka should be thrashed with
in

(salt of

an Udukhala

(a

hand thrashing
oil

mill)

and placed

in

an earthen pitcher, saturated with

or clarified butter. a
lid,
it

Having covered
should
be

the

mouth

of the pitcher with
in
fire

plastered

and burnt

of

cow-dung.

The medicine
heat)
is

thus
the

prepared (with the help of internal

called

Patra-Lavana.
of
this

Medical
in

experts
cases
of

advise

the

application
.'^4.

medicine

Vata-roga.

The Kanda-Lavana
twigs,

'.—Similarly,
S' igru-h-d.xV
as

Snuhiin

Brinjal (V^rtaku), and

(taken
the

equal parts) and rock-salt (of equal weight
drugs) should be thrashed and kept
clarified butter, lard
it

entire
Oil,

in

a

pitcher.

and marrow should be added
salt

to

equal in weight with

and then
lid, it

having covered

the

mouth

of the pitcher with a
in

should be plaster-

ed and burnt
use

a

fire

of cow-dung (as before).
salt

of this or

medicated

which
is

is

called the

The Kanda-

Lavana
in

Sneha-Lavana
25.

recommended by experts
followviz.,

Vata-roga.

The Kalyanaka-Lavana :— The
ing

drugs

with

their

roots,

leaves

and twigs,

Gandira,

Paldsa, Kutaja,

Viha, Arka, Smihi, ApdNddeyi,

mdrga, Pdtald, Pdribhadra,
Nipa,
Putika, Vrihati, Kantikari,
yanti,

Krishnagandhd
Ingudi, Baija-

Nimba, Nirdahani, Atarushaka, Nakta-indlaka,
BJialldtaka,

Kadali,

Varshdbim, Hrivera, KsJmraka, Indra-

vdruni, Sveiamokshaka and Asoka should be gathered in
a green condition
of) rock-salt

and mixed with
in

(as

large
in

a

quantity

and having thrashed them
a

an Udukhala
pitcher
as

should be

burnt

hermetically

sealed

.

ig6

THE SUSIIRUTA
it

SAMIIITA.
be
filtered

[Chap. IV.

above, after which

should

(twenty times)

and boiled

in the

manner

of alkaline preparations

At

the close of the boiling, powders* of the

drugs of the

Hingvddi or
it.

Pippalyddi group should be mixed with
is

is is

Kalatynaka-Lavana and specially efficacious in all cases of Vata-roga and applicable both in food and drink in cases of Gulma,
This medicine
called the

enlarged

spleen, impaired digestion,
intestinal

indigestion,
to

hae-

morrhoids,
cough.

worms,

aversion

food

and

26

lYIemorable

Verse :~Thc
through
its

remedy proves

efficacious in Vata-roga

heat-making potency,

power of liquifying and secreting the deranged Doshas and of restoring and correcting them as well. 27.
Thus ends the
fourth

Chapter

of

the

Chikitsita

Sthanam

in

the

Sub'rula Samhila which deals with the treatment of Vata-\ yadhi.

*

The

total wtit^ht

of these

powders should be one-fourth of the
course of the preparation.

weight of the rock-talt taken

in ihe

— Ddllana.

CHAPTER
Now we
with
the
shall discourse

V.

on the chapter which deals
of

medical
i.

treatment

lYIaha-Vcltadisease

Vyadhi.
Several

authorities

group

the

Vata-Rakta
and

under two different sub-heads, such as superficial and
deep-seated.
unscientific,
itself

But such a

classification
this

is

arbitrary
first

inasmuch as

disease

manifests

on the surface (layer of the skin) like Kushtha and

gradually invades the deeper tissues of the body.
there are no (two) forms of this disease.
1-2.

Hence
of

Causes of Vaita-Rakta
the

-.—The Vayu

body

is

enraged or agitated

by

such causes as
physical

wrestling with a
strength,
etc.,

man of

superior and
is

uncommon

while the blood

vitiated

by such causes
of difficult

as constant over-eating of edibles

which are

digestion and heat-making in their potency or ingestion
of food before the digestion of the previous

meal.

The
blood-

Vayu
in its

thus enraged and

agitated

enters into the

carrying

body and being obstructed passage, becomes mixed with the vitiated blood.
channels of
the
the blood thus combine to give

The deranged Vayu and
rise to

a disease characterised
is

by the

specific

of each, which
teristic pain,

known
at

as VSLta-Rakta.

symptoms The characthe
extre-

which

first

confines itself to

mities, gradually

extends over the whole body.

Premonitory symptoms of Rakta — The disease is ushered in with a
:

Vattaprickino-

pain, a burning
part),

and an itching sensation

(in

the

affected

a swelling, roughness

and numbness

(anaesthesia)

of the diseased locality, throbbing of the veins, ligaments,

38

298

THE SUSIIRUTA

SAMIIITA.

[Chap. V.

nerves and arteries, a weakness in the thighs and sudden

appearance of red or brownish circular patches on the

palms of the hands and
etc.,

soles of the feet, fingers
If

and

heels,

(A.
in

R.— wrists).
its its

neglected
stages,

and immoderately
the
disease

treated

premonitory

soon

develops

characteristic

symptoms
;

in succession,

which
defor-

have been described before mity
it (in

whereas

(a

lifelong)

(of the affected part)
its

is

the penalty for
stage).
3.

neglecting

fully patent or

devoloped

lYIemorabIc Verse :~Men
cate constitution, as well as those
stout or sedentary in
their

of a mild

and

deli-

who
or

are (inordinately)
are

habits

addicted

to

unwholesome and incompatible

food,

etc.,

are

generally
4.

found to be susceptible to an attack of Vata-Rakta.

Prognosis

:

— A physician

is

advised to take

in

hand the medical treatment of a Vata-Rakta-patient who has as yet not lost much strength and muscle, nor is
afflicted

with

thirst, fever, epileptic fits,

dyspnoea, cough,
to food, indi-

numbness
gestion,

(of the affected

part),

aversion

extension

and contraction of the limb, as well
is

as of a person

who

strong and temperate in his living

and can afford to pay for the diet and other necessary
accessories of the treatement.
5.

Preliminary remedial measures :— in
the
first

stage of the disease the

blood,
in

having
its

become
be

vitiated

owing

to

its

being obstructed

course (by

the unusually agitated

Vayu

in

the

system),

should
the
to

gradually and not profusely bled, except

when

body
have

would be found
action

to

have become extremely dry or

lost its natural healthful

glow or complexion through the
morbific principle (Vayu), for

of the aggravated

fear of further aggravating the
tives,

Vayu.

Emetics, purga-

and Vasti (enemas), etc., should be administered and the patient should be made to take a diet consisting

Chap, v.]

CHIKITSA STHANAM.
rice),

299
in

of old and matured clarified butter (and boiled

the case where the aggravated condition of the deranged

Vayu would
ho should be

be found to predominate.

As an
oil,

alternative,

made

to drink a potion consisting of goat's
its

milk mixed with half
weight of

quantity of

with two Tola

Yashti-madhu or goat's milk cooked with
Tola weight) with honey and sugar
S'ringd-

Pris'niparni (two

(added after cooking), or cooked with S'tinthi,
taka,

and Kas'eruka, or cooked with S'j'dmd, Rdsnd,
S'vadamshtri and
milk previously
times
6.
ol

Siishavi, Pris'niparni, Pilu, S'atdvari,
Das'a-niiila.
Oil,

cooked with the addition
a

boiled with the decoction of Das'a-mula of eight
its

own weight and

Kalka of Madliiika, Mcsha-s'ringi

(A. R. Sarngashta), S'vadains/nrd, Sara/a, B/iadra-ddru^

Vachd and Surabhi pasted together, should be administered
in

drinks,

etc

,

(viz

,

anointment, sprinkling,

ctc.\

As an

alternative, the oil

cooked with the decoction of

S'atdvari,

Mavuraka, Madhuka, Ks/iira-Viddri, Vald,
,

Ativald and Trina-pancha-fnula with the paste of the drugs belonging to the Kdkolyddi group, or the oil*
cooked with the
a hundred

decoction
should

and a Kalka of Vala

for

times

be prescribed for the patient.

The
[i.e.,

affected part should be

washed with the milk, boiled

with the roots of the Vata-hara (Vayu-subduing) drugs
Das'a-mula), or

simply with

Amla

(gruel,

etc.),

or

a plaster composed of barley,

Madhuka, Erafida

(castor)

and Varshdbhu (pasted together and heated), should be
applied to the part.
7,
:

Plasters, etc. Mudga pulse aud Masha
*

— Barley,
the

wheat,

sesamura,
equal
which
should
is

pulse should be taken in
" Vala-Taila",

According

to

Jejjata

Acharyya,
treatment

administered in the

medicil

of

Mudha-garbha,

be

prescribed in this case.

300

THE SUSHRUTA SAMHITA.
separately
;

[Chap. V.

parts and pounded

and the paste of the
Kshira-kdkoli,

following

drugs,

viz.,

Kdkoli,

/ivaka,

Rishabhaka^ Vald, Ati-vald, Visa-mrindla
Pris'niparni,

(lotus stem),

Mesha-s'ringi,

Piydla,

S'arkard (sugar),

Kas'eruka, Surabhi, and Vachd should be mixed with

each of the preceding

powders and

each

of these

compounds
oil,

(so

formed) should be

boiled with
butter.

milk,
fiv'c

lard,

marrow

and
as

clarified

The

compounds, thus
should
the affected part

prepared, arc
a

called Payasas,

which
to

be applied
;

hot

poultice

(Upandha)
of the

or an Utkarika,

made

pulp

of oily fruit (seeds) * (prepared

milk) should be applied

;

by cooking them with or powders of wheat, barley,

sesamum, Mudga

pulse,

or

Masha

pulse,
flesh,

and Vcsavdra,
should be used
Sarald,

made

of various kinds of fish and

as a plaster.

Vilvapes'ikd, Tagara, Deva-ddni,

Rdsnd, Haremi, Ktishtha, S'ata-pushpd, Eld, Surd and
cream of milk-curd pasted together, should be applied
to

the

affected

part

as

a

plaster

(Upanaha'.

As an

alternative, the expressed juice of

Matulunga, mixed with

Kanjika, Saindhava salt and clarified butter, pasted together with the root of the Madhii-s'igru and with sesa-

mum,-f should be used

in a similar

way.

The preceding
Vdyu.
8.

remedies should be administered in a case of Vata-Rakta

maikedbya preponderance

of the aggravated

Vsita-Rakta with a preponderance
of Pitta
:

— In

cases of Vata-Rakta where the Pitta

preponderates, the patient should be

made

to

drink

a

potion consisting of a decoction of Drdkshd, Aragvadha,

Katphala, Kshira-viddri,

Yashti-madhii, Chandana

and

Kds
*

;«(^?2)'« sweetened with a quantity of sugar and honey.

Such

as

sesamum, castor«seed, linseed, Vibhitaka-seeds,
that

etc.

t
\

Some

say

a

paste of

sesamum only should be used

as

^

separate plaster.

Chap, v.]

CHIKITSA STHANAM.
alternative,

3OI
Yashti-

As an

a

decoction

of S'atdvari,

madhii, Patola, Triphald, and Katu-rohini, or a decoction
of Gtiduchi, or a decoction of the drugs belonging to the

Chandanadi group, which
allaying
patient,
butter,

are

possessed

of

virtues

for

pittaja

fever,

should

be

administered to the
honey.
Clarified
bitter

sweetened with sugar and
drugs*
proves

cooked and prepared with a decoction of
also
beneficial
in

and

astringent
9.

such

cases.

The

affected part should be
of

a decoction

Visa-inrindla,

washed (Parisheka) with Chandana and Padtnaka
half
its

(taken in equal parts and)
of milk.

mixed with

quantity

As an
with

alternative, the aff'ected part should

be
the

sprinkled

a

compound composed
equal
parts)

of milk,

expressed juice of Ikshu (sugar-cane), honey, sugar, and

washings of

rice (taken in

;

or with curd-

cream, honey, and

Dhanyamla (fermented
anointed with

paddy-gruel),
;

mixed with a decoction of grapes and Ikshu
affected

or the

part

should be

clarified butter

cooked with the drugs of the Jivaniya group, or with the clarified butter washed a hundred times in water, or
with clarified butter cooked

with the Kalka of

the

Kakolyadi group.
Pradeha
S'aivala,

10.

(plaster)

composed of

S'dli,

Shashtika,Nala,

Vanjula, Tdlis'a, S'rigdtaka^ Galodya, Haridrd, Gairika,

Padma-kdshtha, leaves of padma

(lotus),

pasted

with

Dhdnydmla and mixed with

clarified butter,

should

be applied to the affected part.

This plaster (Pradeha)
the

may
All
*

be applied lukewarm even in cases of Vata-Rakta,
a preponderance

marked by
the
D. R.

of

aggravated Vayu.
also

remedial measures (laid

down above) may

Bitter

sweet

— Sweet, bitter, and astringent drugs. — Patoladi group Kashdya drugs drugs — Kakolyadi group.
drugs
;

Triphaladi

group

;

302

THE SUSIIRUTA

SAMIIITA.

[Chap. V.

be advantageously applied in

cases

marked by a

pre-

ponderance of
that co!d

th'3

vitiated

blood, with this exception
blood-lettings

plasters

and

repeated

should
ii.

be resorted to

in the latter

(Raktaja-Vata-Rakta).

Vata-Rakta with a preponderance of Kapha: —Incases where the Kapha preponderates,
the patient should be
of a decoction of

made

to drink a potion consisting

honey

Amalaka, sweetened with or a Kalka of Mad/iiikn, S'ringavcra, Haritaki and Tikta-rohini m\-ii.Q6.
Haridrd
2i\\d
;

or

a

decoction

of

Triphald,

with honey.

As an

alternative,

Haritaki and treacle

with either cow's urine or water, should be given to him,

The

affected part or

limb should be sprinkled or

washed with cow's
decoction of the

urine, oil, alkaline water, Sura, Sukta,

or with a decoction of

Kapha-destroying drugs,
constituting
the
in

A

hot

drugs

Aragvadhadi
the
lubri-

group
cated

may
or

be used

with benefit

sprinkling

affected part.

The body
with

of the patient should be
clarified

anointed

butter,

boiled

with
d.r\d

the cream of milk-curd,

cow's

urine,

wine,

S'ukta

with the Kalka of
kdsJitJia.

Yashti-madJm,

Sdrivd and Padmaof

A

plaster

(Pradeha), composed

pounded
in

sesamum, mustard seed, linseed and barley (taken
equal parts) and mixed and

pasted with S'leshmdtaka,

Kapittha,Madhu-s'igru

d^nd cow's urine,

and Yava-kshdra
12-13.

should be applied (hot to the seat of the disease).

The Five Pradehas :— (i) A
mustard seed,
(3)

paste of white

(2i

that

of

sesamum and As'vagandha,
Kapittha bark,
(51

a similar paste of Piydla, S'elu and
that of
Madhu-i'x'gwx,

(4)

Punarnavd and
be separately

a paste of
these
five

Vyosha,

Tiktd,

Prithakparni and
should

Vrihati,

kinds of Pradehas
alkaline

pasted

with

water and (any of them) applied lukewarm to
14.

the affected locality,

Chap, v.]

CHIKITSA STHANAM.
alternativ^e,

3O3

As an

a plaster composed S' dlaparni,

Pris'niparni,

Vrihati and

Kantakdri, pasted together
applied

with milk and mixed with Tarpana * should be
(to

the

seat

of the disease).

In
of

cases of

Vata-Rakta
in

involving the concerted action

two or three of the
such drugs

Doshas, the remedy consists in applying

combination as are possessed of the efficacy of subduing
the
action of

each of them.

15.

Guda-Haritaki and Pippali-Vardhatnana Yogas
in
all

types of

HaritaH with treacle may be used As an alternative, the Vata-Rakta.
:

patient should be enjoined to use

Pippali,

pasted with

milk or water, every day

(in

the following way).^

The
day of

number
its

of Pippali should be increased

by

five

or ten

respectively on each successive

day

till

the tenth

use

;

after

which period the number of Pippali should
each successive
reduced to the original
five or ten.

be decreased (by a similar number) on

day

till

it

is

The

patient should live on a diet of milk and rice only (during

the entire course

of
as

this

treatement).

This medicine

which

is

known
in

the
of

Pippali-Vardhamaiia.t proves

efficacious

cases

Vata-Rakta,
to
food,

chronic

fever

(Vishama-Jvara), aversion

jaundice,
phthysis,

enlarged
loss

spleen, piles, cough, asthma,
appetite, heart-disease

cedema,
16.

of

and

ascitis.

Clarified butter,

cooked

in

milk with the paste of
should
in

the
*

drugs of

the

Jivaniya group,
fried

be used
is

in
as

Flour of barley or

grain,

dissolved

water,

known

Tarpana. i The dosage

should begin originally with

five or ten Pippalis

according

to the strength of the patient.

X Maharshi Charaka mentions this Yoga in the chapter on Rasayana and prescribes it also in the treatement of Udara. Chakradatta mentions
the use of this medicine
fever.
in

the

treatment

of liver

and

spleen

and of

304

THE SUSHRUTA SAMHITA.

[Chap.

V.

anointing (the body of the patient).
of Sahd, Sahadevd, C/iandana,

A plaster, composed Murvd, Mtistd, Piydla,

Padma-kdstha YasJiti-madhu, S'atapushpd (A. D. Vidiri) and Kushtha, pasted together with milk and mixed with the cream of clarified butter, should
S'atdvari, Kas'eru,

be applied

(hot)

to

the

affected

locality.

A

plaster

composed of

Saireyaka,

Atarushaka,

Vald,

Ati-vald
of a

Jivanti and Susha^i, pasted together with the milk
she-goat, should be likewise applied
disease).

(to

the

seat

of the

As an

alternative, the diseased locality should

be plastered with the

pastes

of

Kds'fnarya,
;

Yashti-

madhu and Tarpana mixed together
chchhishta (bee's wax),

or

it

should

be

treated with Pinda-Taila, prepared by cooking Madhu-

Manjishthd,

resin,

and Ananta-

mula
In
butter

in

milk* (and

oil

taken together).

17-20.

all

cases of Vata-Rakta, old and matured clarified

boiled

with the expressed juice
drinks.

of

Amalaka
part

should be prescribed as

The

affected

should be washed or sprinkled
clarified

with old

and matured
and
paste

butter,

boiled

with a

decoction

(Kalka) of the drugs belonging to the Kdkolyddi group,
or with those of the Jivaniya group, or with
tion of Sushavi,

the

decoc-

or

of Karavellaka,

The Vala-Tailat

should be used for sprinkling and

immersing purposes,
of articles
rice,

and

as drink

and Vasti-karma (enemas).
diet should consist
S'ali

Diet: — The
barley,
*

made

of old and matured

or
\

Shashtika

wheat or

taken

with milk

or

with the soup of

Mudga
Mudha-

Milk

four times of oil should be taken.

The " Vala-Taila" garbha, ch. XV.
t
take the food with milk

desciibed in the medical

treatment

of

X In the case of Vata-roga with preponderant Pitla, the patient should in the preponderance of Vayu, with the soup of ;

Jangala meat; and in the

preponderance of

Kapha, with

Mudga-soup,

devoid of any acid combination.

Chap, v.]

CHIKITSA STHANAM.
flesh

$0$

pulse

or

of

Jdngala animals and
21.

devoid of any

acid combination.*

Frequent blood-letting should be resorted to and
measures, such as, emetics,
purgatives,

Asthapana and
aggravated

Anuvasana should be adopted

in cases of the

Doshas-f (involved in the case).

22.

IVIemorable
Rakta

Verses :— A

case

of

Vdta-

of recent growth, proves readily

amenable to the
i.e.,

remedial measures described before.

Long-standing,

chronic cases (of Vata-Rakta) are never perfectly cured, but
tices

can only be palliated.

The

application of poul-

(Upanaha), of medicinal washes or sprinkles (Parihot-plasters,

sheka),

anointings

(Abhyanga), spacious

and

comfortable

bed-chambers which do not admit of
of
air,

too large an influx

shampooing, and the use
soft

of soft and pleasant beds

and

pillows,
;

are

chiefly

recommended

in a case of

Vata-Rakta
and

whereas physical

exercise, sexual intercourse, display of anger, the use of

heat-making, saline,

acid

difficultly digestible food

and eatables producing effuse scrus or slimy matter in the bodily channels, and sleep in the day-time (should be deemed extremely injurious and hence) should be
studiously refrained from.
23.

The Medical Treatment of Apatanaka — The medical treatment of a patient suffering
:

from Apatanaka (hysterical convulsions), not exhibiting
fixedness of gaze and arched eye-brows, with an absence
*

In the case of Vata-roga, with a pref onderance of PiUa, the patient
take
his food with
;

should

milk

;

in the

preponderance of Vayu, with the

soup of Jangala meat

and

in the

preponderance of Kapha, with Mudga-

soup, devoid of any acid combination. t In the preponderance of

Kapha, emetics should be employed
;

;

in

the preponderance of Pitta, purgatives should be given

and

in

the

pre-

ponderance of Vayu,
resorted to.

Anuvasana and Asthapana

measures

should

be

39

306

THE SUSHRUTA SAMHITA.

[Chap.

V.

of perspiration, quivering, delirium of genitals, found not to
fall

and the numbness

on the i^Tound but capable

of being supported on his arms (Akhattd-pati) and whose

trunk

is

not bent or arched on

its

posterior (dorsal) side

(Vahirayama),

may
then

be attempted (with success).
first
;

The body
snuff

of the patient should be

anointed with emulsions
strong medicated
purifying
(the

(Sneha) and

fomented

should then be administred for
lated

accumuclarified

mucus

in) the head.

After that the patient should
potion

be

made

to drink a clear
in

prepared

of

butter,

cooked

combination with a decoction of the
Vidari-gandhadi group, extract

drugs constituting the
of

meat, milk and milk-curd, so as to arrest the further

expansion of the deranged

Vayu
:

into the system.

Traivrita Ghrita
subduing drugs, such
as,

—A

decoction of the V^yuetc.,

Bhadra-ddrvddi,
flesh

barley,

Kidattha pulse, Kola, and the

of the

Anupa and
should be
five

Audaka animals with
*

the

Pancha-Vargassc

According

to Jejjata,

"Pancha-Vargam" means
viz,^

the flesh of the

kinds of

Anupa animals,
reading
here
is

Kuiachara, Plava, Kos'astha,

Padin and

Matsya

(fishes).

The

doubtful.

The term "Audaka"
to

in the

compound
as

word " Sanupaudaka-mamsam " seems

be

redundant,
class.

inasmuch

"Audaka" animals

are included
I).

in

the

"Anupa"
the

(Sutra, chap.
also
fiive

XLVI. Page
seems
to

487, Vol

In this case

word " Pancha-vargam "

be only an explanation of the term

"Anupa" meaning

the

kinds of

Anupa

flesh,

and

it

seems

to

have surreptitiously crept into the body

of the text from the marginal notes of
of the book.
If,

some
five

authoritative manuscript copy

however, we are

to

abide

by the current reading of the
kinds of flesh in the
Jejjata

book, "Panch'a-varga" cannot mean the
of the

presence
it.

word ''Audaka" mentioned separately, as
it

would have

In
the

that case

can only mean either the
the

five

groups of Pancha-mulas,

viz.,

major

Pancha-mulas,

minor

Pancha-mulas, the Valli-Pancba-mulas,
(Sutra, chap,

the Kantaka-Pancha-mulas

and the Tiina-Pancha-muIas.
I),

XXXVIII, Pages
however,
to

355-6, Vol,

as
it

some would explain

it

to

mean. Others,

prefer the reading as
five

is

and explain the term "Fancha-varga"
the

be the

kinds of medicinal drugs mentioned before in

sentence,

Char- v.]

CIIIKITSA

STHANAM.

307

made.

The

decoction, thus prepared, should
etc.,

be mixed

with milk and fermented rice-grucl,

and then cooked

with an

adequate quantity of

clarified butter, oil, lard

and marrow by casting Kalka

(^paste)

of the

Madhura
(lit.

(Kakolyadi group) into

it

This TraivritaGhrita*

consisting of clarified butter with three other
articles),

lardaceous
to

thus

prepared,

should

be

administered
diet, in

Apatanaka-patients in potions and

effusions

and immersions,
in

in

anointings and errhines, as well as
Diaphoretic measures should
the

Anuvasana

measui'es.
to

be applied
case

according

prescribed

rules.

In

a

marked by an unusually aggravated condition of the Vayu, the patient should be made to stand neck-deep
in a pit tolerably

and cow-dung.
be

warmed or heated with burning husks, As an alternative, Palas'a leaves should
stone-slab
or

strewn

over a hot
sprinkled

over a hot oven,

after

having
should

wine

over

them, and the

patient

be laid

full

length upon these leaves, or
Ves'avdrdy

fomentations should be

made with

Kris'ara

and Pdyasa.

24—25.
in

An
viz.,

oil,

cooked

combination

with the
and
flesh.
leaf,

expressed
Others, again,
fruit,

the Vataghna drugs, Yava, Kola, Kulaltha

mean by

the term "Pancha-varga" the five parts, viz.,

flower,

bark and root, of the Vataghna drugs mentioned in the sentence.

We

have, however, the authority of Vagbhata and Chakradatta in our

side to accept the first

view that the term

"Audaka"

is

redundant,

in-

asmuch as they have not read the word "Audaka"

in their compilations.

—Ed.
'

According

to

Dallana, four seers of clarified butter,

oil,

lard

and

marrow (each weighing one
should be taken

seer), sixteen seers of Kanji, etc., sixteen seers

of milk, sixteen seers of the decoction and one seer of the
in
its

Kalka

(paste)

preparation.

But Gayadasa

is

of opinion that

four seers of milk should be taken instead of sixteen seers.

Four seers of Ghrita,
seers

etc., four seers of

milk, six

seers

of Kanji,

six

of

the

decoction

and one seer of the Kalka (paste) are generally
its

taken

byexperienced physicians in

preparation.— Ed.

308

THE SUSHRUTA SAMHITA.

[Chap.

V.

juice o{ Mtilaka,

Eranda, Sphurja, Arj'aka, Arka, Saptald
in

and S'amkhini should be used
etc.,

washing (Parisheka),
Potions con-

the

body
and

of an

Apatanaka-patient.
(milk-curd)

sisting of

sour

Dadhi

mixed with powdered
clarified

pepper
or
in

Vachd,

or

of

oil,

butter,

lard,

mixed with an empty stomach,
honey,
26.

the

same things and
curative
in

taken
of

prove

cases

Apatanaka.

These remedial measures are applicable

in

cases

of

Apatanaka when the action
alone preponderates.
action of
to

of the

aggravated

Vayu

In a case involving the concerted

each

two or mere of the Doshas, drugs, remedial of them, should be combinedly employed.

Medicinal liquid errhines {Avapida) should be employed
after the subsidence of a severe attack.

The
or

fat or lard

of a

cock,

crab,

Krishna-fish,

porpoise

of

a boar

should

be taken* by the

patient.
(a

As an

alternative,
of)

he should be

made

to

drink

potion

consisting

milk boiled with Vayu-subduing drugs (Das'a-mula,
or a gruel (Yavagu)

etc.\

composed

of barley, Kola, Kidatthaoil

pulse and Mulaka, cooked with curd,
butter.

and

clarified

Oily purgatives,

Asthapana and Anuvasana
if

measures, should

be employed
in ten days.

the

paroxysm does

not subside even

Medicines and remedial

measures laid down under the head of Vata-vy^dhi and the process of Raksha-karma, should be likewise 27. adopted (in cases of Apatanaka).

Treatment of Pakshaghata :— A
cian
is

physi-

enjoined to take in hand the
laid

medical

treatment

of a

patient

up

with

Pakshaghata, unattended
in

by a discolouring of the skin, but having pain affected part, and who habitually observes the
*
lards,

the

rules of
with
these

Vriddha Vagbhata

recommends

external

application

Chap, v.]

CHIKITSA STHANAM.
afford
to

309

diet

and regimen and who can

pay

for

the
first

necessary accessories.

The

affected part should be

anointed
purgatives

and
should

then be

fomented.

Mild emetics

and

subsequently employed for the

purpose of cleansing the system.

Medicated Anuvasana
after

and Asthapana measures should then be employed,
which the general
laid

directions

and remedial measures,
proper time
Appli-

down under

the

treatment of Akshepaka, should

be followed and employed at the

cations of the Mastikya-Siro-vasti with the Anu-taila for

anointing the

body, of the articles

of Salvana-Sveda

for the purpose of poulticing,

and of the Vala-taila as an

Anuvasana measure,
carefully
for

are

the

marked

features

of the

medical treatment of this disease, and should be followed
a

continuous

period of

three

or four

months.

28-

These preceding remedies
tions

as

well

as

dr\'

fomentapossess

(Ruksha-sveda)
virtue

and

errhines,

which

the

of

subduing

the

deranged Vayu
in cases of

and

Kapha

should be likewise employed
29

Manya-

stambha.

Treatment
is

of

Apatantraka
patients
suffering

-.—Fasting

prohibited in cases of

from Apa-

tantraka (Apoplectic convulsions).

Emetic, Asthapana

and Anuvasana measures are likewise forbidden.
passage of respiration should be blown open
breathings in the event of
its

The

by violent
up with an

being choked

accumulation of the deranged
patient

Vayu and Kapha.

The

should be

made

to drink a potion consisting of

Tumbtiru^ Pushkara, Hingii, Amla-vetasa, Haritaki and
the three
of
*

(officinal)

kinds of

salts,

with a decoction

barley.*

As an

alternative,

four seers of clarified
the

Chakradatta quotes

this in the

chapter on

treatment

of

colic

(s'ula),

but does not read 'Amla-vetasa' there.

310
butter,

THE SUSHRUTA SAMHITA.
cooked
in

[Chap. V.

combination with sixteen seers of
salt

milk,

two Pala weight of Sauvarchala
other

and

fifty

of

Haritakis should be prescribed for the use of the patient.
All

remedial

agents,

possessing

the

virtue

of

subduing the deranged
likewise employed.
30.

Vayu and Kapha

should

be

Treatment
from Ardita
measures and

of Ardita :— A

patient suffering

(facial Paralysis)

should be treated with the

remedies laid

down under
affording

the head of

Vata-vyadhi in the event of his being found to be sufficiently

strong

and capable of
for

the

neces-

sary expenses

his

treatment.
of

Errhines, Mastlkya-

S'iro-vasti, inhalation

the

smoke (Dhuma-pana) from
(Upanaha), unguents and
features of the medical

medicated drugs,
Nddi-sveda,
etc.,

poulticing

are the special

treatment of this disease.

After that, a decoction should

be

made

of the drugs constituting the groups of- Trina-

Pa7icha-mula, Mahd-Pancha-mula, Kdkolyddizxid. Viddri-

gandJiddi groups, aquatic bulbs, and the flesh of animals which are aquatic in their habits (Audaka) and those

which frequent swampy places (Anupa), by boiling them together with a Drona measure of milk and double the
quantity of water.
boiled
the

The decoction should be
its

considered

when

three quarter parts of

original weight of

liquid

has

been

evaporated

and should then be

strained.

The decoction
fire

thus prepared should be boiled

with a Prastha measure of oil (four seers)

and be removed

from the
allowed to
off

when
(oil

the

oil is

well

mixed with the milk.

The compound

and milk) thus prepared should be The churned cool down and then churned.
.should be again boiled

cream (Sneha)

with the drugs

of the Madhura (Kdkolyddi) group, Masha-parni and milk (four times that of the original oil). This

medicated

oil

is

known

as the

KsMra-Taila and should

Chap, v.]

CHIKITSA STHANAM.
and unguents,
etc
,

31
to

be administered as potions
Ardita-patient.
butter
in

an

the
it

The above preparation with clarified place of oil is known as the Kshirai^eye-

sarpih and
lotion).

should be used as an Akshi-tarpana
32.

31

Venesection should be duly resorted to

in the

affect

ed parts, according to the directions given before, in cases
of Sciatica,
joints),

Gridhrasi, Vis'vachi (Synovitis of the knee-

Kroshtuka-s'irah,

Khanja (lameness), Pangula,

Vata-kantaka, Pada-ddha, Pada-harsha, Ava-vahuka and

Vadhiryya and
be found
to

in cases

where the deranged Vayu would
in

be

seated
laid

a

Dhamani.
the

Measures
of

and

remedies
should

down under
adopted,

head
in

Vataof

vyadhi

be
33.

except

a

case

Ava-vahuka.

The expressed
after

juice of green ginger,

made lukewarm
honey and
alternative,
oil

mixing
in

it

with (equal quantities

of) oil,

Saindhava
ear
a

salt,

should be poured into the cavity of the
of (acute) ear-ache.

case
of

As an

the
the

urine
urine

a

she-goat, or oil and honey, or

with

(of

a cow)

mixed with the expressed
Sura,

juice of

Mdtulunga, pomegranate and tamarind, or the

oil

boiled

and prepared with
the ear
the

Takra,

Sukta,

salt

and

the urine (of a cow), should be poured into the cavity of
;

fomentation should be given (to the interior of
organ) after the

affected

manner

of Nadi-sveda.

The remedial measures
sorted
to.

for Vata-vyd,dhi

should be
the

re-

We

shall,

however, revert to
34.

subject in

the Uttara-Tantra.

The
water,
*

patient

should

be

made

to

drink a potion of

Sneha-Lavana* dissolved
or the

in an adequate quantity of powders of the Pippalyadi group (with an
described
in

Sneha-Lavana has been

Chap.

4.

(treatment

of

Vata-vyadhi) para. 24.

312

THE SUSHRUTA SAMHITA.
clarified butter,

tChap. V.

adequate quantity of water), or
or saturated with

thickened

pulverised asafoetida and Yava-kshara

(Carbonate of Potass), in cases of Tuni and Prati-tuni.
Applications of Vastis should also be resorted
In a
case
of
in
to.

35.

Adhmana
the

(Tympanites), the remedy
of powders

should

consist

applications

of the
),

Dipaniya (appetising) group, of suppositories
Vastis and
patient
digestive
also

(^Phala-varti

drugs (Pachaniya group).
be

The
fast

should

advised to observe a rigid

and

his

abdomen should be fomented with
as,

hot palms.
rice pre-

After that he should break his fast with boiled

pared with appetising (Dipana) drugs such
Jiraka, etc.

Dhanyaka,

Similarly, a case of

Pratyatdhmana should
be treated
all

be treated

with fasting,

emetics and appetising drugs.

Cases of Ashthilai or Pratyashthila should
as a case of

Gulma and
36-38.

internal abscess, to

intents

and purposes.
asafoetida,

Hingvadi-Vati :— A
Trikatu,
ga7idhd,

compound

consisting

of

Vachd, Ajamodd, Dhanyd, Aja-

Dddimba, Tiniidi> Patha, Chitraka, Yava-kshara, Saindhava salt, Vid salt, Sauvarchala salt, SvarjikdHapushd, Chavyd, Ajdji and Pathyd, powdered together

kshdra, Pippali-mula, Amla-vetasa, S'athi, Pushkara-niula>

and treated many times with the expressed juice of Mdtulunga in the manner of Bhavana* saturation, should be

made

into boluses, each weighing an

Aksha

(two TolAs)

in weight.

One

(such) pill should be taken (in an
in all

empty
cough,

stomach) every morning

diseases of the deranged

Vayu.

This compound

proves

curative
ascites,

in

asthma, internal tumour (Gulma),
*

heart-disease,

" Bhavana"

consists in soaking a

powder

or a pulverised

compound

with the expressed juice or decoction of any drugs or with any liquid and
in getting
it

dry (generally),

This process should be cotinued many limes

(generally seven times) in succesion.

Chap, v.]

CHIKITSA STHA'NAM.
pain
in at

313

tympanites, aching

the sides, in the
of an

abdomen
to

and

in

the

bladder,

cases

aversion

food,
piles,,

retention

of stool, strangunary,
39.

enlarged spleen,

Tuni and Prati-tuni.

IVIemorable Verses :— From
close

the

symptom;^

or leading indications, exhibited in each case and from a

examination thereof,

it

should be inferred whether
or

the

Vayu

alone has been deranged

whether

it

has

combined with any other Dosha, or has
well

affected

any
as

other fundamental principle (Dhdtu) of the organism
;

and the medical

treatment

should
the

follow

a

course, so as not to prove hostile to

Doshas or the
in the case, in

Dha'tus (organic principles)
its

implicated

attempt to subdue the aggravated

case of cold, compact
in

Vayu. In a and painful swelling (appearing
to

any part of the body) owing

the combination of

the deranged

Vayu with

fat,

the treatment

should be
40-41.

identical with that of a swelling in general.

Uru-Stambha :— The
charged with the local
swelling
as
in
fat

deranged

Vayu,
rise
is

sur-

and Kapha gives
thigh which

to a

the

region
;

of the

known

Ura-stambha others designate it as Adhya-Vata. This disease is marked by lassitude and an aching pain in the limbs, by the presence of fever, horripilation and somnolence and by a sensation of coldness, numbness,
heaviness, and unsteadiness in the thighs,
foreign to the body.
42.

which seem

Its

Treatment :— The

patient should be

to drink a potion consisting of the pulverised

made compound

known

as the Shad-dharana-yoga

;

or of the drugs con-

stituting the Pippallyadi group, dissolved in (an

adequate quantity of) hot water without using any oleaginous substance or a lambative, composed of pulverised
;

Triphald and Katuka

mixed with honey,

should

be

40

314

THE SUSHRUTA SAMHITA.
of

[Chap. V.

used; or a potion, consisting

Guggulu

or

S'ildjatu

dissolved in cow's urine, should be administered.

These

compounds subdue the aggravated
with deranged
fat

Yiyu

surcharged
in

and Kapha and prove curative
to
food,

heart-disease, an aversion
abscesses.
fruits

Gulma and
of

internal

A

medicinal plaster composed

Karanja

and mustard seeds, pasted with a copious quantity

of cow's urine should be applied hot to the affected part,

which

may

be as well fomented with cow's urine
;

mixed

with alkali (Kshara)

or the locality

should be sham-

pooed with

articles

devoid of any oily substance.
consist

The

diet of the patient should

of old

and matured
soup of
animals of
butter
use

Sy^maka, Kodrava,Udddla and
dry Mulaka or Patola, or of
the Jangala group

Sali rice with the

the

flesh of
clarified

cooked without

or
oil

vegetables {S'dkd) cooked without

salt.

The

of

and of lardaceous substances
should,

in

general
after

(Sneha-karma)
the deranged fat

however,

be prescribed

and Kapha have

(totally) subsided.

43.
:

Therapeutic properties of Guggulu

— Guggulu
pungent

is

aromatic,

light,

penetrating

into the mi-

nutest parts of the body, sharp, heat-making in potency,
in taste

and digestion, laxative, emulsive, slimy,

and wholesome
is

to the heart (Hridya).

New Guggulu
It

is

an aphrodisiac and
anti-fat

a constructive tonic.

Old Guggulu
is

and
its

hence

reduces

corpulency.

owing
that

to

sharpness
to

and
reduce

heat-making
the

potency
the

Guggulu tends
;

Vdyu and

Kapha
(refuge

it is

its

laxativeness
in

that

destroys the Malas

deposits
its
;

the

Srotas)

and the deranged
bad odours of the
that

Pitta

;

aroma
and
it

removes
is

the

Koshtha
the
(?very

its

subtle

essence

improves
be

appetising

faculty.
ci

Guggulu

should

taken

morning with

decoction of Triphald, Ddrvi and

Chap, V.J

CHIKITSA STHANAjVT,
;

315
it

Patola or with that of Kus'a roots*

may

also

be

taken with an adequate quantity of cow's urine, or with
alkalinef or tepid
water.

The

patient

should

take

boiled rice with soup, milk, or extract of meat after the

Guggulu has been digested.
ascites,

Diseases such

as

internal

tumour (Gulma), urinary complaints (Meha), Udavarta,
fistula-in-ano,

worms

in

the

intestines, itches,

an aversion to food, leucoderma
glands (Arvuda), sinus,

(Svitra),

tumour and

Adhya-Vata, swelling (oedema),
used for a month (with the

cutaneous affections (Kushtha) and malignant sores and
ulcers readily yield to
it,

if

observance of the regimen of diet and conduct laid down
previously).
It

also

destroys the deranged

Vayu
just

incar-

cerated in

the

Koshtha, bones and
trees,

joints,

as

a

thunderbolt will destroy
Thus ends

44.

the fifth Chapter of the Chikitsita

Sthanam

in the

Sus'ruta-

Samhita which deals with the medical treatment of Maha-Vaia-Vyadhi.
*

Some

explain

that

a

third

decoction

should

be that of Triphala,

Darvi, Patola and Kus'a grass taken together.— Dallana.

The decoctions may be prepared
Patola and
t

separately

with

Triphala,

Darvi,

Kus'a.— ^^.
read "Kshira" (milk) in the place of "Kshara" (alkali).

Some

li-

CHAPTER
Now we
shall discourse

VI.

on the medical treatment of
r.

Haimorrhoids (Arsas).

The remedial measures
grouped under four subheads
;

in

haemorrhoids

may

be

namely, the employment of

(active) medicinal remedies, the application of an alkali

(into the seat of the disease), actual cauterization (of the
polypii)

and surgical operation.

A

case of recent origin

involving the action of theDoshas to a slight degree and

uncomplicated with any grave or dangerous symptom

and complication
alone.

may

prove amenable to medicine

Deep-seated polypii, which are soft to the touch

and markedly elevated and extended (external
should
be
treated

—D

R),

with

alkaline

applications,

while

those which

are rough, firm, thick
fire.

and hard should be

cauterized with

Polypii which are raised, exuding

and slender

at

the roots

should

be surgically treated.

Hoemorrhoids which are held amenable to medicine and
are not visible (to the

naked eye) should be treated with
alone.
in

the

help

of

medicines

Now,

listen

to

the

procedure to

be

adopted

the

treatment of

Ars'as

which would require alkaline applications, a cauterization, or a surgical operation.
2.
:

Application
the

of Kshara -The body
from haemorrhoids,
strength,
in the

of

patient

suffering
sufficient

event of

possessing

should be anointed and

duly fomented.

He

should be

made

to

eat

warm
pain

but

demulcent food (Anna) in a
consistency)
cidental
to

fluid state (of a gruel-like

to

alleviate

the

excessive

in-

the

action

of the deranged Vayu.

In

a

eeason

neither

too

hot

nor too cold,

and when

the

Chap. VI.]

CHIKITSA STHANAM.
he should be
clean
a

317
in

sky

is

cloudless,
in

placed

a

raised

up position
on
the
lap

a

and well -equipped place on
bed with his head resting

a plain slab or

on
of an

clean

attendant

and the

anal

region

exposed to
be
of

the sun.
a

In this position the waist should
little

made

to elevate

and

to

rest

on a cushion

cloths or blankets.

the

patient should be

The neck and the thighs of drawn out, and then secured with
as

trappings and held fast by the attendants so

not to

allow him to move.

Then

a straight and slender-mouthed

instrument (somewhat like the modern rectal speculum\
lubricated with clarified butter, should be gently inserted
into the rectum
strain

and the patient should be asked to
time.
it

down

gently at the

After

seeing

the

polypus (through the

speculum\

should

be scraped

with an indicator and cleansed with a piece of cotton or
linen
after

which an

alkali

should

be applied

to

it.

The

exterior

orifice of the

instrument should be closed

with the palm of the hand after this application and kept
in that

manner
after

for a period that

would be required
the

to

utter a

hundred words.
having cleansed
be
polypus,
a
fresh

Then

application

should

made according

to the strength

of the alkali and the intensity of the aggravated

Doshas

involved in the case.

Further application of the alkali

should

be

stopped

and

the

polypus washed with
event of
flabby,

fermented rice-gruel (Dhanyamla), curd-cream, Sukta,
or the juice of acid
fruits,

in

the
little

its

having

been found to have become a

bent down,
fruit.

and

to

have assumed the colour of a ripe Jambu
it

After that

should

be cooled

with

clarified

butter

mixed with removed and

Yashti-Madhu, the trappings
the patient should be raised

should be

up and placed
refreshed

in a sitting posture in

warm water and

with

3l8
sprays
of

THE SUSHRUTA SAMHITA.
cold water, or, according to

[Chap. VI.

some

authorities,

with

warm

water.

Then

the patient should be
the

made
blasts

to of

lie in a

spacious chamber, not exposed to

cold winds (specially),

and advised as regards his
if

diet

and

regimen

Each

of the remaining polypii,

any, should

be cauterized with the alkaline application at an interval
of seven days.

In case of a

number
first

of

polypii,

those

on the right side
those
side
;

should

be

cauterized

and then
to

on the

left,

and

after that those

on the posterior
be
in

and
3.

lastly

those that would be found

front.

Polypii, having their origin in the deranged

V^yu and
;

while Kapha, should be cauterized with fire or alkali those, which are the outcome of the deranged Pitta and
vitiated blood should be treated with a mild alkali alone.

A

perfect

and

satisfactory

cauterization

(Samyag'-

dag^dha) of a polypus should be understood from such

symptoms
tite,

as,

restoration

of the

bodily

Vdyu
in

to

its

normal condition,

relish for food,

keenness of the appestrength,

lightness of the

body and improvement

complexion and

pleasure.
rise

An
to

over-cauterized

(Atias,

dagdha) polypus gives
(in

such

symptoms
thirst,

cracking of the region of the anus, a
the
affected
locality),

burning sensation
fever,

fainting,

and

profuse

haemorrhage (from the rectum), and consequent
;

complications

while an insufficiently cauterized (Hinais

dagdha) polypus

known by

its

smallness of the incidental

ulcer,

tawny brown colour, itching, derangement
organs

of the bodily Vdyu, discomforts of the cognitive

and a non-cure of the

disease.

4.

A
As

large polypus, appearing in a strong person, should
knife)

be clipped off (with a
regards

and cauterized with
polypus
full

fire.

an

external

of extremely

aggravated Doshas (Vdyu, Pitta,

Kapha and

blood) no

Chap. VI.]

CHIKITSA STHANAM.

3I9

Yantra should be used, but the treatment should consist
of

fomentation,

anointing,

poulticing,

immersion,
cauterization
operation.

plastering, evacuating measures (Visrdva),

with

fire

and
laid

alkali

and
in

a
the

surgical

Measures
should
(from
in

down under
to

head of Rakta-pitta
of

be
the

resorted
seat

cases

haemorrhage

of

affection).

Remedies mentioned
whereas

connection
in

with dysentery (Atisara) should be emof a looseness of the bowels
oily
;

ployed

cases

in cases of

constipation of the bowels

purgatives

should be administered, or the remedies for Uddvartta
should be adopted.

These

rules shall hold

good

in the

cases of treating (cauterization, etc) a polypus occurring
in

any

part of the

body whatsoever.
thereto with

5.

A

polypus should be caught hold
a

of and an alkali
a

should be applied
(Kurcha),
or

Darvi, or
In a

brush
of

an indicator (Salaka).
anus,
cauterization

case

a

prolapsus of the

should

be

made
diet

without the help of any Yantra (speculum).

Diet
should

:

— In

all

types

of haemorrhoids,

the

consist

of wheat

barley, Shashtika rice
clarified butter, to

or ^A\i

rice, (boiled)

and mixed with
to

be taken
patient

with milk, Nimba-soup, or
should be advised
Tanduliyaka^

Patola-soup.
(his

The

take

meal) with
As'va-vald,
Chiichchu,

Vdstuka,
tender

Jivanii,

Upodikd,
Chilli,

Mulaka^
Valli, or

Pdlanka,

Asana,

Kaldya,

nature

any other S'dkas (pot-herbs}, according to the of rhe Doshas involved in the case Any other
laxative and

oleaginous, diuretic,

appetising

(Dipana)
also be

diet possessing the virtue of

curing piles should

prescribed.

6.

After the
a case

cauterization of the polypus, as well as in

where no cauterization would be necessary, the
should be

body

of the patient

anointed

with clarified


320
butter and

THE SUSHRUTA SAMHITA.
oil,

[Chap. Vt.

measures both general and specific (mentioned below and in accordance with the Dosha or Doshas involved) should be employed for the
etc,

and

purpose
alleviate

of

improving

the

digestive

powers and

to

any aggravation of the Vaiyu.

He

should

be

made

to drink a potion consisting of clarified butter

cooked with the V.iyu-subduaig and appetising (Dipana)
drugs* (Kalka and
of Hingu,
etc.,

Kvatha) mixed with the

powders

(described in the treatment of Maha-Vata-

vyddhi, chapter. V). In a case of Pitta,ja.-Ar8as, clarified
butter prepared

by cooking

it

with the drugs of

the

Pippallyddi and Bhadra-ddrvddi\ groups, should

again

be cooked with the decoction of Prithakparnyadi group

and the Kalka of the Dipaniya (Pippallyadi) group, and
given as a potion to the patient.
hoid
In a case

of haemorr\

due

to

the

action

of

the

deranged blood

(Raktcirs'as), the clarified butter should be

cooked with
R. Surangi),

a decoction of Maiijishthd,
&c.,

Miirungi,

(D.

while in

a

case

of one

due to the action of the
should be

deranged Kapha, the
with
a

clarified butter

cooked
the

decoction

of

the

drugs

constituting
distresses

Suras ddi group.
be alleviated by

The supervening
the

should
to

remedial

measures

peculiar

each of them

7fire

Cauterization with
*

or with an alkali or
of

any surgical

Such

as the decoction of the drugs

the

Bhadra-darvadi (VayuThis Ghrita should be

subJuing)

and

Pippalyddi

(Dipaniya)

group?.

prescribed in a

Vataja

Ars'aSin

t

The

epithet

"Bhadra-darvadi-pippallyadi"
to

the phrase "Bhadrainto

darvadi-pippallyadi-sarpih" seems
text

be

included
it

the

body of the
of the

through an accident.

In our opinion,

is

only an annotation
last

phrase *'Dipaniya-Vata-hara-siddha" occurring in the

sentence.

E

i.

X The Kalkas of the Pippallyadi group should also be taken in the preparation of the two kinds of medicated clarified butter to be used in
Raktars'as, and

Pittars'as.— Z)a//a«a.

Chap. VI.

CHIKITSA STHANAM.
should

32

operation in the present disease

be effected

by
any

introducing the Yantra (speculum) into the rectum (with
the utmost care,

inasmuch as an error happening

in

of these cases

may

bring on impotency, swelling (Sopha),

a burning sensation, epilepsy, rumbling in the intestines,

retention of stool

and

urine, dysenteiy, diarrhoea, or
8.

may

ultimately end in death.

Rectal

Speculum :— Now
of).

we

shall describe

the dimensions of the

Yantras (and the materials of

which they are made

made
to

of iron, ivory, horn or wood.

The instrument may be It should be made
In the case of a
in

resemble the teat of a cow.
it

male
five

patient,

should

be four
;

fingers

length

and

fingers in circumference

whereas

in the case of a

female

patient, the length should be

commensurate with that of

the palm of the hand (of the

D. R.) and six fingers in circumference.

same length as before The instrument
apertures
in
its

should be provided with two separate
inside,

one for seeing the interior of the rectum and the
impossible

other for applying an alkali, or actual cautery (Agni) to
the

polypus, since

it

is

to

apply

fire

and

alkali

through the same aperture.

The circumference
the
instru-

of the aperture in the upper three fingers of

ment should be

like

that

of

a

thumb.
the
half a

There should
at the
finger's

be a bulb-like protrusion of
bottom, and above
it

same width,
the

a space

of

width.
the

Thus

we

have
9-10.

briefly

described

shape of

instrument.

Ale pa
plasters
their

(plasters)

:— Now we