This is a reproduction of a library book that was digitized by Google as part of an ongoing effort to preserve the information in books and make it universally accessible. Google books http://books.google.com Ne UIE ee AN > र ~ J eS oti # TS क्र 1 9 -- १; ^ र ~+ ण क: Digitized by Google ह ॥ BIBLIOTHECA INDICA; ~. (OLLECTION OF PRIBNTAL Works । PUBLISHED BY THE be ‘ASIATIC SOCIETY OF BENGAL, ew Series, No. 911 THE SUCRUTA-SAMHITA ies fr । OR as - > + CARPENTIER “E22 [187 OF BOOKS FOR SALE ag oe + AT THE LIBRARY OF THE Asiatic POCIETY OF PENGAL, Ls No. 57, PARK STREET, CALCUTTA, AND OBTAINABLE FROM THE SOCIETY’S AGENTS, MESSRS. LUZAC & CO., 46, Grear Russert Street, Lonpoy, W.C., ann Mr. Orro Harrassowitz, Booxsenier, Lerpzic, Germany. व + Complete copies of those works marked with an asterisk * cannot be supplied—some copies of those works marked with an asterisk * cannot be ध | of the Fascicnli being out of stock. BIBLIOTHECA INDICA. a fe ' Sanskrit Series | Advaita Brahma Siddhi, (Text) Fasc. 1 3@ /6f/each =... Rs. 1 8 ‘ate Aires aot the Re Vade, ( ext) Fase. 1-5 @ /6/each = ee ‘Aitareye : Seen a Mag Vol. I, Fasc. 1-5 and Vol. II, Fasc, 1-5 Vol. III oa Fasc 1-5 Vol IV. । 1-3 1. J ५५४ oe pee 6 | 12 Anu Bhasyam, (Text) Fasc. 9 ee oF कै eee 1 , 8 कः _ Aphorisms of San ye eee (English) Fase. ह = 3a asrika Prajiia | (4 1-6 @ /6/ each ert eS i: - Agvavaid न्नी म ५ , (T {५० /6/ कु = 5 a eT I: 4 The present translation of the Sucruta Sarbhité has been undertaken by me at the special request of the Council of the Asiatic Society of Bengal. The original translation, made by Dr. Udoy Chand Dutt was stopped by the untimely death of the translator, after the publication of his second fasciculus. Its continuation by another translator proved so unsatisfactory that it had to be abandoned, after one more fasciculus. Dr. U. Ch. Dutt’s translation, though a very fair performance, laboured under the disadvantage, owing to the translator's want of knowledge of Sanskrit, of not being made directly from the original language. It was also lack- ing all elucidation from the works of commentators. Both points are remedied in the present translation, which accor- dingly has been commenced de novo. R. H. ~ Caleutia, 26th November, 1897. 818751 TRANSLATION OF THE SUCRUTA. FIRST SECTION. ON GENERAL PRINCIPLES. (SOTRA-STHANAM.) THE FIRST CHAPTER. On THE Orniain or MeEpicaL SCIENCE (dyurvéda). (1)' Salutation to Brahma, Prajapati, the Agvin-pair, Balabhid, Dhanvantari, Sucruta, and the rest !8 In the following chapter I shall describe the origin of ‘the Medical Science, even as the blessed Dhanvantari related it to Sucruta. [1] (2) Once Aupadhénava, Vaitarana, Aurabhra, Paugkalavata, Karavirya, Gopura-raksita, Sugruta, and the rest® (thus) ad- dressed the blessed, immortal Divodasa, king of Kaci, the 1 For the convenience of reference the translation has been divided into paragraphs. On the other hand, the numbers, in- serted in the text within angular brackets, indicate the paragraphs into which the Sanskrit original is traditionally divided. The two commentaries referred to in the annotations are cited thus: Bud. = Bhanumati, the commentary ({#k@) of Cakrapanidatta, and Ni. =Nibandha-samgraha, the commentary of Dallana Acarya. * By Prajapati is here meant Dakga, a son of Brahma, and father of Durgaé. His celebrated sacrifice is referred to in § 7. Balabhid or ‘the Slayer of Bala’ is an epithet of Indra. See below, § 8. 8 There are seven pupils: and by “the rest” are meant such physicians as Bhaja and others. Others, however, take Gépura 1 ete SOTRA-STHANAM. [SEc. 1. oe @,se08 e | ‘ e : ew e e a e "२२. Dbapvantayi or ‘Great Surgeon?* as he sat in his hermitage surrounded by a number of Rishis: ^ 0 Blessed One! our hearts are pained to see around us human beings suffering from the painful attacks of bodily, mental, adventitious and natural dis- eases (see § 10), (and to observe) how, helpless in the midst of friends, they are consumed in fruitless endeavours (after cures) and loudly lament (their fate.) With a view to the relief of the diseases of those health-seeking people and with a view to the preservation of our own life, for the sake of doing good to mankind, we have come here with a desire to hear (from you) a brief exposition of the Medical Science. That science is the basis of one’s well-being both in this world and the next. There- fore we have approached you, Blessed One, as pupils.” (3) Tothem replied the Blessed One: You are welcome, my sons; there can be no question about the fitness of any of you to receive instruction! [2] (Listen) then! What is called the Ayurvéda (or Medical Science), is one of the minor portions of the Atharva-véda.6 Svayambhéi or ‘the Self- existent One’ (८.९. Brahma, see §§ 8, 16), before even he created and Rnaksgita to be the separate names of two men, thus making eight pupils, to whom, for “ the rest,” they add Nimi, Kaykayana, Gargyn, and Galava, thus making a total of twelve pupils. So NL, but Bai. only gives the first alternative. In the Bower Manuscript, Part I (verse 8), there isa list of ten Rishis, who applied to Kagiraja for instruction. But the only name common to both lists is Sucrata. Moreover in the Bower MS. Kaciréja is the proper name of the Rishi, while in Sugrata it is an epithet (‘king of Kagi’) of Divddasa, and the latter is identified with the mythical Dhanvantari (see note 4). In the first chapter of the Caraka, another long but quite different list of 51 medical Rishis is given. + Dhanvantari is derived from dhanu, a synonym of Cualya- „ ¢astra or ‘surgery,’ and antari or ‘ going across’; that is ‘one who has mastered surgery. So Ni. He is said to have been the physician, or rather the surgeon, of the Dévas whose wounds he healed in their war with the Asuras. See § 8 and footnote 13. 6 The Atharva-véda consists of the following nine parts: the véda, vakya, itihdsa, five puradnas, and vaidyaka or ‘medical science.’ So Bui. 7 - CHAP. I.] THE ORIGIN OF MEDICAL SCIENCE. 3 men, composed it in a thousand chapters and a hundred thousand verses (64). Afterwards in consideration of the short life and small intelligence of men he re-cast it into eight divisions. These are (1) Galya or major surgery, (2) Calakya or minor surgery, (3) Kaya-cikitsa or the treatment of the body, (4) Bhiita-vidya or the science of demoniacal possession, (5) Kaumara-bhrtya or the management of children, (6) Agada-tantra or the doctrine of antidotes, (7) Rasayana-tantra or the doctrine of alterative tonics, (8) Vajikarana-tantra or the doctrine of aphrodisiacs.” [3] (4) The following is a brief account of each of these (eight) divisions :— The first called Calya® treats of the extraction of extraneous substances (from the body), such as grass, wood, stones, sand, iron, earth, bones, hair, nails, pus, and (retained) secretions ; also the foetus within the womb. It teaches also the use of blunt and cutting instruments, caustics and the actual cautery, and the diagnosis of inflammatory swellings. [4] The second called (alakya™ treats of those diseases and their cures which have their seat in the ears, eyes, mouth, nose, or any other part of the body situated above the collar-bone. [5] The third called Kdya-czhkitsa 8 treats of those diseases and their cures which affect the whole body, such as fever, diarrhvea, hemorrhage, consumption, insanity, epilepsy, skin-diseases, morbid secretion of urine, and others. [6] 0 Calya, lit. means any pointed object. 7 Calakya, lit., surgery performed by means of a galaka or ‘pricker’ or ‘awl.’ Culdka properly signifies the patala-vé/hani, i.e., ‘the instrument for piercing the tunics of the eye.’ Hence galakya or galaka-tantra properly means ‘surgery of the eye’; but it is here used ina wider sense. So एद. 8 Kdya is said, by Bui. and ता. to be a synonym of agni or ‘digestion,’ and for this Bhaja is quoted as an authority. Hence kaya-cikitsa would lit. be ‘treatment of tho digestion. Kaya, however, as Ni. adds, also means the ‘body’; hence kaya-ctkitsa 4 SOTRA-STHANAM. [SEc. I. The fourth called Bhita-vidyd treats of the mental derange- ments due to being possessed by a Déva, or a Gandharva, or a Yakga, or a Rakgasa, or an ancestral spirit or a Picica, or a Naga, and the like. It also teaches how to cure these grahas (or seizures)*® by means of religious offerings and other conciliatory performances. [7] The fifth called Kaumdra-lhrtya treats of the management of infants, of the removal of defects in the milk of wet-nurses, and of the cure of diseases caused by bad milk or by demonia- cal seizure.? [8] The sixth called Agada-tantra, or the doctrine of anti- dotes, treats of the diagnosis of the poisonous bite of snakes, insects, spiders, scorpions, mice, etc. It also teaches how to cure people suffering from any of these various poisons, or from poi- soning due to an (unsuitable) combination (of food). 1 [9] The seventh called Rasdyana-tantra or the doctrine of altera- tive tonics, treats of those medicines which preserve youth, promote (length of) life, intelligence, and strength, and give power to resist diseases. [10] The eighth called Vdajtkarana-tantra'! or the doctrine of aphrodisiacs, treats of remedies for the implenishing, restoring, means ‘the treatment of the body.’ Practically there is no difference. | 9 The number of these graha or seizures, is said to be eight. They are.all due to various kinds of supernatural beings: viz., (1) déva or gods (‘angels’); (2) asura or daitya or enemies of the dévas (‘devils’); (3) gandharva or heavenly minstrels ; (4) yaksa or guardians of hidden treasure; (5) raksusa or monsters (such as the ten-headed Ravana); (6) pitrz or spirits of departed ancestors; (7) 22८८ or flesh-eating demons; (8) १242 or beings 10 serpeutform. There exists also another class of graha, viz., the bala-graha or ‘demoniacal seizures affecting children.’ They will be found enumerated below in chapter 3, § 8, They belong to the fifth division or the kaumdra-bhrtya. 10 The combined materials, by themselves, may be innocuous. Thus Ni. instances the combination of honey and clarified butter. 11 The term v@jikarana is variously explained. द्वु means ‘strong,’ ‘impetuous’; hence vajz-karana is a ‘means of making ` ऋ CHAP. 1.] THE ORIGIN OF MEDICAL SCIENCE. 5 revigorating and recreating respectively of scanty, diseased, dried up, or wasted semen. 19 It also teaches how sexual desire may be stimulated. [11] Such are the eight divisions of Medical Science. (9) ^ Now, whom (of you) shall I instruct, and in which of these subjects?” They replied: ‘Teach all of us, Blessed One, beginning with the very first, the knowledge of (alya or ‘major surgery’.” He said: “ Be itso!” They again said : ‘Blessed One, seeing that we hold all the same opinion, Sucruta will put our questions to you, and while you are instructing him, we (others) will listen with attention.” He replied: “ Be it so!” (6) (‘ Listen) then, Sucgruta, my son! the object of the Ayur-véda or ‘Medical Science’ is the restoration of those who are afflicted with diseases, and the preservation of the others in sound health. [12] dyuk means ‘life’ and véda means ‘to know’ or ‘to attain.’ Hence dyur-véda is that science which is con- cerned with the nature of life and with the means of preserving it. On the first division of it I shall now instruct you in confor- mity with the sacred scriptures and with (the results. of) obser- vation, inference and analogy. Listen attentively |!” [13] (7) This division takes the first place, because the first (application of the healing art) was on the occasion of the healing of *the wounds inflicted (in the assault on the sacrifice) and of the restoration of the head of the sacrificial animal. For (sexually) potent.’ But च्व means also a ‘horse’; hence vdji-kurana is ॐ ‘means of making one like a horse’ (in sexual potency). Tho latter is the usual traditional interpretation al- ready given by Caraka. Both the above iuterpretations are given by Bui. and Nt. The latter, however, adds a third, which makes va@ji to be a synonym of gukra or ‘semen’; hence ० दढ - karana is a ‘means of producing semen.’ 18 ‘Scanty semen’ refers to natural deficiency in youth under twenty-five, ‘wasted semen’ to deficiency due to excesses in middle life, ‘dried-up semen,’ to deficiency due to old age. ° Diseased semen ’ is due to diseases, and may occur at any age. So Bui and पा. 18 The reference is to the celebrated sacrifice of Daksa. The commentaries (BHA. Ni.) take this passage to contain refer- 6 sOTRA-STHANAM. [sEc. 1. it is related, that when Rudra had cut off the head of the sacrifice, the Dévas approaching the Acvin-pair said to them: “‘ Blessed Ones, you twins are admittedly the most excellent amongst us. It 18 you who must restore the head of the saeri- fice.” The twins replied: “So be it!” Then for their sake the Dévas gratified Indra with a share of the sacrifice; and they restored the head of the sacrifice. [14] Moreover among the eight subjects treated of in medical science that (which concerns major surgery) is the foremost, on account of its doing its work quickly, because it must be done by the application of blunt instruments, sharp instruments, caustics, and actual cautery, and on account of its being equal (in value) to all (the other) ences to two distinet occurrences: (1) the great war of the Asuras with the Dévas for the possession of heaven, (2) Dakga’s sacri- fice. But the context, which enters only into the details of the second ccurrence, renders this explanation improbable. The sacrifice of Dakga is related with some minor variations in the Mahabharata and other works. The main story is that Daksa invited all the gods with the exception of his son-in-law Civa or Rudra, who, in revenge, violently mterrupted the sacrifice. He created a monster Virabhadra, who decapitated yajfa or ‘the sacrificial animal’ (a deer), and wounded and maimed most of the guests. Finally Civa was pacified by being given a Share in the sacrifice, whereupon he restored all the injuries done in the en- counter. According to some accounts, Dakga himself was decapi- tated, and as his head had fallen into the sacrificial fire, it was replaced by Civa with a goat’s head. All these accounts know nothing of any intervention of the Agvins as healers, This seems to be an imbellishment of the medical castras, according to whom the Acvins were induced to undertake the restoration by a share of the sacrifice being allowed to Indra, who was their pupil (see § 8). The introduction of Indra is hardly sufficiently accounted for: one would rather expect the Acvins themselves to be gratified with a share in the sacrifice: moreover, one would expect the twins as well as Indra (all being dévas) to be among the original guests and participators. The version of the story in the Mahabharata seems to have more consistency, which, however, in stories of this kind is perhaps not to be expected. Or may it be suggested that Indra is an ancient misreading for Rudra ? ™. CHAP. 1.] THE ORIGIN OF MEDICAL SCIENCE. 7 subjects (put together).'* Hence it is a means of attaining salvation, religious ‘merit, heaven, fame, longevity, and a compe- tency. [15] (8) Brahma was the first to promulgate (the science of medicine) ; from him Prajapati (¢.e., Dakea) learned it ; from him again the Acvin-pair; from the Agvins Indra; from Indra my- self; and my duty it is (now), for the good of mankind, to communicate it here (in this world) to all who desire (to receive) it. [16] On this point there is (the following verse) :— It was I, Dhanvantari, the primeval Deva,'® that removed decrepitude, disease, and death from the Immortals (2.e., the Dévas); and now I have appeared on the earth, in order to teach here surgery as well as the other branches of medical science. [17] (9) In this science by that aggregate, the animated body composed of the five elements,'® is understood the puruga or ‘the 49 Commentaries: “ unless surgical work is done quickly, the patient suffers injury.” The translation, above given, gives two reasons for the excellence of surgery; the passage, however, (as the commentaries point out) may also imply three reasons: “on account (1) of its doing its works (८८६. incisions, etc.) quickly, (४) of its employing mstruments, etc., ($) of its being of equal ‘value to the rest, because, as Bui. explains it enters into the subjects of all the rest. Both Bud. aud Ni. make mention of another recension of this passage, which simply reads adhika- kriyd-karana@t 1.e., ‘on account of its doing more work (than the rest),’ instead of dgu-kriyd-karana@d=yantra ...... simanyac=ca. Both add that, even with this reading, the two clauses yantra-gastra- ksa@r-dgni-pranidhanadt aud sarva-tantra-simanydt must be under- stood as being implied, as giving the reasons for surgery doing more work than the rest. 16 The Gdi-déva or ‘primeval dévas’ are Brahma, etc., as contrasted with the karma-déva or ‘those who owe their divinity to their extraordinary feats,’ such as Indra and others, and with the praydjana-déva or ‘those who owe their divinity to some ne- cessity’ such as Buddha, Skanda and others. So the Com- mentaries. 16 The five mahad-bhita or ‘elements’ are: earth, water, fire, air, and dkdga (or ether). 8 SOTRA-STHANAM. [sEc. I. human being.’ It is he (alone) to whom medical acts!’ refer, (and) he (alone) is the subject (of my discourse). Why? Because the world consists of two classes of beings. For the world is divisible mto these two, the sthdvara or ‘those that cannot move’ and the jangama or ‘ those that can move. ’!8 It may be added incidentally that (from the point of view of fitness for medicinal use) the world is also divisible into the two classes of the calorific क the frigorific; or, having regard to its great variety, it may be slivided into five classes.'9 [18] Now the (jangama, considered as) bhuta (१.९. fromthe point of view ९4 or ^ the manner of their birth’) are divisible into four classes, namely those respectively termed szvéda-ja or ‘ produced from warm moisture’ avda-ja or ^ produced from an egg,’ udbhij-ja or ^ produced from a split in the earth,’ and javdyu-ja or ‘ pro- duced from the womb.’ Among these the puruga or ‘the human being’ is the chief, because the others are intended for his service. Hence it is the purusa or ‘the human being,’ who forms the subject (of my discourse.)*® [19] (10) Any occurrence which causes him pain is termed a vyddht or ‘disease.’ These (diseases) may be of four kinds: adventi- tious, bodily, mental, and natural. Of these the adventitious 17 Such as the administration of medicines, and the applica- tion of instruments, caustics, bougies, etc. (Commentaries). 18 Qn the details of this classification, see below § 12. 19 According as one or the other of the five elements (see foot- note 16) predominates in their composition. 80 The argument runs continuously through paragraphs 18 and 19 of the Sanskrit text. It is briefly this: the world is divisible into two classes, the stationary and locomotive. The latter class, which includes men, is subject to states of disease and health. Yet medical science concerns itself only with the human being. Why? Because man is the chief, all other living beings being sub- servient to him, This is clearly explained in Bad. But Ni. does not seem to have grasped the argument quite accurately. In para- graph 18 it takes purusa to mean ‘a sentient being,’ including both men and pagu or ‘animals,’ while in paragraph 19 it takes purusa as restricted to the human being. CHAP. 1.] THE ORIGIN OF MEDICAL SCIENCE. 9 are injuries caused by violent contact.*! Bodily diseases are caused by any derangement* of the air, or bile, or phlegm, or blood, or of all these (humours) combined, brought on by (irregularities in) food and drink. Mental diseases, showing themselves in the form of anger, grief, fear, joy, disappointment, envy, proneness to detraction, despondency, unfriendliness, lust, avarice, and such- like dispositions, are the result either of (violent) desire or (violent) aversion. Natural diseases consist in (a perversion of) the natural states of hunger, thirst, old age, death, and sleep. All these diseases have their seat in the body and in the mind.% [20] (11) Depuratory and rectificatory remedies, observances regarding food, and corrective practices, properly employed, are the means for checking diseases.%* [2 ] | 9 Such as those produced by weapons, supernatural beings, poison, fire, wind, etc. (Commentaries), Agantu lit. means ‘arriving, ‘adventitious,’ therefore a ‘disense coming from the outside,’ z.e., ‘caused by injurious contact with some external body.’ 88 That is: derangement of the proper proportion of the humours, either through excess or deficiency. (Commentaries). 88 That is: either in the body (as fever), or in the mind (as wrath}, or in both (as epilepsy). Besides, a disease affects the body first, and the mind afterwards, or vice versa. So the Com- mentaries. ४» Depuratories are external or internal. The external are in- struments, caustics, plasters, etc.; the internal are emetics, purga- tives, enemas, errhines, and blood-letting. Rectificatories also are either external or internal. The former are liniments, donches, baths, unguents, applications to the head, liquid and semi-liquid gargles, etc. The latter are digestives, attenuants, nutrients, tonics, aphrodisiacs, antitoxics, etc. Food is of four kinds (having regard to the mode of consumption) : what can be drunk, licked, swallowed, and masticated ; or of three kinds (from the point of view of its effect): relieving deranged humours, curing diseases, and giving health and sustenance. Corrective practices havo reference to the body or the voice or the mind. Bodily exercises are, according to BHA., walking, copulating, dancing, etc., according to कि, fasts, abstinences, etc. Vocal exercises are reading, singing, re- 2 10 3 SUTRA-STHANAM, [SEc. 7, (12) Now food is the sustenance of living beings and ‘the source) of their strength, colour, and vital power. (In order to be such) it depends on the six tastes; and these again exist in the material objects. But the material objects (also) serve as 68८2८ or ‘ medicaments’; and the latter are of two kinds: sthavara or ‘ stationary,’ and jangama or ‘locomotive.’ Of these the stationary ones are of four kinds ; namely, vazaspatz or ^ trees that bear fruit but have no flowers,’ vrksa or ‘ trees that bear both fruit and flowers,’ virudé or ^ plants that grow im the form of ॐ creeper or a shrub,’ and dsadii or ^ plante that die after maturing their पा [22] The jangama or ‘locomotive be- ings’ are also divided into four classes: the yardyu-ja or ‘those produced from the womb,’ the ange-ja or ‘those produced from an egg,’ the svéda-ja or ‘those produced from warm moisture,’ and the wdbh17-7a or ‘those produced from a split (in the earth).’ Of these the womb-born are the domestic animals, men, beasts of prey, and गला. The egg-born are the birds, all slow and quick-moving reptiles, and others. The moisture-born are the worms, insects, ants, and others. The earth-born are the cochineal insects, frogs, and others. As to the ‘stationary beings’ (or plants), their bark, leaves flowers, fruit, roots, tubers, exudations, juice, etc., and as to the ‘locomotive beings’ (or animals), their skin, nails, hair, blood, etc., are the objects of use in medicine. [23] To the class of parthiva or ‘ minerals” belong the following : hearsing, etc. Mental exercises are thinking, meditating, calcu- lating, etc. The term ‘properly’ refers to considerations of locality, time, age, etc. So the commentaries. 86 Examples are: of vanaspati, the Plaksa and Udumbare (or Ficus Tjakela and glomerata), etc.; of vrksa, the mango, jamun (Eugenia Jambolana) and other trees; of virudh, the Vidari, (Ipomoea digitata), pepper, lovage, Galaparni and Prgniparni (Desmodium gangeticum and Uraria lagopoides), etc.; of dsadhi, wheat and other cereals. (Commentaries). 2 Tle commentaries explain that the domestic animals are placed first, because from the point of view of medicinal subser- viency, which is hcre in question, they are the most important. cHaP. 1.] THE ORIGIN OF MEDICAL SCIENCE. 11 gold, silver, gems, pearls, realgar, earth, potsherds, and others.” : (13) With reference to time we have the following varieties = breezy weather, calm weather, sunshine, shade, moon-light, dark- ness, cold weather, hot weather, rainy weather, day and nicht, fortnight, month, season, half-year, and other divisions of time. These, by their very nature, exercise an augmenting, or deranging, or relieving, or repressing influence on the humours (and the consequent diseases) ; hence a knowledge of them is necessary. [24] On this (subject) there are the (following) verses :— With regard to the diseases of men the above-mentioned four-fold group* of causes of derangement and relief has been laid down by the physicians. [१5] Those diseases which are accidental are of two kinds: some affect the mind, others the body ; and their treatment is also of two kinds. [26.] For those which affect the body, the treatment is the same as for bodily diseases. In the case of those which affect the mind, sounds and the rest of the (five-fold) group (of sensations) 99 of an agreeable nature bring relief. [27] (14) Thus far these four terms have been expounded : puruga or ‘the human being,’ vyddht or ‘ disease,’ augadha or ‘ medica- 97 The commentators are much exercised to account for the reason why the parthioa or ‘minerals’ are not included as 8. third class of dsadht or ‘medicaments,’ in spite of their being clearly intended to be a kind of medicaments, Nothing satisfactory is said by them. But Bui. cites Caraka as giving a threefold division of medicamentary objects, yaygama or ‘animals,’ udbhida or ‘plants’ and p&rthiva or ‘ minerals.’ It almost looks as if in the original system of Sugruta, the minerals were not considered medicinal, but were only introduced afterwards. 98 Namely, stationary beings, locomotive beings, minerals, and time, according to the physician Jaijjhbata; or food, practices (see § 11), minerals, and time. Bui. adopts the former, N1., the latter alternative. Neither seems quite sntisfactory, though to me the former appears more consonant with Su¢ruta’s text as it now stands. 99 The five sensations or sense-objects are: sound, touch, form, taste, and smell. 12 | SOTRA-STHANAM. [SEc. I. ment,’ and friyé-kala or ^ time with reference to its suitability for treatment.’ Here the term ‘human being’ includes not only the whole of the materials which compose his body and which (as stated before in § 9) are themselves composed of, the (five) ele- ments,® but also the constituent parts of its major and minor limbs,’! such as the skin, flesh, blood-vessels, nerves, and s0 forth. The term ‘ disease’ includes not only diseases due to air, or bile, or phlegm, or the blood, or to any of these combined, but diseases of every description (incl. adventitious). By the term ‘medicament’ must be understood material objects as well as their guna or ‘elementary properties,’ rasa or ^ tastes,’ virya or ‘sensifie powers,’ and cipdéka or ‘ digestibility.’?* The term ‘treatment’ (4viyd) is the general one for all medical operations, such as cutting, ete., and administering oils, ९९. The term ‘time’ (८५) refers to the variety of time (which may be suit- able) for any particular (medical) operation.®* [28] (15) Here comes in (the following verse) :-— Herewith I have declared (to you) succinctly the germ or quintessence of the (whole) therapeutical science. I shall (now) give (you) a detailed exposition in one hundred and twenty chapters. [29] ॐ Here the dravya or ‘materials’ are the seven dhalu or secondary elements: semen, blood, chyle, flesh, fat, marrow, and bones ; while the five bhutu (or mah@bhita) or primary ‘ elements’ are earth, fire, water, air and दवद. Sothe commentaries. Usually, however, the term dravya connotes the ‘ material objects,’ as distri- butable among the five classes of 07८८4 ; as in ch. 3, § 2 [40], ch. 4, § 2. 81 Major limbs, such as the head; minor limbs, such as the chin. (Commentaries). 38 For an exposition of these four terms, 866 bclow chapters 40 and 41. 83 Surgical operations, such as cutting, opening, scarifying, probing, extracting, bleeding, sewing. Again, oils, sudorifics, eme- tics, purgatives, enemas, fumigations, errhines, gargles, digestives, alteratives, and so forth. (Commentaries). 84 Thus, the forenoon is the time suitable for the administration of emetics, and the early morning for that of purgatives. So Ni. GHAP. I1.] THE INITIATION OF A PUPIL. 13 These one hundred and twenty chapters- will be (arranged) in five sections with reference to the subjects (taught in them) : the S#tra-sthéna or ‘section on general principles ;’ the Niddna-sthdna or ‘ section on pathology,’ the Cartra-sthana or ‘section on anatomy;’ the Cvrkitsita-sthina or ‘section on therapeutics,’ and the Kulpa-sthina or ‘section on toxicology.’ Afterwards I shall expound the remaining subjects in the U/tara- tantra or the ‘ supplementary treatise.’ [30] (16.) Here comes in (the following verse) :— Whoever studies this (science), promulgated by Svayambhi (or Brahma) in primeval times, and made known (to the world) by the king of Kaci (or Benares), that meritorious person is reverenced on earth by kings, and after death attains a position (in heaven) equal to that of Indra. [3] | THE SECOND CHAPTER. ` On THE IniTIATION OF A एएटा,. [1] (1) A physician may admit as a pupil anyone of the Brahman, Kesatriya, and Vaicgya castes who is of (good) family,* youthful, observant of caste-rules, persevering, clean (in body and mind), well-bred,®° modest, energetic, strong, attentive, contented, possessed of a good memory, intelligent, and resourceful. His tongue, lips, and teeth should be delicate. His mouth, eyes and nose should be straight. His disposition, speech, and deportment should be agreeable. And he should be able to bear pain. Any one with opposite qualities should not be admitted as a pupil. [2] | (2) When a Brahman (physician) performs the initiation ceremony, (he should act in the following manner.)*? On an auspi- 85 So N1., but BHA. interprets: ‘one who belongs to a medical family.’ Nu. also gives this as an alternative. 86 Acdra appears to have been wanting in BaA.’s recension of Sugruta’s text. It does not comment on it, and interprets gila as ‘well-bred,’ 87 I have adopted the reading upanayaniyas=tu brahmanah or 14 SOTRA-STHANAM. [380. f. cious {7८6८ or ‘lunar day,’ £arana or ‘lunar half-day,’ muhirta or ८80४ part of a lunar day’ and waksatra or ‘lunar asterism,’ in an auspicious direction, on clean and even ground, a sacrificial spot, four cubits square, should be smeared with cowdung and. spread with darbha grass (Poa cynosurotdes). Then the gods should be honoured with flowers, fried rice, rice, and jewels, like- wise the (officiating) Brahmans, and the (witnessing) physicians. Then, having marked off (the sacrificial square) and besprink- led it (with water), (the officiant) should place the Brahman (pupil) on his right, and kindling before himself a fire with the wood of Khadira (Acacia Catechu), Palaca (Butea frondosa), deodar and bel, smeared with curds, ‘honey and clarified butter, or (with the wood) of the four trees with a milky sap, v7z., the Nyagrodha (Ficus bengalensis), Udumbara (Ficus glo- merata), Acvattha (८/5 religiosa) and Madhika (Bassa lats- Jolia),®® (smeared in the same way), he should offer on it oblations of clarified butter with a sacrificial ladle according to the Darvihoma rite.© Next with the mystical syllable and the great ‘the initiating Brahman.’ Here upanayaniyas has the active sense of 02172८8. I follow herein Bud. But Ni. adopts the reading upanayaniyam tu braéhmapam or ‘the Brahman (pupil) who is to be initiated.’ But this reading does not well agree with the subsequent context brahmanam sthapayitva ‘having placed the Brahman (pupil).’ The case of the Brahman physician and the Brahman pupil is here only given as au exemplar of the initiation ceremony. The commentaries explain that they are only selected honoris causa, but that the same ceremonies take place in the case of Kgatriyas or Vaigyas ; only in the case of a Cidra the ceremony is modified, as noted in § 3. They add, however, that of what- ever caste the medical teacher who arranges for the initiation may be, the initiation rites themselves must be performed by a Brahman. 8 J.e., towards the East or North. (Commentaries ) %9 The members of this group of trees are variously enumerated. Some give the Plakga (Ftcus Tjakela) in the place of the Madhika. Some give the number of the group as five. © The Darvihima rite 18 well-known as that of Brahmans who are chanddvid or ‘proficient in incantations.’ So N1. ™/ CHAP. II.] THE INITIATION OF A PUPIL. 15 mystical words‘! he should pronounce sedia in the name of every deity and every Rishi, and cause the pupil to do the same. (8) A Brahman may give initiation to a pupil of three castes, a Rajanyna (t.c., Kgatriya) to one of two castes,# but a Vaicya to one of the Vaicya caste only. Some say that a Ciidra, if he is of (good) family and (good) character, may also be admitted to instruction, but without the initiatory rites. [3] (4) Then leading the pupil three times round the fire ** and invoking the fire as witness, he should thus address him: “ It must be your inflexible rule to eschew lust, anger, avarice, pride, vanity, envy, rudeness, gossiping, lying, idleness, and every other reprehensible conduct, to keep short your nails and hair, to be clean in your person, to dress yourself in reddish-coloured cloth, and to endeavour to lead an upright, pure, and respectful life. You must be always ready to abide by my directions with regard to residing, going about, lying down, sitting down, eating, and studying, and you must always be intent on furthering my 41 The mystic syllable is 6m and the three great mystic words are bhur, bhuvah, svar. The formula runs as follows: Orn bhih sucha, Om bhuvah evdhd, Om svah svaha, Om bhir bhuvak svah svatha. So N1. ° That is, to Brahmans, Ksatriyas, Vaicyas, and to Keatriyas Vaicyas, respectively. + Paragraph 3 is clearly a later interpolation, as it interrupts tlie account of the initiatory ceremonies. According to NI. it is rejected by the nibandhas or ‘commentaries.’ Bui., however, admits it, and argues strongly in favour of the Cudras. The reason of the interpolation in this particular place clearly is to indicate that the preceding portion of the initiatory rites is omitted in the case of a Cidra, while the subsequent portion (in § 4) is permitted.—-According to Ni. there are two readings: either “sampannam=anupanitam, i.e., ‘he may be admitted without any initiating rites’; or °satwpannam mantra-varjan=upanitam, i.e., ‘he may be initiated, but without the mantra.’ It is not clear which of the two was adopted by Bud. They are, however, practically equivalent. + In the form of pradaksina, i.e., from left to right, so that the right side is kept towards the fire. So Ni. 16 SOTRA-STHANAM. [sEC. 1. pleasure and welfare. If you shall be wanting in all this, you will be a sinner, and your learning will be useless to you and fail to bring you fame. [4] On the other hand, if, while you are regular in the discharge of your duties, 1 should behave improperly towards you, I shall be committing sin, and my learn- ing will be useless to me.” (5) To treat Brahmans, spiritual guides, paupers, friends, ascetics, neighbours, devotees, orphans and widows, and people who come from a distance, (gratuitously) with one’s own medicines, as if they were one’s own relations, 18 night. But hunters, fowlers, outcasts, and sinners should not be treated. By pursuing such a policy, one makes himself known as learned, and attains friends, fame, merit, wealth, and pleasure. [5] (6) Here come in (the following verses) :— On the eighth day of the dark half of the month, as well as on its two last days (८.९. the fourteenth and fifteenth) ; on the same days also of the light half of the month, as well as on the two twilights (¢.e., dawn and dusk) of the day; when there is thunder and lightning at unusual times #5; when one’s people or country or king are in dis- tress; [6] during the whole day on which one has been to a cemetery +€ ; during the time of a battle, or a festival,+7 45 That is, when rain falls in any of the four months compris- ing the cold and dewy seasons (hémanta and ¢icira), ४.९.) from tlie middle of November to the middle of March; or when thunder-. storms occur in the morning or evening. (Commentaries.) 46 Adyatana is the period of a current day, reckoned either from dawn to dark or from midnight to midnight. This appears to me to be the only rational explauation of the compound word. Both Bad. and Ni. explain it thus: “on a cemetery or on a slaughter- ground of pack-animals” taking ydna to mean hasty-Gdi or ‘elephants, etc,’ and adyatana to mean badha-sthana or ‘ place of slaughtering.’ I do not understand how the latter meaning for- adyatana is arrived at 7 47 Such as the festival of Cukra (or Venus) on the full-moon of the month Bhadrapada (August-September); the Kaumudi (or full-moon) festival. in the month Agvina; the festival of CHAP. III. ] THE CONTENTS OF THIS WORK. 17 or the appearance of a portent,#— (on any of these occasions) the student should never read; nor should he do so at any other time when Brahmans do not study ; nor must he ever read when he is impure. [7] THE THIRD CHAPTER. On THE ConrTENTS or THIS Work. [1] (1) It has been already stated (see § 15, p. 12) that the one hundred and twenty chapters (of this work) (will be distributed) in five sections. Of these the (first) section on General Principles will contain forty-six chapters: the (second) on Pathology, sixteen: the (third) on Anatomy, ten: the (fourth) on Thera- peutics, forty: the (fifth) on Toxicology, eight. Then will follow the supplementary part with sixty-six chapters. [2] (2) The following are the forty-six chapters of the Sitra- sthana or ‘Section on General Principles,’ which is called so, because in it the whole of the subjects (of medical science) are presented in clear detail, proper arrangement, and orderly development. [11] 1 The origin of the medical science. 1 The initiation of pupils. 17 The exposition of the (contents of the several) chapters. iv The (importance of) understanding the (medical) terms. v_ Preliminary arrangements in surgical practice. vi Regimen (to be observed) in the various seasons. vii Description of blunt instruments. [3] viii Mode of applying cutting instruments. ix (Practical training in) the application of surgery. Kuvéra (or the god of wealth) at the summer solstice ; the festival of Madana (or the god of love) on the thirteenth day of the light half of the month Caitra (March-April), and others. So N1. 48 Te, any extraordinary natural phenomenon indicative of evil, such as an earthquake or hurricane, 8 mirage or rainbow, or any wonderful change in a planet or star. (So NI.) 18 SOTRA-STHANAM. (Rules with regard to visiting) the siek-room. Preparation and use of caustics. Lecture on actual cautery. Lecture on leeches. Discourse on the blood. [4] Instruction with regard to the humours, con- stituent elements, excretions, ete., (of the body). Piercing the (lobules of the) ear. Diagnosis of immature and mature (inflamma- tions). ` (Application of) liniments. (General rules of) treating inflamed parts. [5] Thmgs salutary and insalutary. Enquiry into (the origm of) inflammation. Discharges from inflamed parts. Characteristics of curable and incurable (inflam- mations). । Classification of diseases. [6] Definition of the various kinds of surgical operations. Diagnosis of the presence of a dead (2.c., foreign) substance (in the body). Extraction of foreign substances. Prognosis of inflammations. Prognostication from the messenger, dreams, ete. [7] Morbid changes (as promonitory signs of death) in the five senses. The same in the general appearance. The same in the constitution (of the body). Avoidance (of treating incurable diseases). Treatment of a king engaged in warfare. Treatment of the feeble. Miscellaneous formulae (for external applica- tions to inflammations). [8] Different varieties of soil (with reference to the collection cf drugs). [sxc. 1 CHAP. III.] THE CONTENTS OF THIS WORK. 19 xxxviii Classification of drugs. xxxix Drugs useful for depuration and rectification (of the humours). xl Exposition of the terms dravya or ‘material object’ and the rest.*® xli Predominant characters of drugs. [9] xlii Information on the (six) rasa or ‘ tastes.’ xliii Preparation of emetics. xliv Preparation of cathartics. xlv Various kinds of liquid substances. - xlvi Qn food and drink. [10] (3) The following are the sixteen chapters of the Midana- sthana or ‘Section on Pathology,’ which 1s so called on account of its describing the causes and symptoms (of diseases). [13] 1 Diseases of the nervous system iit Hemorrhoids iii Calculus in the bladder. iv Fistula-in-ano. ए Skin-diseases. vi Morbid secretion of urine. ए11 Abdomunal tumours. viii Complex labour. 15 Deep-seated abscesses. x Malignant growths. [12] xi Glandular enlargements. xii Scrotal enlargements. 3८111 Fractures ©. xiv Sores on the penis caused by the gaka or ‘hairy caterpillar.’ xv Minor diseases. xvi Diseases of the mouth. ५9 See footnote 30 on p. 12. “The rest” refers to the tastes, elementary properties, sensific powers, and digestibility, see chap. 4, § £. 60 Here the order of the chapters in the book itself differs. The fractures form the 15th chapter, while the penis-sores and the minor diseases form the 13th and 14th chapters respectively. 20 SOTRA-STHANAM. ` [SEC. I. (4) The following are the ten chapters of the Cartra-sthana or ‘Section on Anatomy,’ which was propounded by the Maharsi (४.९. Dhanvantari), in order to give to physicians and YOgis or ‘wizards’ a knowledge of the (constitution of the human) body. [16] 1 Theory of the origin of living beings. 1 Rectification of the semen and menses. 71 Impregnation of the womb. - 1४ Description of the foetus. v_ Description of the (human) body. [14] vi Exposition of the vital parts (of the body). vii Description of the vascular system. vil Venesection. ix Description of the ducts and nerves. x Description of pregnancy. [15] (5) The following are the forty chapters of the Crkitsd-sthana or ‘ Section on Therapeutics,’ which is so called, because it treats of the amending or rectifying or curing or alleviating, as it may be variously termed, (of diseases). [25] i Treatment of the two kinds of inflamed sores 1 Treatment of recent inflamed sores. ni Treatment of fractures. iv Treatment of nervous diseases. v Treatment of major diseases of the nervous system. vi Treatment of hemorrhoids. vii Treatment of calculus. viii Treatment of fistula-in-ano, [17] ix Treatment of skin-diseases. x Treatment of major skin-diseases. x1 Treatment of morbid secretion of urine. शा Treatment of eruptions on the skin (in the fore- going disease). xii Treatment of diabetes xiv Treatment of abdominal enlargements. [18] xv Treatment of complex labour xvi Treatment of deep-seated abscesses. CHAP. 7171. XVil, XVI THE CONTENTS OF THIS WORK. Treatment of malignant ulcerations. Treatment of glandular enlargements. Treatment of scrotal enlargements and diseases of the penis. Treatment of minor diseases. [19] Treatment of sores on the penis produced by the ¢géka or ‘ hairy caterpillar.’ Treatment of diseases of the mouth. Prevention of inflammatory swellings. Prevention of diseases generally. Miscellaneous formulae. [20] Aphrodisiacs in cases of debility. Tonic treatment in every kind of ailment. Means of strengthening the memory and pro- longing life. (The Séma torfics for) the prevention of (all) natural diseases. [21] The tonic known by the name of ‘ pain-killer.’ Use of medicated oils Modes of sweating Emetics and cathartics. [22] Treatment of disorders brought on by the misuse of the two preceding remedies. Classification of syringes, made of a nozzle and bladder, for clysters. Treatment of disorders caused by (the misuse of) such & syringe The application of oily enemas by the urethra (28) en? Enemas made with other liquids. Treatment of a patient weakened (by the use of the above-mentioned remedies). Various kinds of inhalations. [24] 21 (6) The following are the eight chapters of the Kalpa-sthina or ‘Section on Toxicology,’ which is so called because (of its treating) of the preparation and use of remedies against poi- sons. [27] 22 SUTRA-STHANAM. [sxc. 1. 1 The protection of food. ii Account of vegetable and mineral poisons. iii Animal poisons. iv Information on snake-bites. v Treatment of the latter. [26] vi Some dundubht or ‘ far-famed ° antidotes 61. vii Antidotes against rat-bites. viii Antidotes against insect-bites. (7) Thus far altogether one hundred and twenty chapters have been described. Hence forward the Uttara-tantra or the ‘Supplementary Treatise’ will be spoken of, with its several (four) parts as hereafter named.’& [ 28] Its first chapter is concerned with the wpadrava or ‘ troublesome diseases’ (of the eye) ; hence this (supplementary) treatise is also called the Aupadravtka or Treatise on Troublesome Diseases.’ [29] Next follow in order the (various) chapters which describe the diseases (of the eye) i On troublesome eye-diseases generally 1 On diseases in the joinings of the eye in On diseases in the eyelids. iv On diseases in the sclerotica. v On diseases in the cornea. vi On diseases in the whole eyeball. vii On diseases in the lens. [80] viii Classification of the treatments (of eye-diseases). ix Curing of ophthalmia caused by (deranged) air. x Curing of ophthalmia caused by (deranged) bile. xi Curing of ophthalmia caused by (deranged) phlegm. : xii Curing of ophthalmma caused by (deranged) blood. [31] 3111 On scarification in eye-diseases. xiv On incision in eye-diseases. xv On excision in eye-diseases. 6! The order of these chapters in the book itself differs. There the dundubhi form the seventh, and the rat-bites the sixth chapter. 69 For these four parts, 866 below § 12. CHAP. I11.] 4 8:3५ THE CONTENTS OF THIS WORK. 28 On diseases of the eyelashes. On diseases of the lens. Description of external applications (to the eyes). (Treatment of) injuries (to the eyes) caused by violent contact. Diseases of the ears. Their treatment. [32] Description of the diseases of the nose. Cure of these diseases. Cure of coryza. Description of the diseases of the head. Treatment of these diseases. The preceding (twenty-six chapters) constitute the Calakya- tantra or ‘ Treatise on Minor Surgery.’ [33] (8) xxvil XXXiil XXXIV XXXV XXXVi XXXVI XXXVII1 Description of the nine graka (or demoniacal possessions). Treatment of the Standa. Treatment of the Apasmdara. Treatment of the Gakuni. Treatment of the Révati. [84] Treatment of the Putand. Treatment of the Andha-pitana. Treatment of the Mandtka 58. Treatment of the Gita-putand. Treatment of the Nazgamésa. Origin of these seizures. (Cure of the) diseases of the womb. The preceding (twelve chapters) constitute the Kaumara-tantra or ‘Treatise on the Management of Children,’ (and refer to the subjects) named in the Garira-sthana or ‘Section on Anatomy.’ [35] (9) xxxix Cure of fever. xl Cure of diarrhea. xli Cure of consumption. 68 In the book itself the chapter on Mand:ké is placed after that on Cita-putand. | 4 SOTRA-STHANAM. [sEc. I. xlii Cure of abdominal tumours. xlii Cure of heart-diseases. xliv Cure of morbid palor. शभ Cure of hemorrhage. xlvi Cure of fainting. xlvu Cure of alcoholism. [36] शा Cure of morbid thirst. xlix Cure of vomiting. 1 Cure of hiccough. h Cure of asthma. li Cure of cough. hii Cure of aphonia. liv Cure of worms. lv Cure of retention of discharges. [37] lvi Cure of cholera. शा Cure of anorexia. [शा (पक of dysuria. तड Cure of strangury. The preceding (twenty-one chapters) constitute the remainder of the Kaya-ciktisa or ‘ Treatment of the Body.’ * [38] (10) Ix Cure of diseases caused by superhuman agencies. lxi Cure of epilepsy. [शा Cure of insanity. The preceding (three chapters) constitute the Bhuta-vidyd or ‘Science of Demoniacism.’ [39] (11) [ता Enumeration of the (combinations of) tastes. Ixiv Hygienic rules. हए Syntactical rules. Ixvi _ Enumeration of the (combinations of) humours. The preceding (four chapters) must be understood to serve as embellishments of this treatise. 8५ The commentary explains that the term ‘remainder ’ indicates that other portions of the ‘treatment of the body’ have already been given in the preceding part on galya or ‘major surgery.’ The reference here is clearly to the cvikitsa-sthana or ‘section on therapeutics.’ CHAP. III.] THE CONTENTS OF THIS WORK. 25 (12) On account of its excellence the Maharsis have called this treatise the Ué/ara or ‘superior one.’ Its excellence lies in the fact of its comprising so many subjects. It is also called Uttara or ‘supplemental’ by reason of its position at the end. [41 ] The subjects comprised in it, are the following four : 1 Minor surgery, 1i Management of infants, 771 Medical treatment of the body, iv Science of demoniacism. [42] (18) The subjects of aphrodisiacs and alterative tonics are included in the Crkttsd-sthina or ‘Section on Therapeutics.’ ५ [42] The doctrine of poisons is given in the Kalpa-sthina or ‘Section on Toxicology.’ Information about (the treatment of) foreign substances in the body will be found in every part (of this work). [43] (14) This work, then, with its above-named eight divisions, first made known by the Primordial Déva (४.९.) Brahma), whoever will carefully study and use in his practice, he will become a saviour of life in this world. [44] Both are equally necessary : the study of this science as well as its practical application after study. A physician, who is proficient in both, will be honoured by his king. [45] (15) Here come in ,the following verses) :-— One who knows medical science only theoretically, but possesses no practical experience, looses his head in the presence of a patient, just as a coward does in the presence of a challenge to fight. [46] On the other hand, he who is well-versed in praxis, but from self-confidence is neglect- ful of (keeping up) the study of his science,®* does not obtain the esteem of good men, and deserves to be con- demned to death by the king. [47] Both these kinds of 56 Aphrodisiacs are treated of in the 26th, and alterative tonics in the 27th-30th chapters of that section. 66 Te, One who, trusting entirely to his early acquisition of the science as a pupil, neglects to keep up his reading as a practitioner. (Commentaries. ) 4 26 - SOTRA-STANAM. [SEc. ए. unqualified physicians are unfit to practice their calling; for possessing only one-half of the knowledge of it, they are like birds that possess only one wing. [48] Medicines, though they are like nectar, become like poison, light- ning, or other instruments of destruction, if they are administered by an ignorant practitioner.57 Therefore such should be avoided. [49] A physician who is unskilled in operations, such as excision and the like, or application of medicated oils and the like, merely kills people from avarice. It is the king’s fault, if such bad physictans exist. [50] On the other hand, he who 18 proficient in both (theory and practice) is fit to intelligently exercise his calling, just as a carriage with two wheels is fit to accomplish its work in the battle. [51 | (16) Now, my son, hsten attentively to my instruction, how this (medical science) is to be studied. After having performed the prescribed purifications, the pupil must present himself, dressed in his upper garment and with an undistracted mind, at the hour of instruction; and the tutor should then teach him, according to his capacity, either a word, or a quarter-verse, or a full-verse 8; and the pupil must repeat these after him, again and again, in their proper order. In this manner the tutor should instruct each pupil separately; and he should himself repeat the lesson after his pupil. The latter should read not too quickly, nor too slowly, nor with fear, nor with a nasal twang, but with distinct utterance of every syllable, and without distortion of any letter, not gesticulating with eye, eyebrows, lips and hands, but (reading) with a well-modulated voice, neither too high, nor too low. Nor should any one pass between tutor and pupil, while they are engaged in study. [52] (17) Here come in (the following verses) :— Purified, devoted to his tutor, alert, and eschewing laziness - - 67-he allusion is to the story of Garuda who stole the nectar and to whom it turned into poison. So Nt. 68 The text has ¢léka, i.e., a verse of 32 syllables; and Bu. explains that if a medical work is written in prose, the direction refers to clauses of 8, 16, or 32 syllables respectively. CHAP. Iv.] THE TERMINOLOGY OF MEDICAL SCIENCE. 27 and sleep, the pupil should study: in this wise he will attain complete mastery over medical science. [53] One who has completed his studies should then strive to attain clearness of speech, comprehension of the requirements of any case, confidence in himself, skill and practice in medical work, and success (in his profession). [54] THE FOURTH CHAPTER. THE IMpoRTANCE OF UNDERSTANDING THE TERMINOLOGY OF Mepicat Science. [1] (1) Learning by rote without understanding the meaning of what is learned is profitless labour like that of the ass carrying a load of sandalwood. [2] Here comes in (the following verse) :-- As the ass that carries a load of sandalwood is conscious of the (weight of the) load, but not of the (fragrance of the) sandalwood, so those who learn numerous medical text-books, but remain fools with reference to their mean- ing are, ass-like, mere carriers of a load. [3] (2) Hence every word, quarter-verse, full-verse, and half- verse,§8 singly, of these one hundred and twenty chapters ® must be again and again explained (to the pupil) and rehearsed (by the latter.) The reason is that it is a subtle matter to classify and discriminate the material objects, their tastes, elementary properties, sensific powers, and digestibility ॐ ; the humours and constituent elements of the body, its secretions, viscera, vital parts, blood-vessels, ligaments and nerves,® joints, bones, and ` 6 This shows very clearly that the Uttara Tantra is a later addition to the original work of Sugruta which. only contained 120 chapters, up to the end of the Kalpa Sthana. 6 The term sndiyu includes both ligaments and nerves. The nerves are also included in the term dhamant, which comprises both ducts (or vasa) and nerves. The latter were not recognised as a distinct part of the body. 28 SOTRA-STHANAM. [szc. 1. all the factors of pregnancy®!; also to extract foreign bodies, diagnose inflamed sores, and treat fractures; also to prognose the curability or incurability of diseases. These and a thousand other such important matters which require to be thought over are apt to puzzle even men of clear and great intellect, how much more those of small intellect? Hence it is very necessary that every word, quarter-verse, full-verse and half-verse should be over and over again explained (to the pupil) and rehearsed (by the latter). [4] (3) As subjects will be referred to in this (work) which belong to other sciences, and as it will be necessary (for the pupil) to know their meaning, he must obtam information on them from men learned im those sciences. The reason is that it is im- possible in (treating of) any one science to avoid referring to other sciences. [5] (4) Here come in (the following verses) :— Any one who knows no more than a single science, can have no thorough knowledge of that science. Hence a physician will not be proficient in his own science, unless he is versed also in many other sciences. [6] A physician who is not content with merely learning his science from the hps of his tutor, but familiarises himself with 1t by repeated study, he is a true physician; all others are swindlers. [7] The surgical treatises of Aupadhénava, Aurabhra, Sucruta, and Pauskalavati form the basis of all other treatises on the subject. Hence instruction should be given in those works. [8] 61 Sach as semen, menstrual blood, etc. (Commentaries.) 69 According to Ni. the other treatises are those of Karavirya, Gopura-rakgita, etc. But the commentary adds that, according to other commentators, m#lani means only ‘most important,’ 4.e., ‘among the various surgical works those of Aupadhénava, etc., are the most important.’ CHAP, V.] PRELIMINARIES FOR SURGERY. 29 THE FIFTH CHAPTER. PRELIMINARY ARRANGEMENTS FOR SurcicaL Operations. [1] (1) There are three stages in the treatment (of diseases) : the preliminary, the principal, and the after-treatment. These we shall describe separately in the case of each individual disease. In this work, surgery being the most important subject, I shall begin with describing the preliminaries for surgical operations and all the requisites for them. [2] (2) Of surgical operations there are eight kinds, namely, excision, incision, scarification, puncturing, probing, extraction, letting out pus, and stitching. (3) Now when a physician desires to perform any operation, he should first of all arrange in a handy place the following articles: blunt and cutting instruments, caustics and cautery, probes, a horn, leeches, a hollow bottle-gourd,® a bougie,** cotton, pieces of cloth, thread, leaves, bandages, honey, clarified butter, suet, milk; oil, refreshments and decoctions,® liniments, pastes, a fan, cold and hot water, pans, and other useful things. (He should) also (provide himself with) trusty, steady, and strong assistants. [3] Then, on an auspicious दद्र or ‘lunar day,’ karana or ^ lunar half-day,’ muhértta or ‘ 30th part of a lunar day,’ and nakgatra or ‘lunar asterism,’ after having worshipped Agni (t.e., 6 This is the Alabué (Lagenaria vulgaris), the shell of which is hard and ligneous, and when dried is much used in the East as a vessel for holding fluids of all kinds; also for making guitars and banjos. See Pharmacographia Indica, Vol. II, p. 67 % The text has jambav-augtha, lit. ‘having jambu-like lips Ni. explains that the bougie is made of a black stone the extremity of which is shaped like the fruit of the Jambu tree (the Jamun or Eugenia Jambolana) © The text has tarpana and kagdya. According to the com- mentaries, farpanza means gaktu (flour of any parched grain) or milk or other substance mixed with water and given to the patient if he becomes thirsty. Kasdya is explained as the decoction (to one-quarter or one-eighth) of medicinal plants. 30 ^ SOTRA-STHANAM. . [SEC. 1, the god of fire), Brahmans, and (other) physicians with curds, whole (rice-)grains, food, drink, and jewels, offered oblations, and said words of lucky import and welcome, the patient, who must only have taken a light meal, should be set face to face with the physician and firmly secured. The latter, (taking care to) avoid any vital part, bloodvessel, nerve and lhgament,© joint, bone, or duct,© should introduce the instrument in the direction of the hairs of the skin, till pus appears, and then at once and quickly withdraw it (4) In large abscesses the instrument may be inserted to the depth of two fingers’ breadth. [4] The marks indicating an abscess to be ready for operation are, that it has a large base, rounded form, uniform maturation, and a favourable position. [5] Here come in (the following two verses) :— । An abscess with a large base, a rounded form, well- matured, and unconnected with any important organ,‘ and (in short) one which is operated on at the proper time, will readily heal by the operation. [6] It will heal, if it is operated on by a physician, who is fearless and quick, whose instrument is sharp, who does not perspire or tremble, and who does not err (in his diag- nosis.) ® [7 | If on the first incision 68 the abscess is not emptied, it should 6 The term su-vibhakta is rather obscure, even in the com- mentaries. It seems to be here synonymous with sama in § 5 of the Sanskrit text, while in § 5 it seems to be synonymous with nirdgraya in § 6 ` 67 Or it may mean ‘who does not faint (at the sight of blood) So Nr The Sanskrit text has vrana, lit..‘ wound,’ hence ‘ incision.’: This word is used, in medical works, with two different meanings. It may mean either simply ‘a wound,’ or it may be equivalent with ¢dtha or ‘ inflammation,’ ‘ an inflamed sore or swelling.’ Thus Bui. says here: gothd ‘pi vrana-hétutay@ vrana ucyaté, i.e., ‘an inflamed swelling’ may also be called a vrana, when it is caused by a wound or sore. CHAP. V. | PRELIMINARIES FOR SURGERY. 81 be carefully explored, and other incisions should be made. [8] Here comes in (the following verse) In whatever direction (a physician) perceives a sinus, and wherever there is (still) a collection (of pus), there he should ‘make an incision, lest any pus should re- main behind. [9] In the following places: eyebrows, cheeks, temple, forehead eyelids, lips, gums, armpits, abdomen, and groin, a transverse incision is indicated. [10] A circular incision should be made on the palms and soles, and a semicircular, on the anus and penis. [11] Otherwise a bloodvessel or ligament or nerve may be divided, and thus excess of pain, and delay in the coalescing and granulating of the wound will be caused. In the case of complex labour, enlargements of the abdomen, hemorrhoids, calculus, fistula-in-ano, and mouth-diseases,®® the operation should be performed (on the patient) in empty stomach. [12] (5) After the operation, the physician should revive the patient with cold water, and then press the wound all round with his fingers (to empty it thoroughly), smooth it down, wash it with an astringent decoction, wipe it with a piece of cloth, and insert into it a tent thickly smeared with a paste of sesamum- seed, honey and clarified butter, and impregnated with (depura- tory) drugs. Next he should cover it with a paste (of suitable drugs), place over this a thick pad,” neither too wet nor too dry, tie (the whole) with a bandage, and fumigate it with pastils made of pain-killing drugs.?! He should also, for the patient’s pro- tection from dangers, pronounce mantras or ‘ charms’ against evil spirits. [13] 69 In the case of mouth-diseases the reason is that owing to the pressure of the operator’s fingers, etc., or from disgust, the food is thrown up again, and the operation is interfered with. So Ni. Bai. only gives the latter alternative _ 1 The pad may be made either of the crushed bark and leaves of the Paldga (Butea frondosa), Udumbara (Ficus glomerata) and ‘other trees; or of two or four folds of a soft piece of cloth; or of powder of parched wheat mixed with clarified butter. So N 1.3 but एद. only gives the first method. | 11 The object of fumigation is to ward off flies, etc. So Bui. 32 SOTRA-STHANAM. [sxc. f. (14) Also the place should be fumigated72 with pastils made of the powders of Indian édellium, aloe-wood, resin of the Sal tree, (root of) Vacha (Acorus Calamus), and white mustard, mixed with salt and Nim-leaves, and done up with clarified butter. With the rest of the clarified butter (thus done up) the patient’s vital parts (#.e., the heart, ete.) should be anointed. Then taking water from the drinking-water vessel, and sprinkling . it (in the room), the physician should pronounce the subjoined protective incantation7®, [14] (15) For the sake of warding off the malice of the Krtyis7 and Rakgasas, I am performing this protective rite. May Brahma approve of it! [15] Nagas, 068९188, Gandhar- vas, ancestral Ghosts, Yaksas, Raksasas : 175 whoever of these may trouble you, may Brahmi and the other gods always kill them! [16] May the spirits that walk at night in the earth and sky, as well as those that dwell in the four quarters and in the habitations of men, and whom I now salute, protect you. [17] May the Munis (or sages) keep you and Brahma and the heavenly beings, . and the Rajarsis (or royal sages): also the mountains, and all rivers, and all seas! [18] May Agni (or the god of fire) protect your tongue, and Vayu (or the god of wind) your respirations.” May Soma (or the god of the 73 For the purpose of deodorising the sick-room, as well as driving away blue-bottles and other flies which otherwise would breed maggots in the wound. So Ni. 73 The following incantation is in verse. १५ Krtyd 18 a female Rakegasa or fiend, raised by the evil machi- nations of an offended sorcerer. So Ni. 75 See ante, note 9. 76 The Hindis believe in five pranas or ‘vital airs’: 1, prana whose functions are the respirations, also diglutination, and propulsion of the blood ; 2, vyana whose functions are all muscular and vascular movements; 3, apana whose functions are every kind of secretion; 4, udana whose function is the production of every kind of voice; 5, samd@xa whose function is the whole of the assimilative process. CHAP. V.] PRELIMINARIES FOR SURGERY. 33 moon) protect your movements, and the clouds your secre- tary functions. [19] May the lightnings keep your vocal functions, and the thunders your assimilative functions, and Indra, the lord of power, your strength, and Manu 7 your two cervical tendons as well as your intelligence. [20] May the Gandharvas prosper your desires, and Indra keep your good qualities, and king Varuna your knowledge, and the ocean your navel. [21] May the sun keep your eyes, the quarters your ears, and the moon your thoughts. May the lunar asterisms ever keep your figure, and the nights your appearance. [22] May the waters promote the flow of your semen, and the medicinal herbs the growth of your hair. May the sky keep your canals, and the earth your body. [23] May Vaicnavara (or the god of wealth) keep your head, Vignu your energy, the best of men (८.९.) Narayana) your manly vigour, Brahma your vitality, and the polar star your eyebrows. [24] May (all) these divinities, each with respect to his own part of your body, for ever keep you, and may you attain long life. [25] May the blessed Brahma grant you welfare, and the Dévas, as well as the sun and the moon, and both Narada and Parvata.78 [26] May Agni grant you welfare, and Vayu, and all the Dévas that attend on Indra. May the protection granted by Pitaémaha (¢.e., Brahma) procure you welfare and long life. [27] May all calamities of the season be mitigated for you, and may you ever be free from distress. Svaha (or Amen). [28] By this vedic incantation, for the removal of all diseases caused by Krtya, your safety has now been secured by me. May you now attain long life! [29] 77 “Manu” here refers to Prajapati (so Nt.) or the primordial, ‘man,’ a son of Brahma, the demiurge of the world, and father of the human race. 78 Narada and Parvata are a pair of ancient, semi-mythical (dévarst) sages, descendants of Kanva, and authors of certain hymns in the Rgvéda. They are said to act as ‘messengers of the gods.’ 5 84 SOTRA-STHANAM. [SEc. 1. (16) Then he should remove the patient, thus protected, into the house, and prescribe his regimen. Then on the third day, he should open the bandage and, after cleaning the sore, re-apply it. He should be careful not to change the dressing on the second day. [30] If the dressing is changed on the second day, the sore will granulate and consanesce only with much delay, and will become very painful. Thenceforward,?? he should give directions regarding astringents, liniments, bandages, diet and eonduct, in accordance with the state of the humours, the (requirements of the) seasons and the strength (of the patient). Nor should he be in any hurry about causing an abscess to consanesce, if it still contain any pus; for even a slight irre- gularity in the treatment will cause a gathering within, and the abscess will form anew. [31] Here come in (the following verses) :— Hence (the physician) should allow an abscess to eonsanesce only when it is entirely depurated within as well as without. Even during the process of consanescence (the patient) should abstain from indigestible food, violent exercise, and sexual intercourse, and (avoid excitements from) pleasure, anger, or fear, until the wound has firmly healed. [82] In the seasons of Hémanta (December— February), Vasanta (February—April) and Privrs (June- August) the physician should, as a rule, change the bandage every third day, but every second day in Carad (October-December), Grisma (April-June), and Varsa (August—October).© [33] In diseases of very rapid pro- 7” T.e., from the fourth day. So the commentaries. 80 The now current recension of the first half of this verse runs a8 follows: hémanté gigiré c=aiva vasanté c=Apt moksayét, i.e., ‘in the seasons of Hémanta (November-January), Cigira (Janu- ary-March) and Vasanta (Mnarch-May) he should, as a rule, change the bandage (every third day).’ There is, however, an- other recension, which runs as follows : hémanté ca vasanté ca pravrt- kalé ca moksayét, i.e, ‘in the seasons of Hémanta (December— February), Vasanta ( February—April) and Privrs (June-August) he should, as a rule, change the bandage (every third day).’ This recension is mentioned hy both Ni. and Bui., but both ~ CHAP. v.] PRELIMINARIES FOR SURGERY. 35 gress, the physician need not observe these directions. In such a case, as with a house on fire, he must adopt swift remedial measures. [34] If, from the application of the ‘reject it on account, as they say, of the heat which characterises the season of Pravyg-or the early rains. They explain that the reason of the injunction to change the dressing on the third and the second days is that the seasons of Hémanta, Cicira and Vasanta are characterised by cold, while those of Carad, Griema and Varga are characterised by heat; now in a cold season there is no fear of any rapid suppuration setting in, while in a hot season there is that fear; hence arises the necessity of changing the bandage more frequently (7.¢., every second day) in the latter seasons than = (६.९. every third day) in the former. This reasoning I fully admit; nevertheless I am disposed to believe that the rejected recension is the correct one, and accord- ingly I have ventured to adopt it in my translation. From the next chapter (the sixth) it will be seen that there are two divergent systems of arranging the seasons, which I may call the civil and the medical. The following table will render these two systems clear. I. The civil arrangement of the seasons. Season. Months. Months. (1) Cigira Magha-Phalguna 15th January—lLoth March (2) Vasanta Caitra-Vaicakha 15th March—-15th May (3) Grigma Jyéstha-Asadha 15th May-lith July (4) Varsa Cravana-Bhadrapada 15th July—15th September (5) Carad Agvina-Karttika 15th September—l5th Nov. (6) Hémanta Margacirga-Pauga 15th November—loth Jany. II. The medical arrangement of the seasons. (1) Vasanta Phalguna-Caitra 15th February-ldth April (2) Grigma Vaicakha-Jyéstha 15th April-l5th June (3) Pravys Agadha-Cravana 15th June-l5th August (4) Varea Bhadrapada-Agvina IJ5th August-15th October (5) Carad Karttika-Margagirga 15th Oct.-l5th December (6) Hémanta Pauga-Magha 15th Dec.-l5th February It will be noticed that in these two systems the seasons overlap one another, and that while the civil system omits the season of Pravrs, the medical omits the season of Cigira. 36 SOTRA-STHANAM. 86. I. instrument, the patient suffers severe pain, relief may be given him by the application to the part of tepid clarified butter mixed with liquorice. It will be also noticed that the recension which the commentaries reject follows the medical system, while the commentaries adopt the recension which follows the civil system. This can hardly be thought consistent. But further: Pravrs or the early rainy season, which the commentaries reject on account of its heat, is as a matter of fact (and as the experience of any one who has lived in India will bear out) a comparatively cool season; any way, it is cooler than the admittedly hot seasons of Varsa (or Jater rains), Carad and Grigma, and also cooler than the Vasanta of the civil system, which the commentaries adopt; for that civil Vasanta runs from the 15th March to the 15th May, which includes the nearly hottest time in India. The recension which I have adopted is surely, in every way, the most consistent; it gives the Hémanta and Vasanta of the medical system which include the coolest time of the year (15th Dec. to 15th April), it also gives the Pravrs which is the comparatively coolest time (15th June to 15th August) within the Indian hot period of the year (April to November). I suspect the only reason which originated the other recension, adopted by the commentaries, is an apparent incongruity ; viz., the interruption in the sequence of the seasons in the rejected recension, for here Pravrs comes between Grigma and Varsa. For this reason, apparently, the commonly received recension follows the civil system, and thus, by rejecting Pravrs and adopting Cigira, establishes an un- interrupted sequence of seasons in its rule about changing of bandages. But thereby, as it appears to me, medical consis- tency is sacrificed—The commentaries further explain that the expression ‘asa rule ` (in Sanskrit caiva or cipi) permits a relaxation of the rule in the case of sores characterised by deranged bile (pattiika). These require dressing every second day, or even every day according to the seasons. CHAP. VI. | REGIMEN FOR THE SEASONS. 37 THE SIXTH CHAPTER. REGIMEN TO BE OBSERVED IN THE DIFFERENT SEasons. [1] (1) Time, in truth, is the great Self-existent Being’! without beginning, middle and end. From it depend the destruction and production of all material objects®* and the life and death of men. (Hence comes its name sd/a‘ time’); for Adda is either that which never ceases for the smallest sald or ‘moment’ ; or it is that which sankalayatz or ‘composes,’ or which kalayats or ‘ destroys’ living beings.83 [2] (2) Time, considered as a year, is divided by the blessed Sun, through his own motion, in (periods called severally) akgz- nimésga, kastha, kala, muhurtta, aho-ratra, paksa, masa, rtu, ayana, samvatsara, and yuga. [3] Now a nzmésa or ‘wink of the eye’ is the time required to pronounce a short syllable. Fifteen nimésa make a kas{ha. Thirty 128८2 make a kala. Twenty kala plus one-tenth of a kala make a muhirtta’* Thirty muhirtia make 8 The text has bhagavan Svayambhuh, which lit. means that time is identical with ‘the Blessed Svayambhii’ or Brahma. Svayambhé means ‘ self-existent.’ 89 The text has rasa or ‘taste ;’ but both commentaries explain that here, by that term, are signified the dravya or ‘ material objects,’ as being the seats of the tastes. 88 ‘Composing’ refers to the five elements which make up the body and into which it is separated when it dies (see Chap. I, § 9). Kdlayati is a denominative verb, formed from kala, which means not only time but also death. 8 Bui. here points out that the equation 20, kala=1 muhirtta agrees with the subsequent statement, in the 14th chapter on blood, that the rasa or ‘chyle’ takes one month (or 30 days) to complete one circulation by staying 3015 kalds in each of the 6 elementary parts of the body. Accordingly it takes 5 days or 150 muhtrttas for each elementary part; hence 1 muhértia is equal to (%° or) 203; kala. Bui. adds that this equation is founded on Aupa- dhénava’s treatise, (see chap. 1, § 2.) It further says that the statement of Bhéja and Bhalluki that a muhirita is equal to only 20 kala, must be explained as a clerical error (lipi-ddsa). NI. only says that the equation of 20 ष्ठ kala=1 muhurtia is refuted by the commentaries (nibandha). 38 SOTRA-STHAN AM. [SEc. I. an aho-ratra or ‘the period (of a full day) comprising day and night.’ Fifteen ahd-ratra make a paksa or ‘half-month’ ; this is of two kinds: the light and the dark.86 These two together make up a mdsa or ‘month.’ [4] Next the twelve months, beginning with Magha, make up six seasons, each consisting of two months. These are (z¢7ra, Vasanta, Grigma, Varsa, Carad, Hemanta. Of these Cigira consists of the months Tapas and Zapasya; Vasanta, of Madhu and Madhava; Grigma, of Cuct and Qukra; Varsa, of Nabhas and Nabhasya + Qarad, of Isa and Urja ; and Hémanta, of Sahas and Sahasya.86 [5] The foregoing division is from the point of view of winter, summer and rains; but from the function of the sun and moon as dividers of time, there result two Ayana or ‘paths’: a southern and a northern. Of these, the southern (path) consists of (the seasons) Varsa@ or ‘the rains, (Qarad or ‘autumn,’ and Hémanta or ‘winter.’ In these (months) the blessed Séma or ‘the moon’ is very powerful, and the acid, saline and sweet tastes grow strong, and from month to month all living beings continue increasing in strength. The northern (path) consists of the months (24772 or ‘early spring,’ Vasanta or ‘spring,’ and Grisma or ‘summer.’ In these the blessed Arka or ‘ the sun’ is very powerful, and the bitter, astringent and acrid tastes grow strong, and from month to month all living beings continue decreasing in strength. [6] Here comes in (the following verse) :— The moon (lit. ‘the cold-rayed one’) moistens the earth ; and the sun (lit. ^ the brilliant one’) dries it. The 86 Both commentaries observe that the position of the light before the dark half indicates that the author of the treatise followed the amévasya mode of reckoning. But Ni. adds that, according to another reading, the dark precedes the light half. 86 The more usual names of these months are: Magha and Phialguna; Caitra and Vaigakha; Jyéstha and Asddh2; Cravana and Bhddrapada; Agvina and Karttika ; Margagirga and Pausa. See below, § 9. For the identifications of the seasons, see ante Chap. V, § 16, note 80. Afaghka runs from the middle of January to the middle of February. Similarly Phalgunais February-March, and so forth, Sahasya being December-January. CHAP. VI.] REGIMEN FOR THE SEASONS. 39 air, in conjunction with these two, maintains all living beings. [7] Again the two Ayana or ‘ paths’ together make one year, and five of these (years) together make one Yuga or ^ lustrum.’ This whole series of divisions of time, from the 2211284 or ‘a wink’ to the yuga or ‘lustrum,’ as it is always going round like a revolving wheel, is called by some the Kda/la-cakra or ‘the wheel of time.’ [8] (3) Now with reference to the growth, derangement and recti- fication of the humours, the seasons may be also arranged thus : 9 Varsaé or ‘the rains,’ Varad or ‘autumn,’ Hémanta or ‘ winter,’ Vasanta or ‘spring,’ Grisma or ‘summer,’ and Pravrs or ‘the early rains.’ These seasons, beginning with the month Bhadrapada are also constituted of two months each, as follows: Varga comprises the months Bhadrapada and Agvaywa; Carad, the months Karttika and Margagirsa ; Hémanta, the months Pauga and Magha + Vasanta, the months Phdlguna and Caztra ; Grigma, the months 41८260८ and Jyaistha ; Pravrs, the months Asddha and (ravana. [9] (4) Now in the rainy season the annnals* are young and weak in their sensific powers, and the waters are muddy and mostly full of dirty matter ® fallen (into them) from the earth. From the use of these acidity of the stomach™ is produced in 87 This is, of course, the medical division of the year, con- trasted with the civil division previously explained. So, on the whole, both commentaries, though they give a more fanciful reason for pre-positing the civil year, because that year refers to the growth and strength of the rasa or ‘tastes’ which are the causes of the humours. Baa. adds (only to refute it) that accord- ing to Kacyapa the two systems of divisions are held to the north and south of the Ganges respectively, because there is more rain (hence two rainy seasons) in the South, while there is more cold (hence two springs) in the North. Nz. only mentions this theory, without naming its author, and says that Gayadasa refutes it. 88 Such as wheat, rice, chickpeas, etc. So Nr. The text has Gsadhi ; see chapter J, § 12. 89 Such as decayed leaves, dead and putrifying animals. So N1. % Here as well as below, the expression used in the text is 40 SOTRA-STHANAM. [sEc. ए, men, whose digestion has become impaired through their air being deranged by cold, vwing to their bodies being kept in a moist condition by living on ground saturated with the rains from the cloud-charged skies: and in consequence of the acidity of the stomach, they bring on an accumulation of bile. Then, in the autumn, when the sky clears up and the sloughs dry, the accumu- lated bile, diffused (through the body) by the rays of the sun; generates diseases which owe their origin to (deranged) bile. [10] In the winter, these same annuals, from the fulness of time, attain their full sensific powers, and the waters become clear. Thus they become emolient and heavy, and from their use dyspepsia® is produced in men, whose bodies are affected by the frosts and (cold) winds due to the mildness of the sun’s rays: and in consequence, through their emollient, cold, heavy and sticky qualities, they bring on an accumulation of phlegm. Then in the spring, when the accumulated phlegm is diffused (through the body) by the rays of the sun, it generates in men, now less affected (by the cold), diseases which arise from (deranged) phlegm. [11] In the summer, the same annuals become dry, sapless, and excessively light, and the waters likewise. From the use of them, through their dry, light, and sapless nature, they bring on an accumulation of air in men, whose bodies are dry from the heat of the sun. Then, in the early rains, when men’s bodies are kept moist by (living on) ground saturated with water, the accumulated air, diffused (through their bodies) by the chilly winds, generates diseases due to the (deranged) air. Thus it has now been shown how the accumulation of the humours is the cause of their derangement. [12] (5) Now the depuration of the humours which have accumu- lated severally in the rains, winter and summer should, as a rule, only be undertaken after their derangement has come to a head the same: vidaha or vidagdha, which literally means ‘burning’ or ‘burned,’ and figuratively, ‘ digested’ as well as ‘ badly digested,’ ‘turned sour,’ etc. Bui. explains it as “sluggish digestion due to the production of acidity.” Nt. explains it by amlapdka, lit. ‘sour digestion’; and Dr. A. C. Dutt explaines it by ém-dirna or ‘imperfect digestion.’ CHAP. VI.] REGIMEN FOR THE SEASONS. 41 in the autumn, spring, and early rains respectively.®! [13] This done, the rectification of diseases may be undertaken in ac- cordance with their respective nature ; that of diseases due to bile, in the winter; that of diseases due to phlegm, in the summer; and that of diseases due to air, in the autumn. In the fore- going remarks the way has been fully described in which the humours accumulate, become deranged, and are rectified. [14] With reference to these points, the forenoon may be said to be the analogue of the spring; the noon, of the summer; the afternoon, of the early rains; the dusk, of the rains; the mid- night, of the autumn ; and the dawn, of the winter. Hence with regard to the accumulation, derangement and rectification of the humours, the full period consisting of a day and night must be understood to be analogous to a year consisting of winter, sum- mer, and the rains. [15] (6) Further, when the seasons are regular, the annuals as well as the water are also wholesome; and their use gives to people longevity, strength, energy and vitality. On the other hand, irregularity in them is owing to fate. Cold, heat, wind and 9 Both commentaries explain that the phrase “as a rule” (Sanskrit ca) shows that the direction is a permissive one and does not apply to very acute diseases which require instant remedial measures. They add that the samgddhana or ‘ depuration’ should be done, as a rule, after the lapse of thethird month of the total period, ¢.e., in the second month of the respectively suitable season. Thos bile should be depurated in the month Margacirga; phlegm, in Caitra; and air, in Cravana. Bard. quotes from Bhattara Harig- candra the following rule: tars-ddi-sancitan-ddsdn=tri-mdas-dntart- tan=harét, i.e., ‘the humours which have accumulated in the rains and other seasous may be removed after the lapse of three months.’ The following table gives a summary :— Humour. Accumulation. Depuration. Rectification. Bile. Rains (4) Autumn (5), Winter (6). Margacirga. Phlegm. Winter (6). Spring (1); Summer (2). Caitra. Air. Summer (2). Early rains (3), Rains (4). Cravana. The numbers refer to the medical system, see note 80. 6 42 SUTRA-STHANAM. [SEC. I. rain, when they are irregular,” cause the annuals and water to become unwholesome, and their use produces all sorts of diseases, or even deadly epidemics. Hence the use of wholesome annuals and water (is to be recommended). [16] Sometimes even with regular seasons, the people of a country suffer through some sorcery or some curse or the wrath of evil spirits or the wickedness of men. When wind carries into a country the exhalations of the flowers of poisonous animals, its people are attacked with cough, asthma, vomiting, nasal catarrh, headache, or fever, without any particular reference to the condition of their humours (at the time), but simply owing to the (noxious) influence of the planets or lunar asterisms or to an inauspicious sign in one’s house, or wife, or bed, or seat, or conveyance, or beast: of burden, or jewel, or gem, or any utensil. [17] In such a case the impending evil may be turned into good by leaving the place, or by (performing) propitiatory or expiatory rites, or by (using) amulets, incantations, burnt-offerings, dedications, donations, salutations, devotions, asceticism, observances, kindness, charities, receptions of mantras or ‘charms’ and advice. Any of these means may be resorted to with reference to Dévas (or ‘ gods’), or Brahmans, or Gurus (or ‘ spiritual guides’). [18] (7) In the following (verses) we will describe the characters of the seasons when they are regular :—[19] In Hémanta or ‘winter’ a cold wind blows from the North, the atmosphere is charged with dust and smoke, the sun is obscured by mists, all pieces of water are covered with ice, [20] crows, rhinoceroses, buffaloes, rams and elephants are made bold, and Réodhra (Symplocos racemosa), Prigangu (Aglaia Rorburghiana) and Punnaga (Ochrocarpus longifolius) bear flowers. [21] In Cicira or ‘early spring,’ the cold is intense, and the atmos- phere is full of rain and wind; for the rest ‘its character may be said to be the same as that of the winter. [22] On the Malaya mountains, marked by the red-stained soles of the wives of Siddhas and Vidyadharas,™ and scented 98 Hither in amount or incidence. So N1. 98 ‘I'wo classes of supernatural beings, possessed of magical powers. CHAP. VI. | REGIMEN FOR THE SEASONS. 4.3 through the womanly embrace of the sandal trees, [23] there blows, in Vasanta or ‘spring,’ a wind from the South which stimulates love, makes happy the lovers, and breaks down reserve between husband and wife. [24] In Vasanta or ‘spring’ the sky is clear; the groves are adorned with the flowers of the Kitncuka (Butea frondosa), Ambhoja (Nelumbium spectosum), Vakula (Atmusons Elengt), Cita (Mangzfera indica), Agoka (Saraca indica) and other trees, {25] the delightful music is heard of the Indian cuckoo and of swarms of bees, the wind blows from the South, and the country is charmingly adored with fresh green. [26] In Grigsma or ‘summer’ the sun’s rays are hot, the wind blows unpleasantly from the South-west, the earth is scorched, the rivers are low, the sky is, as it were, on fire, [27] the Cakravaka-pairs™ wander about, and the beasts of the forest are distracted for want of water, the shrubs, grasses and creepers wither, and the trees drop their leaves. [28] In Pravrs or ‘the early rains,’ the sky is covered with clouds, brought by the west wind and discharging heavy showers of rain with tremendous thunder and hghtning, [29] the earth is covered with beautifully green young grass, and is bright with the cochineal insert, and gay with (the flowers of) the Kadamba (Axthocephalus Cadamba), Nipa (a variety of Cadamba), Kutaja (Holarrhena antidysente- rica), Sarja (Shorea robusta), and Kétaki (Pandanus odora- trssimus). [30] In Varsa or ‘the rains’ the rivers are full of water and its banks (strewn) with uprooted trees, the reservoirs are radiant with full-blown white water- lilies and blue lotuses, [31] on the ground level land and holes cannot be distinguished, the fields are adorned with manifold crops, the rain falls without much thundering, and the sun is hidden by clouds in the sky. [32] In Carad or ‘autumn’ the sun is ruddy and hot, the sky is clear and: shows white clouds, the ponds are pretty 9 The Anas Casarca, commonly called the ruddy goose or Brahmany duck. 4.4 SUTRA-STHANAM. [SKc. 1. with water-lilies and geese sporting among them, [33] the ground, according as it is depressed or raised or flat, forms ponds or dry land or is covered with trees, and is beautified with the flowering Vana (Barleria cristata), Saptahva (Alstonta scholaris), Bandhika (Pentapetes phoentcea), Kiaca (Saccharum spontaneum), and Asana (Lerminalia tomentosa). [34] Ou the other hand, if there is any excess, or contrariety, or irregularity in the characters of the seasons, the humours of the body are deranged. [85] Phlegm should be depurated in the spring, bile in the autumn, and air in the rains, if it is desired to prevent the outbreak of any disease. [36] THE SEVENTH CHAPTER. Description o¥ Biunt Instruments. [1] (1) O€ blunt instruments there are one hundred and one (varieties). Among these the hand must be accounted the foremost, for the reason that, without the hand, no instru- ment can be used, and that every surgical operations must be directed by it. [2] Foreign bodies are those that cause injury to the body and the mind: and the instruments are the means of removing them. They are of the following six kinds: cruciform instruments,®5 pincer-like instruments, picklock-like instruments,” tubular instruments, pricker-like instruments, and accessory in- struments. [8] ४९ The text has svastika which is shaped like a Greek cross but with the ends of its arms bent rectangularly in the same direction. All instruments of this kind are made with two arms, moveable on a pin placed nearer to one end than the other, by which they are fastened, and on which they act crosswise like scissors. They as well as the sandamga or ^ pincer-like’ instru- ments are merely different varieties of the forceps. 96 The text has ६०1८ which means a lock and key. The ordinary Indian key is merely a picklock or hook. CHAP. VII.] BLUNT INSTRUMENTS. 45 (2) Now there are twenty-four varieties of cruciform instru- ments, two pincer-like, also two picklock-like, twenty tubular, twenty-eight pricker-like, and twenty-five accessory. As a rule, they are made of iron, but sometimes, in default of it, of other suitable materials..?7 The ends of these instruments generally resemble the faces of beasts or birds of prey. Hence they should be made so as to resemble them, following herein (the directions of medical) text-books, or (the verbal) instruction (of teachers), or (simply) imitating (other) instruments (of the same kind), and (withal) adapting them (to the requirements of each individual case). [4] They should be made just of the proper size, with their ends strong and polished ;% they should be also solid, well-shaped, and capable of a firm grasp. [5] (3) Now the cruciform instruments should be made of the length of eighteen fingers’ breadth. Their ends should be shaped like the faces of the (following nine kinds of wild animals:) lion, tiger, wolf, hyena, bear, panther, cat, jackal, and deer, (and the following fifteen kinds of wild birds:) crow, heron, osprey, blue-jay, bhasa,® hawk, owl, kite, vulture, falcon, Kraufica (Ardea jacutlator), fork-tailed shrike, Anjali-karna,'!© Ava- bhafijana,'© and Nandimukha (Zurdus Gingtnianus). The (two) arms should be held together by a pin in the form of a Masiira (Ervum lens), and their ends should be curved like an elephant driver's hook. These (instruments) are intended for the purpose of extracting foreign bodies (impacted) in bones. [6] (4) The pincer-like instruments are of two kinds: with or without arms,!0! They have a length of sixteen fingers’ breadth, 9 The Commentaries mention ivory, horn and wood. 98 According to others “their ends should be gross (like a heron’s beak) or fine (like a lion’s teeth) ” as the particular opera- tion may require. So NI. 99 A kind of vulture that frequents cowsheds. So N1. 100 These two birds are of unknown identity, according to N1. Bu. explains none of the animals or birds. 101 As the commentaries explain, the one with arms is like that used by barbers for depilating the nose, while the armless 4.6 SOTRA-STHANAM. 81५८. 1. and are intended for the purpose of extracting foreign bodies from the skin, muscles, veins, and nerves or tendons. [7 | (5) The picklock-like instruments have a length of twelve fingers’ breadth, and are shaped like the jaws of a 81.10 They are made either with one blade or two blades, and are intended for the purpose of extracting foreign bodies from the ears, nose, and outer canals. [8] (6) The tubular mstruments are of various kinds and used for various purposes, and have a mouth either at one or at both ends. They are employed for the extraction of foreign bodies from the outer canals, for the inspection of (internal) diseases, for the suction (of fluids), and for the facilitation of (other) operations.!%8 In circumference and length they are adapted to the orifice of the outer canal or to whatever purpose may be in hand. The instruments (of this kind) are those used in the ease of fistula- in-ano, hemorrhoids, tumours, abscesses, injections into the rectum and into the bladder, hydrocele, ascites, inhalations, stric- ture of the urethra and stricture of the rectum. Gourds and horns (used for capping) also belong to this class. All these instruments will be described in detail further on. [9] (7) The pricker-like instruments (or probes) also are of various kinds, used for various purposes, and are made of various diame- ters and lengths according to the purpose in hand. Some of one is like that used by goldsmiths. The latter is made of two blades, soldered together at one end; while the former consists of two arms jointed crosswise on a pin. This, therefore, is really a variety of the svastika or ‘cruciform’ instrument, and would seem to be classed here only because of its different function. 108 The picklock is a hook or metal blade curved rectangularly at one end. Two of these may be jointed at the other end ; the instrument then resembles the mouth of a certain fish. Ac- cording to the commentaries this fish is the Bhéfunt or Bhétulit or Bhékati, the tips of whose jaws are hooked. Both एष. and दि.) however, give an alternative interpretation of the word {ala which they seem to prefer. They make it to mean matsya-¢alka or matsya-cakra, 1.6.) ‘the scale of a fish. BHA. also gives the alternative reading fal ‘ palate’ for tala. | 108 Such as the scarification of piles. So the commentaries. CHAP. VII. | = BLUNT INSTRUMENTS. 4.7 them have their ends shaped like earthworms, or the feathered part of an arrow, or the hood of a snake, or a fish hook, there being two varieties of each shape. These are intended respec- tively for the purpose of exploring, raising, transferring, and extracting.'!% Two of them have their ends made of the shape and size of the half of a pea and slightly bent, and are used for the purpose of extracting foreign bodies from the outer canals. Six have their ends covered with cotton and are used for the purpose of wiping out (abscesses). Three have their ends shaped like spoons with a conical cavity, and are used for the purpose of applying caustic solutions, etc. Three others have their ends shaped like the fruit of the Jambu tree (Hugenia Jambolana), and again three, like an elephant driver’s goad. These six (varieties) are used for the purpose of applying the actual cautery. One variety, which is used for the purpose of removing a tumour from the (interior of the) nose, has its end made of the size of half the stone of the fruit of the jujube tree (2८2067८5 Jujuba), of a conical shape, and with sharp edges. One variety, which is used for the purpose of applying collyria (to the eyes), is made of the thickness of a Kalaya pea (or small Masiira or Ervum Lens). with both ends shaped like buds.'°§ One variety, which is used for the purpose of clearing the urethra, is made of the thickness of the upper part of the stalk of the flower of the Malati (Jasminum grandiflorum). [10] (8) The accessory instruments are (the following :—) thread, twine,! bandages, straps (or belts) of leather, bark (of trees) ,!07 109 Thus, those shaped like earthworms are used for probing abscesses ; those like feathered arrows, for raising a spot in order, after incision, to remove a thorn from it (see infra, note 111); the hood-shaped ones, for transferring any material from one part to another within the flesh. So Bad. and N1. 106 Nr. adds that in length it is of eight fingers’ breadth. 106 ‘The text has vézikd, which commonly means ‘a braid of hair,’ but the commentaries explain it to mean here guna-traya or ‘twine made of three threads,’ while rajju is said to mean ‘thread.’ Hair is mentioued further on. -ण The root-bark or the inner bark (bast) is apparently intended. Nt. says, it is used for bandaging fractures, and adds that it is 4.8 SOTRA-STHANAM. [SEc. 1. (tendrils of) creepers, (pieces of) cloth, large round stones, a hammer,'® the palms of the hands, the soles of the feet, the fingers, tongue, teeth, nails, and mouth, hair, the ring of a horse’s bridle, a branch (of a tree),'® spittle, fluxing !!° (the patient), making (him) happy, a loadstone; also caustics, fire, and medicines. [11] (9) With these instruments the whole body may be operated on, that is to say, any one of its limbs as well as its joints, viscera, veins and nerves, according as the case may require. [12] The operations (that may be performed) with them are of twenty (different) kinds :—Wrenching out, filling (the eyes or bladder ete. with oil), bandaging, raising (or smoothing),!!! curling up, transferring, turning round, exposing (or opening out), pressing, clearing canals, pulling to and fro (or loosening a foreign body), pulling out, pulling up (into its nght place), setting upright, bending down, contusing,!"® stirring (with taken from such trees as the Palaca ( Butea frondosa) and Udumbara (Ficus glomeratu), both of which belong to the so-called paiica- valkala set of five trees. See ante, note 70. 108 Used for the purpose of moving or loosening foreign bodies impacted ina bone. It may be made of wood or other material. So Nt. 109 Ni. explains that a bridle-ring and a branch are required for the extraction of foreign bodies. The branch apparently is put through the ring to afford a stronger pull. 110 Te, causing discharges from the bowels, the stomach, or the eye in order to remove foreign bodies or impurities. 111 The text has rythana, i.e., ‘arranging,’ ‘ placing in proper position.’ Both commentaries explain that it means wrdhvi-kara- nam, chittva uttunditasya uddharan-drtham, t.e., ‘raising up for the purpose of removing a thorn after incising (the raised-up part).’ They add, however, that others explain it by varangéna anusaranam, ४.९. ‘smoothing (lit. following up) with the handle (of the instru- ment, which has been used for the operation)’; that is, after an incision (e.g., after an abscess has been opened and emptied), the handle of the instrument is to be passed over the incised part in order to bring together the lips of the wound. 8 The text has bhafijana, lit. ‘ breaking” (the continuity of the CHAP. VII. | BLUNT INSTRUMENTS. 49 a probe), sucking (with a horn or gourd), exploring, splitting, straightening, washing, blowing (powders into the nose), rubbing out (from the eyes, ete.). [13] So much is certain that, considering the innumerable variety (in the circumstances of) foreign bodies, a sensible physician must be guided by his own intelligence in the choice of the precise mode of application of his instruments (in any given case). [14] (10) Now there are twelve (kinds of) defects (that may occur) in an instrument. It may be too thick, or it may be made of impure metal, or it may be too long, or too short, or incapable of grasping, or grasping unevenly, or bent, or (of too) soft (material). Their ends may be too straight, or their pin or ends or edges may be too weak. [15] An instrument which is free from (all) these defects and which is eighteen inches long,—such an one a physician should consider the best and with it he should perform his operations. [16] (11) A foreign body which is visible, should be extracted with an instrument having the head of a lion or other (wild beast). If it is invisible, it should be extracted with an instrument having the head of a heron or other (wild bird). Moreover it should be extracted slowly and in accordance with (the dictates of) medical science or of one’s reason. [17] Because it enters and turns with ease, and also grasps and extracts a foreign body with ease: for these reasons the heron-headed forceps is the best, and for the same reasons it can be applied, without any harm, to any part (of the body). [18] tissues). BuHA. explains that it refers to galya-karm-ddér=mardana or ‘the contusing of a part before it is surgically operated on,’ or, as Ni. puts it, samantaté mardana, i.e., ‘contusing (a part) all round or all over.’ But N1. prefers its own alternative explana- tion that the term means ¢irah-karn-ddér=Gmardana or ‘ well rubbing the head, ears, ete.’ aS 50 SUTRA-STHANAM. [SEc. I. THE EIGHTH CHAPTER. On THE APPLICATION oF Currine InstRUMENTS. [1] (1) There are twenty (varieties of cutting) instruments. They are as follows: 11 1, Mandal-dgra or ‘circular-headed,’ [with a length of six aygula or fingers’ breadth. There are two sub-varieties, one with a circular edge, the other shaped like a razor]. 2, Kara-patra''* or ‘a saw,’ [with a length of twelve fingers’ breadth]. 8, Vrddhi-patra or ‘a razor. [The handle should have a length of five and a half fingers’ breadth, and the blade, one and a half, the total instrument being seven fingers’ breadth long. It has two subvarieties, one with a curved, the other with a resected point. The former is what is called a ksura or ^ razor.’ | 4, Nakha-gastra or ^ nail-parer,’ [with a blade two fingers’ breadth long and one finger’s breadth broad, the total length of the instrument being eight fingers’ breadth. | 5, Mudrikd, a cutting instrument of the size of the last phalanx of the index finger. 6, Utpala-patra, a cutting instrument resembling the petal of the blue lotus. 7, Ardha-dhara, or ‘a single-edged’ knife. [Its total length is eight fingers’ breadth, and its blade measures two fingers’ breadth in length, and at its broadest, one finger’s breadth. | 8, 672, or ‘ needle, [of a length of two to three fingers’ breadth. ] 118 The information, enclosed within angular brackets in the following list, 18 extracted from the two commentaries and has been inserted in the text for the sake of convenience. See also be low, § 5. 11* Literally: ‘having a blade in the form of a hand,’ the fingers representing the teeth of the saw. CHAP. VIU.] CUTTING INSTRUMENTS. 5] 9, Kwuca-patra, an instrument shaped like the leaf of Kuca grass (Hragrostts cynosurotdes). (Its handle is three fingers’ breadth long. ] 10, Afi-mukha, an instrument shaped like the beak of the Ati bird (Zurdus Ginginianus). [Its blade is one, and its handle, seven fingers’ breadth long. ] 11; Garari-mukha, a kind of scissors resembling the face of the Garari एप्त. 12, Antar-mulkha,"'6 a kind of scissors with semi-circular claws, the insides of which are filled up with straight, cutting blades. [1४8 length is eight fingers’ breadth. | 18, Trikurca’a or ‘a three-edged’ instrument, a trocar. [The whole is eight, and the handle five fingers’ breadth long; the distance between the edges is that of a grain of rice. | 14, Kutharika (lit., axe-shaped), an instrument like a gum-lancet. [Its handle has a length of seven and one- half, and its blade, of one-half fingers’ breadth; the latter has the shape of a cow’s tooth. | 15, Virtht-mukha, or a trocar shaped like a grain of rice. [Its full size is six fingers’ breadth, the handle being of two, and the blade of three fingers’ breadth. Its head is shaped like a grain of rice with a very fine point. ] 16, Ara or ‘awl’ [resembling a shoemaker’s awl; sixteen fingers’ breadth in total length, with a sharp end of the size of sesamum seed. | 17, Vétasa-patraka, an instrument shaped like the leaf of the rattan. [The blade is four fingers’ breadth in length, one finger’s breadth thick, and very sharp; the handle is also four fingers’ breadth long. ] 18, Vadtga, an instrument shaped like a fish-hook. [Its total length is six fingers’ breadth, its hook being one-half and its handle five and a half fingers’ breadth. | 146 Ni. says that this is a bird with along beak. There are two varieties of it: one with white shoulders, the other with a red head ; it is the former kiud which is called मकाद or Caraiz. 116 Literally : ‘ having (blades) in the interior of the mouth.’ 52 SOTRA-STHANAM. [sEc. 1. 19, Danta-gayku or ‘ tooth-pick.’ [It may be used for cleaning the teeth from tartar and broken bits. Its head is one-half fingers breadth long. It is quadrangular, and with a sharp edge; and in the upper part of its handle it is like the vrihimukha. | 20, Esani or ‘ probe.’ [2] (2) The mandalagra and karapatra are principally"!7 used for cutting through and scarifying; the vrddhipatra, nakha- castra, mudrika, utpalapatraka, and ardhadhara, for cutting through and cutting 1000 ; 116 the sci, kugapatra, dtimukha, gardrimukha, antarmukha, and trikircaka, for evacuating (abscesses, etc.) ; the kutharcka, vrihimukha, ard, and vétasapatra, for puncturing, also the कट + the vadiga''® and dantagaynku for extracting ; the 28477, for probing and evacuating ;!90 and the different kinds of sci, for sewing. This enumerates the eight kinds of surgical operations for which ¢asfra or ‘cutting instruments’ are used. [3] 117 1.6. they may be used also for other suitable purposes, as indicated by the particle ca ‘also.’ So Ni. and Bui. 118 The text has chéduna and bhédana: the difference indicated is that of deep and superficial incision. The former means ‘cutting through,’ ‘section,’ and includes also the operations of dividing and excising. The latter means ‘cutting into’ and includes both opening and incising. Vyadhana means ‘puncturing’ aud ‘ perforating.’ 119 A yadiga or ‘ fish-hook-shaped instrument’ is also mentioned among the yantra or ‘blunt instruments’ (see Chapter VII, § 7). The reason is obvious: it must be made either blunt or sharp according to the purpose for which it is intended. But both Bua. and Ni. explain that as a yantra or ‘blunt instrument’ it may be of any suitable size, while as a castra or ‘cutting instru- ment’ it must be of the fixed 8126 of six fingers’ breadth, and have a sharp point. They add that for a similar reason also the ésan? or ‘probe ’ is mentioned among both kinds of instruments. 199 The text has dnulémya by which, as the commentaries explain visradvana or ‘evacuating’ is intended, not ‘serving as a guide’ (as Dr. U. C. Dutt translated), which is not any ‘ surgical opera- tion.’ CHAP. VIII. ] CUTTING INSTRUMENTS. a3 (3) We shall now briefly explain the mode of holding these instruments (when they are used) in any operation. The vrddhz- patra should be held at the junction of the blade and handle; in fact, all instruments used for an incision (should be held in this way). The vrddhipatra and mandalagra, when used for scarifying, should be held with the hand a little raised: when used for evacuating (abscesses) they, and in fact all instruments, should be held by the forepart of the handle. In the case, how- ever, of children, of old or delicate or timid men, of women, and of kings and princes, an evacuation should be made with the trikircaka. The vrihimukha should be held with the thumb and forefinger, and with its handle covered within the palm. The kathartka should be held in position with the left hand, and struck with the middle finger and thumb of the other hand held firmly together. The dra, karapatra and 2817 should be held at their extremities. The remaining instruments should be held according to the requirements of each case. [4 | (4) As to the shapes of the instruments they are, in a general way, indicated by their names. (5) As to their dimensions, the length of the nakha-gastra or ‘nailparer’ and the ésani or ‘probe’ is eight fingers’ breadth, that of the रकल or ‘needles’ will be given (hereafter,.'*! The rest of the instruments are six fingers’ breadth in length.!*? [5] (6) The good points in an instrument are the following: it should have a well-made handle, it should be made of good iron, and it should have a fine edge, a pleasing shape, and a well finished end, and it should not be fearful to look at. The edge 181 Te.,in Chapter XXV, on the various kinds of surgical opera- tions. According to NI. some insert here the following direction: “the mudrikad is of the size of the last phalanx of the index finger; the gardri-mukha has a length of eight fingers’ breadth and 18 also called kartiari or ‘scissor.’ ”’ 9४ The text of this paragragh [5], as given in Jivaénanda’s edition, is quite out of order. The true text, as shown by the commentaries and by the logical order of the subjects of the paragraphs, is given in the edition of Kaviraj Gangaprasid Sén, and is adopted in my translation. । 5-4 SOTRA-STHANAM. [810. 1. of instruments, used in incising, should be of the fineness of a Masura (Hrvwm Lens} ; of those used in scarifying, of half a Masura; of those used in puncturing and evacuating, of a hair ; and of those used in dividing, of half a hair.'28 As to the vadiga or ‘hook’ and the danta-canku or ‘ toothpick,’ the former should have a curved end and a fine point, while the latter should have an end shaped like the first leaf of barley. An ésani or ‘ probe’ should, with regard to its end, be shaped either hike an earthworm, or like the previously mentioned instruments (7.e., the hook and toothpick).'#* On the other hand, the defects in an instrument are the following eight: if it is bent, or blunt, or jagged, or too thick or too thin, or too long, or too short. Hence instruments which are free from these defects should be used. The kara-patra or ‘saw’ is the only exception ; for, being used for the purpose of cutting through bones, it must have a jagged edge. [6] (7) The tempering of these instruments may be done in three ways: by means of an alkaline solution, or of water, or of oil. Those tempered in an alkaline solution are used in excising arrows and foreign bodies, and in dividing bones: those tempered in water are used in excising or incising!!8 or cleaving muscles: those tempered in oil, are used in puncturing veins and dividing nerves or tendons. For sharpening these instruments a smooth bone of the colour of Masa (Phaseolus Roxburghtt) should be used, and for preserving their edge, a case made of the wood of Calmali (Bombaz malabarienm). [7] Here comes in (the following verse) :— When an instrument (has been selected) of a good make and with an edge so keen as to divide the hairs on the skin, and when it has been grasped at the proper place [see ante, § 3], only then it may be employed in any surgical operation. [8] 198 Ni. here points out, that the fineness of the edge will vary, according as the same instrument (¢.g., a vrddhi-patra or ‘ knife’) is used for an incision or an excision. 199 This variety in shape of the probe is, as the commentaries explain, expressed in the text by the particle ca ‘and,’ which is omitted in Jivananda’s edition. CHAP. IX.] PRACTICAL TRAINING IN SURGERY. 55 (8) Substitutes for cutting instruments are the following: bamboo, crystal, glass, ruby, leeches, fire, caustic, the nails, leaves of Goji (Hlephantobus scaber) or Géphalika (Nyctanthes Arbor- tristis) or Gaka (Tectona grandis) 196 young shoots, hairs, and the fingers. [9] These substitutes may be used in the case of infante or of persons who are afraid of surgical instruments, or when such instruments are not available. The (first- named) four objects, bamboo, crystal, glass, and ruby, should be used for cutting through or cutting into!!8 some part. [10] The nails should be used, if those two operations as well as that of extraction can be done with them. The mode of using caustics, fire, and leeches will be explained subsequently. [11] If there is any form- ation of pus in the mouth or the eyelids, it may be evacuated with the leaves of GOji or night-jasmin or teak. In default of probes hairs or the fingers or a young shoot will be found useful for exploring. [12] A wise physician will get all these instruments made of pure iron and with sharp edges, by a blacksmith who is skillful and experienced in his craft. [13] A physician who knows the use of cutting instruments always attains success ; hence one should not fail to acquire experience in their handling. [14] THE NINTH CHAPTER. On Practica, Trartnine in SureicaL Opgrations. [1] (1) Even when a pupil has learned the whole of the medical text books, he must still be made to acquire practical proficiency. He must be instructed practically how to perform surgical opera- 185 According to both commentaries G6ji is either the same as 05110 ९2 (Hlephantobus scaber) or Cakhdtaka (Streblus asper). Céphalika is the ‘night jasmine,’ and (aka is the Teak tree. The leaves of all these are used as vulneraries in the form of an epithem. 56 SUTRA-STHANAM., [sEc. 1. tions and how to apply oils and other (medicaments). However great his theoretical knowledge may be, unless he acquires also practical skill, he will never be a proficient in his surgical practice. [2] (2) Now every kind of deep incision as well as the operations of excising and dividing may be shown (to the pupil) on pumpkin- gourds, bottle-gourds, water-melons, and various kinds of cucum- bers.!86 The operation of superficial incision (or opening) may be shown on leather-bags, bladders and pouches, filled with slush : scarification, on stretched pieces of leather covered with hair: puncturing, on the veins of dead animals or on stalks of the water-lily : probing, on the apertures of worm-eaten wood, bamboo, reed, any tubular object, or dried bottle-courds: extracting, on the pulp of the jack-fruit, the bel-fruit, or the Vimbi-fruit (Cephalandra indica), or on the teeth of dead animals: evacua- ting (abscesses), on a lump of wax applied to a board of (almali wood (Bombax mataharicum): sewing, on the ends of two thick pieces of cloth or of two pieces of soft leather: bandaging, on the various large and small limbs of a human figure made of cloth or clay, etc.: bandaging the root of the ear, on a piece of soft flesh or the stalk of a water-lily: applying the actual and virtual cautery, on pieces of soft flesh: introducing catheters, and compressing abscesses (formed) within the abdominal cavity, on the spout of an earthen vessel filled with water, or on the mouth of a bottle-gourd or similar objects. [3] Here come in (the following verses) :— An intelligent physician who acquires a practical know- ledge of surgery by operating on these and similar suitable objects, in the manner above explained, will never go wrong in any of his operations. [4] Hence, if he wishes to attain proficiency in the use of cutting instruments, and of the virtual or actual cautery, he should acquire a practical knowledge of the several operations by practi- sing them on those objects which have been above shown to be respectively suitable for them. [5] 186 The text mentions three kinds: Trapusa or Cucumis sativus, Ervaru or Cucumis utilissimus, and Karkaru or Cucumis Melo. ` ऋ, CHaP. ए. VISITING THE SICKROOM. 57 THE TENTH CHAPTER. Directions ror Visitina a SicKnoom. (1) After haying learned his text-book and understood itg meaning, and after having seen operations performed and acquired practical skill in them himeelf, in short after having mastered the whole subject of medical science, (the candidate) should obtain the king’s permission (to praetise). Then, after having cut his nails and hair, bathed and dressed in clean clothes, taken an umbrella and a stick in his hand, and put on shoes, simple in attire and good at heart, with polite address and without ostentation, friendly inclined towards ali creatures, and accompanied by a trusty attendant, he may now undertake to visit a sickroom. [2] (2) Ata time when the messenger, the weather, the (behaviour of the) kites and other auguries'3’? are favourable, he should go to visit the patient’s house, and having entered it, he should view the patient, touch him, and question him. By these thred modes of examination some say that most diseases can be diag- nosed. But this is not correct. There are six modes of diag- mosing diseases; namely by the five senses, t.e., hearing, ete., and by questioning. [8] As symptoms discernible by the sense ef heanmg such as these may be mentioned: in diseases, eharac- terised by a discharge from an abscess, air escapes with a noise, bringing out with it frothy blood. Symptoms discernible by the sense of touch are coolness or heat, emoothness or roughness, softness or hardness, and other tangible qualities (of the skin) in fever, consumption, and other (diseases). Symptome discernible by the sense of sight are eorpulenee or emaciation, vitality, characteristic remarks, energy, change of colour, and so forth (of प The text has mimitte and maggala, two words of a yery general character for ‘omen’ or ‘good aman.’ The commentaries refer the former to metereolegical conditions, such as an agreeable ibreece, ax the latter to such objects, as the svasizka or ‘cross,’ a wesse! fubl of water, .ete. 8 58 SOTRA-STHANAM. [SEc. 7. the patient). Symptoms discernible by the sense of taste 198 are the various tastes noticeable in morbid secretions of urine and other diseases. Symptoms discernible by the sense of smell are the odours emanating from inflammatory or non-inflammatory states (appearing) on the approach of death or similar conditions. By questioning, (the physician) may ascertain the (patient’s) country,'®® time,'® caste, habits and diet,!5! the cause of his disease, the nature of his pain, his strength and appetite, the regularity or irregularity im his passing of wind, umne and feeces, the duration of his disease, and similar particulars. Seeing that there is a similarity between the (six) modes of examination and the (derangements of the three) humours, the physician is in @ position to diagnose a disease from its symptoms corresponding (severally with the six modes of examination).'** [4] Here come in (the following verses) : Diseases which are wrongly observed, and badly des- 128 Nr. explains that this does not refer to the sense of taste of the physician, but of bees, ants, and similar insects who are attracted by urine. (See note 133). 199 The country may be either jaygala ‘wild,’ or aniipa ‘marshy, or of the ordinary kind. So N1. 180 Time may be considered either from the permanent (nityaga) or accidental (avasthika) point of view. The former refers to the climatic conditions of the patient’s country. The latter refers to the patient’s age, or the circumstances of his disease, such as when his fever comes and goes, etc. So Ni. and उप्र. 131 The text has samya, lit. ‘what is conducive to health’ or ‘hygiene.’ Under this head the commentaries explain that the physician should enquire into both the patient’s habits and his diet. 138 This is a rather difficult clause. Bud. does not explain it at all, and it evidently did not exist in its recension of the text (see below, note 133). In my translation I have followed N1,’s explanation. Ni. takes Géman to mean ddsa or ‘the (three) humours,’ which is an unusual meaning, but I know nothing better: &tman often means carira ‘body,’ and this might be made, thongh not so well, to fit in with N1.’s explanation. The argument of the clause isZas follows. There are six means of diagnosis: tle five senses and questioning. Similarly there are six kinds of symp- (CHAP. X.] VISITING THE SICKROOM. 59 cribed, and badly examined by touch, will confound the physician.'83 [5] — toms of the deranged humours, namely five sensible (audible, visible, tangible, tasteable aud smellable symptoms), and one ascertainable by questioning. Morever these six kinds of symptoms vary accord- ing as the derangement is of bile or phlegm orair. Seeing that there exists this similarity between the two sets, the physician is thereby enabled to identify the symptoms of derangement of any of the three humours, and thus to identify the disease itself which is caused by the deranged humours. Thus, in the case of derangement of the bile, the sores due to it are known by touch, the yellowish colour due to it, by the eye, the sourish taste due to it, by taste, the pungent smell due to it, by the nose, the biting and burning sensations due to it, by questioning. And so forth, in the case of other deranged humours. 188 There is here a distinct trace of an older recension. This verse clearly refers to the same threefold means of diagnosis (sight, touch, questioning) which are mentioned above in § [3], and there declared to be incorrect, The latter part of §[3], and the whole of §[4], are an interpolation of a later revisor. The origi- nal recension evidently still existed in the time of the commentator Cakrapanidatta whose commentary, the Bhanumati, shows that he read the text as follows: §[3]......prayagd véditavyah q §[5] bhavati c=Gtra | mithyd-drsf@ vikara hi dur-dkhydtas=tath=aiva ca} tatha duh-parimrstag=ca mohayéyug=cikitsakam § 1 ॥ tasmat=parikgyak satatamn ९15 ढ siddhim=icchataé | yukty=atva vyddhayuh sarvé pra- manair=dargan-ddibhih 129 His recension omitted the last two clauses of §[3].and the whole of §[4]. - 1४ added, on the other hand, one verse to §[5]. On this text, as he read it, Cakrapanidatta remarks that the word prdyugé as well as the particle ca ‘and,’ appended to prechét in the preceding clause, indicate that, besides the senses of sight and touch, also the senses of smelling and hearing as well as anumdna or ‘inference ’ are admissible as means of diagnosis. He explains that ‘inference’ is necessary, because the sense of taste cannot be exercised by the physician on the patient directly; he must do it through the intermediacy of ants from whose attrac- tion by the urine he infers the presence of sugar in urinary diseases (see note 128). He then quotes Caraka as saying both that “there are three modes of examination, by sight, touch, and 66) sOTRA-STHANAM. (smc. 1. (3) Having thus fully exantined a disease, the physician should undertake the cure of curable diseases, and the relief of the telievable ones, but the incurable ones he should not attend td; also diseases which have existed for more than one year, he should avoid to treat. [6] But even curable diseases of the following persons are, as a rule, most difficult to treat; namely : Brahmans leatmed in the Védas, kings, women, children, old and timid persons, toyal servants, gamblers, physically weak people, éontemuers of physicians, concealers of their diseases, poor, stingy, arid itascible people, also people incapable of self-control, and uch ds have no natural protectors.'% The treatment of these a questioning,” as well as that “there are two modes of examination, by observation (pratyaksa) and inference (anum@na).” The latter, he éxplaitis, mearis that observation refers to sight and touch, while inference refers to the other senses. Dallana Micra, in his com- tiehtary; the Nibandha Ssngraha, further states that the Paiiji- kara, (4.6, Gayddasa) read the text exactly as Cakrapanidatta did, arid declared that those wlio Held “a sixfold mode of examination did ०४ properly understand the text-book.’ The additional verse, Which is above quoted from the original recension, may be thus tratislated : “hence a physician who is desirous of success must always examine every disease in the light of the evidence afforded by sight, touch, and questioning, and not omit to use his reasdnitig powers.’ The phrase yuktyd Eva lit., ‘ even together with fédsonitig or inferetice’ may be noted. It leaves sufficient room for arty evidence afforded by smell, sound, and taste. The older fecension appears to ime to have for itself the preponderance of authority ; but as the newer recension only is now found in the printed texts, I have followed it in my translation. 1% The reasons why these persons are difficult to treat are thus piven by Ni.: the Brafrraans on account of their predisposition to illness through the frequeucy of their ceremonial ablutions; kings on account of their intolerance of a prescribed reginien, or their delicate constitution; women, on account of their reluctanete to disclose their diseases or to submit to enemas, etc.; the young and aged, on account of their delicate constitution and conse- quent inability to bear surgical or mnredidal applications; the timid, on account of their reluctance to submit tod medical treat- invnt; reyal servants, on account of their not being master of CHAP. ॐ] PREPARATION OF CAUSTICS. 61 physician should only undertake with great care: then he will secure for himself merit, wealth, pleasure, and fame. [7] Here €omes in (the following verse) : A good physician will avoid to be alone, or sit close to, or to jest with women ; nor will he accept any present from them excepting only articles of food. [8] THE ELEVENTH CHAPTER. On THE PREPARATION AND Use or Cauvstics. [1] (1) Of all cutting instruments and their substitutes [see chap. 8, § 8] caustics (or vegetable alkalis) are the most important, because by means of them deep and superficial incisions [see note 118] and scarifications may be made, derangements of the three humours (air, bile, and phlezm) may be rectified, and some diseases can be treated with special advantage.'8§ [2] Ksdra or ‘ caustics, are so called because they are a means of attenuating (ksaranda) or destroying (kganana) (deceased skin, muscles, etc.). On account of various kinds of medicinal plants entering into their composition they serve to rectify the three humours when deranged.'36 On account of their white colour, their nature is Junar (४,.९., cooling); but this fact, is by no means inconsistent their time; gamblers, on account of their absorbing attachment + the weak, for the same reason as the young and aged; contemneré of physicians, because they are too conceited to abide by the prescribed regimen; concealers of their diseases, because they will not speak out; the poor, on account of their inablity to purchase medicines; the stingy, because they grudge the cost of medicines ; the irascible, because their ebullitions of anger inten- sify their diseases ; the incapable of self-control, because of their indulgence in unwholesome things; those who have no naturalk protectors (४.८.) widows and orphans), because they have no ong to attend to them. 186 Ni. explains that this refers to the case of hsmorrhage (rakta-pitta) and piles (arcas). | 136 Ni. adds that for the same reason they are also usefal in the treatment of hemorrhage and piles. See preceding ९८९. 62 : SOTRA-STHANAM. ` [886. 1. with their power of burning, maturing and tearing : 19 indeed, on account of the large number of heating medicaments (which enter into their composition) they are acrid, hot and pungent, ‘Their (external) use promotes suppuration, corrosion, depuration, granulation,'®® desiccation, hemostasis, and scarification. Their (internal) use cures worms, acidity, deranged phlegm, skin- diseases, poisonings, and obesity. An excessive use of them induces impotence. [8] _ ` (2) Potashes are of two sorts: for external application, and for internal administration. Their external use is indicated in the case of skin-diseases, keloid, ringworm, leucoderma, lepra, fistula-in-ano, tumours, unhealthy sores, sinuses, condyloma, black moles, chloasma, brown spots on the face, and warts; also in the case of abscesses, worms and poisoning (both on the surface) ; also of the (following) seven diseases of the mouth: tumour under the tongue (or ranula), tumour on the tongue, inflammation of the gums, inflammation due to external injury, and three kinds of vofzn? or inflammation of the throat ; in these (seven) cases only, caustics should be applied as a substitute of cutting instruments.'3® Their internal use is applicable in the case of chronic or slow poisoning, abdominal tumours, abdominal enlargements, cessation of digestion, indigestion, want of appetite, constipation, urinary deposits, calculus, deep-seated abscesses, (intestinal) worms, (internal) poisoning, and piles. [4] Their (internal administration) is unsuitable in the case of persons who have a tendency to (internal) hemorrhage and bilious fever, of children, and old or weak people; also in the case of persons suffering from giddiness, frenzy,' fainting, amaurosis, or other 137 Ni. points out that intense cold (himdnt) has the same effect as great heat. 188 The commentaries say that some omit répana or ‘ granula- tion,’ because (they say) a healthy sore granulates by itself, and does not require any caustic to promote it ; a caustic may rather prove noxious. 189 The commentaries explain that there are five kinds of vohini, but two of them are incurable. 1#0 Caused by poisoning, intoxication, derangement of the blood, or eating of (fresh) betel nuts: so Nt. On the poisonous proper- =, CHAP. XI.] PREPARATION OF CAUSTICS. 63 similar’ diseases. Caustics for internal use are prepared in the same way as those for external use, by burning and straining. The details (of the method of their administration) will be given elsewhere.'*! [8] Caustics may be made of three strengths: weak, moderate, and strong. (3) He who wishes to prepare a caustic, should, on an auspici- ous day in the autumn, after purifying himself and fasting, (select) a large-sized, middle-aged, uninjured '#* Muskaka tree (Stereo- spermum suaveolens), bearing dark flowers 148 and growing on an auspicious spot '** on a (lonely) mountain, and perform the adhtvasana or ‘prelimmary ceremony,’ saying the following incantation 1५6 :— “Oh thou tree of fiery power! thou of great power! may thy power not be lost! Oh thou auspicious one, stay ties of the Areca Catechu, see Pharmacographia Indica, Vol. III, p. 524. It 18 especially the fresh nut which causes intoxication, and the sensations of strangling and giddiness 191 The commentaries refer to the chapter on gulma or abdomi- nal tumours, and subsequent chapters; i.e, to Part VI (Uttara- tantra), chapter 42 ff., where a number of formulae will be found, into the composition of which various kinds of caustics enter. The commentaries, however, add that, in the case of caustics for internal use, the second hoiling is omitted, and the measures for their three strengths are one pala, three karsa (or three-quarter pala), and half a pala of alkaline ashes respectively. 142 By fire or insects: so the commentaries. 1+ The Mugkaka tree is also called Ghanfapafali or Ghanta- paral. It is probably a variety, with particularly dark-coloured flowers, of the Patali or Stereospermum suaveolens, which has dark, ‘dull-crimson flowers, and a campanulate calyx, and is sacred to Durgé. Bui. quotes from Vigvamitra the following verse: ‘there are four varieties of Muskaka with white, dark (kala), red and yellow flowers, among them the dark-flowered one is considered ‘the best.’ | _ ५५ Te, in which there are no holes (¢vabhra) nor any burying place, etc. So Bui. 1५ The adhivdeuna is an oblation (balt-karman) accompanied with an incantation (mantra). According to the commentaries, Bhdja 84 | SOTRA-STHANAM. {SEc. L even here and accomplish my work! When once my work is done, then thou mayest go to heaven!” After which he should make an oblation with 9 thousand white flowers. At daybreak (of the next day), if he observe no change {in the tree) nor any marvel,'* he should proceed as follows.¥47 He should cut down suitable pieces (of the tree), and having gives the following directions and incantation; ‘he should there, with his face to the east, offer an oblation, and then, on all four sides, with joined palms, devoted mind and pure body, addressing the tree, repeat (the following words): ^ Whatever spirits may inbabit this tree, let them depart hence; for to-morrow this tree is to be cut for a high object!”’’ 16 Te, if no branches are broken or other damage done; and no shower of blood (rudhira-varsa) has fallen. So the commen- taries. 47 In the above given translation I have adopted the older recension which, to judge from Cakrapanidatta’s commentary, appears to have been contained in the copy of Sucruta which he annotated. As it is not to be found in any of the modern editions of Sueruta, I give it here, reconstructed from the commentaries. dn the.edition of Kaviraj] Gang&prasad Sen, an attempt to do so १8 made, bat it is given in an imperfect form. It rans as follows: .. adhivisy=ébhimantry=Gnéna mantréna | agnieirya ete. up to gamisyatt gvéta-puspam sakasram juhuydt ॥ prabhaté vatkriam= adbhutam na pagyét tad=upakalpayét 1 khandapah prakalpy—deapitya nirvdté décé citisn krivd tila-nalair=adtpayét 4 ete. The later and ordinary recension is given in divananda Vidya- sAgara’s and other editions. Its translation will run thus: ‘...and perform the adhivasana eeremony. On the following day he should cut down the tree with the following incantation: “Oh theu tree of fiery power” (ete., as above in the text) ; after whieh he should offer an oblation with a thousamd white and a thousand red fiewers. He should then cut the tree into suitable pieces’ (etc., as above in the text). This later recension makes the whole tree, “a large-sized one,” to be.cut down, while the older recension only directs pieces of it to be lopped off. For the case in hand (merely preparing some alkaline ashes) the latter 18 obvionsly the more rational one; .ac- conlingly I have preferred it | CHAP. XI.] PREPARATION OF CAUSTICS. 65 piled them for burning in a spot sheltered from wind,' he should set fire to them with stalks of Sesame. When the fire has burned out, he should collect separately the ashes of the wood and the nodules of the ashes.'*® [6] In the same way the fol- lowing trees may be burned, including their branches, leaves, fruit, and roots : 189 48 According to N1., one recension of Sugruta interpolates here sudha-garkarag=ca praksipya, i.e., ‘and having thrown in some limestone,’ and afterwards substitutes kafa-garkardg=ca or ‘ excess of (lime-)stone’ for bhasma-carkardg=ca or ‘nodules of ashes.’ BHA. knows nothing of this recension: apparently in Cakrapanidatta’s time it did not yet exist. In the modern editions of Jivananda, Avinaca Candra Kaviratna, and Gangaprasad Sen, confusedly, the interpolation is adopted, but not the substitution. Besides ‘“excess of lime-stone” is a very forced interpretation of the word kafa-garkaraé which is otherwise only known as a name of the Bonduc-nut; see below § [9]. 149 The bhasma-garkaré or ‘nodules of ashes’ are thus ex- plained by Bad. from the Nighanta: ^ When during the burning of the (green) Mugkaka wood, its sap exudes, it forms hard parti- cles with the ashes ; these particles are called ‘ nodules of ashes.’ ” According to the commentaries, these nodules are collected sepa- rately, in order to be used in a subsequent stage of the pre- paration of the alkaline lye. See below § [9] _ 60 This does not mean (as it appears to have been misunder- stood by some) that the whole tree should be cut down and burnt, but that any part of it may be used; the remark has evidently special reference to the case of climbing plants (such as the Kosdtaki) which would afford but little wood. The com- mentaries here speculate on the reason why the Muskaka is mentioned separately. They give two alternative explanations. (1) Hither Augkaka by itself, or a mixture of all the others (Kufuja, etc.) together, may be used to prepare ashes. (2) All the plants (Muskaka as well as Kutaja, ete.), in combination, must be used, but in that case one-half of the ashes must be of Muskaka, while the other half should be of Kutaja etc. combined Bua. seems to prefer the former, while Ni. adopts the latter alternative. | 9 66 SUTRA-STHANAM. [smc. 1. Kutaja Holarrhena antidysenterica (Conessi bark), Palaca Butea frondosa (Bastard Teak), Acvakarna Shorea robusta (Sal tree), Panbhadraka's! Erythrina tndtca (Coral tree), Vibhitaka Terminalta belerica (Beleric myrobalan), Aragbadha Cassia Fistula (Indian Laburnum), Tilvaka Symplocos racemosa, Arka Calotroms gigantea Gigantic Swallowwort), Snuhi Euphorbia neritfolva Apamiarga Achyranthes aspera (Prickly Chaff-flower), Patala Stereospernwm suaveolens, Naktamila Pongamia glabra, Vrea Adhatoda Vasica (Malabar-nut tree), Kadali Musa paradtstaca (plantain), Citraka Plumbago zeylanica, Pitika Caesalpinta Bonducella (Bonduc-nut), Indravrksa!§§ Wrightia tenctoria, Asphita'+ Salvadora persica, Acvamiraka j|§ Nertum odorum (Oleander), Saptacchada Alstonta scholarvs, Agnimantha Premna integrifolta, पव Abrus precatorius (Jequirity), Four varieties of Kosataki (५१ Luffa. [7] 461 According to the commentaries, this may also be the Deodar (Cedrus Deodara). 158 Dr. U. C. Dutt identifies this with Terminalia Arjuna. But N1 says that it isa kind of Kutaja, of which there are two varieties: one with brownish flowers, the other with white flowers. Dr. Dymock’s Pharmacographia Indica, Vol. II, p. 397, says that the Wrightia tinctoria is often confounded with and substituted for Holarrhena antidysenterica, but that it has “ white jasmin-like flowers.” ॥68 This is the identification given by Dr, U. C. Dutt, N1., however, identifies it with Sariva (Hemidesmus indicus or Ichnocar- pus frutescens). Bud. does not explain it. Both Sariva are climb- ing plants. | 1b According to the commentaries these are: 1, with large fruit, CHAP. XI.] PREPARATION OF CAUSTICS. 67 Next one 4150४ of the ashes should be.stirred into six dronas of water or of the prescribed kind of urine,!®> then strained (through cloth) twenty-one times, and finally boiled slowly in a large pan, agitating it (all the time) with a ladle. When (the fluid) becomes clear, red-coloured, pungent, and soapy to the touch,!§ it should be taken off (the fire), strained through a large piece of cloth, and placed once more on the fire, while the residium may be thrown away. Of the alkaline water, thus obtained, (eventually) either one kudava (४.९. 8 pala) or one kudava and a half (#.e., 12 pala) will have to be taken.'§? [8] In the meantime some Bonduc-nuts, nodules of the ashes [see note 149], bivalve-shells and conch-shells, after having been made red-hot in an iron vessel,'68 should be thrown into the afore-mentioned (8 or 12 pala of) alkaline water, crushed to powder, and stirred into a paste. Then this paste should 2, with small fruit, 3, with yellow flowers, 4, with white flowers. They are all climbing plants or vines. 185 Te, of a cow. The reference is to the 18४ paragraph of the 7th chapter of the Kalpasthana (or 5th section) ; [see page 640, line 16, of Jivananda’s edition}. So Ni. But the reference in Bui. is to the division on urine in the 45th chapter of the Sitrasthéna (or lst section), where the urine of a number of other animals is also permitted; [see paragraph 1 on page 191 of Jivananda’s edition.] The latter reference is undoubtedly the correct one. 166 This stage is generally reached when the fluid is decocted to one-fourth, or according to others, to one-third of its original quantity. So the commentaries. See below note 159. 167 In the case of fluids the equation of the quantities is doubled. Thus for solids or dry substances one kadava is equal to 4 pala, while for fluids it 18 equal to 8 pala. See paragraph 8 in chapter 31 of the Cikitsaéstana (or 4th Section), page 538 of Jivaénanda’s edition. 168 Bui. says that an iron vessel is used either because of its hardness, or because the iron enhances the strength of the prepara- tion. The English word potash is said to be “derived from the circumstance that the water in which the ashes are washed is evaporated in iron pots.” 68 SOTRA-STHAN AM. [880. 1. be superadded to that afore-mentioned decoction'6® and (the whole) should be boiled under constant, attentive agitation 169 T read tén=aiva prativadpya, i.e., ‘ having superadded to that very (decoction). The commonly printed recension reads téu= aiva dvi-driné 'sfa-pulu-sammitam gankhanadbhy-ddindm praminam prativapya, 1.e., ‘having superadded conch-shells etc. at the rate of 8 pala to that very decoction consisting of 2 drdna.’ Both readings are noted and commented on by Bua. and N1.; and Bua. seems to prefer the reading which I have adopted, and which is clearly, as I shall show, the older and better one. The directions given in the latter are as follows: Of wood-ashes one drina should be taken; ashes being solid, a drdna is equal to 256 pala. Of water (or optionally urine) 6 dréna must be taken, ४.९.) six times he quantity of water, ४.6. 1536 pala (not 3072 pala, as one might suppose, see note 157; the calculation of both commentaries is explicit on this point). The mixture of wood-ashes and water (or urine) is to be reduced or thickened by decoction: no definite limit is stated ; this is left to the physician’s discretion ; practically the required state of decoction is reached at one-third or oue- fourth of the original quantity (see note 156). Of the decocted mixture either 8 pala or 12 pala (here the mode of measuring liquids is adopted, see note 157) may be taken, again at discretion. The commentaries here expressly state that these quantities are mentioned to serve as a guide to the quantities of the extra- ingredients which have to be superadded. Of these extra-in- gredients there are four (bonduc-nut, etc). The quantities of these are once more left to the physician’s discretion: as Bua., expressly states, more or less of them may be taken, only there should be sufficient to form a paste with 8 or 12 pala of the decoction ; thus the latter quantity is a sort of guide. Having prepared this paste of extra-ingredients (the technical term for which is prattvdpa ), it should be thrown into the remainder of the decoction (४.९. 1०४0 what remains after taking away 8 or 12 pala). The whole is now to be boiled until it reaches the proper state of consistency. Now incourse of time, it became the accepted practice to decoct the original quantity of 6 dréna or 1536 pala of water (or urine) to one-third, i.e., to 2 dréna or 512 pala, and to let the ratio of the quantities of the extra-ingredients be 8 pala, The reason was this: taking 8 pala of each of the 4 extras, we ™ CHAP. xI.] PREPARATION OF CAUSTICS. 69 (with a ladle). Great care must be taken, lest (the solution) becomes too thick or too thin. When it has reached the (proper stage of) boiling, it should be removed (from the fire) to a sheltered place and deposited in an iron jar with its mouth well covered. This (process yields a caustic solution of) middling strength. The same process, but without the addition of any superadded ingredients [2.e., without the paste of bonduc-nuts, etc.], gives a weak solution or (what is called) sarvyihima or ‘ a simple mixture.’ [9] As extra-ingredients such of the following drugs as are available should be used :— Danti Baliospermum aaillare, Dravanti © A kind of Danti, Citraka Plumbago zeylanica, Langalaki Gloriosa superba (Superb Lily), Patika-pravala'®! Sprouts of Caesalpinia Bonducella (Bonduc- nut tree), Talapatri Curcultgo orchivides, Vida Vid-salt, black salt, _ Suvareika Carbonate of Soda, obtain 32 pala, and these are the 16th part of 512 pala; a mixture in these proportions was supposed to give the best potash; the 8th part was supposed to give a middling sort, and the 4th part, a weak sort of potash. When this had become the accepted practice, the text was altered and the above-mentioned passage was inter- polated. The commentaries, however, note that some decocted the original quantity to one-fourth, and others, even to one-sixteenth (or 1836 = 96 pala) ; again others made 8 pala to be the total quantity of the extra-ingredients, ४.९.) 2 pala of each of the four. All this shows that the original text was drawn so as to leave a wide discretion to the operator. 160 The identity of this plant is uncertain. The commentaries say that it is a kind of Danti, which Bua. describes as jivita-patra or ‘having living leaves (?)’; but Ni. adds that according to Bhadalaka it is the same as Samvari. But the identity of the latter is also doubtful; it may be Salvinia cucullata or Anthert- cum tuberosunt. 161 Ni. says that according to some this is Chirivilva or Pongumia glabra. 70 SOTRA-STHANAM. {sEc. 1. Kanaka-ksiri'® A kind of earth of gold colour, Hinga Ferula alliacea (asafoetida), Vaca Acorus Calamus (Sweet Flag), Viga Aconitum ferox (Indian Aconite), A cakti (or half a pala) of each of these drugs, in fine powder, will make up the extra-ingredients. The caustic solution prepared with them, is the strongest and (is called) pdhya or ‘ the boiled one.’ !6 (4) In the administration of these (three kinds of caustics) account must be taken of the (nature of the) disease and the strength (of the patient). If any caustic solution should loose its power, some fresh alkaline water may be added, by which its strength will be re-gained.'** [10] Here come in (the following two verses) :— A caustic should be neither too strong, nor too weak, nor too white ; it should be soft and soapy (to the touch) ; 168 The commentaries give the synonym kaykustha, which sug- gests the possibility of the proper reading being kanaka-ksdra, as kanaka-kgsiri is only known as the name of certain plants. On kankustha, see Garbe’s Indische Mineralien, p. 69, No. 141, foot-note. 168 The text classifies caustics into (1) samvyithima or ‘ weak,’ which has no extra-ingredients (prativdpa) ; (2) madhyama or ‘middling ’ which has the extra-ingredients consisting of paste of bonduc-nut, etc.; (3) pakya or ‘boiled,’ ४.९. extra boiled with an additional set of extra-ingredients consisting of paste of Danti, etc. BuA. quotes the following classification from Bhoja: “ Caustics are divided into samvythima or ‘weak’ and pakya or ‘boiled,’ and the latter are again divided into sa-prativdpa or ‘ middling’ (lit., ‘with an extra-ingredient’) and tzksna or ‘strong.’” This is similar to the classification of Sucruta. But Bui. also refers to another system of preparation, according to which all three kinds of caustic solutions are made with extra-ingredients, and are dis- tinguished from each other only by tle quantities of the latter, these being 4, 8, and 16 parts respectively for the weak, middling, and strong solutions. Compare note 159. 16 The commentaries explain that, after adding the fresh alka- line water, the mixture should be again boiled. A caustic may become ineffective either through lapse of time or through deficiency in ingredients. CHAP. हा. | PREPARATION OF CAUSTICS. 71 it should have only a gentle flow,'® and (in its action) it should be beneficial and quick. These are declared to be its eight good qualities. [11] On the other hand, its bad qualities are said to consist in its being too weak, too cool,'66 too hot, too strong, too soapy, too spreading, or too thick ; also in its bemg underboiled, or deficient in ingredients. [12] (5) Now when (the physician) goes to see a patient suffer- ing from a disease curable by a caustic application, he should select (for the operation) a spacious place protected from draughts and the sun, and the conditions previously explained.'*’ He should then, after having placed handy all his appliances, examine the patient’s (diseased) part, rub it, scrape it, and scarify it, and then with a probe apply the caustic; and having done so, he should wait for the space of time required to utter one hundred words.'6 Qn the application of the caustic, the diseased part turns black, and this is the sign of its being (properly) burnt. When this occurs, (the application of) any acetic acid,!® mixed with clarified butter and honey, will give relief. [14] But if by reason of its being deeply imbedded, the burnt "188 8० that, on application, it does not spread unduly. So the commentaries. 166 Ni. explains gattya by guklatd, ‘too white,’ but I am not aware that gattya or gita ever has that meaning. See, however, § 1 and verse [11]. 167 That is, he should select an auspicious moment of time, as expluined in § 3 of the 5th chapter. So the commentaries. 168 [ have adopted Dallana’s recension of this passage, which is adopted in Gangaprasid Sen’s edition and runs as follows: galakayaG ksdram pratisdrayéd=dattvad vak-catu-matram=upékséta. Cakrapanidatta appears to have read chitivad for dattvé and to have omitted wpékséta, while the current edition (of Jivananda and Avinacga Candra) reads pdéayitva for pratisdrayéd=dativa. There is no practical difference in meaning. 169 Accordmg to the commentaries the reference here is to any of the artificially prepared acetic acids, such as the sour gruels fermented from rice or barley or pulses infused in water. On these see infra, chap. 45, §§ [44-47]. | 72 SOTRA-STHANAM. | [886. 1. part does not (easily) come off, an ointment should be freely applied to it, [15] consisting of a paste made of equal parts of the sediment of kavjzka or ‘fermented rice-water,’ sesamum-seeds, and liquorice. [16] The granulation of the wound may be promoted by a paste made of sesamum seeds, liquorice and a little clarified = butter. But how can the fire-like alkaline caustic be neutra- lised by applying to it the (fermented rice-water with its) equally fire-like, hot, pungent, acid taste? [17] If this is your difficulty, my son, then listen to my explanation. Know that in a caustic all tastes are present except the acid. [18] "701६ has an acrid sub-taste, but its prevalent taste is saline; when joined to an acid (substance), the caustic, with its pungent-saline taste, [19] turns very mild and relinquishes its pungent nature. Through its mildness its (burning) is neutralised, just as a fire, when drenched with water, (is extinguished). [20] 110 In the original thisisa rather puzzling passage, and perhaps the reading is corrupt. In my translation I have adopted a sug- gestion of Dallana. Cakrap&nidatta explains: ‘its prevalent taste is acrid, but it has a saline sub-taste.” Dallana points out ` that this cannot be correct: because 1, people take saline things to neutralise acidity in their food; 2, the caustics are treated in the division relating to saline things, but not in that relating to acrid things. A caustic, therefore, is in the main saline; and when in §1 of this chapter a caustic is said to be acrid, it is only said to be so because a caustic is prepared with agnéya or ‘ heating ’ medicaments. Hence Dallana proposes to construe anurasa with katuka, and bhiuyistha with lavana. With the reading as it now stands, such a construction is impossible; that can only be translated: ‘it is acrid, but it has a prevalent saline sab-taste’ ; but a sub-taste can hardly be said to be the prevalent one. Dallana’s contention, however, seems to me to be right; it agrees with Caraka, who, as Cakrapanidatta points out, says katur=lavana- bhiyisthak (ksGrak), i.e., (8 caustic is acrid, but iu the main saline.’ Perhaps the correct reading of the passage should be katukas=tatr=Gnuras6 lavana-bhiyisthas=tath@a (though being an unusual form of ¢léka). CHAP. XI.]} PREPARATION OF CAUSTICS. 73 Now when the burning (of the afflicted part) is done properly, the disease (for which it was applied) is cured, the system is relieved, and the discharge ceases. When the burning is done insufficiently, there is shooting pain, itching, and insensi- bility, and the disease increases. When the burning is done to excess, there is burning pain, suppuration, redness, (increased) discharge, pain in the limbs, sense of weariness, thirst, भत्‌ | fainting, and even death may result. The wound, caused by the (insufficient or excessive) burn of a caustic, should be treated according to the (nature of the) deranged -humour and of the disease. [21] (5) The following persons should not be treated with caustics :'7! weak people, children, old and timid people, those who suffer from general anasarca or (internal) hemorrhage [see ante § 2], preenant and menstruating women, people who are in an advanced stage of fever, who are weakened by phthisis, who are subject to fits of (morbid) thirst and fainting, or who are suffering from seminal exhaustion, or from the displacement downwards or upwards of the testicles or the uterus. [22] Caustics should not be applied to the vital parts, blood-vessels, nerves, joints, cartilages,!7 sutures,'?? dhamani-vessels,!™ throat, navel, inside of the nails, penis, (excretory) canals, and parts thinly covered with flesh,'75 nor to the eyes with the exception of the diseases of the eyelids. [28] But even in the case of diseases curable by (the application of) caustics, these afford no cure to a patient who is subject to fits of anasarca, violent 7! Hither internally, or externally, or both, according to circum- stances. So the commentaries 478 Te, those of the nose, ear, nape, eye and forehead. So the commentaries 178 Of these there are seven: five on the cranium, one on the tongue, and one on the perinsum. So the commentaries. ; 74 On these see below, chapter 9 of the Carira Sthana or 3rd Section. There is nothing exactly equivalent to them in modern anatomy. See also ante, note 60 ५75 Such as the knee, the upper surface of the foot, the forehead etc. So the commentaries | 10 74 SOTRA-STHANAM. (80. 1. pain in the bones, aversion to food, or pain in the heart and jomts. [24] Here comes in (the following verse) :— In the same manner as poison, fire, sharp weapons, and lightning, caustics, if applied by a careless physician, cause death. When applied properly by a careful physi- cian, they quickly cure (many) serious diseases. THE TWELFTH CHAPTER. On THE MopeE or APPLYING THE AcTUAL (^ णह. [1] (1) With regard to surgical treatment, actual cautery is said to be superior to caustics,'7§ inasmuch as diseases treated with the actual cautery do not re-appear, and because it can cure diseases which are incurable by medicines, instruments, and caustics. [2] (2) The means for carrying out the actual cautery are the following : long pepper, goat’s dung, orpiment, an arrow-head, or a wick; also oval-headed probes,'” made of iron or other metals ; further, honey, treacle, and the various kinds of oleaginous sub- stances.'78 Of these, long pepper, goat’s dung, orpiment, arrow- heads and wicks are used in the case of (diseases) affecting the skin ; probes made of iron or other metals (such as copper, silver, etc.) in the case of (diseases) affecting the muscles; and honey, treacle, and oleaginous substances, in the case of (diseases) affect- ing the blood-vessels, nerves, joints and bones. [3] The actual cautery may be used in all seasons except the autumn and 176 The commentaries explain that though in chapter 11, § 1 caustics are said to be superior to all substitutes, including the actual cautery, there is no contradiction here. Each is superior from its own point of view: cautery with regard to effectiveness of treatment, caustics with regard to variety of application. im The text has jambaugtha which is a probe with a head shaped like the oval fruit of the Jambu tree. So BHA. See also ante, chap. 7, § 7. 128 These are the following four: oil, clarified butter, fat, and marrow. , ™ CHAP. X11. } ACTUAL CAUTERY. 75 summer; and even in these (it may be used) if a rapidly fatal disease cannot be cured without it, provided that suitable precautions'79 are taken. [4] In all diseases and in all seasons the actual cautery should be performed on a patient only after he has been kept on a mucilaginous diet, but in the case of complex labour, stone in the bladder, fistula-in-ano, piles, and diseases of the mouth, (it should be performed on him) on an ` empty stomach. [5] (4) Some say that there are (only) two kinds of cautery, namely that of the skin and that of the muscles; but here (in this treatise) there is no prohibition against the cauterization of blood-vessels, nerves, joints and bones.!8 [6] When the skin 179 The commentaries explain that this refers to cool cloths and diet, as suitable to those two hot months. (80 According to Bui. and N1. the reference is to Kacyapa from whom they quote the following verse: “under no circumstances should the irritating part be surgically removed from blood- vessels, nerves, joints and bones, or the potential or actual cautery be applied to those parts.” Kacyapa is one of the ancient Hindi physicians. He is quoted in the Bower Manuscript (see my edition, p- 170, verse 1020) and in the Astinga Hrdaya (VI, 2, verse 43). A Kacyapa Samhita still exists and the above quotation is probably from that work. I have no means of verifying it. Ni. tries to reconcile the discrepancy by saying that Sucrota here only means to say that the cautery should be used to stop the flow of blood, when a blood-vessel or nerve, etc., is divided, but not, that it should be used to cure any disease of those parts ; for the latter object is practically included in the cauterization of the muscles, as a bye-product of it, according to the saying of Madagaunaka : “along with the cauterization of the muscles diseases seated in the blood-vessels, nerves, bones and joints are also relieved.” This harmonization, however, seems untenable in view of Sucruta’s direction in § [8], that cautery should be applied to the blood-vessels, nerves, joints and bones, as well as to the skin and muscles, in the case of a painful inflammation caused by the deranged air of the body. The reconciliation suggested by Bai, has more probability. It says: “the use of the negative phrase “cautery is not prohibited,” instead of the positive ^ cautery 76 SOTRA-STHAN AM. - [SEc. 1. is cauterized, the burning is attended with a (crackling) noise, bad smell, and contraction of the skin. When the muscles are cauterized, (the burnt part assumes) ihe colour of a grey pigeon, is slightly swollen and painful, and its wound is dry and con- tracted. When blood-vessels and nerves are cauterized, the wound appears black and elevated, and the discharge is stopped. When joints and bones are cauterized, the burnt part becomes rough and red, and the wound is hard and solid. [7] In headache and ` ophthalmia the eyebrows, forehead, and temples should be cauterized. In diseases of the eyelids, the roots of the eyelashes should be cauterized, after protecting the eye with a piece of wetted cotton cloth.'8! In very painful affections, caused by deranged air, of the skin, muscles, blood-vessels, nerves, joints, or bones, in sores forming hard and insensible protuberances,'38 in cystic tumours, piles, tumours, fistula-in-ano, enlarged lym- phatic glands, elephantiasis, condyloma, black moles, scrotal enlargements, and injuries to joints and blood-vessels the actual cautery should be applied. [8] (5) Now, there are (four) different ways of performing the is enjoined,” shows that cautery is only intended to be used in the case of a rapidly fatal disease of the blood-vessels, etc.” In any case, tt may be noted that though Sagruta permits the use of the actual cautery, he prohibits the employment of the potential cautery, in the case of diseases of blood-vessels, nerves, etc. ; see § 5 of the 11th chapter. 481 The text has aluktaka, which Nr. explains simply by karpafa or ‘piece of cotton cloth.’ Dr. U. C. Dutt says it is ९ cotton coloured red with lac.” 8 Dr. U. C, Dutt, in his translation takes this and the pre- ceding phrase to signify but one disorder: “when a painful inflammation is caused by deranged air on the skin, flesh, ete., and the inflamed part is hard, swollen and insensible.” But a ‘painful inflammation” could not at the same time be “ in- sensible.” Clearly two distinct disorders are referred to. This is also seen from Cakrapanidatta’s remark that vrana is to be taken simdnya or ‘in a general seuse,’ and therefore not with any particular reference to deranged air. The latter term seems to indicate a different disorder: painful rheumatic affection. CHAP. XII.] ACTUAL CAUTERY. 77 actual cautery: namely, in circles, points, lines, and areas.'88 [9] Here comes in (the following verse) :— When he has examined the place and form of the disease, as well as the vital parts and the strength or weakness of the patient, only then the physician should decide on carefully performing the actual cautery. [10] After the part is thoroughly cauterized, it should be dressed with honey and clarified butter. (6) Now the actual cautery may not be performed on the following persons : those who are of a bilious temperament, who -are subject to internal hemorrhage or diarrhea, and who have unextracted foreign substances in their body, weak people, children, old and timid people, also those who are suffering from numerous ulcerations,'®+ and those who cannot be made to perspire.'®5 [11] (7) We shall now proceed to describe the symptoms of cauter- ization when improperly performed. Fire is made a means of cauterization by being introduced into some oleaginous or dry substance.'®° But an oleaginous substance, if well heated by + fire, will, by following the minute vessels of the body, penetrate into its skin and its other parts, and rapidly cauterize them. Hence in cauterization by an oleaginous substance there is a 188 To suit the differences in the shape of the diseased part, as the commentaries explain. I follow the rpading given in Ganga- prasad Sén’s edition, which is also that of BHA. and Ni. The latter, however, says that some add rég-Gkrtim=avéksya, ४.९. ‘ with 8 view to the shape of the diseased part.’ The reading of Vidya- sagara’s edition rig-adhisthana-bhédad=agnikarma caturdha bhidyé@té, ४.९, ‘on account of the difference in the seats of the diseases the actual cautery is divided in four kinds,’ is clearly a redundant interpolation. 189 Text: anéka-vrana-pidita. Bui., however, reads anéka- oyadhi-pédita, 8.6.) ‘ who suffer from various diseases,’ that is, such diseases as are unsuitable for treatment by cautery, lest they be increased. 186 H.g., those who suffer from morbid pallor, morbid micturi- tion, morbid thirst, hemorrhage, etc. So the commentaries. 186 Te. by strongly heating wood, stones, mctals, etc., or, on the other hand, clarified butter, oil, ete. # 78 SOTRA-STHANAM. (8४९. 1. greater amount of pain. [12] Now there are four grades of cauterization: scorching, deficient burning, proper burning, and over-burning. Scorching is that which merely results in a heavy discoloration (of the skin). Deficient burning is that where severe blisters arise with a sensation of drying up and burning up, combined with redness, suppuration, and pains, and take a long time to heal. Proper burning is that in which the burn is not too deep, coloured (yellow) like the (ripe) fruit of the Palmyra palm (Borassus flabelliformts), well-formed,'®? and furnished with all the characters previously [see § 4] described. Over-burning is that in which the flesh is pendulous, the body languid, the blood-vessels, nerves, joints and bones excessively injured, and fits of fever, burning sensation, thirst and fainting supervene; in which moreover the sore heals very slowly, and, even after healing, has an unhealthy colour. All these four kinds of cauter- izations fulfill (for the physician) their own proper purpose.!88 [13] Here come in (the following verses) :— Irritated by fire, the blood of living beings becomes greatly deranged ; and its derangement quickly communi- cates itself to their bile. [14] For these two (substances) are like one another in regard to their (hot) power, their (bitter) taste and their (character as) elements (of the body). Hence severe pains arise: burning comes as a natural result (of the fire) (15]; blisters quickly spring up; and fever and thirst supervene. (8) Now the treatment adapted to neutralise (the effects of) cauterisation is the following. [16] In the case of scorch- ing, heat should be applied, and heating medicines adminis- tered, for, when the body copiously perspires, the blood be- comes thin. [17] For cold water naturally thickens the blood. Hence heat gives relief, but never cold. [18] In the case of deficient burning, the physician should adopt both cold and hot treatments. Dressing with clarified butter and 187 { 6., neither too much raised, nor too much depressed. So.the commentaries. 188 T.e., they show him both what he should do, and what he must ayoid. So the commentaries. CHAP. XII. | ACTUAL CAUTERY. 79 sprinkling with cold water should be resorted to by him. [19] In the case of proper burning a dressing made of (equal parts of) bamboo-manna, (bark of) Plaksa (67८४5 Tjakela), (red) sandal-wood, and Amrta (Zinospora cordt- folia), and greased with clarified butter, should be applied. [20] Alsoa plaster, made of the pounded flesh of animals living in villages, marshes or water,'8* may be applied. In fact, the treatment should be with enduringly heating medicines, the same as in the case of deep-seated abscesses caused by deranged bile. [21] In the case of over- burning all loose-hanging pieces of flesh should be removed, and a cooling treatment adopted by the physician ; after- wards a plaster made of the grains of Cali or ‘ cold- season-rice, [22] or of the bark of Tinduki (Diospyros Embryopterts) or other trees with an astringent bark, mixed with clarified butter, should be applied ; and the sore should be covered with leaves of Gudiici (Tynospora cordifolia) or of some water-plant. In fact, the physician should follow altogether the same treatment as in the case of erysipilas caused by deranged bile. [23] The following makes an excellent granulating agent for every kind of cauterized burns, namely a paste made of (equal parts of) wax, honey, (bark of) Lodhra (Symp/ocos racemosa), resin of Sarja (Shorea robusta), madder, (red) sandalweed, and (leaves and root) of Marva (Sanseviera zeylanica), powdered and boiled in clarified butter. [24] In cauterizations by (heated) oleaginous substances a dry method of treatment should preferentially be followed. (9) We shall now proceed to describe the symptoms of suffocation by smoke. [25] (The patient) breathes and sneezes hard,!® becomes distended with wind, and coughs ; his eyes become burning and red; [26] his expirations are 189 87९] as horses, etc., boars, buffaloes, etc.; turtles, etc. So Ni. 190 The text has kganti, which Ni. explains by Azkkati or ‘he hiccoughs.’ But the reference is to sneezing, as Dr. Dutt translates. । ४0 SOTRA-STHANAM. [SEc. I. mixed with smoke; he can smell nothing else but smoke, nor can he recognize any tastes; his hearing also is im- paired ; [27] he is thirsty, hot and feverish; he sinks (under the treatment) and faints. Such is suffocation by smoke. Now hear its treatment. [28] The patient should be given clarified butter with the juice of sugarcane, or raisins with milk, or sugared water, or sweetened acid juices in order to cause him to vomit. [29] By vomiting the bowels are cleared, and the smell of the smoke disappears. By this treatment, the languor, sneezing, fever, [30] burning, fainting, thirst, flatulence, (difficulty of) breath- ing, and coughing are alleviated. The use of sweet, saline, acid and acrid gargles [31] restores the functions of the senses and revives (those of) the mind. Errhines, skilfully administered to the patient by the physician, [32] clear his sight and (relieve) his head and neck. A diet should be prescribed of articles which are not heating, easy of digestion, and oleaginous. [33] In cases of burns from hot winds or exposure to sun, a cooling treatment should always be adopted. Burns caused by exposure to icy cold or showery winds are alleviated by (the use of) heating and oleaginous substances. In the case, however, of a burn by lightening there is no chance of recovery.!! [34] 191 The text has atitejas, lit. ‘excessive burn,’ which both 882. and Ni. explain to refer to lightening. एषठ. in its comment, however, adds that “if only slighty burnt by lightning (mandg- dagdha), the patient may recover,” and Ni. supports this comment. This clearly let to the textual addition of verse [35], which is given in Jivinanda’s edition, and runs as follows: “but if the patient survives after being struck by lightening, he should be treated with oleaginous applications, washes and poultices.” In Dallana’s time this addition already existed ; but he says: ‘the commentaries (nibandha) do not acknowledge it. Cakrapanidatta did not read it in his text; and in Gangaprasid Sén’s edition it is omitted. Instead of the usual recension ¢ita-vars-Gnilair ‘ cold and showery winds,’ I read, with Cakrapanidatta, hima-vars-Gnilair ‘icy cold and showery winds.’ Dallana who reads gita explains it by the popular saying: “that hima or icy-cold burns like heat.” ¢ CHAP. XIII. ] APPLICATION OF LEECHES. 81 THE THIRTEENTH CHAPTER. On tHE APPLICATION oF LEEcHES.'™ (1) Leeches may be said to be the mildest of all means for extracting blood, well adapted for princes, rich persons, child- ren, old, timid and weak people, women, and delicate persons. [2] (2) Blood deranged by air, bile, or phlegm may be extracted by horns, leeches, and gourds respectively, or any kind of deranged blood (may be extracted) by any (of the three); but if blood is to be extracted profusely, the horn, leech and gourd should be employed (in the order mentioned).'** [8] Here come in (the following verses) :— The horns of cows are said to be heating, mild and unctuous ;'** hence they are the proper (instrument) for extracting blood in diseases caused by deranged air. [4] Leeches are born in water,- have a cold exterior and are mild ; 19४ hence they are proper (to be used) for extracting 198 The commentaries explain that this chapter really treats of the varions ‘accessory inatruments’ for extracting bleod. Of these leeches are the mildest, then come horns and gonrds, and finally scarification and venesection, the last two being not ‘ mild’ at all 198 [ have adopted the reading of the text of Dallana and Cakrapapidatta. It is also given in the edition of Gangaprasad Sén. According to Dallana the concluding sentence was rejected by some commentators, including Jaijhata. It is also omitted in the editions of Jivanandaand Avinaca Candra. On the other hand, Jivdnanda’s edition interpolates, after the first sentence, the words “ by reason of their unctuons, cooling, and dry natures,” which Dallana says are rejected by all commentators, and they un- donbtedly seem to be superfluous, seeing that their purport is stated in the succeeding verses [4-6] i% Bri. reads glakgnam ‘ smooth’ for usnam ‘ heating 9% Text vari-sambhava ‘born in water,’ to distinguish them from trra-jaluuka, lit., ‘grass-leech,’ ४.५.) a caterpillar. So Bua. Cit-Adhicdsd 18 explained by Nt. as gita-grha or ‘living in cold places,’ bat by Bui. as ¢ita-sambaddhd, which I have adopted. Madhura is explained by Bui, as ‘ mild in application.’ 11 82 s0TRA-STHANAM. [886. 1. blood in diseases caused by deranged bile. [8] Gourds are said to be acrid, dry and pungent; hence they are the proper (instruments) for extracting blood in diseases caused by deranged phlegm.!% [6] Now in cupping, the blood should be extracted by means of a horn to which a small bladder is tied as a cover, after sucking it ; 9 or by means of a gourd in the inside of which a burning wick is placed. [7] (3) The leeches are called jal-dyuka because jala or ‘ water’ 18 their dyuh or ‘food;’ and they are called jal-aukasa because water is their 245 or ‘ dwelling place.’ They are of twelve kinds : six of these are poisonous and just as many are non-poisonous.!% The poisonous ones are (the following): Krsnd, Karvurd, Alagarda, Indréiyudhi, Sdmudrikd and Gocandané. Among these the Krena or ‘black one’ is of the colour of (black) collyrium and has a broad head. The Karvara or ‘variegated one’ is as 190 According ४० Gangapraséd Sén, his Bombay copy adds here the following verse: aldvu=astaygulam vidyat prngan=tu deddaga- ygulam, jalauké ca haréd=raktam तंक sarva-gatam nrndm § i.e, ‘the gourd should be of the size of 8 aygula, and the horn, of 12; the cold leech draws the blood of men from any part.’ Dallana refers to this verse, though he does not quote it. But he quotes the following from an unnamed authority: ‘the horn should be that of a white cow and should be of the size of seven angula, and shaped like the disk of the moon; at the top there should be a hole of the size of a pea.’ According to him, the gourd should measure 8 angula (6 inches) in circumference, and 4 angula (3 inches) in size. Cakrapanidatta’s measures are: the horn should be 3 angula, and its hole should be of the size of the stalk of an oleander flower. His measure for the gourd is not fully given. 197 The sucking, of course, creates a vacuum in the horn; 80 does the burning of the wick in the gourd. I read, with Bui. and N1., vaste or ‘bladder.’ Another reading, also mentioned by Ni. and given in Jivananda’s edition has vastra or ‘piece of ` cloth.’ 198 The commentaries state, that according to another text-book (tantra), not named by them, the poisonous leeches are of eight kinds. CHAP. XIII. ] APPLICATION OF LEEOHES. 88 long as an eel,!9* and has an abdomen, in some places raised, in others depressed.* The Alagardd looks as if covered with hair, has large sides and a black mouth. The Indradyudha or ^ rainbow’ is adorned with (longitudinal) lines on its back, of the colours of the rainbow. The Sdadmudrika or ‘the stamped one’ is of a slightly whitish-yellow colour and marked with flower- hike spots of various forms. The Gdcandand has a bifurcated tail resembling the scrotum of a bull, and a small mouth. If any person is bitten by these, their bite produces’ swelling and excessive itching of the part, and fainting, fever, heat, vomiting, delirium, and general collapse supervene. In such a case the Mahagada®' or ‘Great Antidote’ should be administered in the form of a potion or an ointment or an errhine or in any other form. The bite of an Jndrdyudha is incurable. So far the poisonous leeches and the treatment (of their bite) have been described. [8] Now the non-poisonous leeches are the following : Kapila, Pingala, Ganku-mukhi, Misika, Pundarika-mukhi, Savarika. Among these the Kapila or ‘ the greenish one’ has its two sides of the colour of orpiment, and on its back it is smooth and of the colour of a (green) pea.*°* The Prngald or ‘ tawny जय 199 The original has varmt-matsya or ‘ Varmi fish.’ The Hindi medical dictionaries explain it as a “kind of river fish,” and say that in the vernaculars it is called vant or vani or vdin or ००५५ (Bangali) and bémbi or bam (Hindi). This is the name of the eel. The Petersburg Dictionary does not identify it. Nr says that it is “like a snake,” but it adds that some identify it with the Rohita fish, which is a kind of carp. The comparison with an eel would indicate a rather long species of leech. 200 I.e., probably, as Dr. U. C. Dutt paraphrases it, “it has elevated stripes across its abdomen ”; but not, as Dr. Wise puts it in his Hindu System of Medicine, p. 177, that ‘it moves irre- gularly.” 01 ‘This antidote will be found described infra, in verses [59-61] of chapter V of the Kalpasthana (or 5th Section). 208 Kapila is somewhat puzzling. It cannot have here the usual meaning of ‘ brown’ or ‘tawny,’ because the commentaries explain the following piggala by kapila. Of Mudga (Phaseolus $4 ~ gO0TRa-sTHANAM. [88९. 1. ene’ 18 ` a réddish-brown colour and a round body and moves quickly. The Canku-mukhi is (bluish-red) of the colour of liver, sucks quickly, and has a long sharp mouth. The Miscka or ‘rat-like one’ has the shape and colour of a rat’s (tail)®® and is: 6f a disagreeable smell. The Pundarika-mukhi or ‘lotus-faced one’ is of the colour of a (green) pea,*? and has a mouth like the lotus. The Sdvarikd is slimy, (green-)coloured like a lotus-leaf, and eight, angulas (or 6 inches). in length; it is only fit for extracting blood from animals. Such is the description of the non-poison-. gus (leeches). The countries in which they occur are the Yavana, Pandya, Sahya, Pautana and others.*%* The leeches found in these countries are large-bodied, and strong, suck (blood) quickly and eat much, and are specially free from poison. Those leeches which are produced in dirty water and from the decomposition of poisonous fishes, insects, frogs, urine, and foeces are poisonous. Those which are produced in pure water and from the decomposi- tion of the various kinds of lotus, called Padm1, Utnala, Nalina, Kumuda, Saugandhtka, Kuvalaya, Pundarika,® and of Catvala Mungo) there are two kinds: green and yellow. Cakrapanidatta: says that the havita-mudga or ‘green pea’ is intended; and harita 18 also a synonym of kapila. The latter 18 an undecided colour ` 808 §6. Bui.: it is like the tail of ‘a rat.on account of its length. %% According to Dallana, by Yauvana is meant the country of. the Turuska (६.९.) the trans-Indus country); by Padadyu, the Dekkan or Southern India, by Sahya, the country about the Narbada or Central India, and by Pautana, the country about Mathura or Western India. Both Dallana and Cakrapanidatta state that some commentators reject this passage; but in that case they would have to read, in the following sentence, td@su instead of tésu, in order to make it applicable to the feminine jalaukd, ‘a leech.’ The neuter fésu refers to ksétrani and clearly presupposes the. existence of the passage in question | ४06 All these are different varieties of Nelumbium speciosum: and Nymphaea lotus. According to Dallana, “ Padma is whitish, and Pundarika, very white; Nalina is reddish and Kuvalaya, red ;: Uipala is bluish; Saugandhika is very sweet-scented and opens in moonlight; Kumuda is the well-known vernacular Kuityd or Kai.” The two last-mentioned are white varieties. 0५१, XIII. ] APPLICATION OF LEECHES. 86 {Blyza Octandra) are non-poisonous. [9] Here comes ‘in (the following verse) :— These beneficial (leeches) have their habitat in meadows and fresh, waters; they do not live in confined places, nor do they lie in quagmires. [10] | | As to the means of securing them, they may be caught with (a piece of) wet leather, or with some other (suitable) article.*® They should then be kept in a new large earthen pot, filled with mud and water from a pond or lake. For food, they should be given of the green fungi growing on stagnant water, dried meat, and powdered tubers of aquatic plants ; and for bed- ding, grasses and leaves of water-plants. Every second or third day, fresh water and food should be given, and every week the earthen pot should be changed. [11] Here comes in (the following verse) :— Leeches the middle of which is thick, or which are ex- hausted, or are expanded, or which move slowly, or do not fix, or suck little, or which are poisonous, should not be selected (for use). [12] (4) When about to apply a leech to a person who has got a disease curable by them, the patient should be made to lie down, and the (affected) part, if free from ulcers,* should be rubbed dry with powdered cowdung and earth. Then having taken hold of the leech, and irritated its body with (a mixture of) turmeric and mustard rubbed into a paste with water, it should be placed, for a little while, in a cup of water, till its dullness is seen to have passed off ;*? and then it may be applied to the 906 Fi.g., a piece of freshly killed meat, or one’s leg smeared with batter, or milk, etc, So the commentaries ४07 Because, otherwise, by rubbing the ulcers the disease will be increased ; or else it sucks the ulcer, attracted’ by the wet and swell of the blood. So the commentaries ~ 908 The usual text has vigata-klama ‘ freed from dulness’; but Cakrapanidatta reads vigata-mala which he explains by apagata- vithya-mala, ‘freed from external impurities.’ Both readings make good sense. The leeches are smeared with the paste to excite them, and they are put in water to clean them again from the paste, before applying them 86 sOTRA-STHANAM. [skc. 1. diseased part, covering it with a fine white wet piece of cotton- cloth, but so as to leave its mouth free. If it does not fix quickly, a drop of milk ora drop of blood may be applied to, or a small Incision may be made (in the deceased part). If even then it does not fix, another should be applied. When it fastens on (the part), a leech raises its shoulder and bends its head like a horse-shoe, then it may be known to be sucking; and while it is thus sucking, it should be covered up with a wet cloth. If in the bitten part itching or pain is felt, it is a sign that the leech is drawing pure blood; and such a leech should be re- moved. If on account of its scenting the blood,*® it will not let go, it should be bestrewed with powdered rock-salt. When it now falls off, its body should be irritated with powdered rice and its mouth smeared with oil and salt; then taking hold of it by its tail with two fingers of the left hand, its body should be slowly and gradually pressed with the thumb and index-finger of the right hand, (from the tail) towards the head, and thus it should be made to vomit, until it is thoroughly emptied. When it is thoroughly emptied and placed in a cup of water, it goes about in it in search of food. If it sinks (to the bottom) and does not move about, it is not quite emptied, and should again be made to vomit till it is thoroughly empty. A leech which has been insufficiently emptied, is attacked with an incurable disease called Indramada# A leech which has been completely emptied should be replaced, as before explained, (in the earthen vessel). According as the (quantity of) blood (drawn) is proper or improper, the leech-bites should either (in the former case) be rubbed with honey, or sprinkled with cold water and bandaged, or (in the latter case) the wound may be also poulticed with 809 The usual reading is gonita-gandhéna ‘by the smelling of blood,’ but according to Dallana some substitute cdnita-gardhéna ‘through greed for blood,’ on the ground that leeches have got no sense of smell. 310 According to the commentaries some reject this passage, on the ground that the nature of the Indramada disease is not explained in any medical text-book. Cakrapanidatta himself would seem to have been in favour of rejecting it. CHAP. XIv.] DESCRIPTION OF BLOOD. 87 cooling poultices made of astringent or sweet drugs mixed with clarified butter.*!! [13] Here comes in (the following verse) :— Whoso knows (all about) the leeches, their habitat, the mode of catching them, their varieties, and the manner of keeping and applying them, he is able to overcome all diseases curable by them. [14] THE FOURTEENTH CHAPTER. DEscRIPTION OF THE 31.007. [1] (1) Food, which is derived from the five (primary) elements, is of four kinds, and possesses six tastes, two or (according to others) eight sensific powers, and many other qualities,*!8 yields, if all This is the interpretation given by some commentators, according to Dallana and Cakrapanidatta. It is also adopted by Nr. U. C. Dutt, though in a slightly and incorrectly modified form. It seems to me to be the only admissible one: two alternative blood- effusions are mentioned, and the treatment adapted to each. Dallana and Cakrapanidatta themselves, however, prefer another interpretation with a fourfold division. According to them ayoga 18 of three kinds: hina, ati and mithyé. Rubbing with houey is intended for hina-ydga or ‘insufficient extraction,’ sprink- ling with water and bandaging for atzydga or ‘ excessive extrac- tion,’ and dressing with poultices for mithyd-yaga or ‘imperfect extraction’ (४.९. when impure blood is left in the wound). This interpretation, however, leaves no treatment indicated for yoga or ‘proper extraction.’ Hence those commentators add, out of their own head, that it should be treated by dhauta-ghrt-abhyanga, ४.९., ‘dressing with well-washed clarified butter.’ 949 On the five (primary) elements see notes 16 and 30. The four kinds of food are those which must be drunk (péya), licked (léhya), swallowed (agzta or bh@ya), and masticated (bhaksya or khadita). On the tastes, sensific powers, and other qualities, see infra, chapters 40-42. By the other qualities are especially meant those of light (laghu) and heavy (guru) digestion; so Bui. Altogether twenty guna or ‘ qualities’ are counted. 88 SOTRA-STHANAM. [SEc. 1. it issuitably taken and thoroughly digested, its clarified 18 essence (as a fluid substance) of very great fineness, which 18 called rasa or ‘chyle.” The seat (of this chyle) is the heart, which is purified thereby.*!* Then proceeding from the heart, through the twenty- four dhamant-vessels, ten ascending, ten descending, and four trans- verse, it, day by day, satiates the whole body, increasing, main- taining, and strengthening it, by some mysterious manner of action.2!® From the fact that it pervades the whole body it can be further inferred that its condition is liable to the ills of deficiency and excess.2!6 Seeing that this chyle pervades the "918 The term f&jobhita is explained in three different ways. Cakrapanidatta says it means ‘ pure ' (nirmala or prasanna), and he quotes Caraka in support. But he allows the optional meaning ghrtu-vad=utpanna ‘ produced like clarified butter from butter téjuas being a synonym of ghrta. Dallana also allows the latter ; but he prefers the meaning vahni-sambhita or ‘ produced by fite {४ ९., the digestive fire) 4l¢ The heart is also said to be the seat of djas or ‘ vital force.’ Hence Dallana says that here by ‘heart’ is to be understood not the heart itself but its region, while Cakrapanidatta says that the seat of blood is that portion of the heart which is not occupied hy djas as itsseat. On djassee the nextchapter. I read, with Bui., yuch= chhuddham after sthanam 816 The terms ‘increasing,’ ‘maintaining’ (dhdrayatt or as some read jivayati), and ‘strengthening’ refer respectively to youth, middle age, and old age. So the commentaries. 16 T.e., rasa or ‘chyle’ pervades the whole body, seeing that being healthy (t2j6bhuta) itself, it keeps the body in a healthy state (1/5), 88 explained im the preceding passage. Butthe body is not always healthy ; it is subject to diseases; hence it follows that the rasa itself must be subject to ills. This seems to me the correct con- struction of the passage, and its obvious meaning as intended by Sucruta. The commentators, however, give an entirely different construction and interpretation of it. They construe thus: tasya anusaraté gatir=anumanaid=upalaksitavyG ksaya-orddhi-vatkrtath ; and interpret thus: ‘ The fact of the chyle pervading the body can be inferred from its ills of deficiency and exceas (and the conse- quent diseases of the body).’ But why should the latter be a CHAP. XIV. | DESCRIPTION OF BLOOD. 89 whole body, its limbs, humours, constituent parts,*!? secretions, and receptacies,*!® the question arises,*!® is this substance proof of the prevalence of the chyle throughout the body, any more or any better than the health of the body ? In fact this proof is already given by Sucruta in the preceding passage: it is the health of the body which proves that the chyle which is also a healthy substance pervades the body. But there remains a difficulty which Sugruta had clearly to answer. If the prevalence of the healthy chyle makes the body healthy, how are the diseases of the body to be accounted for? The answer is: that the chyle, though essentially a healthy substance, is subject to deficiency or excess. Moreover the very term upalaksitavyd indicates that some additional mark of the chyle is referred to; its health is pre- viously spoken of, now its drawbacks are noted. Dallana evidently felt this difficulty, for he suggests that ca ‘and’ must be under- stood (drasfavya) with ksayd-vrddhi-vatkrtath. But this would be not only a gratuitous addition, but the awkwardness of his con- struction of anumdndi still remains. The diseases of the body con- sequent on the ills of the chyle are exemplified by Dallana thus: deficiency of chyle causes pains and palpitation of the heart, ७६९.) excess of it, languor of the heart, etc.—It may be also noted, that all modern editions read: gariram=anudhavaté or ‘ flowing through the body,’ while both Dallana and Cakrapanidatta read gariram= xausaratd. This is clearly the older reading which I have adopted. 11 way mean the same as anudhGvaté ‘flowing’ or ‘ moving,’ but not neccssarily ; it may also simply mean ‘pervading’ (as, as a matter of fact, it does mean in the immediately following passage), and in the original context of Sugruta, as I have adopted it from Cakrapanidatta, neither he nor Sugruta can have meant anything else by it. The whole context only further proves the well-known fact, that in Cakrapanidatta’s time and before it the circulation of blood (४.९., chyle reddened) was not yet known. The substitution, im the context, of the explicit term anudhdvaté would seem to have been a resaltant of the spread of that knowledge into India. 817 The dhalu or ‘constituent parts’ (or secondary elements) of the body are seven; see below § [6], and ante, footnote 30. 918 On these parts of the body see the 5th chapter of the Carira- sthina (or 3rd Section), also the next paragraph of the present chapter. Secretions include both excreta and secreta. 319 That question arises in this way: of the parts of the body ` 12 90 SOTRA-STHANAM. [SEc. I. a cooling or a heating one. The answer is this: chyle is indeed an all-pervading substance,3® but from the fact of its being a lubricating, vitalizing, nourishing, and preserving agent, it may be concluded to be a cooling one. (2) Now this chyle, though originally a watery fluid, assumes a red colour by contact with (the bile situated in) the liver and spleen. [1] There are also (the following two verses) :— Now this watery fluid, which (in itself) is devoid of any colour, is reddened through the heating power (of the bile) present in the body of corporeal beings in a healthy state, and it is hence called rakta or ‘blood’ (lit. the red substance). [2] From this same chyle also the so-called rajas or ‘ menstrual blood’ of women is derived; this blood begins to appear at the age of twelve and comes to an end at the age of fifty.*#! [3] That the menstrual blood, however, has the property of heat may be seen from the fact that the womb has both the properties of heat and cold.3*8 Other (medical) authorities add that the blood of living beings is (ultimately) composed of the five elements ; [4] for (they say) the smell of raw meat, liquidity, red colour, tendency to ooze, and lightness, which are the some are cold, as phlegm, others are hot, as bile ; but chyle pervades all; is it, then, cold or hot? So the commentaries. 990 IT read only anusdri with Ni. and Bui. The reading drav- anusari, lit. ^ flowing pervader,’ is an emendation due to the same cause as the reading anudhavaté, see note 216. 891 For the third verse, Dallana mentions the following curious reading, unknown to Cakrapanidatta : rasdd=éva rajas=strindm masi mast try-aham dravét | tad=varsdd=dvidagad=irdhvam yavat=pai- caisatam 6217126 4 1.e., ‘from this same chyle flows the menstrual blood of women, month by month, for three days, beginning from the age of twelve up to that fifty years.’ 298 The meaning is this: it is well-known that the womb, into which both the semen and the menstrual blood enter, possesses. both the hot and cold properties. Now the semen is cold, and, accounts for the cold property of the womb. It follows hence CHAP. XIVv.] DESCRIPTION OF BLOOD. 91 five qualities of earth and the other (four elements respec- tively), are also observable in the blood. [5] (Further,) blood being produced from chyle, flesh 18 next produced from blood, fat from flesh, bones from fat, marrow from bones, and (lastly) semen from marrow. [6] Thus chyle, being itself the essence of food and drink, nour- ishes these (other six) dhdtu or ‘ constituent parts of the body.’ #8 [7] (3) Now the root ras means ‘to go’; and the dhdtu or ° constituent part’ rasa or ‘chyle’ 18 called so, because it moves continually. But it stays in each of the (other six) constituent parts (of the body) for the space of three thousand and fifteen kala. Hence it takes the chyle one month to turn into semen, or, in the case of women, into menstrual blood. [9] Hereon comes in (the following verse) :— Hence the total period is stated, in this (z.e., the author’s own) as well as in other text-books, to be eighteen thousand and ninety (18090) kala. [10] that the menstrual blood must be hot, in order to account for the hot quality of the womb. The ordinary blood is neither hot nor cold, for it is the joint product from the cold chyle and the heating ` bile, see §§ [1,2]. So Cakrapanidatta; but Dallana, who reads Grthavam gonitati=ca, i.e., ‘the menstrual blood as well as the ordinary blood,’ holds that both kinds of blood are hot, the heat of the ordinary blood being inevitably involved in that of the menstrual blood. 935 Jivananda’s edition here inserts the following verse [8]: ^° 6066 one should remember that man is the product of chyle, and, as a prudent man, preserve the chyle by careful attention to food and drink and ways of living.” Neither Dallana nor Cakrapanidatta had it in their copies of Sugruta. 334 See ante, footnote 84. The calculation, according to Bui, is as follows: 30 kdsté make one kala; ५0 kala and 3 kasté (or 20 +3; kald) make one muhirita ; and 30 mahértta make one ahératra or ‘day of 24 hours.’ Accordingly (207, x 30 or) 603 kala make one day. Now chyle takes 5 days or (603 x5 or) 3015 kala for each of its six successive transmutations (into blood, flesh, fat, bones, marrow, and semen or ova in the menstrual blood). Accord- 92 SOTRA-STHANAM. [sxc. I. This chyle pervades the whole body by a very subtle process, after the manner of the diffusion of sound, light and water. (4) Aphrodisiac medicines, when administered, act like (other) secretory agents,#% and cause, by dint of their own power and properties, the rapid secretion of semen. [11] Just as with regard to the bud of a flower one cannot say that there is any scent, nor that there is no scent; yet, considering that the true state of things is not yet perceptible, (it must be so that) there is scent; only, on account of its slightness, it cannot be per- ceived, but after a time, with the expansion of the petals and stamens, the scent is clearly perceived. Even so, with the advance of age, the semen of boys makes its appearance; so do the lines of hair (on the body) and the other signs of puberty, as ingly it takes one month or (3015 x 6 or) 18090 kala (see § [10]) for the entire series of transmutations. One kala=2 minutes and 23,57, seconds; accordingly 3015 kala=5 days. Bui. mentions, however, also another theory. According to it, the period of transmutation varies: 6 days or 12 days or one month, according to the state of the digestion. Bui. further suggests: that this variation is intended to be expressed by the comparison of the ` process of transmutation to the diffusion of sound, light and water (see § [11]). These three things move with different degrees of velocity, and thus indicate three different degrees of rapidity of digestion. Light is most rapid and signifies tiksna or ‘ brisk’ digestion ; sound is less rapid and signifies madhya or ‘middling ’ digestion; water is the slowest and signifies manda or ‘slow’ digestion. Nt. objects to this interpretation as untenable, saying that sound, light and water signify the transverse, up- ward and downward transmission of the chyle through the body. Neither interpretation, however, is probable; the comparison with sound, light and water seems to me only intended to convey the same idea as the phrase ‘by some mysterions manner of action’ in § 1, p. 88.—By Gritava is here meant strindm gukra or ‘the semen of women,’ 3.e., ova as excreted with the menstrual blood. So the commentaries. 985 The original has vtrécana, which is the usual term for pur- gatives, but in ¢ird-virécana the word is used in its more general seuse of a secretory agent. । CHAP. XIV.] DESCRIPTION OF BLOOD. 93 well as menstruation and the other marks of womanhood ; and with the development of menstruation, an enlargement of the breasts, the womb, and the genitals takes place. Similarly, by reason of the body decaying through old age, chyle ceases to be a fostering agent for old people. (5) The above-mentioned [§ [6]] (seven) 22८८ or ‘ constituent parts of the body’ are called so because they make up the constitution of the body. Their growth and decay depends upon the blood. Hence we will now expound the subject of the blood. [12] When it is vitiated by air, blood is frothy, tawny, dark, thin, flows quickly and is indisposed to thicken.#** When it is vitiated by bile, it looks blue, yellow, green, and livid, smells like raw flesh, is not affected by ants and flies, and is indisposed to thicken. When it is vitiated by phlegm, it looks (pale) like a solution of red ochre, is oily, cool, thick, sticky, flows slowly and has the appearance of muscles. When it is vitiated by all three humours in combination, it has all the (above-mentioned) marks, and in addition it looks like (दढ or ‘fermented rice- water’ and has a foul आला. When the blood is vitiated by any two humours at one time, it has the mixed characters (of blood deranged by those two humours).**8 [13] When blood is in its natural (healthy) condition, it may be known from the fact of its showing the red colour of the cochineal insect, and of its being not thick nor in any way discoloured. 996 The original has askandi, which BHA. explains by asamhata or ‘not thickened,’ and Ni. by stya@natva-rahita or ‘ without thickness.’ Dr. U. C. Dutt translates it “dries slowly,” and Dr. Wise has ^“ draws slowly,” which practically express the idea. 297 Here Jivananda’s edition inserts: ^“ when the blood (of one part) is vitiated by the vitiated blood (of another part), it has the same marks as blood vitiated by bile and, in addition, is very black.” Both Bui. and Ni. notice this reading, but do not approve it. 883 Jivananda’s edition here inserts: “of the blood of living beings we will speak elsewhere.” Baia. knows nothing of this reading. Nt. notices it only to reject it. It does certainly seem to be out of place. | 94 , SOTRA-STHANAM. (87८. I. (6) Diseases which require blood-letting will be described elsewhere.** Cases in which blood should not be extracted are swelling due to general anasarca or, in the case of a wasted male? to the eating of acids, and inflammatory swellings connected with morbid pallor, piles, abdominal enlargement, consumption, and pregnancy. [14]. (7) There are two modes of extracting blood by means of gastra or ‘cutting instruments’ [see Chapter viii] : scarification and venesection. In making these, the instrumént should be inserted with a quick movement and so as to avoid injuring any vital part, blood-vessel, nerve and joint, and the punctures (thus made) should be straight downwards, not too close together, very fine, in a straight line, not too deep, nor too super- ल्‌. When the operation is badly done, or done on an inauspi- cious or on a cold and rainy day, on a patient whose perspiration is checked (by the chill) or who has not had his meal, the blood, by reason of being thick, does not come out freely or does not come out at all. [15] Here comes in (the following verse) :— In the case of persons who are suffering from intoxica- tion, fainting, or fatigue, or are troubled with retention of urine, faces and wind, or are overcome with sleep, or are timid, the blood does not flow freely. [16] Vitiated blood, when it remains unextracted, causes itching, 889 1.6. in Chapter xxv, on the Eight Kinds of Surgical Opera- tions. So the commentaries. 980 The original has ksinasya, which might have a more general meaning; but Nr. qualifies it with pumsak, ‘of a male,’ which seems to refer the word to ‘ wasted virility.’ 981 These directions refer to both scarification and venesection ; 80 Bui.; but Ni. appears to refer them only to scarification, and this view has been adopted by Dr. U. €. Dutt. But BHA. is un- doubtedly correct. Bui. explains that blood-letting by means of anugastra or ‘accessory cutting instruments’ having been des- cribed in chapter xiii, now blood-letting by gastra or ‘cutting instruments’ is described. It further refers to Chapter viii, § 3 with respect to the mode of holding the instrument (८.4. the kutharika) CHAP. XIVv.] DESCRIPTION OF BLOOD. 95 swelling, redness, burning, suppuration, and pain. On a hot day, when a patient perspires much, or if the puncturing is over- done by an ignorant operator, the flow of blood becomes exces- sive. From such a discharge severe pains in the head, dimness of sight, ophthalmia, cataract, wasting of tissues, convulsions, hemiplegia, paralysis of a single limb, morbid thirst, burning, hiccough, cough, asthma, anemia, and even death ensue. [17] Here come in (the following verses) :— Hence the physician should not extract blood either on a cold or a very hot day, nor from a patient who is either chilled or very heated, and he should operate on him after having given him repeatedly some gruel.*#88 [18] When, after flowing (some time), the blood shows a proper red colour and stops of its own accord, then the physician may know that the blood is purified and that the bleeding has been properly done. [19] (Further) symptoms of a bleeding properly performed are (a feeling of) lightness, relief of pain, a check to the progress of the disease, and cheerfulness of mind. [20] Those who are in the habit, of having their blood extracted periodically are never subject to skin-diseases, varicose enlargements, swellings, and (other) diseases due to (disordered) blood.#83 [21] (8) I£ the blood does not flow freely, any three or four of the under-mentioned ingredients, or all of them together, just as they may be available, should be reduced to powder, worked up into a paste with mustard-oil and salt,*** and rubbed on the 959 This according to N1., should be tila-yavagu or ^ gruel made of sesamum seed;’ or according to Bai., ttila-tandula-yavagu% or ‘gruel of sesamum and rice.’ But Nr. adds that according to others virala-dravd is intended, which is a gruel of any grain made with clarified butter. According to the commentaries the patient should have two or three meals of gruel, before being bled. The object of this is to warm up his system and thus induce the flow of blood. 383 Such as deep-seated abscesses, erysipilas, etc. So Nr. 889 Ni. reads here luvana-taila-pragadhair, i.e., ‘ made into a paste with salt and sesamum-oil.’ The reading of Bui. is not apparent. 96 SOTRA-STHANAM. [sEc. 1 scarified part, whereupon the blood will flow freely :— Ela Elettarta Cardamomum (cardamoms) Cita-civa Cinnamomum Camphora (camphor) Kustha Saussurea Lappa. Tagara Tabernemontana coronaria. Patha (Roots of) Stephania hernandifolta. Bhadra-daru Cedrus Deodara (deodar). Vidanga Embelia Ribes (baberang). Citraka Plumbago zeylanica (plumbago-root). Tri-katuka The three acrids, ginger, long pepper and black pepper. Agira-dhiima Soot. Haridra Curcuma longa (turmeric). Ark-ankura Shoots of Calotropis gigantea. Naktamala- Seeds of Pongamia glabra. phala. (9) If the blood flows too freely powders of the under-men- tioned drugs should be sprinkled slowly over the scarified part and pressed into it with the point of a finger :— Rodhra Symplocos racemosa. Madhuka Glycyrrhiza glabra (liquorice). Priyangu Aglaia Roxhurghtana., Pattanga Caesalpinia Sappan 886 Gainika Red ochre. Sarja-rasa Resin of Shorea robusta. Rasafijana Extract of Berberts asiatica. Calmali-puspa Flowers of Bombax malabaricum. Cankha Conch-shell. Cukti Bivalve-shell. ४86 Ni. describes this as rakta-candana or ‘red sandal,’ which would be Pterocarpus santalinus. Buda. describes it as ku-candana or ‘inferior sandal,’ which is probably the Sappan-wood. This wood is whitish when freshly cut, but becomes red from exposure to air. It is by some Sanskrit writers included among the differ- ent kinds of sandal-wood, and is described as being of use to heal wounds and stop hemorrhage. See Pharmacographia Indica, Vol. I, page 500. CHAP. उर] DESCRIPTION OF BLOOD. 97 Misa Phaseolus Roxburgh. Yava Barley Godhima Wheat Or powders of the following drugs may be taken :— Sila and Sarja Two varieties of Shorea robusta.*® Arjuna Terminalia Arjuna, Ariméda Acacia Farnestana. Mésagrnga Gymnema sylvestre. Dhava Anogerssus latifolea.s8? Dhanvana Grewia tiliafolsa. T vaca Cinnamon-bark. Or one may take for the purpose {the ashes) of burnt linen, or powders of cuttle-fish bone or of lac. This done, the wound should be firmly tied with (linen or woolen) bandages as prescribed [in Chapter xviii]. The patient should, then, be covered with cool clothes, given cooling food, and kept in a cool room; he should also be treated with cool douches and poultices. (Failing the above-described modes) the wound should be burned with caustics or with fire; or the vein which gives off a too copious flow, should be divided at a place below the original incision 288 (and then cauterised). (10) (After the operation) the patient should be given to drink a decoction of the Kakoli class of drugs [866 Chapter xxxviii, §[81]], or a sweet mixture of sugar and honey. Or he should take the blood of an antelope, deer, ram, hare, buffalo or boar, mixed with milk or pulse-soup or meat-broth, and well greased (with clarified butter). Any complications (that may arise from excessive loss of blood [see above §[17]] must receive that 986 This is the explanation of Nr. The resin of those trees is to be taken. : 887 Neither Bui. nor Ni. explain this name. They do not seem to have had it in their copies of Sucruta, 888 The original has yathékia-vyadhandd=anantaram, lit. ‘ after the previously described incision.’ Ni. explains it by prak-krto- vyadhandd=adhah-sthané, lit. ‘at a place below the previously made incision.’ Bui. does not explain it, Dr. U. C. Dutt, iu his translation, omits it. oC 98 sOUTRA-STHANAM. [880. 1. treatment which is suitable to the particular case. [22] Here come in (the following verses) :— After any extraction of blood, owing to the loss in that constituent part (of the body), the patient’s digestion becomes weakened, and his air becomes much deranged. Hence he should be very carefully [28] kept on sucha diet as promotes the generation of blood, and which should consist of not-very-cooling, light, oleaginous articles, slightly acid or not acid at all. [24]. (11) There are four modes of arresting hemorrhage: contrac- tion (of the wound), thickening (of the blood), desicat- ing, and cauterising. [25] Astringent (decoctions*® ) con- tract the wound; great cold thickens the blood; ashes [see § 9] dry up the wound ; and cautery causes the veins to shrink. [26] If the blood refuses to thicken (by the application of cold), astringents should be applied ; if these fail, ashes should be used. [27] By means of these three modes the physician should endeavour to the best of his power (to stop the bleeding); but if they भा fail of success, cautery may be resorted to as an absolutely effective means. [28 | If after bleeding any impure blood still remains (in the system), the disease will not increase much; in such a case, (the physician) should rest content (with the ordinary modes of depura- पना) and not proceed to violent measures (of repeated bleedings). [29] (For) the blood is the root of the body, and it is the blood by which it is sustained. It should, therefore, be most carefully preserved; for it 1s the basis of life. [30] If through the cold applications [see § 9 ] used to stop the bleeding, the air becomes deranged, and (in consequence) the (scarified) part becomes painfully swollen, it should be treated with applications of tepid clarified butter. [31]. 889 Ni. instances the chebulic myrobalan, and the root-bark of the so-called pavica-valkala trees, see notes 70 and 107; also Pharmacographia Indica, Vol. III, p. 339. $9 Such as purgatives, emetics, etc. ™, RETURN TO the circulation desk of any University of California Library or to the NORTHERN REGIONAL LIBRARY FACILITY Bldg. 400, Richmond Field Station University of California Richmond, CA 94804-4698 is = ALL BOOKS MAY BE RECALLED AFTER 7 DAYS 2-month loans may be renewed by calling (415) 642-6233 1-year loans may be recharged by bringing books to NRLF Renewals and recharges may be made 4 days prior to due date DUE AS STAMPED BELOW DUE AREF 2 ee 818751 UNIVERSITY OF CALIFORNIA LIBRARY ay) 9 ate EGE A क ` 8 . es Sa A mied