English
lnhular instruments : Tubular instruments ( na'll yantra ) are many and they serve various purposes. Some of them have opening at one end, and others at both ends (or some are single- barrelled, and others are double-barrelled ). They are used for the extraction of foreign bodies from vessels (Tubular forceps, with long and 496 ANCIENT HINDU MEDICINE slender blades, intended for use through a cannu- : la or other tubular instrument), for the explora- ' tion of (internal) lesions ( Bougie, a cylindrical instrument, resembling a Sound, usually more or less flexible and yielding, and which is employed in the diagnosis and treatment of stricture of tubular passages, such as the urethra or the rectum ; Brobe, a slender rod of silver or ./ other flexible metal, with blunt bulbous tip, and | which is used for exploring sinuses, fistulas or other cavities ; Sound, an elongated, cylindrical, i usually curved instrument of metal and which is used for exploring the bladder or other cavi¬ ties of the body, or for dilating strictures of the urethra or other canal ; with the general use of electricity, many devices have been perfected, by introducing a tiny incandes¬ cent bulb at the end of the tube and a reflector at the top, which projects the exact condition of ^ the internal organs as larynx, pharynx or ■ urethra, through laryngoscope, pharyngoscope and urethroscope), for suction of fluids (as Catheter, for draining away urine from the bind¬ er, in case of its retention from any cause ; or Trocar for withdrawing fluid from any cavity, as in hydrocele), and for facilities for other operations (as Director in lithotomy). The SURGEBT 497 "breadth and the length of the tubular instrument should harmonize with the narrow canal (in which it is to be used ). The tubular instruments that are used in fistula-in-ano, guramata, tumors, abscesses, for injection, irrigation, in hydrocele, ascites, for fumigation, in stricuture of urethra, and stricture of the rectum, and other instru¬ ments such as *alavu yantra' ( bottle-gourd ? ) and speculum will be mentioned later. Frobes : The probes ( salaka yantra) have various uses ; their dimension and their length are dependent on their requii’ements. They hi.ve their ends shaped like an earthworm, the feathered part of an arrow, the hood of a snake, or a fish¬ hook, and there are two varieties of each kind. They are used for exploration ( esana, such as Bougie, probe or sound ), retraction ( vyuhana, as by a E,etractor ), grafting ( cJialana ) and extraction ( aharana, by a tubular forceps ). Por extraction of foreign bodies from vessels, two salaka forceps ( Haemostatic forceps ) are used, whose ends are slightly flattened like those of a lentil ( Ervum lens). Six are used for the drainage of pus having ends covered with cotton. For the application of caustics, three kinds are used whose ends are shaped like a spoon with a conical eavity. For cautery six kinds are used of which 32 498 ANCIENT HINDU MEDICINE the orifice is shaped like the fruit of Eugenia; jambolama, and the other like that of the ele¬ phant-driver’s goad. For. the removal of the nasal polypi, one kind is used whose orifice is- shaped like half the stone of Ziziphus jujuba, of conical formation with sharp edges (Meyer's ring knife or Luc’s forceps ). One kind is used for the application of ointment ( in the narrow aural < or nasal passages ) whose both extremities are shaped like a pea or a flowering-bud (as in Tilley’s Burr ). For the urethral passage one kind is used whose circumference is like the fliower-stalk. of Jasminum grandiflorum. Accessoj'y Appliances :—The accessory appli¬ ances are thread, twine, bandage, skin-gloves, {charmmcmta), birch-skin ( ?aZ^aZa = bark),. ( tendril of ) creeper ( for gently dislocating foreign bodies from delicate sensitive oi’gans or abscess cavities ), lint, a large rounded stone, ^ hammer ( for loosening foreign bodies impacted in bone ), the palm of the hand, the sole of the foot, finger, tongue, tooth, nail, mouth (for suction of the fluid as in ascites ), hair, borse-hair ( for suturation ), a branch ( of a tree, for extrac¬ ting foreign bodies, from superficial wounds ), expectoration, fluxing ( causing discharge in the eyes or throat to remove foreign bodies ), cheer- SURGERY 499 fulness, loadstones ( used for finding out whether there are iron fragments in the wounds, as loadstones possess polarity and are attracted hy iron ), caustics, cautery and medicines (including disinfectants ). These instruments can be applied all over the body, any of the limbs, joints, viscera and vessels ( including nerves ). Extraction ( of foreign bodies with pulling ; nirgliatana), injection (of disinfectants in the blad¬ der or enema in the rectum, purana) : bandaging ( vandliana ), retraction (of the lips of the Avound hy a ^Eetractor^ for inspection, extraction of the foreign body and disinfection,: replace¬ ment ( of the lips of the wound in their proper place : varttana), grafting (principally cutaneous, to cover the wounded scar : Chalana), wrenching ( of a foreign body, with a forceps to facilitate its extraction : vivarttana), dilatation (of any canal or cavity by a ‘speculum’ for exploration ; vivarana)^ pressing ( of the wounded parts to loosen the foreign body, or for the drainage of the pus, if suppuration has taken place : disinfection ( of the wound, canal or cavity : visodhana ), extraction ( with force : mJcarsana ), pulling out ( dliarana ), pulling gently to and fro (to loosen the foreign body : dnchhana ), elevation ( of the 500 ANCIENT HINDU MEDICINE foreigu body, in order to loosen it : unnamana ), depression ( of the fereign body ; vinamana ), pressure ( by manipulation of neighboring tissu¬ es : bhanjana ), suction ( by a tube of the fluids, as in hydrocele or ascites : achusana ) explora¬ tion ( of canal or sinus : emna ), splitting up (a foregn body, to facilitate its removal : darana)^ straightening ( of the foreign body, in order to loosen it : rjuharana ), irrigation (of the wound with an '^Irrigator' : frahmlana ), blowing dis* infectant powders, vulneraries or errhines to deep-seated wound, narrow canal or nasal pas¬ sage : pradhamana ), and rubbing ( with hair¬ brush any wound cavity : pranidrjjana )—these twenty-four are the uses of the ‘yantra* ( blunt instruments ). As the foreign bodies can be of infinite varie¬ ties, so a wise surgeon must intelligently choose his instrument for each individual case. Defects in Instruments : Too cumbersome or light, long or short appliances, the blades lacking the power of grasping, or grasping it badly, bent, shaky, too-high-jointed or loose-jointed, loose- bladed or loose-tipped appliances are the twelve defects in ^yantrcC ( blunt instruments ). The instrument that is free from these de- l^fects, and which is eighteen fingers’ breadth long, SURGERY 501 is the only proper oue, which the surgeon must select in surgical operations. The surgeon shall extract, according to the surgical code, the visi¬ ble missile ( salya ) by the ‘Lion jaic forceps’ and the invisible missiles by ^kahha-muhha’ ( heron- beaked forceps = dental forceps ). Among the ‘ycmtras’, ^heron-beaked forceps’ is the best, as it can be easily introduced every¬ where, and easily withdrawn with the extracted missile”. Siisruta 1. 2-18 196. i 5T^rri! I ajsiraraiftifti i =Cfct ii ^ cia| ^gf^’aiRr. I C i w Qta fnstq^^ i I nsnan: i q^ft>ra^qraif<!r i <jrf^ Rara cmuflrecrarifti at i ci^ sjRTitariu’ot saraw ’jji- qf^r jii?Tai: cif!RP|RfRni5n^q^!?=?[- ariKtcT it ’a I umPt! =a aria^fr n a. tra siswtaiiPT fqfaji^aiciviafgftfwjnT- 503 ANCIENT HINDU MEDICINE Sharp Instruments : Sharp instruments ( sastra ) are of twenty kinds. They are as fol¬ lows : ( 1 ) Circular knife ( mandalagra ) ; 11 ii c citfn wif feiiwr^sri^€mi f M =h jT'srp!! "fittfei? iii ■ si^RfiwF^fq ^Ptra^rapj 5n5nnft5TSTrPT sjsfWlsmft’iire^i^F'a I ^qr ’I’ljq^sug^W'S'uqFfaig# w C qiq’Ofjfii'qtqRi^^’iiiggq- feiqt i ^Tq?:^^Hrag# i' i ^iqtns^^fpD n?n^'iifciTg i ^!Pn ^iig^^rPr '^ifTq^- sPiwPTiiqi I whmiqtPt 5iT?qqq^tPT qiqrfwirefH- FcTlPt I 'q^^l'i)'- ll^tra’ i ^qWlfqsft^uini'^qf ^iRratg^- w’fiHqHmKT!?5ifkrcr 11 \o ^qq>qH!iirq gctrq^retqrnjT^^^-qTpuqi?- ct5rTF^f%Tsiwr?’fi-JHsrg^-qrars- qf^qisinirre.qJwqre’ireqk^RvraiPi =^- q;rfwq5irf^ ■q Pt i q:<iTPi ft cisii i 11 sjsHqf^tra g pT^tct5T55!!qsi5ru?^TqTi5r^5mfqq^5TfqqT<ii-qt?q>nq - SURGERY 603 ( 2 ) Saw ( hara-patra, resembling hand, that is, consisting of a thin blade with sharp teeth in the edge, as the hand lias fingers) ; (3) Lancet ( vrclclhi-patra, a. short, wide, sharp-poin¬ ted and two-edged blade, resembling the leaf of ‘vrddhV —Batata edulis ) ; ( 4 ) Canalicular Tinife ( nakha-sastra, resembling nail-parer ); ( 5 ) Oum lancet ( mudrika, a short lancet of the size and shape of the last phalanx of the index finger) ; ( 6 ) Thumb lancet ( utpala-patra, re¬ sembling the petal of Nymphaea stellata ); ( 7 ) Amputating knife ( arddlia-dara, a single-edged -^55# II u H3!^' fh5(5ii ^q ctf% gtsitfr 11 u ?5Jf' I g sjt: a[^' u I'S ^ 3!Qq’ ^ ^mig 1 ^ ^ct; Iran ^ ^ ii.