English
sed by caustics, cautery and toxins, or in those where there is discharge of gas, or in the interior of which there is sanies or foreign body. These should be at first disinfected ; dust, hair, nails, fragments of bone (any foreign body), when found in a wound, should be removed before sutures are applied, as otherwise they are likely to provoke suppuration and pain. There¬ fore they should at 6rst be disinfected. The lips of the wound then should be raised and placed in proper apposition, and sutui'es applied slowly with the fine cotton thread, or the bark-fiber of Caesalpinia digynia, flax, catgut (smyM = tendon), hair (horse hair), fibers of Sanseviei'a zeylanica, or Tinospora cordifolia, in any of those sutures, (1) Twisted suture {vellitaka)^ (2) Quilled suture {gophnika)^ (3) Continuous suture (tunna-sevam), (.4) Interrupted suture trju-gt'anthi) or any other kind best suited to the requirement, and after the saturation is over, the sewed parts should be gently pressed by the finger and levelled. In I SURGERY 513 parts of the body covered with little flesh, or over joints, a full-curved suture needle, of two fingers’ width long, should be used. Por fleshy parts, a straight, three-edged, suture-needle, ^ three lingers’ breadth long, is proper. In the vital parts, scrotum and the abdomen, a half-curved suture-needle (curved like a bow) is good. These three varieties of needles should be sharp-pointed, their body rounded like the flower-stalk of Aganosma cargophyllatum, and should be cap¬ able of easy handling. Sutures should not be made either too far off or too close to the edges of the wound. In the former case, lips of the wound will become painful, and in the latter case, they may be torn off. Then the stitched part should be covered with cotton (as a surgical dressing) or linen (as a lint), and a powder com¬ pound of Aglaia roxburghii, antimony sulphide, Glycerrhiza glabra, and Symplocos racemosa, or the powder of Boswellia serrata or the ashes of burnt linen, should be sprinkled over it ( as antisepsis). Then after proper bandaging, the patient shall be told the hygienic rules, he will have to observe.” Susruta I. 25. 2-12^®*. 198. 33 514 ANCIENT HINDU MEDICINE Caustics :—“Eor particular purposes, of all sharp or accessory instruments, caustics are the ■^irf^ ^ ftsqk f?(i; ii 3ii^5Rl*ir3it II sto: ^sfhirg 3^ 1 ^ftreiwjiTl'tfijtCt*!! t ^ 11 ft1%’!g: ftreti^R 1 ’Wtt% ire-qr’ft 11 a tsii: faiTT qffqqr II . qmi JirSJ: a’5!T ^’wrfjfqi^ % IK ^r?Fq!: siqiufe^ 1 f%f%cT WISH feqcj: q^ wtg: 1 qrg: sJltBt qq' qiqast; 11 qi< 3 I|qqT; ^qqiin fqqsi sftfqqq I ftqqk qjqqqiftfi^ 111 qq^qftqqJJi: qiqf)ill ftqiftqn I 5^1^ qoian^iqf qii^qn: afttqqiqf: ■. SUKGERY 515 ' < bestt (when alkalies in concentrated form (caus- ^ tics) are 'brought into contact with the animal ' i • fsftJira. ii c " faT; jrit; i ^ 5T 5iT I 5TFfi€fl%ciJ!!5jra ^3 I ^P5’ct*)'i<aii'?ipT snr ii ^Ictifsr q^ts^fsT qR^gwaj a’3i ii ■ ^ 5 ra n \o aat 3^' 5j^rt%cnt i ^ It ^ n’t: I 3!^; ii ?Tft I ^ ^ It =3 I ^Rrai gpRn n ' 'ig^an fim *nJi-3raartftgttqft i t^cttfewr. g^nf%cn: ii gifeft at at’Jifai i t '. ' firay- ^ggstiw-flw'a^; water ' • n ^ 616 ANCIENT HINDO MEDICINE tissues, they enter into chemical combination with the oxygen present, and thus give rise to an active necrosis or destructive inflammation ; alkalies are likewise solvents of albumin ; these physical and chemical properties render the caustic alkalies active in producing counter-irri¬ tation, and their escharotic effects have been made • use of in the destruction of morbid tissue, whether of neoplastic or inflammatory origin, and chronic synovitis). Due to the escharotic pro¬ perty of the (concentrated) alkalies, they are called caustics They are acrid, irritant, pungent, (and their external use causes) destruc¬ tion of the tissues ( eschars ), corrosion, disin¬ fection, granulation, desiccation, hemostatis, scarification, ( and their internal administration cures), intestinal worms, hyperacidity, eructation, cutaneous lesions, auto-intoxication ; but their excessive use induces impotence. Alkalies are of two kinds (concentrated which is strong, and non-concentrated which is mild), for external application (strong) and for internal administration (mild). Their external application SURGERY 517 is indicated in lepromes, keloid, ringworm, leuco- dei’ma, psoriasis guttata, fistula-in-ano, tumors, indolent ■ ulcers, fistula, condyloma, mole, impe¬ tigo, lichen planus, warts, external sores, dermato¬ phyte, poison-bites, and gummata ; besides these, the application of caustics in seven kinds of mouth diseases (tumor of the tongue, stomatitis ulcerosa, chancres of the lips and the tongue, etc.) and three kinds of throat-neoplasms, is appropriate. Internally alkalies may be adminis¬ tered in auto-intoxication, adenitis, tympanites, indigestion, dyspepsia, anorexia, constipation, gravel, calculus, abdominal tumors, intestinal worms, poisoning and gummata. However its (internal) use is counter-indicated in persons who have a tendency to hemorrhage, biliousness, in children, the aged or weak persons, or those who are suffering from giddiness, delirium, epi¬ lepsy and amaurosis.” Susnita I. 11. 2-5 198 (a), ra- ANCIENT HINDU MEDICINE sfs Cautery : “Cautery-is more potent in its action than caustics. For once cauterized, lesions lose- their sepsis, and even tliose which defy the medi¬ cinal, operative and caustic treatments, become hereby amenable.’' Susruta I. 12. 2*®*. Leeches : “By leeches (Hiruclo ), bleeding (or remoA^al of congestion ) can be accomplished in the easiest way of kings, wealthy personages, women, children, the aged, timid, weak or deli¬ cately constitutioned individuals.’’ Susruta I. 13. 2.®®“. Emma : “As enema ( vasti ) serves multifaxd- ous purposes, according to the medical experts, ^I era I <rei u u. 199 . ftratg sjJi’giRr; I ' ci^^r- 3 11 H - Xl^cRr'fW, I SURGERY 519 it is the best of all analeptic ( sneha ) remedies. If, it be properly applied, it makes the weak strong (Stimulating enema), the lean stout (enema nutriens), the stout lean (enema purgans), strengthens eye-sight ( by removing the decom¬ posing materials from the intestine, the toxic products of which are absorbed in the system, and provoke reflexably various maladies ) and prolongs youthfulness. It promotes the general health of the body, adds to its vigor, brightens complexion, is a restorative of health and con¬ duces to the logevity of life ; and its use in fever (enema purgans), diarrhoea ( enema adstringens ), amaurosis, catarrh, cephalalgia, ophthalmia, hemiprosoplegia, mimic convulsion, apoplexy, general paresis, tympanites, hemiplegia, flatu¬ lence, gravel, hyperalgia, oschitis, syphilis, constipation, strangury, bubo, hemorrhage, hydrothionuria, fecal impaction, aspermia, meno- stasia, galactozemia, cardipalmus, lockjaw, torti? collis, piles, calculus and abortion, is appro¬ priate. Fountain-syringe : For a boy one , year old the tubOj (^netra ) shall be six fingers’ breadth, long, having the dimension of the little finger, and I at ^ the extremity of which, the nozzle QcariiiM) should be fixed, one and a half fingers* 520 ANCIENT HINDU MEDICINE breadth long ; the orifice at the mouth of the tube should be like that of a heron’s feather, and at the end, like Pl'.aseolus mungo. Por a boy of eight years of age, the tube shall be eight fingers breadth long having the dimension of the ring- finger, and at the extremity of it, the nozzle should be fixed two fingers’ breadth long ; the orifice at the mouth of the tube shall be like the feather of the vulture, and at the end like Phaseolus radiatum. And for a person, sixteen years old, the tube shall be ten fingers’ breadth long, having the dimension of the middle finger, and at the extremity of it, the nozzle should be three and a half fingers’ breadth long ; the orifice at the mouth of the tube shall be like the peacock’s feather, and at the end like that of a pea. The reservoir {asthapana) for the enema, for persons, one, eight or sixteon years of age shall be the size of their two handfuls, four handfuls, and eight handfuls of their individual bands respectively ( the modern fountain-syringe is an apparatus, consisting of a rubber reservoir for holding fluid for the enema, to the bottom of which is attached a rubber tube, provided' wdth a suitable nozzle, usually made of vulcanized rubber ; and it is used for rectal or vaginal injections, irrigating wounds, etc., the SOEGERY 521 force of the flow being regulated by the height of the reservoir above the point of discharge ). The size of the tube and the reservoir is not only to be graduated according to the age ( of the patient), but also in addition to it, his- physical condition and vigor. For a person, above twenty five years of age, the tube shall he twelve fingers’ breadth long, having the dimension at the mouth like the thumb, and at the end like the little finger, and the nozzle shall be three fingers’ breadth long ; the orifice of the tube at the mouth should be like the feather of a female vulture, and at the end like the stone of plum. The tube should be firmly fixed with the reseryoir. And the reservoir should be capable of holding twelve handfuls of enema. After seventy, the tube shall remain just the same, but the quantity of the enema should be reduced to that of a person of sixteen years of age. o The tube should be made of gold, silver, copper, bronze, ivory, horn, glass or wood,, polished, strong, shaped like the bovine tail with gradually reducing dimension, straight and with globular orifice.