Ashtangasamgraha 13.27

13.27

mṛdgrāmyamāṃsavallūramajīrṇaśramamaithunam |

padātermārgagamanaṃ yānena kṣobhiṇāpi vā ||

adhonābheryāvadaśmaryadhaḥ pratipannā tatastailābhyakte kṛttanakhe vāmahastapradeśinīmadhyame pāyau praṇidhāyānusevanyāsādya ca prayatnabalābhyāmaśmarīṃ meḍhragudayorantaramānīya nirvalīkamanāyatamaviṣamaṃ ca bastiṃ sanniveśya bhṛśamutpīḍayedaṅgulībhyāṃ yāvat granthirivonnataṃ śalyaṃ bhavati |

tataḥ sevanyāḥ savye pārśve sevanīṃ yavamātraṃ muktvā nidadhyācchastramaśmarīpramāṇena |

dakṣiṇato vā kriyāsaukaryahetorityeke |

yathā na vibhidyate vicūrṇyate vā tathā prayateta |

taccūrṇamalpamapyavasthitaṃ punaḥ parivṛddhimeti |

tasmāt samagrāmagravakreṇādadīta ||

chitvā tvacaṃ janayati tena syātkṛṣṇamaṇḍalam ||

Clay, domestic meats, dried meat, indigestion, exertion, sexual intercourse, / walking on foot on the road, or traveling by an agitating vehicle. // From below the navel, until the calculus has descended below; then, the index and middle fingers of the left hand, having nails clipped and anointed with oil, are introduced into the anus; approaching along the perineal raphe, bringing the calculus with effort and force into the space between the penis and the rectum, and having positioned the urinary bladder so that it is free of folds, undistended, and even, one should press hard with the fingers until the foreign body stands out elevated like a tumor. / Then, on the left side of the raphe, leaving the raphe by the measure of a barley corn, one should apply the knife according to the size of the calculus. / Or on the right side for ease of the procedure, according to some. / One should endeavor so that it is neither fractured nor pulverized. / Even a small amount of its powder remaining undergoes increase again. / Therefore, one should extract it whole with a curved-tip instrument. // Having cut through the skin, it produces [a lesion]; by that it may [involve] the black circle.