Ashtangasamgraha 36.10

36.10

Then, having performed auspicious rites for the patient, considering the disease, strength, habituation, and so forth, having made him drink unctuous wild meat broth or gruel, and having comforted him for just a muhūrta, in the forenoon or afternoon, having fomented him with one of the heating methods—charcoal heat or hot steam—one should seat him on a soft seat as high as the knees, with his elbows placed on his knees, his feet planted evenly, facing the sun. / And at the hairline, one should bind [his head] with one of a cloth, leather, or bark strip. / Then the patient himself, with two fists having the thumbs tucked inside the cloth, should firmly press his own neck veins, and bite his teeth with his teeth, / and inflate both cheeks. / And a man standing behind him should restrain him with a cloth placed between the fabric and the nape of the neck, without obstructing his vital breaths; this is the method of restraint for puncturing veins, except for those facing inside the mouth. / Then the physician should tap the vein with the middle finger braced against the thumb. / And having observed it raised, pulsating, or giving a tactile sensation, holding the kuṭhārikā in the left hand with its shaft upright, having placed it in the middle of the vein and sighted it, he should strike it in the same manner with the middle finger or press with the pad of the thumb. / In the case of [a vein] hidden by thick skin, he should observe its raising from the pressure of the thumb. / Veins fill up from coughing and by the agitation of anger. / But having raised the tip of the nose with the thumb, one should puncture the near-nasal vein with a vrīhimukha instrument. / That [eruption] which is punctured, caused by vāta and pitta, is [called] gardabhī by those two [doṣas].