[Pramāṇa](https://indike.org/pramana/) › [Indian literature](https://indike.org/pramana/in) › [Medicine](https://indike.org/pramana/in.med) › [Early and ascribed compendia](https://indike.org/pramana/in.med.samhita) › [Aṣṭāṅgasaṃgraha](https://indike.org/pramana/in.med.samhita.astangasamgraha) › [English (machine translation)](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt) › 37 # Ashtangasamgraha 37 English (machine translation) 37 - **Language:** English ### [37.1](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.1) Now, therefore, we shall explain the chapter named "Procedure for the Extraction of Foreign Bodies". Thus spoke the great sages, Ātreya and the others. Thus spoke the great sages, Ātreya and the others. ### [37.2](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.2) For the course of foreign bodies is threefold: upward, downward, and oblique. Moreover, each of these is twofold, according to whether it is straight or crooked. And one should apply a paste of barley alkali, pearl oyster shell, and saurāṣṭrī. ### [37.3](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.3) There, one should know a wound containing a foreign body as dark, covered with eruptions, accompanied by swelling and pain, repeatedly discharging blood, elevated like a bubble, and having soft flesh. ### [37.4](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.4) Specifically, when a foreign body is located in the skin, the swelling is discoloured, elongated, and hard. When it is located in muscle, there is increase of swelling, non-healing of the tract of the foreign body, intolerance to pressure, burning heat, and suppuration. ### [37.5](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.5) When it is lodged between the muscle bellies, it is like that which has entered muscle, with the exception of swelling. When it has entered a vein, there is distension of the vein and piercing pain. When it has entered a ligament, there is tossing about of the web of ligaments, severe irritation, and intense pain. Or with banyan leaf, coconut shell, or with rock salt, vacā, akṣibheṣaja, and white mustard. If it is not relieved in this manner, one should induce vomiting, and puncture a vein on the forehead. ### [37.6](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.6) When it has entered a bodily channel, there is loss of the bodily channel's own functions and qualities. When it is lodged in an artery, wind rushes out making a sound and ejecting frothy blood, and there is pain in the limbs and nausea. When it has entered a bone, there are diverse kinds of pain and swelling. And anointing with a decoction of nimba and āragvadha. ### [37.7](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.7) When it has entered a joint, it is like \[when lodged in\] a bone, and there is obstruction of movement. When it has entered a bone joint, there is a sensation of fullness in the bone and intense friction. ### [37.8](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.8) When it has entered the viscera, however, rumbling and abdominal distension occur, and urine, feces, and food are seen issuing from the mouth of the wound. When it has entered a vital point, it is like being pierced at a vital point. And repeated practice of cleansing. In jālāgardabha, one should employ dhātrī fruits. ### [37.9](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.9) And one should detect a foreign body in the skin and the rest by the discharges described respectively. When foreign bodies have subtle paths, these very signs are indistinct. ### [37.10](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.10) In those whose bodies are purified, \[foreign bodies\] situated along the natural direction heal up. And displaced by aggravation of the doṣas, sexual intercourse, physical exercise, and trauma, they cause affliction again. When it does not subside, however, having anointed and sudated it, one should soften it. When it has ripened, having cut it open with a surgical instrument and covered it with a paste of nimba, sesame, and paṭola, one should bandage it. A decoction of latex trees, kadara, and khadira is the wound-wash. When it is purified, one should heal it with an oil processed with sweet and astringent drugs. ### [37.11](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.11) In this matter, when it is lost in the skin: on the skin which has been oleated, sudated, and rubbed with a powder of earth, black gram, barley, wheat, and cow dung, wherever irritation or pain occurs; or where solid ghee applied melts quickly; or an unguent dries; there one should recognize the foreign body. When it is lost in muscle, one should prepare the patient with procedures such as oleation; and in one who is emaciated, wherever it has become loose, unattached, and being agitated produces irritation or pain, there is the foreign body. ### [37.12](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.12) Likewise even in the cavities of the viscera, bones, and muscles. ### [37.13](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.13) When it is lost in a vein, a bodily channel, an artery, or a ligament, having mounted the patient on a horse-drawn chariot with a broken wheel, one should drive him swiftly on a rough road; then one should recognize it by irritation and the like. One should apply an unguent with barley groats, meat paste, salt, guḍūcī, ārevata, śyāmā, dantī, kulatthikā, and mūrvā. ### [37.14](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.14) When it is lost in a joint, examining the joint prepared with oleation and sudation through extension, flexion, bandaging, and pressure, one should recognize it as before. When it is lost in a bone, intensely treating the bones, which have been oleated and sudated, with bandaging and pressure, one should detect it in the same manner. ### [37.15](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.15) When it is lost in a vital point, however, since vital points are not different from muscle and the rest, the examination is as described \[for them\]. ### [37.16](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.16) The general sign, however, is wherever irritation or pain occurs during mounting a tall elephant shoulder or a horse, swift movement, jumping, swimming, and physical exercise; or during yawning, belching, coughing, sneezing, spitting, laughing, and breath-control; or during the excretion of waste products and semen; or where, even upon slight exertion, there should be numbness, heaviness, knocking, or swelling, there one should declare a foreign body to be present. ### [37.17](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.17) In brief, a foreign body is of four kinds, divided into round, two-sided, three-sided, and four-sided. When it is unseen, one should infer it from the round shape \[of the swelling\]. ### [37.18](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.18) In the extraction of all large foreign bodies, there are only two methods: against the direction \[of entry\] and along the direction \[of entry\]. And having sprinkled this \[wound\] whose heat has departed with warm water, having cut around it with a surgical instrument as appropriate, one should remove it. ### [37.19](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.19) There, one should bring out toward oneself that which is against the direction \[of entry\], and away from oneself that which is along the direction \[of entry\]. That which is transverse \[should be drawn\] from where it is easily extractable; then, having cut, one should remove it. Or with that which is prepared with sweet and astringent drugs. And one should fill what is slightly remaining with powder of sarjarasa resin. ### [37.20](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.20) A foreign body that is against the direction \[of entry\], does not protrude, is cuttable, and has a broad mouth, one should drive out \[by striking\]. Likewise those fallen between the armpits, the groins, the chest, and the ribs. ### [37.21](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.21) And one must never extract a viśalyaghna \[foreign body\] or one lost in a vital point, which is without swelling and pain, and free from suppuration. Having anointed with mustard oil prepared with the juice of nidigdhikā, one should rub it with powders of rocanā, green vitriol, and realgar. ### [37.22](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.22) Now, a foreign body accessible by hand one should extract by hand. When that is impossible, \[one should extract it\] by an instrument as appropriate. When it is still impossible, having made an incision with a surgical instrument, then having made the wound free of blood, having sudated it, cauterized it with fire, ghee, honey, and the like, nourished it, and bandaged it with ghee and honey, one should prescribe the regimen. That which is attached to a vein or a ligament, having released it with the tip of a probe, one should extract. A foreign body approaching the heart one should extract from him when startled by cold water and the like. That which is difficult to extract along its path, one should extract even from another direction in this manner. Excising a carmakīla and a jatumaṇi likewise with a surgical instrument— ### [37.23](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.23) Holding a man down by the feet, one should draw out with an instrument \[a foreign body\] lost in a bone cavity or bitten by a bone. Or when it is impossible in this manner, having caused the handle of the foreign body to be gripped with an instrument in one who is held firmly by strong men, or having bent it back, having tied it on one side with bowstrings and on the other side tied it to the bit of the bridle of a horse firmly restrained by five points, then one should strike it with a whip in such a way that, raising its head with force, it pulls out the foreign body. And one should plaster it with pastes of latex tree barks ground with milk; or with balā, atibalā, madhuka, and turmeric; or with madhuka, agaru, payasyā, and kālīyaka; or with tender kapittha, tinduka, and rajani; or with amlikā root; or with a boar's tusk combined with honey and ghee. ### [37.24](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.24) Or having bent down a sturdy tree branch, having tied \[the foreign body\] to it as before, one should pull it out. Or mañjiṣṭhā ground with honey; or fresh pomegranate bark with goat's milk; or young āmalaka kept in cow's urine for seven days, with that very \[milk\]; or kāleyaka, lodhra, and blue water-lily filaments with curd-whey; or ash of a white horse's hoof with butter. ### [37.25](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.25) A weak handle, however, \[one should extract\] having bound it with kuśa grass; and a handle seized by swelling, having pressed back the swelling. ### [37.26](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.26) If it bulges in an improper place, it should be extracted along its original path after dislodging it with the blow of a stone hammer; / or with powder of jujube kernel, kodrava, and parched grain mixed with ghee; / or with white yak bone, tālapattrī, breast milk, honey, and ghee. ### [37.27](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.27) A barbed foreign body should be extracted by crushing its barbs with an instrument, / or by grasping it appropriately with a tubular instrument or a multi-mouthed instrument, and extracting it as described before with a probe or another \[instrument\]. / If it is aligned with the hair, unbarbed, and the wound opening is not small, \[it should be extracted\] with a magnet. / If it has reached the colon, \[it should be extracted\] with purgation. ### [37.28](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.28) Obstruction of vāta, feces, urine, or a fetus should be treated by straining downward; vitiated vāta, poison, breast milk, and the like should be extracted by suction using the mouth or a horn. ### [37.29](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.29) When a foreign body has entered the channel of the throat, one should insert into the throat a thread tied to a lotus root. / Then, recognizing that the foreign body has caught hold of it, one should pull out the thread and the lotus root together. / In the absence of a lotus root, this very procedure applies to a lotus stalk as well. / If a foreign body made of lac is stuck in the throat, one should insert a tube into the throat, and then a fine-tipped probe heated with fire; then, dousing it with cold water once it has seized the foreign body, one should extract it when it has become firm. / Even if it is not made of lac, a heated probe smeared with either lac or beeswax \[is applied\] in this very manner. / A fish bone or another similar bone foreign body lodged in the throat should be removed with a finger wrapped in thread or a cloth strip; / or else, one should make the patient drink a hair-ball tied with a strong, long thread along with liquid, and induce vomiting; / and as he vomits, one should suddenly pull the thread caught in one part of the foreign body; / or one should remove it with a soft toothbrush bundle; / or push it further down. / If a hair-ball gets lodged, a bone-barb \[is used\] likewise. ### [37.30](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.30) And one whose throat is wounded should lick powder of triphalā combined with honey, ghee, and sugar, holding it in the throat; / or with prapauṇḍarīka, madhuka, padmaka, blue water lily, sārivā, plantain root, coral, and red ochre. / He should take cold and sweet food and drink, an airy place, daytime sleep, and contentment of mind. ### [37.31](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.31) A person full of water should be pressed down with the head downward, shaken, and made to vomit, or buried up to the mouth in a heap of ashes. / For otherwise, due to the water straying into the wrong channels, there arise flatulence, cough, dyspnea, catarrh, injury to the sense faculties, fever, and other disorders of śleṣman, and death. / There, one should counteract the kapha appropriately. / A foreign body consisting of a morsel of food should be made to go down with water, / or one should strike the shoulder with the fist. ### [37.32](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.32) Likewise, having everted the eyelid and removed \[a foreign body\] lodged in the eyelid, one should apply fomentation with hot water vapor, and irrigation with decoction of madhuka mixed with honey, and with ghee. / Even spontaneously, a foreign body falls from parts of the body such as the eyes through tears, sneezing, coughing, eructation, urine, feces, and flatus. / Or with devadāru, sarala, balā, and śigru roots; / or with realgar, tuttha, and rasāñjana; / or with a mild alkali, an application of ten mātrās \[is made\]. ### [37.33](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.33) When an insect has entered the ear canal, there occurs pricking pain, heaviness, and a buzzing sound; and when it moves, there is even more severe pain. / In that case, filling \[the ear\] is done with salted water, or with comfortably warm liquor combined with madhuka. / And when the insect has come out, it should be discharged. / But if it dies right there, suppuration, putrefaction, and moistness occur. / In these cases, one should apply what is prescribed for ear discharge, / and what is prescribed for pratīnāha. / An ear full of water should be filled with oil and water churned by hand; / or, having turned \[the head\] sideways, one should strike it with the hand or suck it out with a tube. / And here there are verses: / And one should perform emesis and purgation as in pitta; / and its plaster is made of paste of sandalwood and madhuka with ghee, / or with paste of sarjarasa, blue water lily, conch shell, vetasa, plantain root, mūrvā, and madhuka. ### [37.34](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.34) A foreign body made of lac or made of metals such as gold and silver, remaining for a long time, / is mostly dissolved by the heat generated from the body. ### [37.35](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.35) Foreign bodies of horn, bamboo, wood, bone, tooth, hair, and stone, however, / and those made of clay, do not disintegrate within the body. / In koṭha, one should observe the treatment of kuṣṭha. ### [37.36](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.36) A foreign body of horn, bamboo, iron, tāla, or wood, even after a long time, / is mostly rejected; for it quickly causes suppuration of the flesh and blood. ### [37.37](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.37) If a foreign body has penetrated deep into the flesh and that area does not suppurate, / then, by means of massage, sudation, purification, emaciation, and nourishment, ### [37.38](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.38) by sharp poultices, food and drink, and by marking with dense applications of the knife, / having caused it to suppurate, one should extract the foreign body by incision, probing, and pressing. ### [37.39](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.39) Having observed the manifold variety of foreign bodies, locations, and instruments, / an intelligent \[physician\] should discern the foreign body and extract it by various appropriate means. ### [37.40](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.40) When the wound has subsided, its edges are not overly tender to the touch, / and swelling and heat are slight, one should declare it free of foreign bodies. ### [37.41](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.41) The body itself is the ultimate foreign body, turbid with its innate doṣas and waste products; / an arrow or the like is considered a foreign body within a foreign body, on account of its particularity. ### [37.41\_1](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37.41_1) Thus ends the thirty-seventh chapter. ## Commentaries (1) - [Śaśilekhā](https://indike.org/pramana/in.med.samhita.astangasamgraha!indu.44.27) — Indu, Sanskrit ## Linked texts (1) - [Aṣṭāṅgasaṃgraha](https://indike.org/pramana/in.med.samhita.astangasamgraha.37.1) — Vāgbhaṭa, Sanskrit --- Source: [https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37](https://indike.org/pramana/in.med.samhita.astangasamgraha~en-mt.37) · Pramāṇa