Cakradatta (Cikitsasangraha) 77: Adhikāra 77

Now, having unctuated the body, fed with food accompanied by unctuous meat-soup, / fomented with his face turned towards the sun, seated on a seat as high as his knees,

with a soft cloth wrapped around the ends of his hair, his elbows placed upon his knees, / he should press the two jugular veins firmly with his fists enclosing the thumbs.

He should also perform clenching of the teeth, coughing, and puffing out the cheeks. / A person should restrain him from behind and wrap a cloth [around him].

Having thrown [a strap] around his neck, placing the left forefinger inside the nose, / having thus made the vein prominent according to rule, one should puncture the vein located in the head.

One should puncture a vein of the hand in an arm whose elbow is unbent, / having bound [the arm] while he sits comfortably, with his fist enclosing the thumb,

and a band tied four finger-breadths above the puncture site. / On the foot, however, well-positioned, pressed below the knee-joint,

firmly with both hands down to the ankle; and upon that foot / the second [foot] slightly flexed and mounted, then, as on the arm,

having bound it, one should puncture the vein. In this manner, even in sites not explicitly mentioned, / the one skilled in methods should devise the appropriate restraint in each respective region.

Then, having placed the vrīhimukha instrument on the site to be punctured, the physician / should press it with thumb and forefinger, covered by the palm.

Applying the kuṭhārī instrument with the left hand, however, with the other / he should strike it with the middle finger released from restraint by the thumb.

In a fleshy area, one should insert the vrīhimukha to the depth of a grain of rice; / over bones, one should puncture the vein with the kuṭhārikā to the depth of half a barley-corn.

If blood does not flow properly, one should smear the opening of the vein with bilva, tryūṣaṇa, turmeric, and nata, / along with chimney-soot, salt, and oil; / when it flows properly, with lukewarm oil and salt.

Even in a strong person whose blood is impure, one should not let flow more than a prastha; / for from excessive bleeding there may be death or severe diseases of vāta.

In that case, inunction, meat-soup, milk, and the drinking of blood are the medicament. / When the blood has flowed, having slowly removed the tourniquet, having washed [the area] with cold water,

the opening of the vein should be bandaged, smeared with a cloth soaked in oil. / If it remains impure, one should let it flow again in the evening, or on the next day.

If the blood does not stop, however, one should promptly perform haemostatic treatment: / with lodhra, priyaṅgu, pattuṅga, māṣa, yaṣṭyāhva, and red ochre,

potsherd-earth, añjana, linen soot, and kṣīrī-tree bark and shoots, / one should dust the mouth of the wound; and he should drink a cold infusion of padmaka and the like.

Or one should puncture that very vein immediately after that puncture; / or one should quickly cauterise the opening of the vein with a heated probe.

Even with some [morbid matter] remaining, the blood should be retained, and one should not cause excessive bleeding; / one should remove the remainder with a horn or the like, or bring about clarity.

Free of vital spots, in a region as near as possible, one should puncture the vein; / but not in those under sixteen, those past seventy, or those who have had blood drawn,

nor in those un-unctuated, unfomented, excessively fomented, or suffering from vāta diseases; / nor in pregnant women, puerperal women, those with indigestion, bleeding disorders (raktapitta), dyspnoea, or cough;

nor in those suffering from diarrhoea, abdominal disease, vomiting, anaemia, or consumption of the whole body; / nor in one who has drunk unctuous substance, nor in those undergoing the five purification procedures.

One should not puncture a vein that is unrestrained, nor obliquely, nor one that has not risen; / nor during excessive cold, heat, wind, or cloudiness, except in an emergency disease.

Food and drink that is neither too hot nor cold, light, and appetising / is wholesome when blood has been removed; / for then the body has unsteady blood, / and the digestive fire in particular must be protected.

A person who partakes of wholesome food and conduct / for a month, or until the attainment of strength; / whose complexion and sense faculties are clear, who desires the objects of the senses, whose physical strength and bodily urges are unimpeded, / endowed with comfort and possessed of nourishment and strength — him they describe as a man of purified blood.