Indian Medicine (Medicin), translated by C. G. Kashikar c9.59

c9.59

Both the scarification and blood-letting (sirāvyadha) are effected with sharp instruments and are, therefore, more severe forms of blood-letting. Bad blood causes abscess, swelling of the spleen, fever, diseases of mouth, eye and head and many other diseases; therefore, one should open the veins for letting out the superfluous blood. Blood-letting is unsuitable for those who have undergone one of the five curing remedies (cf. § 24) or have taken oily substance, have no bad blood, are below 16 years or above 70 years, women who are carrying or are lying in and also for people suffering from asthma and cough, diarrhoea, vomiting, anaemia, oedema all over the body, apoplexy, hemiplegia etc. The lancets *kuṭhārikā* and *vrīhimukha* are mentioned as the instruments used in blood-letting. cf. § 28. Before the operation the patient should be anointed, sauce of meat of wild animals and rice should be given to him to eat and he should be asked to get seated in a soft seat. A servant should put a piece of cloth around his neck from the back side and hold him fast with it, without causing choking. It depends on the place of the ailment as to which veins the surgeon has to open. Thus in the case of ailment of head and eye, veins on the forehead or on the nose and on external eye-angle, in ear-diseases the veins on the ear, in nasal diseases a vein on the point of the nose, in madness a vein in the chest, on external eye-angle and on the forehead, in deep-seated abscesses those in the sides and between the armpit and nipple should be opened. The lancet is to be inserted quickly, neither too deep nor too superficial, in the middle of the vein without striking a dangerous place (*marman*). If the blood does not flow in required quantity, the wound-place should be rubbed with a paste of lampblack, salt and oil mixed with powdered *tagara* (*tabernaemontana coronaria*) whereupon the blood flows properly. When it has flowed enough, the place should be moistened with lukewarm oil and salt. If the patient faints, he should be brought to senses by cold water and fanning, and the blood-letting should be continued further; in the case of repeated faints it should be resumed one or two days later. The maximum of tapping blood amounts to 1 *prastha* (= 16 *pala* or handfuls). After the operation an oily cloth should be laid on the place and tied (AS, AHr). According to Suśruta, cold should first be applied for blood-stopping, whereby the blood becomes thick and then astringent decoction or ash should be applied for drying the wound; and in worst cases hot iron should be used. Besides, he mentions various powders for rubbing in the case of excessive blood-flow (Su. 1.14; 3.8; AS 1.36; AHr 1.27).