We will now expound the chapter known as Yantrasastra vidhi – procedures of the use of instruments and appliances; thus said Atreya and other great sages. (1)
अथातो यन्त्रशस्त्रविधिं नामाध्यायं व्याख्यास्यामः । इति ह स्माहुरोत्रेयादयो महर्षयः ॥१॥
मनः शरीराबाधकराणि शल्यानि । तेषां नानाविधानां शल्यानां नानादेशनिविष्टानामाहरणेऽ भ्युपायो यन्त्राण्यर्शोभगन्दरादिषु शस्त्रक्षाराग्न्यवचारणे शेषाङ्गरक्षणे च । तथा बस्तिप्रणयनादौ शृङ्गालाबुघटिकादयो जाम्बवौष्ठादीनि । अन्यान्यपि चानेकरूपाण्यनेककर्माणि स्वस्थातुरोपक रणानि । अतः कर्मवशात्तेषामियत्तावधारणमशक्यम् ॥२॥
All those which produce troubles to the mind and body are known as Salya.
Notes:- In the literal sense the term ‘salya’ means that which pierces, or moves quick into the body. It is commonly used to denote spear, lance or arrow and in the technical sense to denote any external (foreign) object coming into the body. Some times some objects which are parts of the body, – its tissues and excertions which have become abnormal and even the foetus which is retained unduly long due to any reason, are named as salyas; emotions like anger, grief, fear, lust etc., are called as salyas for the mind. All these are to be removed from the body and mind. as early as possible for the restoration of health.
The different kinds of instruments which are used for the removal of various kinds of foreign bodies which are lodged in different parts of the body are known as Yantras (instruments and appliances which have no sharp edges), they are also useful for the inspection of heamorrhoids, fistula-in-ano etc., for application of alkalies, sharp instruments, fire cautery etc., and also to protect the other parts of the body, such as those used during the administration of enemas, the horn of animals, the gourd, pottery, jambavosta ( a lip shaped instrument prepared from metal) etc. They are of many shapes and of many functions (uses) and used both during health and ill-health. Hence it is not possible to describe all of them in detail here, in respect of their functions (uses). (2)
Yantra prakara – Types of Yantras
अन्ये पुनरेकोत्तरं यन्त्रशतमित्याचक्षते । इह पुनः समासतः षोढा निर्दिश्यन्ते । तद्यथा स्वस्तिकसन्दंशतालनाडीशलाकाख्यान्यनुयन्त्राणि च ॥३॥
Some authorities say that yantras are of one hundred and one in number. But here they are described under six kinds, such as Svastika (those which resemble the svastika sign ( diagram ) in appearance, Sandarnsa (those which have teeth), Tala (those which have flat discs), Nadi (those who are hollow tube), Salaka (those which are solid rods) and Anuyantras ( minor, accessary or very small instruments). (3)
तत्र स्वस्तिकयन्त्राणि कङ्कसिंहगृध्रकुररादिविविधव्यालमुखान्याकारानुगताभिधानानि प्रायशो लौहान्यष्टादशाङ्गुलानि । मसूराकारप्रान्तैः कण्ठे कीलैरवबद्धानि मूलेऽङ्कुशवदावृत्त वारङ्गाण्यस्थिविनष्टशल्योद्धरणार्थानि । तेषां सिंहव्याघ्रभुजङ्गमकरादिमुखानि दृश्यवारङ्गेषु शल्येषु प्रयोजयेत् । इतरेषु तु यथयोगं व्रणाकारानुरोधेन कङ्ककाककुररादिमुखानि ॥४॥
Svastika yantras derive their name from the resemblance of their faces with the faces of kanka (heron), simha ( lion ), grdhra (hawk), kurara bird (osprey) and such other wild animals and birds. They are usually made from metals and are eighteen angulas (fingers breadth) in length. They have their face in the shape of a lentil, held firmly with a nail at their neck, their arms bent in the shape of a elephant’s goad and having good handle. These are useful for removing the foreign bodies lodged inside the bones. Those which have faces resembling the faces of lion, tiger, snake, crocodile etc., are useful for removing the foreign bodies which are visible. In others (invisible foreign bodies) those instruments which are suitable for the shape of the wounds and those which resemble the face of crane, crow, heron etc., are useful. (4)
सनिबन्धनो निर्निबन्धनश्च षोडशाङ्गुलौ संन्दशौ द्वौ भवतः । तौ त्वङ्मांससिरास्त्रायुगतश ल्योद्धरणार्थमुपदिश्येते।तथान्यः सन्दंशः षडङ्गुलोऽर्धाङ्गुलविस्तृतो वक्रद्विबाहुरङ्गुष्ठाङ्गुलिप्रान्त समागमाकृतिः सूक्ष्मशल्याक्षिपक्ष्मव्रणाधिमांसाहरणे ॥५॥
Sandamsa yantras are of two kinds, those with a catch and those without a catch (at their back) and they are of sixteen angulas in length and two in number. They are useful for removing foreign bodies from the skin, muscles, veins, tendons etc., Another variety which is six angulas in length and half angula in width, curved, having two arms, having the shape of the ( tip of) thumb, meeting the (tip of the index) finger, useful for the removal of tiny foreign bodies, eyelashes, wounds and adhimamsa (muscular out-growth). (5)
तद्वच्च मुचुटी । सा तु सूक्ष्मदन्तर्जुर्द्विभुजा मूले रुचकनद्धा वलयपीडनात् छिन्नार्मशेषगम्भीर – व्रणाधिमांसाहरणे ॥६॥
Mucuti is also similar. It has small teeth, straight and with two arms, having circular edges at its base (place of holding), useful for cutting the remains of an arma (pterygium) muscular out-growths from deep wounds. ( 6 )
तालयन्त्रे अपि द्वे द्वादशाङ्गुले मत्स्यगलतालकवदेकतालकद्वितालके कर्णनाडीशल्याहरणार्थे ॥७॥
Tala yantras are also of two kinds, that which has one flat surface and that which has two flat surfaces at its front end, useful for removal of foreign bodies from the channels of the ears. (7)
नाडीयन्त्राणि सुषिराण्यनेकप्रकाराण्यनेकप्रयोजनान्येनकतोमुखान्येकतोमुखानि च भवन्ति । स्त्रोतोगतशल्यदर्शनार्थमाहरणार्थं क्रियासौकर्यार्थमाचूषणार्थं चेति । तानि स्रोतोद्वारपरिणा हानि यथा योगप्रदीर्घाणि च कुर्यात् ॥८॥
Nadiyantras are hollow, of different kinds ( shapes), of different functions (uses), either with two orifices (one at each end) or with one orifice only; they are useful for seeing and removal of foreign bodies which are lodged in deep channels (pores etc.), for fecilitating instrumental activity and also for the purpose of sucking. It can be made suitable to the diameter (width) of the channel where it is to be used and as much long as is necessary. (8)
कण्ठशल्यदर्शनार्थं नाडीं दशाङ्गुलायतां पञ्चाङ्गुलपरिणाहां द्विकर्णस्य तु वारङ्गस्य सङ्ग्रहार्थं त्रिच्छिद्रमुखां नाडीं तत्प्रमाणतः कुर्यात् । तथा चतुष्कर्णस्य पञ्चच्छिद्रमुखाम् । शल्यनिर्धातिनीं तु पद्मकर्णिकाकारशीर्षां द्वादशाङ्गुलां त्र्यङ्गुलसुषिराम् ॥९॥
The tubular instrument to be used for inspection of the throat shall be ten angulas in length, five angulas in diameter, a handle for holding and with two orifices (at both ends); that which has two ears (flaps) can be with five orifices; that which is useful for crushing (or hammering) the foreign body may have a head resembling a pellicle (round part in the centre of the lotus flower), twelve angulas long and three angula being the diameter of the tube. (9)
अर्शोयन्त्रं त्रिविधम् । ताम्रायोहैमं दान्तं शार्ङ्गवा वा गोस्तनाकारं चतुरङ्गलायतं हस्ततलायतमेकं पञ्चाङ्गुलानि परिणाहेन पुंसां षङ्गलानि स्त्रीणाम् । द्विच्छिद्रं दर्शनार्थमे कच्छिद्रं कर्मणि । तथा हि सुखेन दर्शनं शस्त्रक्षाराग्न्यनतिक्रमश्च । छिद्रं तु त्र्यङ्गलायतमङ्गुष्ठो दरविस्तारम् । यदङ्गुलमवशिष्टं तस्याधोऽर्धाङ्गुलमुपरि तथार्धाङ्गुलोच्छ्रितोद्वृत्तकर्णिकम् । तृतीयं तु तादृशमेव शम्याख्यं पार्श्वच्छिद्ररहितं पीडनार्थम् । भगन्दरे तु छिद्रादूर्ध्वमोष्ठमपनीय कुर्वीत । तद्वच्च घ्राणर्शोऽर्बुदयन्त्रं नाड्याकारं द्व्यङ्गुलायतमेकच्छिद्रं प्रदेशिनीपरीणाहम् ॥१०॥
Arsoyantra (instrument for inspection and treatment of haemorrhoids) is of thrce kinds; the first kind prepared from copper, iron, gold, ivory, horn or wood, resembling the teat (nipple) of the cow in shape, four angulas or of the length of the palm of the hand in length, with a diameter (of the tube) of five angulas for use in males and six angulas for use in females; that with two slits for inspection and that with single slit for surgical operations.
It should be convenient for easy inspection and also for use of sharp instruments, application of alkalies, touching with fire ( hot iron rod) and such other functions. The slit shall be three angulas in length and the size of the thumb in width. It shall have circular ridges all around at a level one angula from the bottom and half angula from the top. The third one, known as Samyakhya, resembling the earlier one in shape, without the side slit meant for the purpose of squeezing (dilating the orifice ctc.). For use in cases of rectal fistula, the instrument should be made without the lip like projection at the tip of the slit. Similarly for those to be used for nasal polyp, and malignant growth, the tubular instrument shall be of a length of two angulas, with a single slit of the size of the index finger. ( 10 )
Notes: Indu, the commentator clarifies that the three kinds of rectal instruments are; 1. that which has one slit on any one side 2. that which has two slits one on each side and 3. that which has no slit at all. All of them will be five angulis in length and four angulis in diameter. At the upper and lower ends of the slit there shall be a ridge (stop edge) inside the instrument but not outside it. The instrument used in rectal fistula there will be no lip-like projection as seen in the one used in haemorrhoids.
तथाङ्गुलीत्राणकमङ्गुलीप्रवेशितं किञ्चित्स्थूलवृत्तौष्ठमूर्ध्वाधश्छिद्रं गोस्तनाकृति चतुरङ्गुलं दान्तं शार्ङ्गं वार्क्षं वा । तद्दृढेन सूत्रेण मणिबन्धप्रतिबद्धमास्यविस्त्रावणे योज्यम् ॥११॥
Angulitranaka (finger guard) shall be such as will allow the finger inside, slightly thick, having lip ( ridge) all around at the top, with two orifices above and below, resembling the teat (nipple) of the cow, four angulas in length, made from ivory, horn or wood. It shall be tied with a strong thread to the wrist (of the physician) and used for draining the mouth (of its secretions, dirt, exudations). (11)
योनिव्रणदर्शने यन्त्रं षोडशाङ्गुलम् । मध्ये सुषिरं चतुर्भित्तिं चतुश्शलाकं सञ्चारिण्यामुद्रयोर्ध्व निबद्धमुत्पलमुकुलवक्त्रं मूलेशलाकाक्रमणादूर्ध्वविकासि च । नाडीव्रणप्रक्षालनाभ्यञ्जनयन्त्रे षड्ङ्गुले बस्तियन्त्राकारे मुखतोऽकर्णिके मूलमुखयोरङ्गुष्ठकलायप्रवेशस्त्रोतसी । दकोदरे नाडीमुभयतोद्वारां पिच्छनाडीं वा युञ्ज्यात् । स्नेहबस्त्युत्तरबस्तिप्रधमनधूममूत्रवृद्धिनिरुद्धमणि प्रभृतिषु यथास्वमेव यन्त्राण्युक्तानि ॥१२॥
The instrument for inspection of the vaginal ulcers will be sixteen angulas long, hollow in the centre, with four apartments and four rods movable upto the opening, its mouth resembling bud of the lotus in shape, because of the presence of the rods and opening upwards. The instruments for washing and squeezing a sinus ulcer shall be six angulas, resembling an enema bag, but devoid of ridges, with orifices capable of allowing the thumb and a pea at the upper and lower ends respectively.
The instrument for use in cases of jalodara (ascitis) shall have opening at both ends; or the tubular quills of birds may be made use of.
The instruments useful for administration of lubrication enema, urethral enema, nasal insuffulation inhalation of smoke and those useful for treating retention of urine, phimosis etc. will be described in their own context. (12)
शृङ्गं तु ह्रस्वमध्यदीर्घमष्टादशद्वादशाङ्गुलायतं त्र्यङ्गुलप्रवेशमुखमग्रे सर्षपोपमच्छिद्रं तनुचर्म नद्धं चूचुकाकारमुखं च । तद्वातविषरक्ताम्बुदुष्टस्तन्यचूषणार्थम् । श्लेष्मरक्ताचूषणार्थस्त्वला बुः । स द्वादशाङ्गुलदीर्घोऽष्टादशाङ्गुलपरिणाहस्त्रिचतुरङ्गुलवृत्रसमुच्छ्रितमुखः परिवेष्टित दीप्तकुशबल्वजपिचुगर्भश्च प्रयोज्य: । तद्वदेव च मानकर्माभ्यां घटी। सा तु गुल्मोन्नमनविलय नार्थं च ॥ १३ ॥
Srnga (horn of animals used as an instrument) shall be thin (small, slender) in the centre, eighteen or twelve angulas in length, the diameter of the orifice at the base shall be three angulas and that at the tip of size of a mustard seed, the tip resembling the nipple in shape and covered with thin leather cap. This is useful to suck the air (gas), poison, blood, water (watery exudations) and bad breast milk.
Alabu (the ripe fruit of any gourd removed of its rind and seeds, hard and resembling a pitcher in shape) is useful for sucking the kapha and blood. It shall be tweleve angulas in length, eighteen angulas in circumference, three or four angulas in width, having wide mouth; containing in its interior a burning oil wick, reeds or fibres.
Ghati (the pot) used for measuring things and also used for pulling and squeezing of tumors, shall be similar ( in size and its contents with the gourd). (13)
शलाकायन्त्राण्यपि नानाकृतीनि नानार्थानि यथायोगं दैर्ध्यपरिणाहानि च भवन्ति । तेषामेषणकर्मणी द्वे गण्डूपदमुखे। स्रोतोगतशल्याहरणार्थेऽष्ठाङ्गुलनवाङ्गुले द्वे मसूरदलमुखे । षट् शङ्कवः । तेषां व्यूहनक्रियौ द्वादशषोडशाङ्गलौ द्वावहिफणामुखौ । तथा चालनार्थे दशद्वादशाङ्गुलौ शरपुङ्खमुखौ | आहरणार्थे बडिशमुखौ। तथा गर्भशङ्कुः शङ्कुतुल्योऽष्टादशाङ्गुलः प्रणताग्रो मूढगर्भाहरणे । तथा सर्पफणावदेवाग्रवक्रं तदाख्यमश्मर्याहरणांर्थम् । तथादन्तनिर्घातनं चतुरङ्गुलं शरपुङ्खमुखं स्थूलवृत्तप्रान्तम् ॥१४॥
षट् कार्पासकृतोष्णीषाणि विविधव्रणक्लेदक्षारप्रमार्जनक्रियासु । तेषामपि दूरासन्नघ्राणव्रणोप योगिनी षट् सप्ताङ्गुले द्वे । पायौ दशद्वादशाङ्गुले । कर्णशोधनं स्रुवमुखमश्वत्थपत्राग्रम्। तथा क्षाराग्निकर्मार्थे जाम्बवोष्ठानि द्वादशाष्टाङ्गुलानि क्रमाद्व्यङ्गुलाङ्गुलार्द्धाङ्गुलफलानि ॥ १५ ॥
Salaka yantras – (probes, rods, stillets etc.) also, will be of different shapes, of many functions (uses), of length and thickness, convenient for the puropse meant. Among them two, useful for probing, will have their face like that of an earthworm. The two, useful for removing the foreign bodies lodged in the tissue pores, channels shall be of eight and nine angulas respectively having the mouth resembling the cotyledon of a lentil in shapes.
Sanku (hooks) are six, of them, the two used for holding the tissues together shall be twelve and sixteen angulas respectively and having the mouth like the hood of the snake; the two useful for lossening (by shaking), shall be ten and twelve angulas respectively and their mouth resembling sarapunkha in shape; the two useful for pulling out shall have their mouths shaped like a fishhook. the foetal hook shall be like an arrow head, eighteen angulas long, its tip bent (like a hook) and used for pulling out the impacted foetus; that resembling a hood of serpent and named likewise, bent in its tip is used for removal of urinary stone; that useful for extraction of the tooth, shall be four angulas long, mouth resembling sarapunkha and with round sturdy arms.
Six of them (salaka yantras) shall have caps made of cotton, and used for cleaning (removing) the different kinds of ulcers of their exudations and for application of caustic alkalies; out of them, two of six and seven angulis, respectively are two useful for ulcers located deep inside the nostrils, two useful for the rectum, and measuring ten and twelve angulas respectively; that useful for cleaning the ears shall be having their mouth like a wooden laddle with two cups, side be side, and its tip resembling the leaf of pipal tree; the jambayostas (forceps made of wood or metal) used for application of caustic alkalies, and fire cautery shall be twelve and eight angulas respectively with areas of flat surfaces of two, one and half angulas respectively. (15)
शलाकाश्च स्थूलसूक्ष्मदीर्घह्रस्वमध्याः । आन्त्रवृद्धौ त्वर्धेन्दुवक्रा मध्योर्ध्वनिर्गतशलाकाः । दहने नासार्शोऽर्बुदयोः कोलास्थिदलमात्रमुखा वेल्लितौष्ठा क्षारविषौषधप्रणिधानाय च दर्व्यस्तिस्त्रोऽष्टाङ्गला दर्व्याकाराः कनिष्ठिकानामिकामध्यमाङ्गलिनखपरिमाणनिम्नमुखा स्तथाञ्जलिसंस्थानाः । उत्तरबस्त्यञ्जनादिषु यथायथमेवोपदिष्टानि ॥१६॥
salaka yantras shall be thick, thin, long, short and medium in size and shape. That useful for treating intestinal hernia shall be curved like half-moon, with an outstretched rod in the centre; that useful for cauterising with fire, the nasal polyp and malignant tumors, shall have mouths of the size of seed of kola fruit and lips of the size of seed of vella (vidanga); the three Darvis (spoons) useful for holding and applying alkalies and poisonous drugs, shall be eight angulas long, have the shape of a hood of a snake (or a laddle), their mouth, having depressions of the size of the nails of the little finger, ring finger and middle finger respectively. Those used for urethral enema and application of collyrium to the eyes will be described in their own contexts. (16)
अनुयन्त्राण्ययस्कान्तरज्जुचर्मान्त्रवस्त्राश्ममुद्गरपाणिपादतलाङ्गुलिजिह्वादन्तमुखशाखानख बालाश्वकालपाकहर्षभयानि ॥१७॥
Anuyantras (accessory or minor instruments) are the magnet, rope, sheets of leather, inner bark of trees, stone, hammer, the palms and soles, fingers, tongue, teeth, mouth, hands, and feet, nails, hairs, the horse, the time, digestion, pleasure and fear. (17)
एतानि देहे सर्वस्मिन् देहस्यावयवेऽपि वा । सन्धौ कोष्ठधमन्यां च यथायोगं प्रयोजयेत् ॥१८॥
These can be made use of for the whole body or parts of it, in the joints alimentary tract, the arteries (veins also) as found suitable. (18)
Yantra karma- functions of instruments
यन्त्रकर्माणि तु निर्घातनपूरणबन्धनव्यूहनपरि वर्तनचालनविवरणपीडनमार्गशोधनविकर्षणा हरणव्यथनोन्नमनविनमनभञ्जनोन्मथनाचूषणैषणदारणर्जूकरणप्रक्षालनप्रधमनाञ्जनप्रमार्ज नानि बाहुल्येन चतुर्विशतिर्भवन्ति ॥१९॥
The following are the twenty four important functions (uses) of the yan ras – nirghatana (beating, hammering, crushing), purana (filling), bandhana (fastening, binding), vyuhana (arranging, collecting together), parivartana (turning about, turning over, changing sides), calana (creating movement, shaking), vivarana (widening), pidana (squeezing), margasodhana (clearing the passage) vikarsana ( extraction, pulling out ), aharana (pulling, removing) vyathana (causing pain), unnamana (bending upwards), vinamana (bending down ward), bhanjana (breaking, crushing), unmathana (excavating, sounding, churning upwards) acusana (sucking), esana (probing), darana (tearing, breaking, dividing), rujukarana (straightening) praksalana (washing) pradhamana (insufflation, blowing in), anjana (anointing, smearing, coating) and pramarjana (sweeping, brushing, cleaning). (19)
विवर्तते साध्ववगाहते च ग्राह्यं गृहीत्वोद्धरते च यस्मात् । यन्त्रेष्वतः कङ्कमुखं प्रधानं स्थानेषु सर्वेष्वधिकारि यच्च ॥ २०॥
Among the yantras, the kankamukha (heronbill forceps) is the most important because it comes out easily, (can be pulled out easily), goes deep inside easily, easy to handle, holds the objects firmly and brings them out and so rules supreme ( suitable of use, very convenient and very helpful) at all places. (20)
Sastras- sharp instruments
शस्त्राणि तु षड्विंशतिर्भवन्ति । तद्यथा दन्तलेखनमण्डलाग्रवृद्धिपत्रोत्पलपत्राध्यर्धधारमुद्रिका कर्तरीसर्पवक्त्रकरपत्रकुशापत्राटीमुखान्तर्मुखशरारीमुखत्रिकूर्च कुठारिकाव्रीहिमुखशलाकावेतसपत्राराकर्णव्यधनसूचीसूचीकूर्च खजैषिणीबडिशनखशस्त्राणि चेति । प्रायश्च तानि षडङ्गुलानि सुध्मातावर्तितायोघटितान्युत्पलपत्रनीलानि सुग्रहाणि सुरूपाणि सुधाराणि सुसमाहितमुखाग्राण्यकरालानि प्रत्येकं च प्रायो द्वित्राणि स्वप्रमाणार्धचतु र्थभागफलानि । तानि व्याधिदेशवशात् प्रयुञ्जीत । तेषां नामभिरेवाकृतयः प्रायेण यन्त्रवद्व्याख्याताः ॥ २१ ॥
Sastras (instruments with sharp edges) are twenty six in number. They are dantalekhana (dental scrapper), mandalagra (with round, circular tip) vrddhi patra (blade shaped like the leaf of vriddhi (Habenaria intermedia ), utapalapatra (blade resembling the leaf of utapala), adhyardhadhara (having the blade in more than half of its length), mudrika (fingers knife), kartari (scissors), sarpavaktra (blade resembling the tongue of a snake), karapatra, (saw) kusapatra (blade resmbling the leaf of kusa grass) atimukha (blade resembling the beak of ati-an aquatic bird), antarmukha (blade bent inwards), sararimukha (blade resembling the beak of the skimmer bird), trikurcaka (three metallic spikes), kutharika (axe), vrihimukha salakas (the tip resembling a grain of rice with pointed edges), vetasapatra (the blade resembling a leaf of vetasa) ara (the shoe-makers knife or the awl), karnavyadhana suci (needle for peircing the ear) suci (needles), kurca (brush with spikes), khaja (churner), esani – (needle and probe) badisa (curved hook with sharp point resembling a fish hook) and nakhasastra (blade to pare the nails).
Generally they are six angulas in length, prepared from properly smelt iron, having the blue colour like petals of utpala, easy to handle, possessing good shape and fine cutting edge, with well made out mouths (tips), not ugly, each one in pairs; their blade, comprising half or one-fourth of their length. They are to be used as is found suitable to the disease and region of body. Their shape is generally indicated by their names as was with the case of the yantras. (21)
तत्र त्रयमाद्यं लेखने । वृद्धिपत्रादीनि त्रीणि पाटने । चत्वारि भेदने । मण्डलाग्रादीन्यष्टौ छेदने । कुशपत्रादीनि पञ्च प्रच्छाने । कुठारिकादीनि षट् व्यधने । तेषामाराव्रीहिमुखे भेदने छेदने च । सूच्य: सीवने । सूचीकूर्च: कुट्टने । खजो मथने । एषिण्येषणे भेदने च । बडिशो ग्रहणे । नखशस्त्रमुद्धरणे । छेद्यभेद्यलेख्यप्रच्छानेषु च । इति द्वादशविधे शस्त्रकर्मण्युपयोगः ॥ २२ ॥
Out of these, the first three are meant for lekhana (scarification), the three commencing with vrddhipatra are for patana () and the four (commencing with vrddhi patra) are for bhedana (), the eight commencing with mandalagra are for chedana (excision). The five commencing with kusapatra are pracehana (). The six commencing with kusapara are for vyadhana (puncturing), of these the ara and vrhimukha are for bhedana (separating, splitting) and chedana (excision,); the sucis are for sivana (suturing) sucikurcas are for kuttana ( ), khaja is for mathana (churning), the esanis (probes) are for esana (probing); badisa is for grahana (holding, catching, hooking), nakhasastra is for uddharana (pulling up, clevating) and also for chedana (excision,) bhedana (piercing), lekhana (scarification) and pracchana ( ) – thus are the twelve functions and uses of the sastras. ( 22 )
Notes:- Indu, the commentator specifies the names of the instruments as follows: dantalekhana, mandalagraand vrddhipatra are for lekhana (scarification); vrddhipatra, utpalapatra, adhyardha dhara are for patana ( ); vrddhipatra, utpalapatra, adhyardha dhara, mudrika, kartari, sarpavaktra and karapatra are for chedana (excision,); kusapatra, atimukha, antarmukha, sararimukha and trikuraca are for pracchana ( ); kutharika, vrhimmukha salaka, vetasapatra, ara, karnavyadana suci are for vyadhana ().
विशेषतस्तु दन्तलेखनं सुप्रबन्धवच्चतुरस्त्रमेकधारं दन्तशर्करालेखने । मण्डलाग्रं प्रदेशिन्यतर्नख विस्तृतफलं तल्लेखनच्छेदनयोर्वर्त्मरोगोत्सन्नदन्तमांसदुर्निविष्टव्रणगलशुण्डिकादिषु प्रयोज्यम् ॥ २३॥
To describe in detail, Dantalekhana shall have four sides ( faces ) each connected firmly with a band (nail) having one sharp edge and useful for scraping the crustations on the teeth.
Mandalagra shall have a face of the size of nail of the index finger and meant for scraping and tearing, in diseases of the eyelids, out-growth of gums, ulcer with irregular shape, uvular enlargement and other diseases. (23)
वृद्धिपत्रं क्षुराकारं तत्तून्नते गम्भीरे वा श्वयथावृजुसूच्यग्रमिष्टम् । विपरीते तु पृष्ठतो ऽवनतधारम् ॥२४॥
Vrddhipatra is like a barber’s knife in shape (curved) tapering to a sharp point at its tip (with a sharp edge inside) for use in bulging or deep seated swellings. Its opposite, is the one having a backward bend and a sharp edge outside. ( 24 )
अङ्गुलिशस्त्रकं मुद्रिकानिर्गतमुखं वृद्धिपत्रमण्डलाग्राध्यर्धधारान्यतमतुल्यार्धाङ्गुलायतधारं प्रदेशिनीप्रथमपर्वप्रमाणार्पणवृत्तमुद्रिकं दृढसूत्रप्रतिबन्धं कण्ठरोगेषु प्रयुज्यते ॥२५॥
Angulisatraka shall be having the orifice to allow a finger, has a blade (sharp edge) of half angula, like that of any one of vrddhipatra, mandalagra or ardhyardhadhara, fixing into the first phallenge of the index finger like a ring and tied firmly. It is of use in diseases of throat. (25)
कर्तरी त्रिभागपाशा व्रणस्नायुकेशसूत्रच्छेदनार्था । सर्पवक्त्रं वक्रमर्धाङ्गलफलं घ्राण कर्णार्शोऽर्बुदच्छेदनार्थम् निबद्धमस्थिच्छेदनार्थम् मध्यर्धाङ्गुलफलम्॥२६॥ । करपत्रं दशाङ्गुलं द्व्यङ्गुलविस्तारं सूक्ष्मदन्तं खरधारं सुत्सरु – । कुशपत्राटीमुखे द्व्यङ्गुल । अन्तर्मुखमर्धचन्द्राकार
Kartari shall have its handle at one third of its length and useful to cut the ulcers, tendons, hairs and threads.
Sarpavaktra shall be having a curved edge of half angula in size, and useful for cutting (piercing) the polypii of the nose and ears, and malignant tumors.
Karapatra shall be ten angulas in length, two angulas in width, with fine ( small) teeth, rough edge, fixed firmly with a handle ( wooden) and meant for cutting the bone.
Kusapatra and Atimukhi shall have faces (sharp edge) of two angulas in width,
Antarmukha shall have the shape of half-moon, with its face, slightly more than half angula. (26)
कुठारिका पृथुदण्डा गोदन्ताकारा अर्धाङ्गलफलास्थ्याश्रितसिराव्यधार्था । व्रीहिमुखमध्यर्धाङ् गुलफलं मांसलप्रदेशसिराव्यधार्थ वर्मोदरगुल्मविद्रध्यादिव्यधनभेदनार्थं च । शलाकोभयतो मुखी कुरबकमुकुलाग्रा ताम्रमयी लिङ्गनाशव्य धनार्था ॥ २७ ॥
Kutharika shall have a thick rod for handle, is shaped like the tooth of the cow, a face (sharp edge) of half angula in width and meant for removing the foreign body lodged inside the bones and for cutting the veins.
Vrihimukha shall have a face (sharp edge) of slightly more than half angula and is meant for cutting of the veins in fleshy parts, to cut or pierce in cases of scrotal enlargement, enlargement of abdomen, abdominal tumors, abscesses etc.
Salakas useful for piercing, the cataract shall have sharp points at both ends, resembling the bud of kurabaka, and made of copper. ( 27 )
आरा चतुरस्त्रार्धाङ्गलवृत्तमुखा तावत्प्रवेशा बहलकर्णपालीव्यधार्था पक्कामशोफसन्देहभेद नार्था च । कर्णव्यधनं त्र्यङ्गुलायतमङ्गुलसुषिरं घनं यूथिकामुकुलाग्रम् ॥२८॥
ara will have four faces, (sharp edge) with circular edge of half angula in size, and capable of easily entering in. It is meant to pierce the thick pinna of the ears and a doubtful swelling to detemine whether unripe or ripe.
Karnavyadhana shall be three angulas in length and has one angula of sharp of point, hollow, strong and its tip being in the shape of the bud of yuthika. (28)
सूच्यस्तिस्त्रो वृत्ता निगूढदृढपाशाः । तत्र मांसलेष्ववकाशेषु त्र्यङ्गला त्र्यस्त्रा । सन्ध्यस्थिव्रणेष्वल्पमांसेषु च द्व्यङ्गुला वृत्ता पक्कामाशययोर्मर्मसु च सार्धद्व्यङ्गुला धनुर्वक्रा व्रीहिमुखा च ॥२९॥
Suci are of three kinds; round, (rod like) concealing the thread and strong. The first kind with three faces, ( cutting edges) three angulas in length, for use in muscular parts; the second kind, for use in joints, wounds of the bones and in less muscular parts, shall be two angulas in length, and round; the third kind, for use in alimentary tract, and vital spots shall be two and half angulas in length, bent like a bow and having its tip of the shape of a rice grain. ( 29 )
सूचीकूर्चो वृत्तैकमूलोऽग्रे सुनिबद्धसप्ताष्टसूचिकः कुष्टश्वित्रव्यङ्गेन्द्रलुप्तसुप्तादिषु । खजस्त्वर्धाङ् गुलायताष्टकण्टकमुखस्ताम्रो लौहो वा नासाभ्यन्तरगत शोणितमोक्षणार्थः । एषण्या द्वे सुश्लक्ष्णस्पर्शे तयोरेकाष्टाङ्गला गतिकोथशल्यस्त्राववत्सु व्रणेषु सुषिरान्वेषणे । अन्या सूचीसंस्थाना क्षाराक्तसूत्रप्रतिबद्धा नाडीनां भगन्दरगतीनां च भेदने । बडिशोऽत्यवनतमुखः सूचीतीक्ष्णाग्रो ग्रहणे गलशुण्डिकार्मादेः । नखशस्त्रमष्टाङ्गुलमेकतोऽश्वकर्णमुखमन्यतो वत्सदन्तमुखं सूक्ष्मशल्योद्घृतौ ॥३०॥
Sucikurcas are round, (rodlike) with a with seven or eight needles imbeded into it, it is useful in diseases, like leprosy, leucoderma, pigmented patches, alopecia and loss of tactile sensation.
Khaja has a circumference of half angula, with eight spiked faces, made of copper or iron and useful to release the accumulated blood inside the nose.
Esanis are two; one of eight angulas in length, very smooth to touch and useful to drain out the exudations and foreign bodies from putrifying wounds and to determine the cavity inside the ulcers. Another is like a needle, to which a thread processed with alkalies is attached and useful for separating (widening) the sinus in ulcers and rectal fistula.
Badisa shall have its tip curved deep down, the tip as sharp like the point of the needle and useful for holding enlargements of the uvula, pterygium etc.
Nakhasastra will be eight angulas in length, having two faces, one like the ear of the horse and another like the teeth of a calf and useful to remove (pull out) small foreign bodies. (30)
Anusastra – accessary instruments
अनुशस्त्राणि तु जलौकः क्षाराग्निसूर्यकान्तकाचस्फटिककुरुविन्दनखशाकशेफालिकादिखरपत्रसमुद्रफेनशुष्कगोमयादीनि । स्वबुध्या च विकल्प्य विविधानि यन्त्रशस्त्राणि तत्कर्माणि चोपकल्पयेत् । हस्त एव चात्र प्रधानतमस्तदधीनत्वाद्यन्त्रशस्त्राणाम् ॥३१॥
Anusastras (accessary/minor instruments) are the leeches, alkalies, fire, sunstone, glass, rock-crystal, corborandum, nails, rough green leaves like that of sephalika and others, cuttle-fish, dried cowdung etc.
The physician should fabricate, the blunt and sharp instruments by his own intelligence as found suitable to the surgical operations.
Among all the blunt and sharp instruments the hand itself is the most important, because all others yantras (appliances) and sastras (sharp instruments) are under its control (of the hand only). (31)
Yantra-sastra doshas – defects of instruments
तत्र दीर्घहस्वस्थूलतनुवक्रविषमग्राह्यग्राहिशिथिलता इत्यष्टौ यन्त्रदोषाः । अत्राद्याः पञ्च कुण्ठखण्डखरधाराश्चेत्यष्टावेव शस्त्रदोषाः । अन्यत्र करपत्रात् ॥ ३२ ॥
Very long, very short, very thick, very thin, curved, irregular (difficult to handle), either not holding the objects or holding them loosely – are the eight defects of the blunt instrument; the first five of the above, along with bluntness, broken and rough edges are the eight defects of sharp instruments except of karapatra (saw). (32)
Sastra payana tempering
तत्र क्षारेण पायितं शस्त्रं शरशल्यास्थिच्छेदनेषु । उदकेन मांसच्छेदनेषु । तैलेन पाटनभेदनेषु सिराव्यधस्नायुच्छेदनेषु च प्रयुञ्जीत ॥३३॥
Sharp instruments, tempered with alkalies are useful to remove arrows, foreign bodies lodged in bones and for tearing; tempered with water they are useful to tear the muscles; tempering with oil for purposes of piereing, cutting, venesection and tearing the tendons. (33)
Sastradhara – the incision
धारा पुन: छेदनानां मासूरी लेखनानामर्धमासूरी। व्यधनानां विस्रावणानां च कैशिकी ॥३४॥
The incision for chedana (excision,) shall be circular like the lentil; for lekhana (scratching, scarification) semicircular like half-lentil; for vyadhana (puncturing ) and visravana ( draining out ) it shall be like a hair (straight and thin) ( 34 )
तेषां छेदनभेदनलेखनानि वृन्तसाधारणे भागे प्रदेशिनीमध्यमाङ्गुष्ठैः सुसमाहितो गृह्णीयात् । वृन्ताग्रे विस्त्रावणानि प्रदेशिन्यङ्गष्ठाङ्गलीभ्याम् । हस्ततलप्रच्छादितवृन्ताग्रं व्रीहिमुखं मुखे । मूलेष्वाहरणार्थानि । पाशस्योपरि मध्ये लघुसन्दंशं कर्तरीं च । शेषाण्यपि यथायोगं क्रियासौकर्येण ॥३५॥
For doing chedana ( excision) bhedana ( incision separating ) and lekhana (scarification), the physician should hold the sharp instruments, near its joint, firmly by the help of his index, middle finger and the thumb; for doing visravana (draining out), it should be held at its tip with the thumb and index fingers; Vrhimukha is to be held with its body concealed in the palm and near its mouth, the hind part to be withdrawn later; kartari (scissors) should be held at the handle and laghu sandamsa (small forceps) in the middle; the other instruments should be held as found convenient for carrying on the surgical work. ( 35 )
निशातनी तु तेषां सुश्लक्ष्णा शिला माषमुद्द्रप्रभा । धारासंस्थापनं च शाल्मलीफलकम् ॥३६॥
The Nisatani (sharpening stone) should be made out of smooth stone, having the lustre (colour) like green-gram and black gram. The finishing touch to the blade being given by plaque of wood of Salmali. ( 36 )
Yogya bhisak – qualifications of a surgeon:
नचाधिगतशास्त्रोप्यकृतयोग्यः सुबहुशो वाप्यदृष्टकर्मा शस्त्रकर्मणि प्रवर्त्तेत । सिरास्त्रायुमर्मादि व्याप्तत्वाद्देहस्य । तस्मात् सरोमचर्मपुष्पफलालाबुत्रपुसोदकपङ्कपूर्णदृतिबस्तिवर्ध्यमांसपेशि कोत्पलनालादिषु यर्थार्हमाहरणादियोग्यां कुर्यात् । तथा घटपार्श्वस्त्रोतस्यम्भोभिः पूर्णेन नेत्रेण बस्तिपीडनयोग्याम् मृदुमांसखण्डेष्वग्निक्षारावचरणयोग्याम् । पुस्तमयपुरुषाङ्गप्रत्यङ्गेषु बन्धनयोग्याम् । अपि च ॥३७॥
The physician who has not mastered the science, who has not been made eligible (by serving as an apperentice with an expert), who has not gained practical experience by attending (observing) surgical operations in large numbers, should not undertake surgical work, because the human body is full of veins, tendons and vital spots. Hence, he should attempt, by practising surgical activities on hides with hair, flowers, fruits, gourd, cucumber, leather bag filled with water and silt, urinary bladder, hernial mass, (tumor, outgrowth) muscles, ( of animals), stalk of lotus and others as are suitable for activities like extraction etc. He should also acquaint himself with activities such as a pot getting empty of water through pores in its sides and practise squeezing of a filled-in enema bag through the nozzle, application of alkalies and fire cautery on soft muscles; the various types of bandaging on artificial stuffed human figures having all the parts. (37)
Sava chedana – dissection of the cadaver
युक्तकारीभिषग्बुभूषुः पुरुषं संपूर्णगात्रमविषहतमदीर्घव्याधिपीडितं निष्कृष्टदृष्टान्त्रमावहन्त्यामापगायां मुञ्जबल्वजवेष्टिते पञ्जरस्थमप्रकाशे देशे कोथयेत् । सं सम्यक्प्रकुथितं चोद्धृत्यायतदेहं कृत्वोशीरवेणूकूर्चादीनामन्यतमेन शनश्शनैरवघृष्य त्वगादीन् सर्वानेव बाह्याभ्यन्तरानङ्गंसिरास्नाय्वादीनवयवानाचार्योपदर्शितेनागमेन चक्षुषा च लक्षयेत् ॥ ३८ ॥
The physician, who desires to be an adept (expert) in surgery, should obtain a cadaver (dead body) complete with all its parts; of a man who has not died of poison or long standing illness; then all the contents of the intestines removed, the body wrapped firmly with munja grass, reeds and inner bark of trees; tied with ropes; the body so covered is placed inside a cage. The cage is then taken to a flowing stream of water and kept immersed in water in a secret place and allowed to decompose. After it has decomposed, it should be taken out, coverings removed and with the help of soft brushes made of usira and bamboo reeds, it should be peeled off slowly, observing the skin and all other external and internal organs, veins, tendons and other viscera etc, as described in the texts and as indicated by the preceptor. (38)
इति शास्त्रेण यद्दृष्टं दृष्टं प्रत्यक्षतश्च यत् । समागतं तदुभयं भूयो ज्ञानं विवर्धयेत् ॥ ३९ ॥
Thus, the knowledge obtained from the texts and that obtained from direct observation both combined together will enhance the knowledge of the physician. (39)
Sastrakosa – instrument kit
स्यान्नवाङ्गुलविस्तारः सुघनो द्वादशाङ्गलः । क्षौमपत्रोर्णकौशेयदुकूलमृदुचर्मजः ॥४०॥ विन्यस्तपाशः सुस्यूतः सान्तरोर्णास्थशस्त्रकः । शलाकापिहितास्यश्च शस्त्रकोशः सुसञ्चयः ॥४१॥
The sastrakosa (instrument kit) shall be nine angulas in width, thick, twelve angulas in length, made from flax (linen), leaves, wool, silk, inner bark of plants or soft leather, inlaid with threads, (apartments made for each instrument separately) well sewn; instruments being kept inside covering their blades with wool (or wollen cloth). The wallet is then rolled and the opening flap, held tight by fixing a rod. (40-41)
Notes In this chapter the author has tried to describe most important and commonly used blunt and sharp instruments. The description is not very vivid and lacks specificity at many places. Hence the knowledge we gain by this description should not be considered as very correct and should not form the basis for reviewing the merits or demerits of these instruments. On the other hand we cannot but appreciate the ingenuity, in fabrication and skill in making use of quite a large number of instruments, of the physicians (surgeons) of ancient India; methods of tempering of sharp instruments, show the advances in technology.
॥ इति चतुस्त्रिंशोऽध्यायः ॥
Thus ends the thirty-fourth chapter.