Instruments that are fitted with handles of easy grip and are made of good and pure iron, well shaped, sharp, and are set with edges that are not jagged and end in well formed points or tops, should be deemed as the best of their kind.
incapable of cutting hair, unequal sharpness of the edge, rough-edgedness, over-thickness, over-thinness, over-lengthi-ness, and over-shortness are the defective traits in a surgical instrument. Those possessed of contrary features should be used. But a Karapatram set with a very rough (dentated) edge may be used for the purpose of sawing the bones.
A surgical instrument meant for excision (Bhedanam) should be set with an edge as thin as that of a Musura pulse (lentil seed), while an instrument used in scraping should be set with an edge half as thin as that of the former. An instrument used either in connection with the measures of secretion or cutting by uplifting (Vyadhanam) should be set with an edge as fine as the human hair, while an instrument of incision should have an edge half as thin as that of the former.
Surgical instruments should be tempered with one of the three substances such as, alkali, water, and oil. Instruments used in cutting an arrow, a bone, or any foreign matter (Shalyam) pricked into the human body, should be tempered with alkali, whereas those that are made use of in cutting, cleaving, and lopping off the flesh from an affected part), should be tempered with water. Instruments used in opening (Vyadhanam) a vein (Shira) or in cutting open a nerve (Snayu) should be tempered with oil, and should be whetted upon a species of stone-slab resembling a Masha pulse in colour, and their set-edge should be protected by putting it in a sheath made of Shalmali wood.
An instrument, well-ground, well-shaped, fitted with a convenient handle and capable of (laterally) cutting a hair in two and made according to measures laid down in the Shastras, should be alone used in a surgical operation.
The skin of bamboos, crystals, bits of glass, Kuruvindas (a sort of crystal) leeches, fire, alkali, nails, the leaves of trees known as Goji, Shephalika and Shakapatra, the tender sprouts of corn, hair, and the fingers, should be included within the category of the minor instruments of surgery and (which may be used in certain instances in substitution for the principal and usual ones).
The four articles such as strips of bamboo skin, crystals, bits of glass, and the rock known as Kuruvinda, should be used by an intelligent physician in incising or excising Bhedanam) operations, where the patient would be found to have a dread of the knife, or too young to be surgically operated upon with it, or where the proper instrument cannot be procured. The nails of fingers should be used in operations of incising, excising or extracting in (substitution for the instruments enjoined to be used for the purpose), when such a course would appear feasible. The processes of applying alkalis, leeches and cauterisation will be dealt with later on. In Diseases affecting the eyelids or the cavity of the mouth, operations for the purposes of secreting or evacuating the accumulated pus or phlegm;, may be performed with the leaves of Shakapatra, Shephalika or Gojis. In the absence of a probe or director, searching may be done with the help of a finger, or with a hair, or with a corn sprout. An intelligent physician should deem it his imperative duty to get his surgical instruments made by a skilful and experienced blacksmith, and of pure, strong and sharp iron (steel). A physician, skilled in the art of using surgical instruments, is always successful in his professional practice, and hence the practice of surgery should be commenced at the very outset of medical studies.