Parts To Be Guarded In Lithotomic Operations

The Mutra-vaha (urine-carrying) and the S'ukra-vaha (semen-carrying) ducts or channels, the Mushka-srotas (cords of the testes), the Mutra-prascka (urinary) channels, the Sevani (the raphe of the perineum), the Yoni (uterus, vagina, etc.), the Guda(rectum,)and the Vasti (bladder) should be carefully guarded at the time of performing a lithotomic operation. Death results in the event of the urine-carrying channels being in any way hurt during the operation owing to an accumulation of urine in the bladder. Similarly, any hurt or injury to the semen-carrying ducts at the time, results in death or in impotency of the patient; a hurt to the cords of the testes begets an incapacity of fecundation; a hurt to the urinary ducts leads to a frequent dribbling of urine; while a hurt to the Yoni (uterus, vagina, etc.), or to the raphe of the perineum gives rise to extreme pain The symptoms which characterise a hurt to the rectum or to the bladder have been described before. 19.

Memorable Verses

The surgeon who is not well cognisant of the nature and positions of the Marmas or vulnerable parts seated in the eight Srotas (ducts) of the body such as, the raphe of the perineum, the spermatic cords, the cords of the testes and the corresponding ones in females (Yoni), the anal region, the urinary ducts, the urine-carrying ducts, and the urinary bladder and is not practiced in the art of surgery brings about the death of many an innocent victim. 20.

Thus ends the seventh Chapter of the Chikitsita Sthánam in the Sus'ruta Samhitá which deals with the treatment of Urinary calculus.