Defective Venesection

Now we shall describe the twenty kinds of defects relating to an opened vein (Dushta-vyadhana). They are as follows: - Durviddhá, Atividdhá, Kunchitá, Pichchitá, Kuttitá, Aprasrutá, Atyudirná, Ante-abhihatá, Paris'ushká, Kunitá, Vepitá, Anutthita-viddhá, Sastrahatá, Tiryag-viddhá, Apaviddhá, Avyadhyá, Vidrutá, Dhenuká, Punhpunarviddhá and Marmaviddhá, i.e., incised about the Sirá-marma, the Snáyu-marma, the Asthi-marma and the Sandhi-marma. 52-53.

Their Definitions

The vein in which an act of venesection is unattended with a satisfactory outflow of blood owing to its being incised with an extremely slender instrument and is marked by an extremely painful swelling in consequence thereof, is called Durviddhá (badly incised). The vein in which the incision becomes excessive and no blood comes out properly or enters an internal channel owing to the largeness of the incision, is called Atividdhá (over-incised). An opened vein in which the incision has been made in a curving manner and is attended with the foregoing results, is called Kunchitá(crooked or contracted). An incised vein presenting a flattened or thrashed appearance on account of its being opened with a blunt knife (Kantha-Sastra) is called Pichchitá (thrashed). The vein at the sides of which incisions have been successively made, instead of in its body, is called Kuttitá (lacerated). An incised vein, unattended with any bleeding owing to the patient's fright, coldness or loss of consciousness, is called Aprasrutá (unbleeding).

A vein with a large incision in its body made with a sharp and flat-edged instrument, is called Atyudirná (improperly wide-incised). An opened vein in which blood oozes out in small quantity is called Ante-abhihatá (struck in the interior). An opened vein in an anaemic patient (marked by a total absence of bleeding and) stuffed with Váyu (lit., as if the flow has been dried up by the Váyu), is called Paris'ushká (dried up). A vein opened but to a quarter part of the proper length and attended with a scanty outflow of blood, is called Kuuitá (partially incised). A vein which trembles owing to its being bandaged at a wrong place and from which blood does not flow out in consequence, is called Vepitá (quivering). A vein incised without being previously properly raised up and attended with a similar result (ie., absence of blood), is called Anntthita-viddhá. A vein cut into two and attended with excessive bleeding and inoperativeness of the organ is called Sastrahatá (knife-cut). A vein incis:d with an instrument applied slantingly and (consequently) not fully opened, is called Tiryag-viddhá (obliquely incised). A vein incised several times and (every time) with an improper instrument, is called Apaviddha (wrongly incised) A vein unfit for opening (i.e., whose opening has been forbidden in the Sástras is called Avyádhyá (unfit for opening). A vein opened carelessly and hastily is called Vidrutá (erratic). A vein bleeding continuously owing to its being repeatedly pressed and successively opened, is called Dhenuká. A vein variously cut owing to its being pierced into the same part with an extremely slender-pointed instrument, is called Punah-punarvidahá (repeatedly incised). If a vein in the Snáyu-marmas, the Asthi-marmas, the Sirá-marmas or the Sandhi-marmas be opened, it is called Marma-viddhá and in such cases severe pain, emaciation (Sosha) deformity or (even) death may be the result. 54.

Memorable Verses

Practice (even) docs not give the necessary skill in surgical operation of the veins etc., as they are naturally unsteady and changing like fishes. Hence a vein should be opened with the greatest care. An opening into the body, made by an ignorant and unskilful surgeon, is attended with the aforesaid dangers and many other distressing symptoms. An act of venesection, properly performed, gives more speedy relief than that derived from the application of medicated oil etc , or of plaster as well. Venesection (bleeding) properly performed is half of the treatment described in surgery like the application of Vasti-karmas (enematic measures) in therapeutics. 55.

A man medically anointed (Sneha-karma), diapho-rised (Sveda) vomited (Vamana), purged (Virechana), or treated with both the Vasti-karmas (Anuvásana and Asthápana) or bled shall forego anger, physical labour, sexual intercourse, sleep in the day time, excessive talking, physical exerciser, riding or driving etc., sitting on his haunches, frequent ramblings, exposure to cold, winds and the sun, hardly digestible, uncongenial and incompatible food until the strength is perfectly restored or, according to some authorities, for a month. These subjects will be fully dealt with later on Aturopa-drava-chikitsá. ch. - 39). 56.

Memorable Verses

The vitiated blood incarcerated in any part of the body should be abstracted therefrom by scarifying it, by cupping it with a Sira (pipe), a horn, a gourd, or leeches, or by the opening of a vein respectively, according to the density of the blood. (Others assert that) leeches should be applied in the case of the (vitiated) blood being confined deep into the body, scarification with a surgical instrument should be made in the case of clotted blood, with a pipe in the case of extensive vitiation of the blood throughout the body and with a horn or a gourd in the case of the deranged blood having been seated in the skin. 57-58.

Thus ends the eighth Chapter of the Sárira Sthánam in the Sus'rutá Samhitá which treats of venesection.