Susruta Samhita - Mandhata Global

Chap. XVII.] CHIKITSA STHANAM. 423
Treatment with Kshara-Sutra :—An
erudite surgeon should open a i-inus, occurring in any
of the Marmas, or in a weak, timid, or emaciated person
with an alkalined string (Kshara-Sutra\, and not with a
surgical knife. The course of the sinus should be first
ascertained with a director ;
and a needle, threaded with
a string of alkalined thread should be passed from one
end of the sinus and quickly drawn out through the other.
Then the two ends of the thread should be firmly fasten-
ed together. An intelligent surgeon should likewise pass
another alkalined thread in the event of the alkali of the
first thread being comparatively weak. This should
be repeated till the sinus completely bursts out.
The surgeon should know that the same procedure
may be as well adopted in cases of fistula-in-ano.
Similarly in cases of tumours (Arvuda), etc. they
should be lifted up (with the hand) and tied round at
their base with an alkalined thread, or it should be
punctured around with a kind of needle with their mouth
resembling a barley corn and then tied again at their
base with an alkalined thread. After their bursting (and
falling ofi), they should be treated as common ulcers
(Vrana\ 16,
The different kinds of Plug-Stick (Varti) described
in the Dvi-Vraniya Chapter (Chikitsita— chap.-i.) may
be similarly used with advantage in all cases of sinus.
The use of a plug made of the following drugs, viz.,
the bark and fruit of the Ghonta, (the five officinal kinds
of) salt,* LdksJid, Puga and the leaves of the Alavand -f-
* According to Chakradatta's reading and S'ivadas's commentary there-
on, only the Saindhava (instead of the five oflicinal kinds of salt) should be
taken. We, however, follow Dallana's interpretation with good results. -.Si/.
t ''Alavana" has been explained by Dallana as "Kaka-mardanikd"
and by S'ivadasa as "Jyotishmati". S'ivadasa is, however, followed in
practice in this case.