Ashtang Hridaya Sutra sthana chapter 26

1. Ashtang Hridaya
Dr. Abdeli Bhadarva Page 1
A.H.Su.26
Shastravidhi Adhyaya
 Shastra means sharp surgical instrument
 Number: 26
 Characteristics of Shastra:
 It should be prepared from skilled metal smiths, as per traditional method of
preparing surgical instruments.
 Length: generally six Angula (fingers breadth)
 capable of splitting the hair/shaving
 Good to look at, with sharp edges
 Good to hold firmly
 Shastra should not be of ugly shape.
 They should be prepared from well blown– removed of impurities strong steel
like iron.
 The front of their mouth. i.e.– the shape edges well hammered – to make them
sharp
 Color: resembles the blue lotus
 With shape in accordance with their name
 Always ready at hand for use
 Their blades- cutting edges being 1/8th of their own size (total length).
 Each – instrument two or three in number should be made use as suitable to the
place site of operation
 Suchi: Needles for suturing/swing are of three kinds.
One is round; others two are strong and thick having threads passing through a hole in
their body near its root.
 The needles for suturing in fleshy parts will three edges and length of three
Angula.
 For use in less flashy places, bony joints and wounds on Asthi, with a length of
two Angula.
 Vrihimukha Suchi-
 Curved needle is bent like a bow or like the grain of paddy.
 Useful for- sewing/ suturing of intestines, stomach and vital spots
 Two and half Angula in length.
 Anushastras are - which are non-metallic.
 They are many.
Jalauka
Kshara
Dahana
Kacha–

2. Ashtang Hridaya
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Upala –cow dung cake
Nakha- nail
stone, etc.
 Shastra Karma: 13
1. Chhedan
2. Bhedana
3. Lekhana
4. Vedhana
5. Eshana
6. Patana
7. Utpatana
8. Kuttana
9. Prachchhana
10. Seevana
11. Manthana
12. Grahana
13. Dahana
 Shastra Dosha: 8
1. Kuntha (bluntness)
2. Khanda (brokenness)
3. Tanu (thinness)
4. Sthula (stoutness)
5. Hrisva (smallness)
6. Dirgha (lengthy)
7. Vakra (curvedness)
8. Kharadhara (rough edge)
 The Shastrakosha (instrument wallet) should be
 9 Angula in width & 12 Angula in length (9 ×12).
 It should be made from jute, leaves, wood, silk, inner bark of trees or soft leather.
 It should be endowed with threads, well stitched with compartment for
instruments, which should be kept wrapped in wool.
 Its mouth closed and held tight with a rod- acting like a bolt
 Pleasing to look at as well as to preserve.
Jalauka Avacharana Vidhi
 Indication:
 Leeches should be made used of for letting out blood from happy persons
 Pittaja Rakta Dushti
 Children, old age
 Klesha Asahishnu

3. Ashtang Hridaya
Dr. Abdeli Bhadarva Page 3
 Who live royal life, king etc.
 Characteristics of Grahya and Agrahya Jalauka.
Agrahya (prohibited) Jalauka:
 Leeches which are born (& live) in dirty and polluted water by putrefied by deas
bodies of fish, frog and snakes & their excreta.
 Leeches, which are
 Red, white or very black in color
 Chapala – very active
 Poisonous
 Thick and slimy.
 Leeches, which have
 Variety of streaks on the upper parts of the body like rainbow.
 More hair
 This kind of Jalauka should be avoided.
 If used, they produce itching, ulceration, fever and giddiness,
 Treatment: it is treated with drugs which mitigate poison, Pitta and Rakta.
Grahya (Useful) Jalauka: Following kind of Jalauka are Nirvisha- non poisonous- so can be
used.
 Those born in clean water
 Which are blue
 Round in shape
 Having blue lines in their back, rough/ hard back
 Thin body
 Slightly yellowish belly
Raktamatta: Even these, when they do not vomit the sucked blood fully, when they are applied
frequently, and when they are inactive even after getting into water, should be considered as
Raktamatta and should be rejected.
Jalauka should be used in diseases such as, Gulma, Arsha, Vidradhi, Kushtha, Vatarakta,
diseases of neck & eye, Visha, Visarpa.
Procedure:
 The leech that are kept for short time in water containing paste of turmeric / grain washed
water (Avantisoma) / buttermilk should be made comfortable by putting back in pure
water.
 Jalauka should be made to stick to the body of the patient.
 Jalauka are attracted to the desired part of the body, by rubbing the part with ghee, mud,
breast milk / blood or by making a wound with a sharp instrument.

4. Ashtang Hridaya
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 When it starts drinking blood by raising its shoulders, it should be covered with a soft
cloth.
 Thus stuck up, the leech will suck only the vitiated blood first from the mixture of
vitiated and pure blood, just like the swan sucks the milk from a mixture of milk and
water.
 When pricking pain or itching develops at the site of the bite, the leech should be
removed.
After care of Jalauka:
 They are then made to vomit the sucked blood by touching their mouth with salt and oil
or by gentle rubbing in the direction of their mouth after smearing fine rice flour over
them.
 After making them vomit they should be protected from Raktamatta and should not be
used again for seven days.
 After proper vomiting- the Leech regains its previous activity and becomes strong.
 By too much of vomiting - becomes very weak or may even die.
 If vomiting is improper- it becomes lazy, inactive and intoxicated.
 They should be transferred from one pot to another, filled with good mud and water, in
order to destroy- avoid putrefaction by saliva, excreta of leeches, because the leeches
become poisonous with such a contact.
After care of patient:
 When in doubt of impurity, the site of the bite should be made to bleed by applying paste
of Haridra, Guda (jaggery) and honey.
 Later a piece of cloth soaked in Shata Dhauta Ghrita or cooling pastes prepared from
drugs of Sheeta Virya should be applied – over the site.
 With the removal of vitiated blood, the redness and pain subside immediately.
 The vitiated blood, displaced from its site and accumulating in the interior of the wound
becomes greatly sour by stagnating overnight; hence it should be expelled out again.
 After the bleeding procedure, the site of bleeding should be covered with cooling paste.
By doing this, if it causes Vayu Prakopa and leads to the pain, itching and edema at the
site.
 Treatment: the area should be bathed with warm ghee.
Other methods of blood letting
 Alabu & Ghatika: Alabu or Ghatika (cupping method) should not be used to remove the
vitiated blood when the blood is vitiated by Pitta, because they are associated with fire. It
would further aggravate Pitta. They should be used in case of vitiation by Kapha and
Vata imbalance.

5. Ashtang Hridaya
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 Shrunga: The blood vitiated by Kapha should not be extracted by using a Shrunga
because of thickness of the blood, whereas blood vitiated by Vata and Pitta should be
removed by the sucking horn. Shrunga is good for Vata and Pitta imbalance and not
indicated in Kapha.
 Pracchana:
 The part of the body above the site, selected for bleeding should be tied tightly
with a rope of leather scrap.
 Tendons, joints, bones and vital spots are avoided and Prachanna Karma
(scratching, incision) by sharp scalpel done from below upwards.
 It should not be done in horizontal direction.
 Useful in blood accumulated in any localized area- small area.
 Done when the blood is solidified.
 Jalauka: Useful in Grathita Rakta & when vitiated blood is deep seated.
 Siravyadha: Done when vitiated blood spreaded all over the body
 Shrunga etc. (Alabu, Ghatika): in numbness and when vitiated blood is localized in skin.
Rakta Appropriate measure
Vata Dushita Rakta Shrunga
Pitta Dushita Rakta Jalauka
Kapha Dushita Rakta Alabu