Pranashta Shalya Vijnaiyamadhyaya – 26th Chapter of Sushruta Samhita

Abstract

Pranashta Shalya is 26 Chapters of Susruta Samhita, which states that Foreign Bodies such as Hair, Bone and Stone do not get dissolved in the body but become liquified and then fuse with tissues. Susruta Samhita is an ancient Sanskrit Text which covers Surgery and medicines. This text Covers various branches of the medicinal discipline which includes Shalakayatantra. Rigveda and Atharvaveda are the earliest documented ancient Indian Books which have various references to health and diseases. Ayurveda is the branch of Atharvaveda which is the fourth book of Vedic Literature. Susruta Samhita has 184 chapters which contain 1200 descriptions of Illness, 700 medicinal plants, 64 preparations from mineral resources and 57 preparations which are based on animal sources. These texts explained various techniques of incisions, Probing and extraction and other intestinal obstructions and principles of the management of fracture. In this article, we are going to discuss knowledge of foreign bodies.

Introduction

Susruta is the author of Susruta Samhita which has great historical importance and perfectly describes Surgical training, Instruments and Procedures which is further followed by modern science. The Oldest Susruta Samhita palm leaf manuscripts are preserved at Kaiser Library, Nepal. Susruta Samhita is divided into two parts- The first five books are the oldest texts and the later section was added by Nagarjuna. Susruta Samhita provides details on Toxicology, Pediatrics, Pharmacology and other branches of Traditional system medicine known as Ayurveda. Examples of operations include – Rhinoplasty, removal of the dead fetus and lithotomy which are unique with various practical techniques.

Pranashta Shalya Vijnana

1. Nirukti Of Shalya (Etymology)

The Roots Sal and Sval mean moving Quickly and the first root Sal is derived from the term Shalya. There are two types of Shalya- Endogenous (which are produced within the body) and Exogenous (which are produced outside the body).

2. Definition Of Shalya

Shalya which creates misery or pain in the body is known as Shalya. The description of the same surgery is given here and it is called Shalyatantra.

3. Shalya Bheda (Types Of Shalya)

Shalya is of two types Sarira (body) and Agantuka (the diseases which are from outside sources).

1. Saririka Shalya (which is derived from itself) –
   • Teeth, Nails and Hair
   • The dhatus (tissues)
   • Waste products the food
   • Imbalanced doshas
2. Agantuj Shalya (derived from outside) – These are the factors and the substances which are from other Shalyas of the body which produce pain and misery.

4. Shalya Adhikara (Composition Of Foreign Body) –

• Shalya is composed of metals, Bamboo, wood, Grass and bones of animals and from iron itself.
• Iron which is used for slaughtering (causes injury), the term shalya is extensively used which describes the weapons made up of Iron which are known as Shalya.
• Those Shalya which are made up of Iron (Arrow) alone are difficult to pull out as they have a small mouth (small orifice) which is being thrown from a distance.

5. Shalya Types

It is of two kinds-

1. Karni – Having an Ear and is attached to the front part
2. Slaskshana – This has smooth ends without any attachments.

These arrows are of various types such as in the shape of leaves, Flowers and fruits of different kinds which resemble the faces of wild animals and birds.

6. Shalya Gati

Direction of the movement of foreign bodies. The direction of movement which is of various kinds (arrow) can be either big or small and has 5 directions such as

• Upward
• Downward
• Backwards
• Sideward
• Straight/ from the front

7. Ashraya Of Shalya (Dwelling Of Foreign Body)

• The foreign body (arrow) because of the weakened power or can be due to any obstruction which gets clogs into the skin and in the wounds (seat of tissue), in arteries, channels and in the muscles or in any part of the body.

8. Shalya Lakshana (Symptoms Which Are By Foreign Body)

These are of two types- General (Samanya) and Vaisesika (special).

1. Samanya (General) – The wounds are associated with the below-giving features which tell about the existence of a Foreign body inside it-
   • Black blue colour
   • There are a lot of eruption
   • Swelling and pain
   • Leaks blood
   • Bubble like budge
   • The softness in muscles
2. Vaisesika (Special) –These are the notable symptoms as follows
   • When it gets lodged in the skin – The colour of the skin will be changed, with swelling which is broad and hard to touch.
   • When the Shalya gets lodged into muscles – There will be symptoms as follows-
     • An increase in swelling and new growth will be seen in various paths of foreign bodies.
     •  tenderness with the formation of pus.
   • When the Shalya gets lodged into the Muscle sheath – There will be symptoms as follows-
     • Sucking pain
     • Swelling
   • When the Shalya gets lodged into Veins – The symptoms will be
     • Distension of vein
     • Pain
     • Swelling in the Veins
   • When the Shalya gets lodged into Snayu (ligaments) – Symptoms will be as follows-
     • Trembling ligament networks
     • Profound Swelling
     • Pain
   • When the Shalya is in Dhamani (Artery) – In this the symptoms show-
     • The Vata gets aggravated and there is free flowing of vata doshas along with a sound
     • Pain all over the body
     • Nausea
     • Thirst
   • When the Shalya gets lodged in the bone – The symptoms involved are-
     • Different kinds of pains
     • Swelling
   • When it gets lodged into the cavity of bones – The symptoms are as follows-
     • There is the filling of the cavity
     • Pricking type of Pain in the bones
     • Severe rubbing
   • When it is lodged into Bony Joints – The symptoms are as follows-
     • Loss of functions of joints
     • The foreign body gets lodged into the bone region.
   • Shalya gets lodged into the Alimentary Canal – The various symptoms are as follows –
     • Gurgling sounds
     • Flatulence
     • There is an appearance of urine and feces from the opening of the wound.

When the Shalya is in Vital spots the symptoms of the injury appear whenever there are movements.

9. Prognosis

• Whether the foreign bodies are big or small, the person whose body is pure (without any vitiated doshas) when it is present in the direction of Hair, gets healed, when it is present in the passage of the throat, vein, muscles and in the cavity of the bones.
• When the shalya (foreign body) is displaced from its position, it causes the doshas to become more aggravated, resulting in indigestion, injury, and further body difficulty.

10. Shalyaasthana Jnanodaya

• When the Shalya (foreign body) gets lost or found deepened in the skin, first Snehan (oleation) must be done
• Then a paste of Mud, flour of Masa and Yava along with Godhuma and cow dung are mixed together and properly rubbed on the skin area.
• The site where swelling, redness and pain which is seen while rubbing at the sites of insertion of foreign body.

The Second Method Is

• When the solid ghee or paste of Sandalwood, is applied on the body, that place where the ghee melts and the paste of sandalwood gets dried up, can be the site of lodging.

When the Foreign body is lodged into Muscles

• There must be oleation and other therapies which are not contradictory. In an emaciated person, the site of lodgement must be loosened (non-sticky). This gets displaced and causes redness, swelling and pain where there is the presence of a Foreign body.

When the foreign body is lodged in the Siras, Dhamani and Snayaus

When it has been lodged in Sira (veins), Dhamani (artery), Srotas (channels) and Snayu (ligaments), he/she must be advised to sit on the cart and the wheel must be broken and allowed to run on the irregular road. The place where the swelling arises there is the presence of the foreign body.
When the foreign body is lost, the patient must be given an oleation and sudation so that the bones are held tightly with various bandages and then squeezed hard. The red, swell site must be the site of the presence of the foreign body.

Foreign body in Bony Joints

When it is concealed in bony joints, then the oleation and sudation process must be done. Then it is necessary to apply bandage, pressure, flexion and extension. In the place where swelling is felt with pain, there will be the presence of Shalya.

When the foreign body is present at vital spots apart from tissues, the determination site of a foreign body should be during the below- mentioned activities-

• Riding an elephant or horse.
• Climbing a horse
• Exercise
• Wrestling
• Walking a long distance
• Swimming
• Jumping High
• Belching
• Coughing
• Controlling breath
• Eliminating flatus, urine, faeces and semen
• Deep Inspiration

Identification Of Foreign Body

The place where there is a pricking type of sensation with numbness and absence of sensation, feeling of heaviness or where there is discharge and pain that is the place of the Foreign body.