Astanga Hrudaya
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सिरास्नायुविलग्नं तु चालयित्वा शलाकया। हृदये संस्थितं शल्यं त्रासितस्य हिमाम्बुना॥२६॥
Removal of shalya which cannot be held by instruments: Foreign bodies lodged in the veins and ligaments (tendons, nerves) should be pulled out after loosening them with the help of rod like instruments. Removal of shalyas embedded in the chest/heart :If the foreign body is embedded in the heart/chest, in a person, chilled water should be sprinkled.
english translation
sirAsnAyuvilagnaM tu cAlayitvA zalAkayA। hRdaye saMsthitaM zalyaM trAsitasya himAmbunA॥26॥
hk transliteration by Sanscriptततः स्थानान्तरं प्राप्तमाहरेत्तद्यथायथम्। यथामार्गं दुराकर्षम् अन्यतोऽप्येवमाहरेत्॥२७॥
Later, after knowing that it has reached a distant place (different site in chest), it should be removed by situational usage of instrumentation as apt to that site and shape, size and shape of the foreign body and the pathway in which it has been impacted. The foreign body located in the heart is difficult to extract/remove. Removal of un-removable Shalyas embedded in other sites of the body: The un-removable (difficult to remove) foreign bodies located elsewhere in the body too should be removed just as mentioned in case of heart (they should be removed when they move away to a distant place).
english translation
tataH sthAnAntaraM prAptamAharettadyathAyatham। yathAmArgaM durAkarSam anyato'pyevamAharet॥27॥
hk transliteration by Sanscriptअस्थिदष्टे नरं पद्भ्यां पीडयित्वा विनिर्हरेत्। इत्यशक्ये सुबलिभिः सुगृहीतस्य किङ्करैः॥२८॥
Removal of shalyas embedded in the bones : Foreign bodies lodged in the bones should be removed by holding the patient tightly (in position) with the help of the legs of the physician. If it is not possible to remove the foreign body even by this method, it should be pulled out by attendants who are strong.
english translation
asthidaSTe naraM padbhyAM pIDayitvA vinirharet। ityazakye subalibhiH sugRhItasya kiGkaraiH॥28॥
hk transliteration by Sanscriptतथाऽप्यशक्ये वारङ्गं वक्रीकृत्य धनुर्ज्यया। सुबद्धं वक्त्रकटके बध्नीयात्सुसमाहितः॥२९॥
Measures taken to remove the shalyas when they cannot be pulled out When it is not possible to extract the foreign body even by the above said method, the tail end of the foreign body (example, arrow) should be bent and fastened tight to the string of a bent bow.
english translation
tathA'pyazakye vAraGgaM vakrIkRtya dhanurjyayA। subaddhaM vaktrakaTake badhnIyAtsusamAhitaH॥29॥
hk transliteration by Sanscriptसुसंयतस्य पञ्चाङ्ग्या वाजिनः कशयाऽथ तम्। ताडयेदिति मूर्धानं वेगेनोन्नमयन् यथा॥३०॥
And the bow should be tied perfectly to the bridle bit of a horse whose all four limbs and face are tied aptly. The horse should then be whipped, so that it raises its head suddenly and with force exerted on the foreign helps in removal of the foreign body.
english translation
susaMyatasya paJcAGgyA vAjinaH kazayA'tha tam। tADayediti mUrdhAnaM vegenonnamayan yathA॥30॥
hk transliteration by Sanscript