AN ENGLISH TRANSLATION OF THE SUSHRUTA SAMHITA Vol. II. NIBANA-STHANA TO KALP VSTHAN A. AN ENGLISH TRANSLATION OF THE SUSHRUTA SAMHITA A KUI.I. ANI> COMPREHENSIVE INTRODUCTION, ADDITIONAL TEXTS, DIFFERENT HEADINGS, NOTES, COMPARATIVE VIEWS, INDEX, GLOSSARY AND PLATES IN THREE VOLUMES KAVIRAJ KUNJA LAL HHISH AGRATNA, M.R.A.S. Vol. II. NIDANA-ST1IANA, S'AIUUA-STIIANA, CIIIKITS1TA- STIIANA AND KALAI'.VSTHaTa. CALCUTTA: l'UHLISHKI) HY THK AUTHOR, NO. 10, KASHI GHOSE's LANE All Rights Reserved. MINTED IV M. 1IHATTACHARYYA, AT Till: BHAKAT MiHIR PRESS, 35, SOY DAUAN STREET, CALCUTT*. PREFACE. It is with mingled feelings of pain and pleasure that we now place before the public the Second Volume of our English Translation of the Susruta Samhita. The arduous task of com- piling a connected and succint history of any part whatever, of the ancient Hindu System of Medicine— requires greater leisure and jviore extensive reading than we can lay any pre- tension to. Years of patient study and constant discourse with our sainted preceptor the late, lamented Mahamahopadhyaya Kaviraj Dwaraka Nath Sen, Kaviratna, that refulgeat link of the golden chain of the Dnanvantaric succession, have enabled us, however, to grasp the leading facts, and during the last few years we have worked continuously, in moments snatched from the practice of an anxious profession that knows no respite, to arrange these facts in their present form. It breaks our heart to record the sad departure of our venerable ,Acharyya from this sublunary sphere to a land ''fram whose bourne no traveller e'er returns.'' It is hardly necessary for us to reply to those critics who, through their ignorance of the original f « ; Sanskrit works, persist in describing Ayurveda as an empirical system destitute of Anatomy, Physiology or Pathology in any scientific sense. It behoves us, however, in this preface to meet some of the charges which have been brought against us. Exception has been taken to our not includ- ing in the opening stanza the usual invocation to the Supreme Self (for a successful completion of the work) although it has found its way into almost all th'e printed editions of the work extant. Now the stanza referred to finds no place in the various manuscript copies of the original wbrk which are in our possession, or on which we have been able to lay our hands. The work jvas first put into print by the late Dr. Madhu- sudan Gupta and we believe that it was only in this printed edition that the benedictory address in question^ appeared for the first time, and that it has since crept, by the process of circulation, into subsequent printed editions. In this opinion we are supported by the fact, ' that in none of the various commentaries and anno- tations on the Susruta Samhita is any mention made of the line in question, whereas, had it been the opening stanza of the original work, it would certainly have received at least a passing notice at the hands of the commentators, however easy or simple it might have been. Further, were it composed by Susruta himself, it would not have ( 3 ) been in the form ip which we find it in the printed editions. The ancient sages used invariably the auspicious expression "WTO*. * or. " sifaj'''' and the like, when commencing a work and never invoked any particular deity for a happy termination of their undertaking.* These are the reasons which have led us to omit the passage in our present translation. Another objection raised by a certain section of the community is that we should not have at all undertaken to translate the work into the English language. Their contention is that the Ayurveda, being an integral portion of the Eternal Vedas, should, on no account, be rendered into a* 'Mkchchha Bhdshd and thus made accessible to the public at large, irrespective of caste or creed. Such an objection, at this time of^the day, is, to say the least, most puerile ! Truth is truth, and latitudes and longitudes are not its boundary lines. The Vedas themselves have been trans- lated into many European languages. To keep the truths promulgated by our ancient sages con fined within the coterie of the privileged classes and thus to deprive the educated public of the * Thus :- 'a) " procedure. •Here we must not stop wittiout expressing our sincere and hearty thanks to our learned and valued friends Kaviraj Jogindranath Sen, M.A., Vidyabhusajja, Kaviraj Jnanendranath Sen, B.A. ( Kaviratna and ProfesSor Satycndranath Sen, M.*A., Vidyavagisa, who have rendered us material help in the publication of this volume. We must freely admit that but for the active and continued * co-operation of the above-named gentlemen we could not have brought out this volume so promptly and successfully. Our thanks are also due to Dr. S. Sanyal, B.Sc, L.M.S. for his kind help, to Dr. S. N. Goswami, B.A., L.M.S. for his kindly supplying us with materials for writing the Introduction, and to our readers for their kind encouragement. ( 5 ) In conclusion, we implore our readers to excuse the errors of omission and commission which are inevitable in the execution of such a huge work, more especially when the author is encumbered with the responsible duties of his profession involving, as they do, the life and death of persons entrusted to his care. iO, Kashi Ghosiie's LANE.i Calcutta. [ Kunja Lai, IJiiisiiagkatna. November, lgil. • : o, LJ -f\ INTRODUCTIO In the introduction of the first volume of our translation of the Susruta-Samhita we have attempt- Ayurveda Is not e( j to place before the public a correct an Encyclopaedia r . ,„, „. . „ , or ancient medical interpretation of Vayu, Pitta and Kapha, tTs e r onBiology T " a ' the falsely s °- cal,ed humour3 of the body 4 and it is a great pleasure to us, that our pronouncement has been very kindly accepted. In the introduction of the present volume we would draw the attention of the readers to the fact that Ayurveda is not at all an encyclopaedic work, — an Encyclopaedia of the Indian • * Berdoe says :— "What is known as the Humoral Pathology formed the most essential part of the system of the Dogmatics. Humoral Pathology explains all diseases as caused by the mixture of life four cardinal humour*, vh. t Ihe blood, bile, mucus or phlegm and water. Hip- pocrates first leaned towards it, but it was Plato whodevoloped it. The stomach is the common source, of all these humouri. When diseases develop, they attract humours. The source of the bile is the liver, of the mutus the head, of the water the spleen. Bile causes catarrhVand rheu- matism, dropsy depends on the spleen." Be it observe.1 that among the humours of Hippocrates there is no place for Vita although in point of fact both his Physiology and Patho- logy are to be traced to the "Tri-dhitu" of Ayurveda, The secrtt of this anomaly is that the theory of Vdta was found to be a complicated one and Hipprocates, cot being able to comprehend its original import, left it out and cautiously introduced, in its stead, his own theory of "water". Sowe fin,! "Humoral Pathology is not of Indian origin ; neither it is the same which the Indian Risbis of Rigteda developed under the name of Tri-dhitu." It is simply an imitation of Suirula who introduced blood ( ^lfoqqqff : ) as the fourth factor in the genesis of diseases. But the bor- rower, in his interpretation of Simula, had made a men of it. He retain* ed blood, but substituted "water" in place of Vata, the most important of the three, for reasons best known to him* li' INTRODUCTION. system of Medicine in all its departments^ but it is the Science of Life entire. Though it is customary and convenient to group apart such phenomena as are termed mental and such of them as are exhibited by men in society, under the heads of Psycho- logy and Sociology, yet it must be allowed that there are no absolute demarcations in Nature, corresponding to them, and so in the entire Science of Life, psychology and sociology ' are inseparably linked wish Anatomy and Physiology, nay, more, with Pathology and Hygiene and above all with Treatment. In short the Biological Sciences must deal with whatever phenomena are manifested by living matter in whatever condition 1 it is placed. Life in health ( $1^: ) as well as Life in disease ( ^.Wj: ), therefore, fall within the scope of Biology— even life exhibited by man in Society ( farrM ) 16 not exempted from it. fW T» tRtWI??: S 3*H?t l| TOT, ftWTT, ?*T V-aiTO I In calling Ayurveda, therefore, the entire Science of Life, "• Ayurveda,--the We ' lre not Ruided ,1y ' lny P re i udice entire Science of of our own, but we rely solely on *' facts and figures, and these, when closely studied, will lead any one to arrive at the same conclusion, not unlike our own and to interpret Ayurveda as a collection of Biological Sciences in all departments. In the firs', place, for the guidance of our readers, we will mention that the name Ayurveda itself is a strong evidence in favour of its being called the Science Negative Eviden- ces thereof:— of Life. Secondly, we will refer to 1. The Name it- t [, e arran g e ment of the subject-matter in the Sirira-sthina which is popu- larly belived to be the anatomical portion of the book, as tending to the same conclusion. In ment of the sub- "'is section, chapters on Midwifery je'ct-mattws. and Management of Infants follow close to the heels of those on. Anatomy and Physiology, and INTRODUCTION. iii • these latter ag»in»are immediately preceded by chapters on Psychology. This intermixture is certainly an anomaly and can in no wise be satisfactorily explained unless we have to look upon these as general truths of Biology, elucidated by the Introduction of special truths exclu- sively collected from the science of medicine — fatting «hi4 q^fVwri i To call it Descriptive Anatomy or Physiology, in the modern sense of the term is simply ridiculous. The absence of any reference to brain and Want of Descrlp- spinal cord, to pancreas and heart, in tive Anatomy and r , , , „, . , Physiology in the a book of Anatomy and Physiology is stnanaltaelf^- r!ra ' unpardonable and in the Sarira-sthana we feel this absence almost to despon- dency. Moreover, in western medical science, Grey's Ana tony and Kirke's Physiol.igy, for instance, in their built, exceeds, each, more than a thousand of pages and to present to the public, «nder the same name less than half a dozen of pages, as the result of Indian wisdom, is certainly a very miserable contrast— a contrast that is calculated .'to inspire no admiration, but, en the contrary, to generate in scientific minds an universal apathy, at least an apatfw towards all that is connected with the systenfof Indian Medicine In order to save our venerable Rishis from this disastrous plight, we announce here foremost of all, that our beloved Science of Ayurveda is by no means an Encyclopaedic work, but distinctly possesses every characteristic Positive Eviden- thgt marks the Science of B j olog " yi I The definition The very name Ayurvada indicates 0f Sa£e" as Life as that !t is actually a science of Ayus defined by Mr. Her- an( j the word Ayus is used here in the bert Spencer. same sense as Mr. Herbert Spencer understands by his remarkable definition of Life. In his masterly classification Mr. Herbert Spencer has, in his Biology, given, indeed, the first place to Anatomy and Physiology, but still it is divested of any elaborate chapters, dealing with the subjects. a iy INTRODDCTIOH. In the science of Life a short refereScelto the structures of the body or its functions is quite sufficient to illustrate its principles, and if we fail to find therein any discourse on the descriptive Anatomy and Physiology, we still consider that there is nothing amiss. But unfortunately the fate of Ayurveda is otherwise. Though the very name indicates that it is Biology pure and simple, still it is denounced for its dificiencies in Anatomy and Physiology, and doomed for ever, Sanskrit words are notorious for their confusion of meanings, but, as regards Ayurveda there exists no difference of opinion, at least, so far as the first word is concerned. Ayus is Ayus everywhere in Ayurveda and it is the only fault our venerable Rishis may be reasonably charged with, that they did, not put themselves into any great trouble to *xpkin Ayus, but, on the contrary, unlike scientific men, misspelt their energy to ascertain the significance of the insignificant portion of Ayurveda, that is the meanings of the ro8t "Villi)" in the light of Grammar. The scientific ear, ever unsatisfied with these grammati- cal eruditions, ha» ultimately thrust an Encyclopedic value upon what is properly speaking'a book of Biology. Of course, there is a marked difference between the. two. An ordinary treatise on Biology deals with the general truths of life, and does not represent, by way of illustrations, all its special tilths, nor their practical sides, but so far as Ayurveda is concerned, the general truths of Biology are thrown into the background and the special truths, gleaned exclusively from the science of medicine, are given great prominence (fj^irrSfj "BwSt "s^lWTrri ), so much so, that it is now regarded as a system of Medicine and Surgery which has neither Biology, nor Anatomy, nor Physiology, nor Pathology — but is a systematised Empiricism or Quackery, This is certainly a great misfortune. Apart from the name, the arrangement 'of the subject, to which we have just referred, at least, in the section of SArira-sthiifa (the falsely so-called Anatomy of INTRODUCTION. the Hindus),— is^a direct contradiction to its bieng considered as an Encyclopaedic work. The existence of the chapters or midwifery and management of infants in the same, following immediately the chapters on Anatomy, serves as a strong additional evidence thereof. It is an anomaly no doubt, that Midwifery has been offered a place in the section ol Anatomy, but the confusion does not Reasons for Id cor- . . „ , . . ., , . noratlne Midwifery S et at a >' confounded, if we are led to e^Mcttonf** bdieve that the science of generation of a superior race (if we are at all permitted to use the term) forms, indeed, an important depart- ment of Practical Biology. From whatever standpoint we look to the question, we find there are grounds to lead any one to pronounce in our favour and to' come to the conclusion at which we now venture to arrive. Besides these two important facts, we now cite the following passage as Internal evldewee- . . . . . . . , , a strong internal evidence in favour of our view. Maharshi Punarvasu, after giving us a short table of the principal structures of the human body, remarks tnat even this reference is considered by many as superfluous, ' Eeasonsifo'romlt- ' on the .8 roufl ' d . thaV an acquaintance ting Descriptive with the molecular construction of an organism is quite sufficient to help us as a reliable guide to treatment. The passage referred to is quoted below : — Now we ask the reader if this is not a sufficient evidence, proving to the hilt, that Ayurveda is nothing but Biology and that we run no risk of committing a grave omission if the chapter on Anatomy is wholesale dispensed with from Ayurveda, For the improvement of this awkward position — that in the section of Anatomy there should be no Anatomy —the entire credit is due to Susruta, as he has very wisely made tbe suggestion, that a knowledge of the anatomical ' structures of tbe body is of great value, at least so far as it* fl JNTRODUCTIOK helps the Surgeons and the Surgeons only in their operations.* But so far as Biology is concerned with medicine, Susruta does, not forget to lay particular stress on the knowledge of the molecular construction of the body. The following memorable passages actually preached by this renowned Surgeon, some three hundred centuries ago, still stands as a model from which modern Science, even in its present ad- vancement, can draw inspirations. He says ; jit)? 4* vm m em: wifnnv?: 1 swmwrt ^wnilWTO fro 11 2. TOffl:«J!a ?!>! vji iwb v^m 1 • ir*r«mt ft ?? 5? ira?e^ ju^ 1 That is, the protean work of the protoplasm in which the gre»t Self resides cannot be detected by the body's eye ; to know its work, mind's eye is necessary, along with the body's eye. For acquirin^efficiency in Surgery alone, the dissection ' Sustula recommends dissection «n dead human bodies and suggests that it is.only required of those who will practise surgery and that students of medicine can do without it. Hcrophilus practised dissection on living bodies and with the object of practising medicine successfully, but it soon fell into disrepute and did not at all influence the art of Medicine. He was condemned even by his own pupil Philinusof cos who declared that all the Anatomy his vivisecting master had taught him had not helped him in the least in the cure of his patients. Such Weed was the fate of vivisection for which Europe now takes pride. But Susruta's, Avogharikam is now considered by many as the only perfect mode of dissection ever known. It is with the help of this method of dissection that the layers of epidermis and derrrn's could be discovered and blood-vessels with their minute branches could be counted to be as many as thirty millions. Not only this, but also in the opinion of jeyeral European lavants, Susruta still stands as a model of surgery and European surgery has borrowed many things from Susruta and hat yet trtlny things to learn. iKTfcODUCTIOM. Vii of dead body £no£ of living body as proclaimed by' Herophilus), nay, the Aviighirshana which brings into view The knowledge lhe ,ayers of the e P' dermis Rnd the of the Molecular dermis, the number and branches of Construction of the , , , ,. , . body Is all that Is blood-vessels and nerves that he embed- wanted- ded j n musc ] eS| etc , is only necessary. Professor Michael Foster's remarks in his article on Physiology in the Encyclopedia Britannica, to all appearnces, are just in the same line, if not identical with our extract, when he says "that the problem of Physiology, in the future, is largely concerned in arriving by experiment and infer- ence, by the mind's eye, and not by the body's eye alone, assisted, as that may be, by lenses yet to-be introduced at a knowledge of the molecular construction of the protean protoplasm ; of the laws according to wbich it is built up and the laws according to which it breaks down ; for these laws when ascertained will clear up the mysteries of the ' protean work which the protoplasm does." In short the knowledge of the molecular construction of the body is just the thing with which Biology is concerned, and such is the unanimous verdict both in the East as well as in the West, in the most ancient and in {tie most modern Sciences of the world. Now, if the 'knowledge of the molecular construction of the protoplasm, of the laws according to which it is built up, and the laws according to which it breaks down,' is all that is necessary for an accurate knowledge of Anatomy and Physiology, our 'Ayurveda is pre-eminently the S«iencrr3 sfa re'er to an organised living body ; firsit: and "HJTC ore identical with processes of breaking down and building up of the organism without destroying its identity. The idea of continuous adjustment is included also in these two words. So we find, the definition olAyus, as sugessted by Punarvasu, _. includes more than what is proposed io Tie same as Life- . . „ , , „ ,...;• , . ., Mr. Herbert Spencer sdeumtion of Life. ^ The words sift and^rfamr^, as explained by the great annotator Chakrapini, represent two more distinct phases of Life, the INTRODUCTION. IX first bearing upon* the existence in the system of a preven- tive factor of putrefaction, the second as defined by Mr. adjust the internal relations by deli- ' cate touche?, which professor Michael Foster speaks of as "continuously p.issing from protoplasm to protoplasm and compared with which the nervous impulses (which are perhaps electrical in nature) Prof- Michael . . , „ M „,„ Foster on the The- are grosser and coarser shocks. Now ory of Sensation. , his liis , ep ithet, vis., "sfifH" as ex- plained by Chakrapani— "al^rfr ITO'1 wft"- furnishes us with a clue to determine what Ayus ( ^rj: ) actually means. Our Sacred UpanishacTs now come for- The Findings of ward t0 our re n e f a „d tell us, in the first the Upanishaos. , . , , _ , plice, "s\-{: HIT., < i , Ayu and Frana are one and the same principle. In the second placc*"a: m\ ^ HWy,", ie, Prana.md Vayu are identical. In the third place, "jWWJ ^TwiaffW:", i.e., Vayu is not unlike Ether. In the fourth place, "«sf 3TTO w

' '•, Vayu is the universal store of energy ; in the Physical world it is known by the name of Vayu ; in the Living world it is called under a different name and that name is Praua (m«!:) From the above short table we come to know that the agent that adjusts the internal relations to external relations, is Ayus and that Ayus is Life, and that Life is a motion of the great etherial fluid which is known in Sanskrit as 'V and that "zmiii" is the sum of all the various The same as prl- energieg _bi !ogical and abiological— mltlve fluid as ae- ° - ° fined by Lord which under the name of heat, light, ^ el " a ' electricity-or consciousness, etc., manifest . themselves both in the Physical as well as in the Metaphysical INTRODUCTION. wunu, anu uiai rrdna (ktc) is another (ante of the same force that, in acting on an aggregated living body, divides itself into five distinct force?, vii., Prdna, Apina, Samdna, Uddna, and Vydna, and subserves Hie functions of correlation ( ^q; ) and sustentation (firt) and controls oxidation (ifin). So Prdna continuously helps to adjust, like the main-spring of a natch, the internal relations to the external relations. We are indebted to the master mind of Sankara for his able exposi- tion of the functions of this main-spring, vJyn and Ether ° f that is > o( the etherial vlb «tions (^tc) as transformed into the vital font in an organised body. We quote below what he says about it in his celeberated commentary on the Vedanta Darsana. The five divisions . . , of Viyu In Its ac- fro w iw »wt t jthrt ttstc mg- tion 08 , a living W| ,^ „ ft «^tf , f^fo, aggregate. That'is, the primitive fluid that is endued with motion in its evolution of Life gets knotted into five divisions, viz, Prdna, Apina, Samdna, Uddna and Vydna, and this acting on any aggregated living matter is called Prana. So what we call Prina is not the Vayu itself, Jmt a particular mode of its motion. Hence the question of identity and non-identity is a matter of choice. Shortly speaking, this is the Biology of the Hindus. This too is the sum and substance into which (as a department of Biology), Physiology unfolds itself. •* This too evidently serves as the line of Biology forms the demarcation between ^jt^: and %m%., basis Medical c , - ... , Science developed fan?: and ^rfVmg:. From this too as so ranch col- Health and Disease, Hygiene and lateral branches- , 7„ . , Treatment, Psychology and Sociology have all their origin and start. In fact, Biology forms the basis upon which the great edifice of the Indian Medical Science, as a collateral branch, has been developed. Conclusion. The genera , truth$ of Bio , ogy a e a)| there in the Ayurveda ; bu,t the special truths from medicine INTRODUCTION. XI have been given A grtat a prominence that the real character of the book has been overshadowed and it has been trans- formed into a Science of Medicine. ♦ ***»♦-» With a view to convey to the minds of our readers an idea of the different branches of the Medical Science which developed as a'collateral branch of this great Science of Life, we would here touch upon a few of them in passing. Magnetism had formed its way into the therapeutics of the ancient Hindus and animal magne- gne lBm ' lism was very extensively practised in India long before they were recognised by Mesjner in Germany and subsequently by John Elliotson in England. The Indian writers on Medical Science of the good old days have described in length the HyaropatHy. medicinal properties of the waters -of , the principal river*, lakes, water falls and mineral springs of the country that were known at the time and their respec- tive curative powers as applied to various ailmerfts that human flesh is heir to. This goes a long way to establish the fact that Hydropathy was known in fcidia long before it was even dreamt of in the Western world. The ancient Hindu sages from time immemorial .had been cognizant of the benefits of Massage. massage and shampooing and taken to practising them. Whereas, it is but of late that the, advantages of these methods have begun to be appreciated by the Western Medical School and it no longer hesitates to acknowledge them as efficacious therapeutic agents. The Science of begetting healthy and beautiful children, which is just beginning to receive atten- Qesesiology. t ; on - ia otner couDtries was not un- known to the ancient Hindus, and Manu in his Mdnava- dharma-Sdslra has laid down special injunctions which still form an integral part of the domestic life of the orthodox section of the community. As a matter of fact, they knew C xii INTRODUCTION. • that mental impressions of the parentj at* the time of con- ception exercise a great influence over the future destiny of the child in embryo. Thus we read in the Sastras :— "A woman, though at a distance, conceives a child of the shape of the person she loves ardently and thinks of at the time. Just as a tree that grows is not different from the parent tree whether we plant a branch or sow a seed, so the main features of the child partake of the features of its father, though there might be slight changes due to the soil." The subtle soul co-operates with the Manas (the mind) ; the mind co-operates with the senses ; the senses perceive objects ; all this' takes place in little or no time. The above is the connection between the soul and objects around us. What is there which the mind cannot comprehend ? There- fore, wlterever the mind enters, the soul follows it. "The soul being subtle, whenever it eflters another soul, requires some time and an effort of the mind to know the Witter. .The soul, which intensely meditates on an object, assumes the shape of that object.'' etc, etc. In a book entitled Bhoja-Prabandha being a collection of the anecdotes realating to the reign Anesthetics. . _, . „,. , * ,. 8 of Bhoja Raja, by Pandita Ballala there is narrated the detail of an interesting surgical opera- tion . which had been performed on the RAjA, who was suf- fering from an excruciating pain in the head. All the • medical aid obtaining at the same time was availed of, but in. vain and his condition became quite critical when two brother physicians accidentally arrived in Dhar, who were duly called in, These physicians, after carefully examining the patient, held that unless surgically treated no relief could possibly be afforded to the Royal patient. Accordingly they administered an anaesthetic called Sammohini with ♦ fiA-B»riha Mihb'i Brih.t Sumhitl Book, II. Chapter In* Vertes 1-3. INTRODUCTION. XIII • a view to rende* him insensible and, when completely under the influence of the drug, they trephined his skull, removed the malignant portion of the brain, the actual seat of the complaint, closed and stitched up the opening and applied a healing balm to the wound. Then they adminis- tered a restoration known as Sanjivani to the patient, who, thereupon, regained consciousness and felt quite at ease. This incident (as narrated by Thakur Saheb of Gondal in his Short History of Aryan Medical Science) goes to prove that the attendant physician of Buddha, is likewise recorded to have practised cranial surgery writh the greatest success. Instances of successful cases of abdominal section are also not rare. Thus it will appear 'that the ancient Indians knew and successfully practised surgical operations which are regarded now-a-days as the greatest triumphs of modern surgery. The purpose of chloroform in th£ palmy days of yore was, used to be served by Sammohini, but there is hardly a drug known to modern Pharmacopoeias, corresponding whith Sanjivani which certainly lessens ti»e chances of deaths that at present sometimes occur under anaesthetics. „, Let them, who allege lhatthe Hiudu system of the heal- ing Art is unscientific, now pause and reflect ere they make such an unwarranted and irresponsible assertion. How can a system which contains so accurate an account of the unions of bones and ligaments, anastomoses of nerves, veins and arteries, etc , and which assures the world of the existence of three crores and a half of veins and arteries in the human body giving facts and figures thereof with such mathe- matical precision, be regarded as being unscientific ? It is certainly an undeniable fact that one of the colossal achievements of modern Western Medical Science is its Anatomy; but the point at issue is whether the process of laying open the structures of the body Dissection. with thfl ij, ncetS( ;, at all a satisfactory method. For, is it not a fact 'that the finest and the ' x ; v INTRODUCTION. minutest arteries pi the skin are never d&clqjed, if the scalpel it used so recklessly to remove the skin all at once and not allowed to go deeper into the muscles to expose the minute branches of blood vessels and nerves that may happe i to lie embedded therein ? But, on the contrary, look at the process promulgated by Susruta for demonstrating practical Anatomy 1 Its originality and perfection beats hollow all the known methods, although it was discovered in almost the pre-historic age. The process prescribed by the Hindu system is as follows : — Cover a dead body with Kusa grass and place it at the edge of the water of a rivulet. After three days take it out carefully, and gradually take off the succsestve' layers of the epidermis and dermis and of the muscles beneath by gently nnd lightly rubbing it over with a soft brush. Thus the smallest and the thinnest arteries? which have by this time swelled and obtained a distinct existence are made palpable everywhere even to the rhinutest. „ The. process is termed, as we have pointed before, Ava- gharsbana by Susruta. The Western method might be an easier and a more off-hand one, but by no means precise. Though tl*: merit of discovering this mode Avagharsliana. of dissection is due to Susruta, we are all blind to it and call Hippocrates the father of Medicine 1 It is generally believed that with a view to further his researches and perfect his knowledge, it is Hippocrates who inaugurated ■'the system of dissection of dead human bodies and he did the work secretly. Credulous people may lend a willing ear to such assertions but the fact is, that it was not till a century later that Hirophilus openly resorted to dissection of human bodies and thereby earned an undying fame in Europe, obliterating Susruta's name for ever, though, virtually speaking, he (Susruta) was the pioneer of dissection and figured in the world more than a millenium before the advent of Hippocrates and over eleven centuries prior In the age of Herophilus. , INTRODUCTION. XV • It would oot,»peshap3, be out of place here to mention that Dr. A. F. R, Hoernle, M. A , F. R. S, C. J. E... Ph. D., in his recent publication on Hindu Osteology, has proved it to the hilt, how systematic, scientific, unerring and exatt were the researches of the ancient Hindus and what a mine of resplendent truths lay imbedded in them ! We, in our Intro- duction of the first volume of this work, have tried to prove how very superb, salutary and supremely happy was the theory of Viyu, Pitta, and Kapha promulgated by Susruta, There we have incidentally mentioned that the Science of Embryo- logy was not unknown to the Hindu sages. In the present volume we mean to prove to a point that the main principles promulgated in the Anatomy, the Physiology and the Patho- logy of Susruta yield in no way to the principles on those subjects included by the modern Western Scientists and investigators. On the other hand, we boldly affirm trial in the thecries propounded by Susruta some two thousand years back there lies a fund of truths which might well throw 'a flood of li,'ht on the field of labour of the modern scientific men. of the West. For is it not a fact that the theories of Vamana (causing to eject the contents of the stomach by mouth), Virechana (causing the evacuation of the intestines), Nasya (causing to inhale through the nose), AnuvAsana and Asthd- fana which, in ancient India, had earned the appellation of Pancha-Karma, and had gained universal prevalence, and were extensively practised by oriental physicians from time im- memorial, have,of late, been hailed by the medical authorities of the day as the most approved" and commended mode of treatment. Sceptics who care nor to examine and weigh solid facts, bluntly allege that the Ayurvedic system is not based upon experiment and observation—the keystone of alt true Science, and such being the case its Anatomy, Physio- logy, Pathology and Therapeutics are all erroneous. The. suggestipn, cruel and baseless as it is, originally emanated, from an eminent Indian physician who has earned an u,n- XT j INTRODUCTION. enviable reputation by writing a Trait* on Hindu Materia Medica. He says :-"It (the Ayurvedic system) is built not >o much upon experiment and observation as upon an erroneous system of Pathology and Therapeutics. - ' But such an expression would not stand the light of day. Indeed none but the ancient Hindu sages did set a high value on experiment and observation, and where they did not claim some occult knowledge or intuition, it is upon these two that they mainly based all their knowledge. The Materia Medica of the Hindus is really a marvel. Its description of the properties of drugs belonging to the animal, vegetable and mineral kingdoms, and of the articles of food essential' to the maintenance of health and strength, its selection of the specific dietaries and elimination of what are prohibited in particular ailments are every day being found cSrrect. The European preparations of Indian drugs 'and diets are corroborative evidence thereof. The theory adopte'd by the ancient Hindus as the basis of their investiga- tion is that every substance, whether regitable or animal, possesses five properties namely,— Rasa, Guna, Viryya, VipAka and Prabhdva which lenses alone cannot reveal, nor the body's eye after observation and experiment made upon rats and rabbits. And those who have opportunities of studying and practising both the Eastern and Western Medical Science assert that the ancient Medical Science of the Hindus once reached the highest standard of excellence and perfection in Materia Medica, Therapeutics and Hygiene and was simply unrivalled and unapproachable, as it blended Philosophy with Science— the mind's eye with the body's eye. A dispassionate examination of these facts (and such as can be multiplied to any extent), will convince an impartial reader that Ayurveda, as we find it described in Charaka Samhitiand SusrutaSamhitA, if approached in a spirit of fairness and enquiry, might reveal the germs of not a few fit the marvellous achievement of the present age in the domain of Medical Science and afford to the assiduous INTRODUCTION, XV11 - student 8 vast jcope and varied materials for comparision between the Eastern and the Western systems, and render material help in improving upon the one with the aid of the other, and this to the benefit of the suffering humanity at large. Lastly it is our prayer, that if Western Medical Science was ever anywise, directly or indirectly, benefited by the ancient Medical Science of the Hindus, it is but meet and fair that the former should come forward to render all possible aid to her parent Science, and that as it is almost dying now for want of aid and succour we look hopefully to our present benign Government in whose power lies the means of its complete regeneration. PLATE No. I. (innei side). "J" i indicates the points recogruted in Juijut.u. Sec Chapter VI, S'ariia-S'lhana. PLATK No It. Vital pointt (Marinas) in the leg \ Vital points (Marma.) in the back (outer ride). ot the thigh »nd the leg. "J" indicates the points recognued in Juijutro. See Chapter VI, S'irira-StMna, CONTENTS. NIDANA STHANA. (Section on Pathology). CHAPTPR I. Dia«aa«B of the Nervous Bystem, etc :— The action of the VAyu in its normal state.— The Frana Vayu— The Udana yayu— The Samina Vayu — The Vyana Vdyu — The Apina Vayu. — Descriptions of the nature of the diseases— When they are localised in the different parts of the system. —Pathology of Vita-rakta— Its premonitory symptoms— Its prognosis. —Spasms— Convulsions— Epilepsy without Convulsions— EpiTepsy with Convulsions.— Hemiplegia— Its Prognosis.— Wryneck or Torticollis. — Facial Paralysis — Its Premonitory Symptoms — Its Prognosis. — Sciatica. — Erb's Paralysis. — Synovitis of the Knee-joints. — Lameness.— Vita-Kantaka. — Pada-Daha — Fada-llarsha. — Ams'a-s'oshaka. — Ear-ache.— Deafness.— Nasal voice.— Indistinct Speech.— Tuni — Prati-tuni.— Tympanites.— VM. shthili— Pratyashthila. ... ... , ... Pages I— 17. CHAPTER II. Haemorrhoids:— Classifications— Pathology— Premonitory Symptoms. — VStaja Type— Piltaja Type— Kaphaja Type— Raktaja Type— Sannipitaja Type— Congenital Type. — Figwarts or condylomatous growths about trA genitals.— Prognosis. ... ... ... ... 18—24. CHAPTER III. Urinary Oalcnlii :— General ^Etiology.— Premonitory Symptoms.— Leading Indications,— S'leshmaja As'mari— Pittaja As'mari— Vitaja As'mari. —Seminal Concretions.— Supervening Symptoms.— Situation of the Blad- der.— How stones ate formed in the Bladder. ... ... iS— 3°- CHAPTER IV. Fistula-ln-ano and Fistular Ulcers :-Ctaifotions-rrcmoniiory Symptom-Dem-atm of the term BhagarKlara.-Vfoja Typc-PUtaja Typc-Kaphaja Typc-Sannipatib TylKt-Tranmadc Type-S'ahif onaka Typc-Ushlra-griva Typc-Parisravi Type-S'ambukavarta Tppc-Un- indrgi Type— Fistulous Pustules.— rrognosis. ... ... 3 1 34- CHAPTER V. Cutaneous Affections in general :— Premonitory Symptoms— /Etiology — Classifications. — Aruna-Kushtha — Auilonibara — Rishya-jihva — Kapala Kushlha (Macula).— K.-ikanaka— Puml.irika— Dadrn (ring-worm) — Slhnlartishka— Eka-Knshtria (Ichthyosis)— Chaima-dala (Hypertrophy of the skin)— Visafpa-Kustitha— I'arisarpa-Knshllia— Sidhina— Vicliarchika (Psoriasis)— Vipiidika— Kitima (Keloid)— r«ma (Eczema)— Kachchhu- Rakasa" (Dry Erythema)— Kila'sa. — Congenital cause of Kushtha. — Prognosis, — How Kushlha becomes contagcons.— Some other contagious diseases enumerated. ... ... ... •■■ 35 — 4 2 - CHAPTER VI. Diseases Of the Urinary tracts :— Pathology— Premonitory Symp- toms.— General characteristics,— Kapha ja Type*— Pit taja Type— Vdtaja Type.— Names an Hxtiemelics.— Venesection on 111: different parts of the body. —Proper an 1 Defective Venesection— Classi- fication and definition of Defective Venesection. ... ... 198—208. CHAPTER IX. The Description^ the Arteries, Nerves and Ducts :— Region and Number of Dhamanis. — Functions of the up-coursing Dhamanis.— Functions of the down-coursing Dhamanis. - Function; of the lateral cours- ing Dhamanis.— The Situation of the Srotas and the specific Symptoms when pierce 1 at the roots. ... ... ... 209— 215. CHAPTER X. Nuralng and Mamgdment, etc of Pregnant Women from the day of conception till parturition ^General rules. —Especial Regimen during the periof of Gestation. — Sign of imminent Parturition— Effects of premature Urging — Preliminary Measures. --Post-parturient Measures. -j Natal Kites.— Diet for Children.— Treatment of the Mother— Makkalla pain and its treatment. — Management cf the Child. — Lactation. — Selection of Wet-nurses.— Examination, etc. of Breast-milk. — Treatment of Wet-nurses, — Infantile Diseases and their Diagonosis— Treatment of Infants.— I ifant- ile Elixirs.— Nursing of child. — Symptoms when malignant stars, etc. strike the child. — 'Eductatiun and Marriage. — Defective Pregnancy— Its Symptoms anl Medical treatment.— Miscarriage— Its treatment. — Manage- ment of Pregnancy an 1 special Recipe for Pregnant Women according to c months of Gestation. ... ... ... ... 216 — 238. End of the contents of ffcrlra Stnana. CHIKLTSITA STffiWA (Section on Thekamctics). CHAPTER I. The two kinds of inflamed Ulcers:— The Causes, Symptoms ami Classification of Ulcers.— Idiopathic and Traumatic ulcers. —General and specific Symptoms. —Symptoms of different Dosha-origined ulcers.— Symp- toms of Blool-origincJ ulcers.— Symptoms of ijnddha Vrana.— Therapeu- tics,— The sixty different Factors of medical treatment of ulcers.— Upadrava or the Supervening Symptoms of ulcers. ... ... 269—264. CHAPTER II. The medicil treitmsnt of Triunntic Wounds or Sores :— Different Jjliap.-s an 1 Classifications of Sores. — Their definitions — Their specific Symptoms— Their treatment.-— Treatment of Cuts or Incised Wounds. — Treatment of 1-Aciscd Wounds. — Treatment of Viscera when perforated. — Subsequent treatment.— Treatment of Diabetic Ulcers. — Treatment of Ulcers due to Kushtha or malignant Ulcers. ... 265—278. CHAPTER HI. The medical treatment of Fractures and Dislocations :— Symptoms of incurable fractures.— Bandage. — Diet. — Defective Bandaging —Washing.— Vrrgnosis.— Treatment of fractures in particular linbs.— Gandha-Taila.— Suppuration of fractured Bones— Symptoms of Complete Union of fractured Joints. ... ... ... 279—288, CHAPTER IV. The medical treatment of Vata-Vyidhi or Nervous disorders : — Nervous affection of the AWs'aya — Nervous affections of the Pakvas'aya — S'alvana-upanaha. — General Measures beneficial to Vata-Vyadhi. — The Tilvabi-Ghrita,— The Anu-Taila,— The S'ata-pika and Sahasra-pika Tails, —The Patra-lnvara— The Kanda or Sncha-lavana. — The Kalyinaka- lawna. ... ... ... .-. ... 280—296. CHAPTER V. t Trie meaicai treatment of Mahsl-Vata-Vyridni :— Causes or Vata-Rakta.— Its definition — Premonitory symptoms — Specific features of Vata-Rakta — Prognosis.— Preliminary remedial measures.— Piasters etc. — Treatment of Vata-Rakta with a preponderance of different Doshas. — The five Pradehas— Guda-Haritaki and Pippali-Vardhamana Yogas.— Diet.— Regimen of conduct.— The Medical Treatment of Apatanaka,— Traivrita Ghrila.— Treatment of Pakshaghata.— Treatment of Many^-stambha.— Treatment of Apatantraka.— Treatment of Ardita,— Kshira-Taila.— Tympanites etc. — Hingvadi-vati,— Symptoms and Treatment of Uru- stantbha.— Therapeutic properties of Guggulu. ... ... 297 — 3'5- CHAPTER VI. The medical treatment of Ara'aa (Haemorrhoids) :— General remedial measures,— Application ol Ksbira (Alkali).— Symptoms of salisfactory, excessive and defective Cauterisation.— Diet —Rectal Speculum, — Flasters.— Treatment of Internal piles.— Dantyarishta.— Abhayitishta.— lihallataka-yoga.— Other forms of lihallritaka-yoga.— Regimen of diet and conduct. ... ... — ••• ••• 3 I( V3 28 . CHAPTER VII. Tie medical treatment of As'mari (Urinary-^Wculua, etc) :— Different modes of treatment in As'mali. — Treatment of Vilaja, Pittaja and Kaphaja As'mari.— Alkaline treatments. — Modes of Surgical operations, —Prognosis.— Lithotomic operations.— Post-surgical measures.— Surgical treatment in Seminal Concretions.— Diet.— Parts to be guarded in Litho- tomic operations. ... ... ~ ... 3 2 9'337- CHAPTER VIII. Tie medical treatment of Blagandara (Fiatula-in-ano, etc) :— Classification.— General treatment. — Specific measures.— Different Forms and Names of incision. — Treatment of Ushtra-griva.— Treatment of Parisravi. — Bhagandara in infants— Treatment.— Treatment of traumatic type.— Treatment of Tri-doshaja type.— Syandana Taila.— Description of instrument. — Regimen of diet. ... ... ... 338-345- CHAPTER IX. , The medical treatment of Kushtha (Cutaneous Affections in general) :— Pathology.— Conduct of diet and regimen.— Regulation of diet ami conduct.— Preliminary treatment.— Treatment of Doshaja types.— Maha-tikta Ghrita.— Tikla-Sarpih.— Medicinal plasters.— Alkaline treat- ment.— Treatment of S'vitra.— Nila-Ghrita.— Maha-nila Ghrita.— Treatment by Bleeding, Kinetics and Purgatives.— Vajraka Taila.— Mahii-Vajraka Taila.— Treatment by Khadira.— Diet. ... ... ... 346-361. CHAPTER X. The medical treatment of Mahi-Kushtha (Major Cutaneous Affections!.— Mantha-Kalpas.— Diet.— Medicated Arishtas, Asavas, Suras (Wine) and Powders.— Medicinal Ayas-krili.— Anshadlia Ayas-krili. — Mahausfiadha Ayas-kriti.— Khadira preparations.. ..Khadira-Siira pre- parations. ... ■■• ■ ■*- -■- 362-371. CHAPTER XI. The medical treatment of Prameha (Diseases of the Urinary tracts): — Two-fold Classifications, Causes and Symptoms. — Forbidden articles of fond and drink.- Articles of diet.— Preliminary treatment. -The five medicinal remedies.— Specific treatment of Kaphaja Meha —Specific treatment of Piltaia Meha.— Specific treatment of V.itaja Meha. —Palli- ative measures— Medicinal Arishtafc, Asavas, Yavagus, etc.— Mode of treat- ing a poor Prameha-patient. ... ... ... ... 372-37S. CHAPTER XII. The medical treatment of Prameha-Pidaka' (the Abscesses or Eruptions which mark the sequel of a case of Prameha) :— Curable cases of Prameha- Pidaki— Treatment.— Dhanvantara-Ghrita.— Fomentations for- bidden in cases of Madhu-meha.— S'ala-sdradi Avaleha.— Kavayasa Chtirna. — Loharishta.— Traits of cure. ... ... .-. 379-3*3- CHAPTER XIII. The medical treatment of Madhu-meha :- S'iia-jatu- its origin, properties and use.— The Makshika-Kalpa,— The Tuvaraka-Kalpa, 2S6-391. XI ' CHAPTER XIV. The medical treatment of Udara (Dropsy with an .abnormal condition of the Abdomen) : — Symptoms of cu/able and incurable types. — Diet of articles forbidden. — Treatment of Vfitaja, Pittaja and Kaphaja types. — Treatment of Dushyodara. — Genera] treatment of Udara. — Ilaritaki Ghrita.— Maha-vriksha Ghrita,— Chavya Ghrita.— An.-iha-Vartis.— Treat- ment of Plihodara. — Shat-palaka Ghrita. — Treatment by Venesection. — Treatment of Baddha.Gudodara. — Treatment of Parisravi Udara.— Treat- ment of Udakodara. — Treatment by tapping. — Diet. ... 392-403. CHAPTER XV. The medical treatment of Mndha-Garbha (Difficult and mal- presentation of the Fcetus and Difficult Labour) : — Varieties of Mudha- Garbha.— Incantations, — Postures of the Firtus.— Operations involving destruction of the Foetus. — Craniotomy. — After-measures. — Diet and regi- men of conduct.— The Bala Taila.— The Uala-Kalpa. . 404-411. CHAPTER XVI. The medical treatment of Vidradhi (Abscesses) and Tumours:— Classifications. — Tteatment of Vataja, Pittaja and Kaphaja Vidradhi. — Karanjadya Ghrita. — Treatment of traumatic and blood-origincd types. — Treatment of internal Vidradhi.— Treatment of Vk'jadhi. — Treatment of Majja-jata Vidradhi. ... * ... -.. ... 412-417. CHAPTER XVII. The medical treatment of Erysipelas etc. , Sinus and Diseases of the Mammary Glands '. — Classifications of curable and incurable types of Visarpa (Erysipelas)— Treatment of Vdtaja and Pittaja Visarpa. — Gauryadi Ghrita.— Treatment of Kaphaja Visarpa.— Treatment of Nadi- Vrana (Sinus).— Treatment of Vdtaja, Pittaja, Kaphaja and S'alyaja Nidi (Sinus).— Alkaline treatment— Treatment by Plug-stick— Bballatakadya Taila— Treatment of Stana-Koga— Purification of breast-milk— Surgical treatment of Stana-Koga. ... ... ■■• ... 418-426. CHAPTER XVIII. The medical treatment of Granthl (Glandular Swellings), Apachl (Scarvi), ArTUda (Tumour) and Gala ganda (Goitre) ;— General Xll treatment of Oranthi-Trealment of Vataja, Pitfaja, Kaphaja and Medoja Crantbi. -Medical treatment of Apachl— Surgical treatment of Apachi— ArVUda-Treatmcnt of Vataja, l'ittaja, Kapha] a and Medoja types of Arvmla (T»mour).-Oala-ganda-Trcatmcnt of Vataja, Kaphaja and Medoja types of Oala-ganda ((joitre). ... -. - 427-438- CHAPTER XIX. lhe medical treatment of VriddHI Hernia, Hydrocele, Scrotal Tumour, etc.), Upadams'a (Diseases of the Genital Organ) and S'llpada (Elephantiasis) :— Treatment of Vataja, l'ittaja, Kaktaja, Kaphaja, Medoja and Mutraja Vriddhi — Treatment of Antra- Vridilhi.— Treat- ment of TJpadams'a— General treatment—Treatment of Vataja, l'ittaja, Kaphaja, Tridoshaja anil Kaktaja types uf Upadams'a.— Treatment of Slipada— General treatment— Treatment of Vataja, l'ittaja and Kaphaja types of S'lipada— Alkaline remedies. ... ... ... 439 — 449. CHAPTER XX The medical treatment of KshudraRoga (Minor Ailments):— Treatment of Aja-gallika and Y'ava-prakhya,— Treatment of Vivrita, etc.— Treatment of S'arkararvuda, etc.— Treatment of Pada-dari, etc.— Treat- ment of Alasa and Kfdara.— Treatment of lialdncss and Alopecia, etc.— Treatment of Darunaka, etc.— Treaftncnl of jatu-mani, etc — Treatment of Yuvana-pidaki— Treatment of the Retroflexion of the Prepuce.— Treatment of the Constriction or Stricture of the Urethra— Its surgical treatment.— Treatment of the Stricture of the Anus, etc. — Treatment of Valmika, Ahi- putana and the Prolapsus of the Amis. ... ... 450-4555. CHAPTER XXI. The medical treatment of the Sores on the Penis produced by the BUka".— The specific treatment of the dilferent types of S'uka- dosha— General treatment.— Prognosis. ... ... ... 459-461. CHAPTER XXII. The medical treatment of the Affections of the Mouth :— Treatment of Vataja, Pittaja, Kaphaja and Mfdoja types of Oshtha- Xlll kopa— Treatment of (he diseases of the Daata-mula«— Treatment of Danta-Veflhtaetc— Paridara— S'aushira—Upakus'a— Danta-Vaidatbha— Adhimamsa. — Treatment of Danta-nadi. — Treatment of the diseases of tht* different types of Tooth proper.— Treatment of Tongue-diseases— Treatment of Valaja, Pitta] a and Kaphaja types of tongue-diseases— Treatment of ike different type:: of TaTu-gata diseases—Treatment of Throat-diseases,— Treatment of Va'taju, Pittaja, Kapftaja and Kaktaja types of Rohini,— Treatment of the different type* of the Sarva-sara Mukha-Roga.— -Incurable types of Mukha-Koga. ... ... 462-474. CHAPTER XXIII. The medical treatment of Sopha (Swelling^— Classifications^' general S'opha— Its causes. — The specific symptoms of Posha-origined lypesof S'opha, — Symptom of Vishaja S'opha— Complications — Prognosis, — The Special treatment of the different types of S'opha.— General remedies. —Diet. ... ... ... ... ... ,475-477- CHAPTER XXIV. The Rules of Hygiene and the Propfcilactic Measures :— Tooth-brushing— Cases where tooth-brush ing is forbidden.— Eye arid Mouth- washing. — Collyriuni.—S'tro'bhyanga. -^Combing.— Anointing.— Parisheka. — Affusion. — Effusion. — Anointments. — Prohibitions of Anointments, etc. — Physical Exercise. —Rubbing and Friction.— Massage.— Bathing.— Piohibi- tion of ISalhing.— Anuk-pana.— A'lepa, — Food. — Pravala and Kivdta.— Sleep-— General Rules uf Conduct.— Rules for Drinking Water, etc.— Curd (Dadhi)— When and How to bo taken.— Women unfit to visit.— Evil Effects of the foregoing Abuses. *- ... ... 480-502.' CHAPTER XXV. The medical treatment of a Variety of Diseases :— Diseases of the Ear-lobes— Classification— Causes and Symptoms— General treatment- Specific treatment.— Treatment of Palita.— Treatment of Vyanga, etc. 503-504. CHAPTER XXU ' The medical treatment for ine ins the Strength and the Virlh Power of weak persons :— rx-finition of Vaji-Karana— Means of Vaji-karana.— Causes and Symptoms of the six Forms of Sexual incapacity. —Incurable types.— Kcmcdics-Utkarika— PupaliM.— Cakes etc. 510-514. CHAPTER XXVII. The Recipes and Modes of using Elixirs and Rejuvenators ;— The Human Organism— Which will make it invulnerable to the inroads of any Disease and Decay.— Time of using Rasayana. — Rasayana for Mental and Physical maladies.— Vidanga-Rasayana— Vidanga-kalpa.— Kas'marya- kalpa.— Bala-kalpa,- Ali-bala, Naga-bald, Vidari and S'atavari-kalpa.— Varihi-kalpa —Use of S'ana (-seeds). ... ... ... 515-52I. CHAPTER XXVIII. The Elixirs and Remedial Agents which tend to improve the Memory and invigorate the Mental Faculties as well as to increase the Duration of Human Life :~S'vet:ivalgnja- Rasayana — Krishnavalguja- Rasayana— Manduka-parni- Rasayana — Br ahmi- Rasayana — Brahmi-tlhrila — Vacha-Rdsayana— S'ata-paka-Vacha-Ghrita.— Measures for prolonging life,— Uses of Gold. ... ... ... ... 522-523. CHAPTER XXIX. The Restorative and the Constructive Agents which arrest innate morbific tendencies and decays :— Classifications of Soma. — Mode of using the Soma.— Regimen of Diet and Conduct after taking Soma.— Its « Therapeutic effects. — Distinctive features of the Soma-plants — Their des- criptions—Their Habitats. ... ... ... ... 530-538. CHAPTPR XXX. The Tonic Remedies which remove Mental and Physical Distress :— Persons unfit for the use of Rasayna — Names of the healing drugs.— The Mode of their use. — Regimen of Diet and Conduct— Dosage — Therapeutic effects,— Differentiating traits.— Mode of Culling the above drugs.— Their Habitats.— The common Habitat of all the Oshadhis. 539-545- XV ,CHAPTER XXX.. The medicinal uses of Sneha, etc, :— Classifications of Sneha— Description of Sneha— The specific uses,— Measures of drugs.— The Kashiya-poka-Kalpa.— The Sneha-paka-Kalpa.— Alternative methods.— Application of Sncha according to specific Dosha and Season. — Degrees of Cooking a Sncha— Distinctive traits of the complete cooking of a Sncha. — Process of Internal Use of Sncha —The Specific Uses of Clarified butter— The Dosage.— Evil Effects of over-dosage— Sadyah-Sncha.— Forbidden cases of Sneha-pana — Good Effects of Sneha-pana. ... ... 546-557. CHATTER XXXII. The medical treatment by measures of Sveda (Fomentations, Diaphoretic measures etc.):— Classifications of Sveda. -"-Its Specific Appli- cations. — Effects of Sveda. — Prohibited cases of Sveda. — Symptoms of per- fect and imperfect Sveda.— Measures In be followed after Sveda. 558-564. CHAPTER XXXIII. The Distresses which prove amenable to the use of Purga- tives and Emetics :— Importance of Purgatives and Emetics.— Mode of application of Emetics.— Symptoms of excessive, satisfactory and deficient Emetics. — Eftects of satisfactory Emetics.— Cases where Einesis is forbid- den.— Cases where Einesis is recommended.— Mode of administering Purgatives.— Classifications of Roshtha. — Diet.— Benefits of proper Purga- tion. — Persons who should not be purged. — Persons who should be purged. —Necessity of applying Sncha before Ithc administration of Purgative or Emetic. ... ... ... ... ... 565.589- CHAPTER XXXIV. The treatment of the Disorders resulting from an Injudici- ous Use Of Emetics or Purgatives '.—Their Classes.— Causes and treat- ment. — Evils of an Unpurged Residue of a Purgative or Emetic. — Evils of a Digested Purgative, etc.— Evils of insufficient or excessive expulsion of the Doshas.— Flatulent Colic— Partial and Deficient Medication (Aynga).— Over-drugging with purgatives, etc. (Ati-yoga).— Hemorrhage due to excessive Vomiting or excessive Purging (Jivddfina).— Jiva-s'onita, how to be known.— Flatulent distention of the Abdomen (Adhmana).— Cutting pain in the Amis, dc-Dyscnteric stools (l>amrava).-Diarrhcra (P«vihikS).-Ovcrwfelining Ihc hcart.-Kctcntion tVitandha) of flatus, stool ami urine. ... ••■ •" '" ^77 5 *}• CHAPTER XXXV. The Dimensions and Classifications of a Netra and a Vasti With their therapeutic applications :— The importance of Vasti- Karma.— The application of Vasti in different diseases. — Dimensions of the Pipe.-— Materials of the Pipe.— Construction of the Vasti.— Classifications of the Vasti. —Nomenclature of the Vasti. — Application of N'iruha-Vasti and Asthapana -Vasti.— Their therapeutic Effects— The different Defects of a Vasti. ... ... ... ... ... 590—598 CHAPTER XXXVI. The medical treatment of the mishaps which are consequent on the Injudicious Application of the Pipe and the Vasti .— Remedies for the injudicious application of the Pipe.— Disorders resulting from a defective Vasti (bladder) and its contents.— Disorders resulting from the defective Position of the Patient,— Remedies for the Complications of the defective position of Niuiha-Vasti and Sneha- Vasti. —Intervals for the application of Purgative, Kmeiic, Astiidpana-Vasti and Anuvlsana- Vasti. ... ... i... ... ... 599—607. CHAPTER XXXVII. The treatment with Anuvsisana-Vastl and TJttara- Vasti :~The Process of Anuvasana- Vasti— The process of preparing several medicated Oils and Snehas.— Proper time for the application of Sneha-Vasli.— The mode of applying a Sncha-Vasti. — Symptoms of insufficient, excessive, and satisfactory application of Anuvrisana- Vasti. —Diet after the application of a Vasti.— The Successive Actions of a Vasti. — Distresses from Injudicious Application of Sncha-Vasti.— Specific Symptoms— Their rt medics. — TJttara- Vast Is— Dimensions of the Pipe of the Vasti for a Male and for a Female patient.— Mode of application, — Vaginal Uttara-Vasti. — Diseases amenable to Uttara-Vasti. ... ... ... ... 608—626. XVII CHAPTER XXXVIII. The mode of applying, as well as the treatment with a Nirudha-Vasti :— The mode of Preparing a Vast!.— The mode of Apply, ing a Vasti.— Symptoms of a satisfactory application of a Vasti.— Subsequent treatment and Diet —Drugs lo I): us at in a Niruha-Vasti.— The Formula of a Niruha-Vasti.— The process of preparation.— The Dva*dasa-Prasrui — Classifications of Vastis according to the range of their therapeutic appli- cations.— Corrective Vast is. — Lekhana-Vasti. — Vaji-Karana-Vasti. — Vrim- hana-Vasti.— Pkhchhila-Vasti. — Grahi-Vasti,— Sneha-Vasu.— Utkles'ana- Vasti. — Dosha-hara-Vasti.— Soothing Vasti.— Yukta-ratha-Vasti.— Sicldha- Vasti. — Must.4dika-V.-isU. — Variations in the composition of Vastis in cases of persons of different, Temperaments. — Nomenclature of different Vastis and their Specific Uses. ... ... • ... 637 — 646. CHAPTER XXXIX. The treatment of distressing Symptoms which are manifest- ed in a patient :— The quantity of diet to be taken after the exhibition of a Niruha-Vasli. — Internal application of Snehn after Mood-letting. — Preparations of different diets. — Diet !o be taken according to the Dosha and to the Strength of the patient.— Regimen of conduct. — Articles of diet. 647-652. CHAPTER XL, The treatment which consists in employing the Dfeuma (Fumes), Nasya (Snuffs) and Kavala (Gargles) ;— Classifications of Dhuma— Materials of different Dhuma-Varti.— Formation of the Pipe used in Dhuma-P^na — Mode of inhalation of different Dhunms— Prohibitive cases — Time of Dhuma-pana (Smoking}— The therapeutic effects of Dhuma* Pana— Mode of Smoking.— Snuffs and ErrMnes (Nasya)— The Nomen- clature of the term ''Nasya"— Classifications of Nasya— S'iro-Virechana— Its application— Dosage of Sneha-Nasya— Effects uf proper, excessive and defi- cient application of a Sneha-Nasya — Avapida-Nasya — Forbidden casts,— Prati-marsha Nasya when to be used— Its effects. — Specific use of Sneha- Nasya— Kavala-graha (Gargles)— Classification— Mode of application— Their uses— lvavala and Gandusha distinguished— How long Kavala should be retained— Symptoms of satisfactory, deficient and excessive Gargling. — Prati-sarana— Its classification ami effects. ... 653—671. End of the Contents of the Ohikitsita Sthana. KALPASTHANA. (.Section on Toxicology), CHAPTER I. The mode of Preserving Food and Drink from the effects of Polflon :— The necessary qualifications of a Superintendent of the Royal Kitchen—The necessary features of a Royal Kitchen.— Characteristic features of a Poisoner.— Indications of poisoned food and drink, etc.— General treatment.— The mode of preparing Soap, etc. ... ... 673—684. CHAPTER II. The Indications (Effects, Nature and Operations) of Sthavara Poisons :-*Sthavara Poison— Its source.— Names of the different Vegetable and Mineral poisons. — l-'fffcts of poison on the Human organism. — Effects of Bulb- poisons— Specific properties and actions of Bulb-jioifions— Definition of Dushi-visha— Symptoms of weak and slow poisoning— Derivative meaning of Dushi-visha-— Symptoms of the different stages of Sthdvara Poisoning— The medical treatment. — Koshatakyadi-Vavagu— Ajeya-Ghrila — Vishiri Agada.— Treatment of the supervening Symptoms of l'oisonii.g.— Prognosis. ... ... * ... ... ... 685—694. CHAPTER III. The Subject of (the nature, virtue, etc. of) Animal Poisons :— I Different locations— Characteristic features and purifications oi poisoned Water.— Poisons in the Atmosphere and its purification.— Mythological origin of Poison.— Properties of Poison — Nature and Location of .Snake- poison— General treatment of poisoning— Symptoms of taking poison internally.— Fatal bites.— Prognosis, ... ... ,.. ^^j — 702. CHAPTER IV. The Specific Features of the Poison of a Snake-bite —Gasifica- tions of Snakes— Classifications of Snake-bites— Their specific Symptoms- Characteristic features of the diffeient species of Snakes.— Features of the different Castes amongst Snakes.— Particular Habits of the different kinds of Snakes,— -Names of the different species of parvi-kara Snakes— Names qf the different species of Mandali Snakes — Names of the different species of Rajima'n Snakes— Names of the different species of Nirvisha Snakes— Names and Origin of the different species of Vaikaranja Snakes— Sub-families of the Vaikaranja Snakes, —Characteristic features of Male and Female Snakes — Features of their bites— General and specific symptoms of a bite by a Daivi- kara Snake— Specific symptoms of a bite by a Mandali Snake— Specific symptoms of a bite by a Rajimdn Snake — Specific symptoms of bites by Snakes of different Sexes and Ages, etc. — Symptoms of the different stages of poisoning from the bites of a Daivi-kara Snake — Different stages of poisoning from the bite of a Mandali Snake— Different stages of poisoning from the bites of a Rajima'n Snake.— The Vtgdntara {or the intervening) Stages. — Different Stages of poisoning in cases of Lower Animals. — Different stages of poisoning in cases of Birds, ... ... 703 — 714. CHAPTER V. The medical treatment of Snake-bites :— General treatment of Snake-bites. — Mantras (Incantations)— Blood-letting in Snake-bites— Specific trealemcnt of the bite by a Hooded tDarvi-kara) Snake, a Mftndail Snake and a Rnjimaii Snake.— Contra-indicatiun to blood-letting incases of Snake-bites— Dosage of Collyrium, etc., to be resorted to in cases of different Beasts and Birds.— General dosage of medicines in cases of Snake- bites — Specific treatment of poisoning according to the Physical Symp'oms —Specific treatment of the different Supervening Symptoms —Remedy for the aggravated Doshas due to Poison— Medical treatment of persons made unconscious from the effects of a Fall or Suspended Animation.— Symptoms of svounds from Poisoned Darts, etc.— Treatment of a Poisoned Wound- Recipe of different Agadas— Mahagada— Ajitagada— Ta>kshyagada— Riiha- bhdgada — Sanjivana Agada— Darvi-kara Rajila-visha*hara-Agada — Man- dali -vishahara Agada— Vams'a-lvagddi Agada— Puncha-s'irisha Agada — * Sarva-Knmika Agada— Ekasara Agada. ... ... 715—727, CHAPTER VI. Oases Of Rat-poisoning :— Different Varieties of Rats— General Symptoms of Rat-poisoning— Specific symptoms and treatment of Rat- poisoning— General treatment.— Causes of EftbleS— Symptoms of Hydro- phobia— Prognosis.— Symptoms of Jala-tra~sa— Its treatment— Treatment of bites by rabid-dogs— Treatment of teeth and nail -scratching. 728 — 736, XX CHAPTER VII. Treatment with the Sounds of a (medicated) Drum, etc., possessed of Atttl-veaomoua Virtues : -Kshaiagada— Its Uses and Therapeutic Kffects — Kaly.inaka-Ghri'a — Amrita-Ghrita — Mahri-sugandhi Agad i— Rules of Diet and Conduct.— .Symptoms of Elimination of Poison. 737-741- CHAPTER VIII. On insects, i.e., the measures, etc. to be adopted in cases of Insect-bites, etc- '---The Germination and Classification of insects — Insects of Vataja, Pittaja, Kaphaja and Sannipatika temperaments.— Symptoms of their Bites— The Kanabha class of Insects— The Gaudhcyaka class of Insects— S'ata-padi— Manduka (Frogs)— Pipilika (Ants)— Makshika (Stinging Flies)— Mas'akas (Mosquitoes).— Incurable classes— Treatment of a bite b)' strong and aculc-poisonc.il Insects— Recipes of Remedies in different cases. — Origin and Classification of Scorpions— .Specific traits and characteristics of Mild-poisoned Scorpions, Madhya-visha Scorpions and Tikshna-visha Scorpions— Treatment of Scorpion-bites.- Spider-bites. — Development of Luta-poison— Its Potency— Location,— Characteristics of Poison according lo its seat in the body of a Spider— Mythological Account of the Origin of LuU— The different names of Spiders and the general Symptoms of theJr'' Bodies— Specific Symptoms of Spider-bites and their Treatment— General Remedies— Specific symptoms of the Incurable cases of Spider-bites— Their treatment.— Surgical Treatment— Treatment of Ulcers incidental to the Bites by Insects or Snakes, ... ... 742—762. End of the Contents of the Kalpa Sthana- THE SUSHRUTA SAMHITA NIDANA STHANAM. CHAPTER I. Now wc shall discourse on the Vatavyadhi- (discascs of the nervous system) Nideiaam*. Metrical text:— Having clasped the feet of the holy Dhanvantari, who had arisen out of the primordial ocean with the pitcher of ambrosia on 'his head, and who was the foremost of all knowcrs of truth, Sus'hruta interrogated him as follows :---'TcIl me,0 thou, the foremost of discourses, all about- the different locations and functions of the bodily Vayu (nerve force), both in its normal and agitated conditions, (as well as when it changes its natural seat through a concourse of disturbing or aggravating causes). Instruct me on the nature of distempers, which result from its deranged u condition." 2. The holy Dhanvantari, the greatest of all healers, having listened to the foregoing words of Sus'hruta, replied as follows: — This vital Vayu (nerve force), which courses through the body, is sclf-bcgottcn in its origin, and * Th: term Nidanam, usually translated as Pathology, is meant to include factors, which fall within the respective provinces of Pathology, /Etiology, Symptomology and Pathognomy as welt. For the meaning and functions of Vayu see Introduction vol. I. pp. xli. — xlii. THK SUSIIKUTA SAM1IITA. (Ch»p. t is regarded as identical with the divjne energy of eternal life (God), inasmuch as it is unconditional and absolute in its actions and effects, eternal and self-origined, and is subtile and all-pervading (like the sky and the atoms). It is the primary factor, which determines the principle of cause and effect in all forms of created things, whether mobile or immobile. It is so called (Vayu) from the fact of its coursing (skr. V;i— to move) throughout the universe. It determines the growth, origin and disintegration of all animated organisms, and as such, it receives the homage of all created beings. Although invisible in itself, yet its works are patent or manifest. It is cold, light, mobile, dry and piercing, and follows a transverse course. It is characterised by the two attributes (proper-sensibles or Gunas) of sound and touch. It abounds in the fundamental quality of Rajas (principle of cohesion and action), is of inconceivable prowess, propels all the deranged or obstructing prinicples (Doshas) in the organism, (or in other words, is primarily concerned with the deranged principles of the body which are pathogenic in thejr actions). It is instantaneous in its action, and radiates or courses through the organ- ism 'in constant currents. It has its primary field of action in the intestinal tract (Pakvadhana) and the rectum (Guda). In its deranged state, it is the principal factor, which, (in combination with the deranged Pittam and Kapham), lies at the root, of all diseases, and is accordingly termed the king of diseases (Rogarat). 3. The action of Vayu in its normal State :— Now, hear me describe the symptoms, which mark the Vayu, as it courses through the organism. The Vayu, in its normal or undisturbed condition, main- tains a state of equilibrium between the different Doshas artd the root principles of the body (Dbilu) ; it further Ch »P- '-J XI DANA STIIANAM. J • tends to maintain uniform state in the metabolism of the body, (protoplasmic, Agni*) and helps the organs of sense-perception in discharging their specific functions. The bodily Vayu, like the Pittam in the organism, is grouped under five different subheads according to the difference in its functions and locations, and is classified as the Prana, Udana, Samana, Vyana and Apana.f These five classes of V;iyu. located in their specific regions, contribute towards the integration and main- tenance of the body. 4 — 6 The Prama Vayu :— The Vayu, that courses in (governs)thc cavity of the mouth, \ is called the Prana, its function being to force down the food into the cavity of thestomach, and to assistthe different vitalising principles of the body (such as the internal heat or fire etc ) in dis- charging their functions in life, and to contribute to the general sustenance of the body. A deranged condition of this particular kind of Vayu (Prana) is usually followed by hic-cough, dyspnrea and other kindred distempers. 7. The Udana Va'yil : —The most important of the vital Vriyus, which courses (sends its vibrations) upward, is called the Udana. It produces speech, song, etc." In its deranged state it brings on diseases which are speci- fically confined to regions lying above the clavicles. 8. The Samana Va^yu:— The Samana Vayu*. courses in (governs) the stomach (Amashaya) and in the • See Introduction Vol. I. p.p. XLVIII— XLIX MahSmahopadhylya DvarkJ Nalha Kaviratna interprets this Agni as digestive heat (Jatharigni). t The Pra'na Vaju is identical with the energy 0/ the nerve centre in the medulla ; the Udana with that of the one which is situated in the speech centre. The Samina is same as the energy of the epigastric plexus, the Udar.a is same as the energy of the Motor-Sentory Nerves, and the Apiina is identical with the force of the Hypogastric plexus. t The field of its action includes the regions of the heart, throat, head and the n<*e. ■ 4 THE SUSIIRUTA SAMIIITA. [Chap. I. • region of intestines (PakvAshaya). [fc functions consist in digesting the chyme brought down into the intestines in unison with the digestive ferment (Agni), and especially in disintegrating its essence from its refuse or excreted matter. A deranged or aggravated condition of the Samana Vayu causes dysentery, Gulma, and impaired digestion, etc. <■). The Vyana Vayu :-Thc Vayu known as the Vyana courses (acts) through the whole organism, and its functions consist in sending the lymph chyle etc. all through the body and in helping the out-flow of blood (Asrik"! and p'erspiration. Five kinds of muscular move- ments* arc ascribed to the action of the Vyana Vayu, a deranged condition of which is generally attended with diseases which arc not confined to any particular region, member, or organ of the body, but arc found to affect th; whole organism (such m, fever, etc), io. The Apana Vayu :— The Vayu known as the Apana acts in the lower region of the intestines (Pakvadhanal Jts functions consist in bearing down the foetus and the feces and m evacuating the urine, semen andcatamenial blood. An enraged condition of this Vayu tends to bring on serious diseases, which are peculiar to the urinary bladder and the distal portion of the large [■intestine (Guda). An aggravated condition of both the Vyana and Ap:lna Vayus may produce Pramcha and disorders of the seminal fluid, while a simultaneous excitement of the live vital Vayus leads to a sure and speed}' termination of life. 11-12. X.r.v we shall describe the nature of diseases, brought about by the localization of the variously aggravated Vayus in the different parts of the body. —In the cavity * Such as expansion, flexion, lowering do^n and lifting up or lateral thrusting of any part of the body. Cha P- '•] NIDANA STIIANAM. 5 of the stomach (Atnashaya) the deranged or aggra- vated Vayu gives rise to vomiting, vertigo, epileptic fits, thirst and pain at the sides (Pars'va Sula) and about the region of the heart (Ilridgraha). In the intestines (Pakvashaya) the enraged or disturbed Vayu gives rise to a rumbling in the intestines, a piercing pain about the region of the umbilicus, scanty and painful urination and stool, or their entire suppression (Anaha), and pain about the region of the coccyx (Trika). I j — 1 5. Similar- ly, incarcerated in the sense-organs, such as the ears, etc. it tends to deprive them of their respective faculties. In the skin (lymph chyle) it produces a discolouring of the complexion, parchedness and twitching in the skin, and causes a complete local anaesthesia, giving rise to a tingling, piercing pain in the skin, which spontane- ously bursts, or becomes marked with cracks and fissures. Similarly, the aggravated Vayu interfering with* the principle of b'ood gives rise to ulcers. In the flesh, it produces painful nodes and tumours (Granthi), while in the principle of fat it brings on almost painless tumours (Granthi) unattended with Any kind of" ulcer. Incar- cerated in the veins &c. (Sira) it produces a stiffening or painful contraction, or a varicose or neuralgic condition ; in a ligament (Snayu).it produces numbness (anaesthesia), palsy, aching pain and convulsive jerks ; in a long joint, it tends to deprive it of its contraclibility and produces a painful inflammatory swelling (about the affected part). In the bones it produces a wasting (atrophy) of the bones which crack and begin to spontaneously burst, attended with the characteristic bone-ache. Again in that important principle of life, the marrow, it tends to dry it up and produces a sort of pain, extending all over the body which knows no respite or abatement. Similarly, jn the principle of semen it tends to produce a scanty, 6 THE RUSHRUTA SAMHITA. t Ch, P- '• • defective, or excessive emission of that vital fluid, or a complete stoppage thereof. 16—23. The Viiyu, thus disturbed and agitated, affects in succession the lower and the upper extremities of the body, and the head, or extends all over the body and deranges all its root-principles (Dhatu). The symptoms, which mark such conditions of the body, are numbness (paralysis), convulsive contortions of thelimbs (Akshepa), anaesthesia, and various kinds of pain (Sula), and swelling (Sopha) of the body. The deranged Vayu, having enter- ed the natural scats of the Pittam or Kapham, develops symptoms, which arc peculiar to cither of them, and gives rise to numerous diseases. 24 — 25. The symptoms, which characterise the union of the deranged V.iyti with the Pittam (in its particular seat) arc a burning sensation, heat, thirst, and loss of conscious- ness' in addition to the symptoms of the Vataja disease so generated in that particular part of the body, while a similar unison with the Kapham develops coldness, swelling and heaviness (of the affected part). The disturbed or agitated Vayu'in unison with the principle of bjood gives rise to a sort of pricking pain (pins and needles in the affected locality), which can not bear the least touch, or is marked by complete anesthesia, and symptoms, peculiar to the deranged Pittam, follow in its train. 26—28. Vomiting, and a burning sensation, etc. in the body, mark the instance when the Prana Vayu is surcharged (Avrita) with the Pittam ; while weakness, lassitude, somnolence and a general discolouring of the com- plexion (U. R., — loss of taste) characterise a case when it is surcharged with the deranged Kapham A burning sensation in the body, loss of consciousness or epileptic fits, and a sense of giddiness (vertigo) and Cha P- '0 NIDANA STllANAM. 7 physical languor arf the indications, which distinguish a case of the Udana Vayu being surcharged with the Pittam ; while a stoppage or absence of perspiration, appearance of goose-flesh on the skin, impaired diges- tion, coldness and numbness of the affected part characterise a case of the same being surcharged with the Kapham. 29—32. Copious flow of perspiration, heat with a burning sensation in the body, and epileptic fits indicate a case when the Samana Vayu has become united with the Pittam ; while a copious flow of stool and urine, and an excess of mucous secretion (Kapham) from the nose (fluent cory/.a) etc. and horripilation mark a case, where it has become saturated with the Kapham. 33—34. Heat and a burning sensation in the affected part and a profuse monorrhagia mark a case when the Apana Vayu becomes surcharged with the Pittam, where- as a sense of heaviness in the lower limbs characterises a case when it becomes overcharged with the Kapham. 35~3f>- [Symptoms such as,] binning and jerking in the limbs, and a sense of physical languor become manifest- in the event of the Vyana Vayu being surcharged with the Pittam, while a general heaviness of the limbs, stiff- ness or numbness of the bone-joints, and an incapability of locomotion indicate the fact of its being surcharged'' with the Kapham. 37—3$. The Nidanam of V^ta Raktam :— An over-indulgence in grief, excessive sexual inter- course, inordinate physical exercise, drinking large quantities of wine, observance of a regimen of diet and conduct in a particular season of the year which is im- proper to it, use of articles of food which arc not con- genial to one's own temperament and an improper or THK SUSHHUTA SAM1HTA. [Cliap. i. 'baneful use of such oleaginous substances (as oil, clari- fied butter etc.) arc the factors, which vitiate in common the blood and 1'ittam of a person. The foregoing causes especially tend to vitiate or agitate the Vayu and blood in persons of delicate constitutions, or in corpulent persons, or in those who observe a form of perfect continence. 39. The vital Vayu becomes enraged or agitated by exces- sive riding on horses, camels or elephants, or through the lifting or carrying of great weights, etc., or by an in- ordinate indulgence in things which are possessed of the specific virtue, of enraging or aggravating that vital principle. On the other hand, an over-indulgence in such articles of food as arc heat-making in their potency, or a surfeit of edibles largely composed of sharp, acid or alkaline substances, as well as a large consumption of potherbs etc., or an exposure to heat tends to vitiate the blood of the organism, and which, on account of such contamination, tends to speedily obstruct the passage of the ileet-coursing Vayu. The Vayu, thus impeded in its courscjbccomcs more and .more agitated each moment, and is prone to speediiy agitate the blood in a similar way. The antecedence of the term "Vata" or "Vayu" in the nomenclature of the disease (Vata-llakta) is owing to the precedence accorded to the action of the dcraneed 'Vayu in bringing about the malady, although it effects this in concert with the vitiated blood of the organism. 40. Similarly, the disease brought about by the agitated 1'ittam. in conjunction with the vitiated or agitated blood, is called the Pitta- Raktam, while the one incidental to the combination of the deranged Kapham with the vitiated blood is called Kapha-Raktam. In a case of Va'ta-Rftktam, the legs, or the lower extremities can Chtp, I.J NIDANA STHANAM. 9 * not bear the least touch (Hyperesthesia) and a sort of pricking, piercing pain (pins and needles) U experienced in those regions. The legs become withered or atrophied and lose all sensibility to touch. In a case of Pitta Rlktam, the legs become extremely red, hot, soft and swollen, characterised by a sort of indescribable burning sensation. In a case of Kapha-Raktam, the legs become swollen and numbed. The swelling assumes a whitish hue and feels cold to the touch, and is accompanied by excessive itching. In the SAnnipAtika or Tridoshaja form of Dashta-Raktam, the legs exhibit symptoms, which arc respectively peculiar to all the three preceding types. 41 — 43. Premonitory Symptoms: -in the incuba- tive stage of the disease the legs perspire and become •cold and flabby, or (on the contrary), the local perspira- tion is stopped and the legs become hot and hard. More- over, a pricking pain is experienced in the affected parts which arc marked by complete amusthesia, heaviness, or heat, and discolouring of the skin. Thc/iiscase creeps in cither from the lower extremities, or in some cases, first affects the upper ones and gradually extends all over the body like an enraged rat-poison. Prognosis : — Theform of the disease in whichthe skin of the part lying between the instep and the knee- joint becomes abraded or spontaneously bursts open, exuding pus and blood, attended with loss of strength (Prcciput— Opisthotonos). When the extremely enraged ind powerful bodily Vayu (nerve-force), accumulated in • TV patient suffers from vanishings (tdmyatC) anil loss of con- :ioasness through the instrumentality of the enraged and aggravated aylt, hence the disease is so named— Gayadha, t Jejjad« holds that the enraged Vayu, in unison with the deranged lapham, gives ris; to another kind of convulsions (Akshepaka) which he a: denominated as Danda-palanakh which, exhibits such symptoms as coldness, swelling and heaviness of the body on account of its being brought about by a concerted action of the deranged Pittam and Kapham. Several authorities aver thjt there are four distinct types of Akahepakah, such as Dandtpatinakh, Antarayamah, Vahlrayamah, and Akshepakh of ttaumaticfAbhighittaja) origin. Ckp. I.] NIDANA STHANAM. J I t the regions of the fingers, insteps, abdomen, chest, heart and throat, forcibly draws in the local ligaments (Sn&yu), the body becomes contracted and bent forward, bringing about a curvature of the inner trunk. The disease in this form is called Aiitara'ya'ma Dhanushtambha. The movements of the cyc-i become impossible, which become fixed in their sockets ; the jaw-bones become paralysed, the sides arc broken, and the patient ejects (at intervals quantities of) slimy mucous (Kapham). These arc the features which mark the first type (Antarayama Dhanushtambhal. On the contrary, when the same enraged Vayu, centred or lodged in ligaments which traverse the posterior side of the body, attracts them violently, the body is naturally bent backward. The patient experiences a sort of breaking pain at the chest, waist and thighs, (which are ultimately broken). The disease is called Vahira'ya'ma, and should be looked upon as beyond the pale of all medicinal treatment. 47 — -50. Four types of Akshcpaka aft; usually* Recognised in practice such as, the (1) one incidental to the concerted action of the enraged bodily Vayu and Kapham (2), the one brought about through the union of the enraged Vayu with the deranged Pittam, (3), the one due to the single action of the agitated Vayu (4) and the one due to any external injury or blow (Abhighataja).* An attack of Apatditkah due to excessive haemorrhage, or following closely upon an abortion or miscarriage at pregnancy (difficult labour), or which is incidental to an external blow or injury (traumatic), should be regarded as incurable. 51 — 52, * Brahma Deva designated the four types of the disease, as Apatanakah, Samsrishla Akshepakah, simple Akshepakah and the Abhighataja (traumatic). 12 ' THE SUSHRUTA SAMHITA. t cha P- l - I The disease, in which the extremely agitated Viyu affects the nerve chains (Dhamanis) which spread either in the left or in the right side of the body, whether in the upward, downward, or lateral direction, making them lax and vigourless, and in which the joints of the other side of the body become useless and inoperative, is called Pakshaiyhaita (Hemiplegia) by eminent physicians. The patient, the whole or half of whose body has become (almost) inoperative and lost all sensibility, but who retains his consciousness so long as there remains the least vestige of vitality in the affected part, suddenly falls down and expires. 53—54. Prognosis: -A case of I'akshrighata (Hemi- plegia), brought about through the single action of the enraged or agitated VAyu of the body, can be cured only with the greatest care and difficulty. A case of the same disease, engendered by the aggravated V;iyu in conjunction with the deranged Pittam or Kapham, proves amenable to medicine (Sadhya). It becomes in- curable whrfi caused through the waste of the root prin- ciples (Dhatu) of the body. 55. Apatatltrakah (Convulsions) :— The Viyu, aggravated (by its specifically exciting factors and principles) and dislodged from its natural seat or recep- tacle in the body in consequence thereof, courses upwards and finds lodgment in the regions of the head, heart and temples. It presses upon those parts and gives rise to convulsive movements of hands and legs, or at times bends them down. Symptoms ! — The patient lies with his eyes closely shut, or stares with a sort of fixed or vacant gaze, the eyes remaining fixed or immovable. The patient loses all perception, and groans. Respiration becomes difficult, or symptoms of temporary asphyxia Chap. 1.] NIDANA STHANAM. . 1 3 and unconsciousness set in. Consciousness and a normal condition of the organism return with the passage of the enraged Vayu from the heart, while on the other hand the patient relapses into unconsciousness simultaneously with the envelopment of the heart with that enraged and Kapha-saturated Vayu. This disease is called Apatantrakah and is ascribed to the action of the enraged Vayu surcharged with the deranged Kapham. 56. Many£lStambha:— The local Vayu, agitated through such causes as sleep in the day lime, reclining with the neck on an uneven place or pillow, gazing upward for a considerable length of time, or looking aside in a contorted way, and enveloped in the deranged Kapham, gives rise to the disease known as Manyu- stambha (wry neck or torticollis). 57. Arditam (Facial Paralysis): --'Pregnant women, mothers immediately after parturition (Sutika), infants, old and enfeebled persons are most prone to fall victims to this disease*. It has been also known to result from excessive hemorrhage or loss of blood The local Vayu, extremely enraged or aggravated by continuous talking in an extremely loud voice, chewing of hard substances, loud laughter, yawning, carrying extremely heavy loads, and lying down in an uneven position on the ground, finds lodgment in the regions of the head, nose, upper lip, chin, forehead and the joints (inner cornea) of the eye, and produces the disease called Arditam by distorting the face. Symptoms." — The neck and half of the face longitudinally suffer distortion and are bent. The head shakes; the power of articulating speech is lost, and the * The portion of the text included within asterisks has been rejected by Jejjadacha'ryya as spurious. 14 THE SUSHRUTA SAMHITA. [Cbap. I. « eyes arc distorted into a variety of shapes. The portions of the neck and the chin, as well as the teeth on the affected side become painful. Premonitory Symptoms :— The disease generally commences with shivering, horripilation, cloudincss.of vision, upconrsing of the bodily Vayu and anaesthesia, a pricking pain in the affected locality, numbness or paralysis of the jaw-bone, or of the cervical muscles of the neck. Physicians, conversant with the Etiology of diseases, call it Arditam (Facial paralysis). Prognosis: — A ease of Arditam, appearing in an ex- tremely enfeebled or emaciated patient, or exhibiting such symptoms as a winkless vision, inarticulate speech which hardly seems to come out of the throat, excessive palsy of the face, as well as the one of more than three years' standing, should be deemed as incurable. 58. GridhraS'i (Sciatica) -The disease in which the two great nerve-trunks (Kandara), which emanating from below the lower extremity of the thigh reach down to the bottom of the insteps and toes, and become stuffed or pressed with the enraged Vayu, thus depriving the lower extremities of their power of locomotion, is called Gridhras'i. 59.. VlS'vachi (lube's paralysis or ISracial neuralgia):— The disease in which the enraged Vayu affecting the nerve-trunks (Kandaril) which run to the tips of fingers from behind the roots of the upper arms, making them incapable of movement and depriving them of their power 'of flexion or expansion is called Vis'vachi.* 60. KrOShtllkas'irSha (Synovitis of the knee- joints): — An cxtrimcly painful swelling in the knec- * When the aforesaid nerve of a sirgle aim is afTecld ihc disease is restricted to it alone, while it attacks the both when both their nerves ajc affected. Chap. I.] NIDANA STHANAM. 1 5 • . ' joints, which is originated through the concerted action of the deranged Vayu and the vitiated blood is called Kroshtukas'irsha from the fact of its resembling the head of a jackal (Kroshluka) in shape. 61. Khanja (Lameness)— The disease proceeds from the drawing up of the nerve trunks (Kandanfr) of a leg by the deranged Vayu lying about the region of the waist. When both the legs arc similarly affected, the patient is called a Pangu. He. whose legs tremble before starting for a walk and who afterwards manages to go on limping is called a Kala'ya Khanja one in whom the bone-joints become loose. 62—63. Vata Kantaka : -The local Vayu, enraged by making a false step on ail uneven ground, finds lodg- ment in the region of the ankle (Khudaka, rnstcp according to others), thus giving rise to a disease which is called Vata Kantaka. The burning sensation in the soles of the feet caused by the enraged local Vayu, in conjunction with the deranged Pittam and blood, .is called Pa'da-cWha, wjiich is gc*ijrally seen to afflict persons of pedestrian habits. When the legs are deprived of all sensibility of touch, and a sort of tingling pain is experienced in them it is termed Fa'daharsha, which is due to the deranged action of the Vayu and Kapham. The disease in which the enraged local Vayu , dries up the normal Kapham lying about the shoulder- joints is called Ansa-s'hoshaka. The form in which the aggravated local Vayu contracts the nerves of the arms is called Avava'huka*. 64-67. Vadhiryayam (deafness): -The disease occurs only when the deranged Vayu, either singly or sur- * The Ansashosha is due to the single action of the enraged Vayu, while Ava-vihuka is due to I he concerted action of the deranged VJyu and Kapham.. \6 THE SUSHRUTA SAMHITA. C ch »P- '• ( charged with the Kapham, stuffs the sound-carrying channels (Srota) of the cars. 68. Kama S'lllam:— The disease in which the deranged Vayu causing a piercing pain in the regions of the cheekbones, head, temples and neck, gives rise to a sort of aching pain in the tympanum, is called Karna- s'ulam (otitis). The local Vayu, deranged and saturated with the Kapham stuffing the nerves (Dhamani) which conduct of the sound of speech, produces complete (in some cases partial) loss of the power of speech— eg. Muka (dumbness , Minmina (nasal voice) and Gad-gada (indistinct speech). 69—70 A sort of pain, which (rising from the bowels or the urinary bladder and ranging downward) gives rise to a bursting sensation in the regions of the anus and the genitals, is called Tuni, whereas the one, rising upward from the preceding parts and extending up to the region of the intestines, is called Prati-tuni. A distension of the abdomen (Udara), attended with the incarceration of flatus (V;iy;i) and anjntensc pain and rumbling in its inside, is called Adhminam (Tympanites?. When it first affects the stomach (Amas;'iya") and is unattended with an oppressive feeling about the heart and pain at the sides' it is called Pratyadhma'nam The Vayu saturated with the deranged Kapham causes the preceding type of distemper. 71 — 74. A knotty stone-like tumour (Granthi) of consider- able density, whether fixed or mobile, and appearing below the umbilicus, and having an elevated shape which is always found to be extended in an upward direction, is called a Va'tasthila', (which) as its name implies, is due to the action of the local deranged Vayu. The tumour, thus formed, obstructs the emission of flatus and impedes the evacuation of faces. A tumour of similar shape, Chap. I.] NIHANA STHANAM. 17 • appearing laterally or across the region of the abdomen (Jathara) and obstructing the passage of stool, urine and flatus (Vata) is called a Pratyashthila'. 75 — 7"5. Thus ends the first Chapter of the Niflana Slhanam in tho Su^hruta Samhita, which treats of lh; Nicttnam of the diseases of the nervjus syBtem. CHAPTER IL New we shall discour.se on the Nida'nam of ArS'aS (Ilaimorrhoids). I. Haimorrhoids may be divided into six classes vis:— (i) Vataja (clue to the action of the deranged Vaytr, (ii) Pittaja (due to the action of deranged Pittani), (iii) Kafihuja (due to the action of deranged Kapham), (iv) Rdktajti (due to the action of the vitiated blood), (v) Samiifidtajii (due to the concerted action of tile deranged Vayu, Pittani and Kapham ■ and (vi) Sahiija (congenital). Pathology : —The deranged Vayu, l'itlam, etc. enraged by their specific aggravating causes, or by such act? or conduct as partaking of food composed of in- compatible substances, eating before the previous meal has been digested, inordinate sexual intercourse, sitting on the haunches, excessive riding, and the voluntary suppres- sion of any natural urging of the bod)-, either severally or in combination of „ two or three Doshas, or vitiating the blood of a person, who observes no moderation in food and drink &c, become dislodged from their natural seats in the body [according to the law of l'rasaranam (expansion and change of place by a deranged organic principle)] and are carried down through the large intestine (l'radhana Dhamani) into the descending colon and getting lodged therein, give rise to growths of polypi or fleshy condylomata, which arc known as piles. These growths chiefly appear in persons suffering from impaired digestion (Agni), and gain in size through friction with the wearing apparel, weeds, wood, lumps of clay or stone, or by contact with cold water. 3. The lower end of the large intestine, which passed into the flexure of the rectum and measures four and Cha P n J NIDANA STHANAM, IC)' a haif fingers in iength, is catted the Gudam tttt.— the channel of fecai matter), the interior of which is provided with three spiral grooves. Each of these grooves or ring-like muscles lie a finger and a half apart, and arc respectively known as Pravahini, Visarjani and Sam varan i, or the grooves of out-flow, defecation and closure of the anus (sphincter ani), covering a space of four fingers and having late-rally an elevation of one finger's width. 4. Metrical Texts :— These grooves are like the involuted indentures of a conch shell, situated one above the other, coloured like the palate of an elephant. A part of the channel, half a finger's width in length as it is usually measured from the outer hairy orifice of the rectum, is called the anus (Gudoushlha), 5—6. The first of the aforesaid grooves or rings lies about # a finger's width apart from the orifice of the anus. Premonitory Symptoms : —A n on -relish for food, a tardy and difficult digestion of food (brought into the stomach), acid eructation*, a sensed weakness in the thighs, a rumbling sound in the intestines, emacia- tion of the body, frequent eructations, swellings around the eyes, a croaking sound in the intestines, cutting pain in the rectum (Guda), apparent indications of an attack of phthisis, jaundice, dysentery, cough, riyspncea, vertigo, somnolence, excessive sleep, weakness of the organs (Indriya), are indications which predict the advent of this disease, and which become more marked with its progress, 7. The Va'taja Type : -Piles, due to the action of the aggravated Vayu, are non-exuding, rose-coloured, and uneven in their surface. They resemble the Kadamba flowers in structure and are cither tubular or sharp- pointed like a needle, sometimes assuming the shape of 30 THE SUSHROTA SAMIflTA. t cl »P' "■ • the wild Tundikcri flower, The stool of a hemorrhoid patient of this type becomes excessively hard, and can be evacuated only in a sitting posture, with the greatest pain and difficulty, An excruciating pain is experi- enced in the regions of the waist, back, sides, anus, umbilicus and the genitals. Symptoms peculiar to (iulma, Ashthih't, enlarged spleen and abdominal dropsy add to the distress of the patient, whose skin, nails, eyes, teeth, face, urine and stool also assume a daik black colour. 8, The Pittaja Type: -Piles, brought on through the action of the deranged 1'ittam, are slender, blue-topped, shifting in their nature, yellowish in their hue, or are coloured like shreds of liver, resembling in shape the tongue of the Suka bird. The;- are thick at middle, like barley grains, or resemble the mouth of leeches and secrete a sort of slimy exudation. The stool is marked with blood, and the patient complains of a painful, burning sensation (in the rectum) at the time of defecation. Kcvcr, with a burning sensation and thirst, and epileptic fits, supervene. The skin, nails, eyes, face, teeth, stool, and urine of the patient assume a yellow hue. 9. The Kaphaja Type : -Piles, due to the action of the deranged Kapham, become white, arc sunk about their roots, and are hard, round and glossy. They assume a greyish hue and resemble the teats of a cow or the stones of the Karira, or of a Panasa fruit. These piles do not burst, nor do they exude any sort of secretion. The patient feels an irresistible tendency to scratch the excrescences. The stools become copious in quantity and are charged with mucous (Slcshma), resembling the washings of meat. Indigestion, fever with shivering (Sita-jvara), and heaviness of the head and cedema Chap. II.] NIIJANA S.T1IANAM. 21 • with a non-relish for food are the symptoms which be- come manifest with the progress of the disease. The skin, finger nails, eyes, teeth, face, stool and urine of the patient also assume a white colour. 10. The Raktaja Type : -Piles (hemorrhoids), having their origin in the vitiated condition of the blood resemble the sprouts of the Vata tree in shape and are of the colour of red coral, or the seeds (daik led) of Gunja berry. They exhibit all the symptoms, which are peculiar to the 1'ittaja type of this disease. Pressed hard by the constricted farces in their passage through the anus, they suddenly g'ive lise to a haemorrhage of vitiated (venous) blood, and symptoms characteristic of excessive bleeding arc found to supervene. II. The Sannipata Type : In a case of haemorrhoids due to the concerted action of the deranged Vayu, l'ittam and Kapham, symptoms characteristic of each of these types manifest themselves in unison. 12. ■> , The Congenital Type :— Congenital hemor- rhoids (Sahaja Arsas) arc usually ascribed to defects in the semen and ovum of one's parents and should be medicinally treated with an eye to the special deranged Doshas involved in the ease. The polypi (in this type) arc hardly visible and are rough and yellowish, with their faces turned inward. They are extremely painful. A person suffering from this type of piles gets thinner and thinner every da)' and eats but very little. Large veins (Sira) appear on the surface of the body. The patient becomes irritable, the semen decreases in quantity, making the procreation of a small number of children possible only by him. The voice becomes feeble, the digestion is impaired, and disorders affecting the head 22 THE SUSIIRUTA SAMHITA. I cb P- "■ nose, cars and eyes follow. A croaking sound is heard in the intestines, attended with a rumbling in the abdomen. All relish for food vanishes and the region of the heart seems to be smeared with a kind of sticky paste (of mucous), etc. 13. Auhoritative verse on the subject :— A qualified physician should undertake the medical treat- ment of hemorrhoids which occur cither about the outer or the middle groove of the rcctum,(in as much as they prove amenable to medicine). A polypus, appear- ing about the innermost ring or groove of the rectum, should be treated without holding out any definite hope of cure to the patient. 14. LingarsaS (Fig warts or condylomatous growths about 'the genitals) :— The deranged and aggravated Vayu etc., finding lodgment in the genitals, vitiate the local flesh and blood, giving rise to an itching sensa- tion in the affected localities. The parts become ulcerat- ed (through constant scratching) and the ulcers become studded withs£*out-like vegetations offlcsh(\varts),which exude a kind of slimy, bloody discharge. These growths, or excrescences generally appear on the inner margin, or on the surface of the glans penis, in the form of soft, slender vegetations of skin, resembling the hairs of a email brush (Kurchaka). These vegetations ultimately tend to destroy the penis and the reproductive faculty of the patient. Bhage(rS'as:— The deranged Vayu etc. of the body, lodged in the vaginal region of a woman, gives rise to similar crops of soft polypi in the passage. They may crop up isolated at the outset, and (by coalescing) may assume the shape of a mushroom or an umbrella, secreting a flow of slimy, foul-smelling blood. The deranged Vayu, etc. may further take an C'»P- H.] MDAXA STHANAM. 23 upward course, and rinding a lodgment \n the cars, nose, mouth and eyes may produce similar warts in those localities. Warts, which crop up inside the cavities of the cars, may bring on earache, dumbness, and afoul dis- charge from those organs, while those (cysts) cropping up in the eyes will obstruct the movement of the cyc-Iids, giving rise to pain and a local secretion and ultimately destroy the eye-sight. Similarly, such growths in the nostrils produce catarrh, excessive sneezing, shortness of breath, headache, nasal speech and the complaint known as l'ulinasya. Such vegetations cropping up in and about the lips, palate or the larynx, tend to make the speech confused and indistinct. When appearing in the mouth, the)' impair the faculty of taste, and diseases which affect the cavil) - of the mouth follow. Tfle ex- cited Vyana Vayu, united with the aggravated Kapham, produces a kind of hard papillomatous growths on the skin (about the anus) which arc called the Charmakilas (papillomata).* 15. Authoritative verses on the, subject : — These Charmakilas ma) - be attended with a kind of pricking pain through an excess of the deranged Vayu, whereas those which have their origin in the deranged Kapham (lymphatics) assume a knotty shape and be- come of the same colour as the surrounding skin. On • the other hand, they become dry, black or white, and extremely hard through an exuberance of the deranged local blood and l'itlam. 16. The symptoms of polypi, appearing in the neighbour- hood of the anus, have been described in full, while the general characteristics of those, which arc found to crop up around the genitals, have been briefly discoursed * According to others, Charmakilas may crop up on the skin of any part of the b dy. 2 4 THE SUSHRUIA SAMHITA. tCh.p. "• upon. An intelligent physician should ponder ove'r the two groups of symptoms while engaged in treating a case of piles. A aisc of piles exhibiting symptoms pccuh'ar to the (wo deranged Doshas is culled the Samsargajam. Six distinct types of bio-Poshaja piles arc known in practice* 17. Prognosis !— A msc of piles due to the con- certed action of the three deranged Doshas of the body, (with its characteristic symptoms) but partially develop- ed, may be temporarily checked (Y;ipya). Cases, which arc of more than a year's standing, as well as (hose in which the haemorrhoids are due to the concerted action of the two Doshas (Samsargaja), or are situated in the middle groove of the rectum, may be cured but with the greatest difficulty. Cases of (he Sannipatika or congenital (Sahaja) types should be given up as incurable. The Apana Vayu, in a person whose rectum is overrun with such polypus growths, tries to pass out through the anus, but is driven back upward, being obstructed i*i* its passigc by the vegetations, and then mixes with his Vyana Vayu, thus imparing (the five- functioned) fire (Pittam) in his body. 18-19. * Such r.s (1) th? one due to the concerted action of the deranged Pittam and Kapham, (2) the one incidental to the simultaneous derange- ment of the V;\yu and the Kapham, (3) the one brought about through the disordered condition of the Vayu and blood, (4) the one clue to the combination of the deranged Pittam and Kapham, (5) Ihc one produced by the concerted action of the deranged Pittam and blood, (6) the one which results from the combined action of the deranged Kapham and blood. Thus ends the second Chapter of the N'idftnasthftnam in the Sus'ruta Samhitit which deals with the Nidinam of piles. CHAPTEK III. Now we shall discourse on the Nida'nam of As'- mari (urinary calculi), I . The disease admits of being divided into four several types, such as the Vritaja, the 1'ittaja, the Kaphaja and the Sukraja (Seminal) concretions. An exuberance or preponderance of the deranged Kapham should be under- stood as the underlying cause of all invasions of this disease. 2. General aetiology :— The Kaphah gl Type :— Particles of bones, eaten with (cooked ) meat by an imprudent, greedy, glut- tonous person, may be carried down with the hard and constipated stool by the Apana VAyu (into the rectum), thus scratching or abrading the margin of the anus, or burrowing into the rectum in the event of their being evacuated in improper directions through (transverse, or horizontal postures). The scratch or abrasion is soon transformed into a fetid and putrid ulcer, infested with • worms and parasites, as a plot of miry ground will soon swarm with a spontaneous germination of similar parasites. These worms and parasites cat away the sides of, or largely burrow into, the region of the anus, and jets of urine, fecal matter, and flatus (VAyuJ are found to gush out of these holes. This type of Bhagandaram is called Unmargi. 7. Authoritative verses on the sub- ject : — A pustule, appearing about the region of the -anus and characterised by a slight pain and swelling, .and spontaneously subsiding, should be regarded as a simple pustule, which is of a quite different nature from a fistula in ano, which has contrary features (i.e., invariably found to be attended with a violent pain and swelling e^;., and takes a long time to heal). A ^Fistula-pustule crops up within a space of two fingers' width of the PAyu proper (distal end of the 5 34 THE SUSIIRUTA SAMHITA. [Ch«p. IV. t rectum), is sunk at its root, and attended with pain and febrile symptoms. Pain, itching and burning sensations are experienced about the anus after a ride in a carriage, or after defecation. The anus becomes swollen, and the waist painful in the premonitory stages of Bhagandaram. 8—9. Prognosis :— Almost all the types of this disease (Fistula in ano) yield to medicine after a prolonged course of treatment, and arc hard to cure, except the Sannipatah and traumatic ones, which arc incurable. 10. Thus ends the fourth Chapter of the Nidani Sthanam in the Sushrula Samhita, which treats of the Nidanani of \ (6titla in ano (Bhagandaram). CHAPTER V. Now we shall discourse on the Nida'nam of KllSh- tham (cutaneous affections in general). I. Improper diet or conduct; especially ingestion of improper, unwholesome, indigestible, or incongc- nial food; physical exercise or sexual intercourse immediately after partaking of any oleaginous subs- tance, or after vomiting ; constant use of milk in com- bination with the meat of any domestic, aquatic or amphibious animal ; a cold water bath after an exposure to heat ; and repression of any natural urging for vomiting etc, are the factors which tend to derange and aggravate the fundamental principle of Vayu in a person. The enraged or aggravated Vayu, in combina- tion with the agitated l'ittam and Kapham, enters into the vessels or ducts fSira), which transversely spread over the surface of the body. Thus the enraged Vayu deposits the Fittam and Kapham on the skin through the medium of their channels and spreads thj.>m over the entire surface of the body. The regions of the skin in which the aforesaid morbific diatheses are deposited become marked with circular rings or patches. The mor- bific diatheses (Doshas), thus lodged in the skin, continue to aggravate, and having been neglected at the outset, tend to enter into the deeper tissues and thus contaminate the fundamental principles (Dhatus) of the body. 2. Premonitory Symptoms :— A roughness of the skin, sudden horripilation, an itching sensation in the surface of the body.excess or absence of perspiration, anathesia of the parts, a black colour of the blood, and a rapid growth and expansion of any ulcer (appearing on the body) are the symptoms which mark the premoni- tory stages of Kushtham. 3. Jf5 THE SUSURVTA SAMHITA. (Chip. V. » Classification :— [Diseases, falling under the group of Kushtham, may be divided into two broad subdivisions], vh.,—Mahdkushthas (major) and Kshudra (minor) Kushthas, the, first consisting of seven, and the second of eleven different types, aggregating eighteen in aH. The Mahakushthas arc classified as, Aruna, Audumvara,Rishya-Jihva, Kapala, KAkanaka, Pundarika, and Dadru, The minor or Kshudra-kushthas (Lichen and Dermatitis) arc Sthularushkam, Mahakushtham, Eka- kushtham, Charmadalam, Visarpah, l'ari.sarpah, Sidhma, Vicharchika, Kitima, Pama, and Rakasd. All the types of KushthaYn, whether major or minor, involve the action of the deranged Viyu, Pittam or Kapham, and are con- nected with the presence of parasites in those localities* The preponderance of any particular morbific diathesis (Dosha) in any case of Kushtham should be looked upon as its originating cause. The type, known as Aruna Kushtha, is due to the action of the preponderant Vayu ; Audumvara, together with Rishya-Jihva, Kapala and Kakanaka, tn.a preponderance of the deranged Pittam ; while Pundarika and Dadru owe their origin to an excess of the deranged Kapham. These types of major or minor Kushthas are successively more extensive in their action and more incurable on account of their respectively invading a greater number of the bodily elements (Dhatus). 4 — 6. Mahakushthas :— Aruna-kushtha owes its origin to an exuberance of the deranged Vayu. It is .slightly vermilion-coloured, thin and spreading in its \ * Ceitiin authorities hold that, all types of Kushtham (cutaneous affections) to be of parasitic origin. The Garnda Puranam avers that, the parasites, which infest the external principles of the body, are the primary causes of cataneous affections— AHjAMaita-Ai/azwft/dr/'tf A ihlemshajd vMyaiamMaM. Ch. CLXIXV. 4, Cta»p.V.) KIDANA STHANAM. 37 • nature. A sort of pricking, piercing pain (is experienced in the affected locality) which loses all sensibility to the touch. The type known as Audumbara is coloured and shaped like a ripe or mature Audumbara fruit and has its origin in the deranged Pittam. The type called Rishyajihva is rough and resembles the tongue of a Rishya (Deer) in shape and colour. The type known as Kapa'la (Macula caarula:) resembles a black (deep blue) Kharpara ( baked clay ). The Krfkanaka type is characterised by a dark red and black colour like the seed of the Gunja berry. A sort of sucking and burning pain is experienced in the affected locality in all the four preceding types of the disease which are the outcome of the deranged Pittam. The whole diseased surface seems as if burning with fire, and emitting hot fumes. They are speedy in their origin and rapidly suppurate and break. All these types soon become infested with parasites. These arc the general features of these forms of Kushthas. 7. Pundarika:— The patches resemble the petals of a (full blown) lotus flower in colour, and Dadru (Ringworm) assumes the colour (faint blue) of an Atasi flower, or of copper. They arc spreading in their nature and are found to be overspread with pustules. Both the Dadru and Pundarika types arc raised, circular, and characterised by itching and take a considerable time to be fully patent. These are the general charac- teristics of Dadru and Pundarika. 8. Kshudra Kushthas :— We shall now des- cribe (the features of the diseases known as) Kahudra- knshthas (M. Text):— The type known as SthaWrushkft appears about the joints. It is extremely thick at ifs base, is cured with the greatest 'difficulty, and is strewn over with hard pustules (Arungshi).- In the type kncAurn 38 THE SUSHRUTA SAMHITA. t Chap, V. as of Mahrfkushtham the skin contracts, and with the bursting of the skin (a piercing pain is felt in the affec- ted part), which loses all sensibilityto the touch, accom- panied by a general sense of lassitude in the limbs. In the Ekakushtham (Ichthyosis) type the skin assumes a reddish black colour. It is incurable. In the form known as Charmadalam (Hypertrophy of the skin") a burning, sucking, drawing pain is experienced in the palms of the hands, and in the soles of the feet which become cha- racterised with an itching sensation. The disease, which affects in succession the (organic principles of) skin, blood and flesh, and speedily extends all over the body, like Erysipelas, and is attended with a burning sensation (Vidaha), restlessness, suppuration and a piercing pain and loss of consciousness (epileptic fits), is called Visarpa Kushtham. The form in which a number of exuding pustules gradually extend over the surface of the body is called Parisarpa Kushtham. The type of the disease which is white and thin, and is characterised by itching and docs nqt create any disturbance (in the patient), is called Sidnma (Macula: atrophies). This form is generally found to restrict itself to the upper part of the body. Vioharohika (Psoriasis) is characterised by excessive pain and itching and gives rise to extremely dry crack-like marks on the body [hands and feet]. The same form of malady attended with pain, burning and itching, and restricting itself solely to the lower extremities, is called Vipa'diki The type in which the eruptions exude (a kind of slimy secretion) and which arc circular, thick, excessively itching, glossy and black-coloured is called Kitima (Keloid tumours). Small pustules or pimples characterised by an itching, burning secretion and appearing on the surface of the body are called Prima' (Eczema). The preceding kinds of pimples attended Chap. V.] NIDANA STHANAM. 39 1 with burning vesicles, arc called Kachchus and are found to be chiefly confined to the legs, hands and buttocks. A sort of dry and non-exuding pimples characterised by excessive itching and appearing all over the body, is called Rakasa' (dry Erythema). 9-10. The forms known as Sthuhirushka, Sidhma, Rakasa, Mahakushtham and Ekakushtham should be considered as offspring of the deranged Kapham. Parisarpa-kush- tham alone is due to the action of the deranged Vayu, while the remaining types (of minor Kushtham) owe their origin to the action of the deranged Pittam. n. Kilasam: — The disease known as Kilasam is but another form of Kushtham. It may be divided into three types according as it is brought about through the action of the deranged Vayu, Pittam or Kapham. The difference between Kilasam and Kushtham is that the former confines itself only to thcTvaka (the skin)and ts marked by the absence of any secretion,* A case of Kilasam caused by the action of the deranged Vayu is circular, vermilion-coloured and rough to the touch. The affected part when rubbed peals off scales of morbid skin. A case of Kilasam, due to the action of the deranged Pittam, is marked by eruptions, resembling the petals of a lotus flower (in shape and colour), and arc attended with an extremely burning sensation. In the type originated through the action of the deranged Kapham, the affected part (skin) assumes a glossy, white colour, becomes thick and is marked by an itching sensation. The form in which the eruptions or patches extend and become confluent, invading even the soles of the feet, ' A case of Kushtham has its primary seat in the blood and skin (of the patient), in which it lies confined during the period of incubation, after which it attacks the skin and secretes the characteristic secretion of the deranged Dosha involved in it. 4° THE SUSHRUTA SAMHITA." . [Chip. V.. • • the palms of the hands and the region of the anus, and in • ■ which the local hairs mumc a red colour should be regarded as incurable.- A case of Kilasham, which is the outcome of a burn (cicatrix) should be likewise con, sidered as incurable. 12. A preponderance of the deranged Viyu in a case of Kushtham (leprosy) is indicated by a contraction of the skin, local anaesthesia, a copious flow of perspiration, swelling, and piercing or cutting pain in the affected part' together with a deformity of the limbs and hoarseness.' Similarly, an excess of the deranged Pittam in a case of Kushthara/should be presumed from the suppuration of the affected part, from the breaking of the local skin ' from the falling off of the fingers, from the sinking of thenose and ears, from the redness of the eyes and from the germination of parasites in the incidental ulcer. An Excessive action of the*"dcranged Kapham, in a case of Kushtham, gives rise to itching, discolouring and swelling )fthe affected part which becomes heavy and exudes he characteristic secretion. The types, Pundarika and , Cakanam, which are due to the germinal defect of ' he patient, are incurable, inasmuch as they involve according to Dallana) the concerted action of the hree.. simultaneously deranged Doshas from the very utset.' 13. Memorial verses :-As a tree, full grown in the course of time, has driven its roots, which derive their nourishment from the rain water, deeper and deeper into the successive strata of the soil, so this disease (Kushtham), first affecting and confining itself to the upper layers of the skin, will invade the deeper tissues and organs etc. of the patient, if unchecked until al- ' most all the fundamental principles or elements Dhatus ■are attacked by its virus in the course of time. 14. Ch»P- V.] NlbANA STHANAM. 41 The symptoms of a case' of Kushlbam confined only to the serous (Tvaka) fluid of the skin are the loss of the perception of touch, a scanty pcrsp%ation,.itchingand dis- coloration and roughness of the affected part. The symp- toms which manifest themselves when the disease is con- fined to the blood arc complete anaesthesia, horripilation, absence of perspiration, itching and excessive accumu- lation of pus in the affected parts, The symptoms of Kushtham affecting only the flesh are thickness of the patches, dryness of the mouth, roughness and hardness of the patches which become covered with pustular eruptions and vesicles, and an excruciating pricking pain in, and numbness of, the affected part. The symptoms of (Kushtham) invading the principle of fat only arc a fetid smell and an excessive accumulation of pus in the affected part and a breaking of the skin, exposing deep gashing wounds which soon become infested with para- sites. The body seems as if covered with a plaster. Symptoms of (Kushtham) affecting only the bones and the marrow arc a sinking (lit: breaking) of the nose, a redness of the eyes, loss of voice ;tnd the germination of parasites in the incidental ulcers. Symptoms of the disease restricting itself only to the principle of semen arc a crippled state of the hands and distortion of the limbs, loss of the power of locomotion, spreading of ulcers and all the other symptoms peculiar to the pre- ceding types of the disease, 1 5—20. A child, which is the offspring of the contaminated semen and ovum of its parents afflicted with Kushtham, should be likewise regarded as a Kushthi. 21. Prognosis:— A case of Kushtham appearing in a person of prudence and discretion and confined only to the serum (Tvaka), flesh and blood of his orga- nism should be regarded as curable. A palliative treat- 6 ^2 THE SUSHRUTA SAMHITA. [Chap. V, nient is the only remedy m cases where the disease is found to invade the principle of fat ; whereas a case where the poison is found to have penetrated into any of the remaining organic principles should be given up as incurable. 22. Wise men hold that, for killing a Brahmana, or a wo- man, or one of his own relations, for theft, as well as for doing acts of impiety, a man is sometimes cursed with this foul disease by way of divine retribution. The disease rcattack* a man even in his next rebirth in the event of his dying with it. Uncurcd Kushtham (leprosy) is the most painful.and most troublesome of all diseases. 23—24. A Kushthi (leper), getting rid of this foul malady by observing the proper regimen of diet and conduct and by practising expiatory penances and by resorting to proper medicinal measures, gets an elevated status after death. 25. Kushtham (Leprosy) is a highly contagious disease ; the contagion being usually communicated through sexual intercourse with a leper (Kushthi), or by his touch or breath^ or through partaking of the same bed, and eating and drinking out of the same vessel with him, or through using the wearing apparel, unguents and garlands of flowers previously used by a person afflicted with this dreadful disease. Kushtham (Leprosy), fever, pulmonary consumption, ophthalmia and other Aupasar- gika disease (incidental to the influences of malignant planets or due to the effects of impious deeds) arc communicated from one person to another. 26. Thus rlxU the fifth Chipter of the Nidanasthanam in the SushruU SamSila 1 which treats of the Nidinam of cutaneous affections (Kushtham). CHAPTER VI. Now \vc shall discourse on the Nidanam of Pra-i' meha (diseases of the urinary tracts). I. It may be prognosticated that an idle man, who, indulges in day sleep, or follows sedentary pursuits 'or is in the habit of taking sweet liquids, or cold and. fat-making or emollient food, will ere long fall an easy, victim to this disease. 2. Pathology : —The bodily principles of Vltyu, Pittam and Kaphah of such a person get mixed with improperly formed chyle of the organism. Thus deranged, they carry down through the urinary ducts the de- ranged fat, etc.* of the body and find lodgment at the mouth (neck) of the bladder, whence they arc emitted through the urcthraf, causing diseases, known by the (generic) name of Prameha. 3 Premonitory Symptoms: -A burning sensation in the palms of the hands and of thfc, soles of the feet, a heaviness of the body, coldness or slimincss of the skin and limbs, sweetness and whiteness of the urine, somnolence, lassitude, thirst, a bad-smelling breath, a shortness of breath, slimy mucous deposit on the tongue, palate, pharyx and teeth, clotted hair .and an in- ordinate growth of the finger and toe nails arc the indications which mark the advent of the disease. 4. General Characteristics:— A copious flow of cloudy or turbid urine characterises all the types of the disease, which, together with the abscesses and eruptions (Pjdaka) which mark its sequel, should be • The particle "cha" in [he lent denote! other virus or mnrLilic milter. Dallam. t Remain Incarcerated therein according toothers. 44 THE SUSHRUTA SAMR1TX [Chap. VI t regarded as involving the concerted action of the de- ranged Dosha* (Vayu, Pittam and Kaphah). 5. The Kaphaja Types .--Cases of Prameha, which are caused by an exuberance of the deranged Kapham, may . be grouped under ten subheads such as, Uthka-mtha, Ikshu-meha, SurA-meha, Sikata-melta, S'a- mi-melia, Lamma-melia, Pishta-meha, Samha-meha, S'uk- ra-melia and Pkna-melia. The ten aforesaid types are curable, inasmuch as the medicines which tend to remedy the deranged Kapham (Dosha), the cause of the disease, prove also remedial to the other principles of the body (dash, marrow, blood, semen etc) deranged (Dushya) from the same causes. 6. The Pittaja Types :-Thc types, which arc brought about through an exuberance of the deranged Pittam, arc named as A'ila-melm, Haridrd-mc/ta, Amla- titelia, Kslmra'-melia, Maujislitlia-imim, and S'vmta-meha, Palliation is all that can be effected in these types, inasmuch as the medicines which tend to correct the de- ranged pittam, whjch has brought on the disease, fail to exert similar virtues on the organic principles (Dushyas) deranged by it. 7. The Va'taja Types :-Thc types of Prameha which are produced by an aggravated condition of the bodily Vayu arc divided into four subgroups, such as Saifi-mciia, I 'asilme/ta, Kshoudm-meha and Hasti-meha. These should be regarded as most incurable inasmuch as no kind of medicine can restore the fleet-coursing, deep diving {it. invading the bones and the marrow) Vayu, which at the same time also augments the Pittam, to its nonnal state and thus advances (unchecked) in its work of disintegration. 8. The deranged Kaphah, in conjunction with the (morbid) Pittam, Vfyu and fat, gives rise to all Kaphaia Chap. VI. 'MDANA-STHANAM.- 4J types of Prameha. , The deranged Pittam, in conjunc- tion with the deranged Vayu, blood, fat and Kapham, produces the Pittaja ones ; while the deranged Vayu, in unison with the deranged Kapham, Pittam, fat, marrow and Vasa (myosin), engenders the types of Vataja Prameha. 9. Symptoms of Kaphaja Mehas :-Thc urine* of a person suffering from an attack of TJdaka- msha becomes white and water-like and is passed without the least pain. In ,1 case of Ikshnmeha the urine resembles the expressed juice of sugarcane. It has the colour of wine in a case of Sura'meha. The urine in a case of Sikata'meha is passed with pain and is found to leave a sediment of extremely fine and sand-like concretions (Sriata's). In a case of Sanaimeha the urine gushes out at intervals in jets and is charged with a slimy mucous (kaphah). The urine in a case of Livauameha becomes limpid (non-viscid) and acquires a saline taste. There is horripilation at the time of micturition in a case of Pishtameha (tjiyluria), the urine resembling a stream of water, charged with a solution of pasted lice (i'ishtam). In a case of Sindrameha, the urine becomes thick and turbid, while in a case of Sukraiheha the urine resembles semen (or the mine is found to ' be charged with semen : Mridhaba). In a case of "Tie Sanskiit term Meha literally means to micturate. The verba! noun Mehanam signifies urination as well as the act of passing any morbid urethral secretion. Hence the urine in most of these cases denoUs the [act of its being charged wi'.h pus or any other morbid secretion of the urinary oigans such as Oj.xh (albumen), marrow, etc., which imparts thur characteristic colours to the fluid, —a fact which determines the nomen- clature of the disease and forms the keynote of its diagnosis in life, Ayurveda.— Ed, 4$ THE.SUSHRUTA SAMHITA. [Chip. ' V i Pheriameha the patient pisses frothy urine in broken jets, to. Symptoms of Pittaja Mehas :-Now we shall describe the characteristic features of the types of Pramcha, which arc due to the action of the deranged Pittam. The mine in a case of Nikmeha becomes frothy, transparent and bluish. The urine in a case of Haridra'meha becomes deep ' yellow like turmeric (Haridri) and is passed with a burning pain. The urine in a case of Amlameha acquires an acid taste and smell. The urine in a case of Ksha'rameha* resembles an alkaline solution filtered (through a piece of linen). The urine in a case of Maujistha'meha resembles the washing of the ManjistM, while in a case of Eaktameha, the urine is found to be of blood-colour (or charged with blood - Madhava). II. Symptoms of Vataja-Mehas ;-Now we shall describe the characteristics of the different types of Pramcha, which arc due to an exuberance of the deranged V.fy*i. In a, case of Savpimeha, the urine looks like a stream of clarified butter, while in one of Vasa'meha it resembles the washings of Vas/i. In a case of Kshaudrameha, the urine looks like honey and acquires a sweet taste. In one of Hastimeha, the patient passes a copious quantity of urine, like an excited elephant, at a time, and in one unbroken stream, (the organ becoming steady immediately after the act of micturition). 12. Supervening symptoms :-The fact of the urine being assailed by a swarm of flies, lassitude, growth of flesh (obesity), catarrh, looseness of the limbs, a • The urine acquires a distinct alkaline laile, smell, colour and touch. (Midhaba Nidinam). t QhariVa has included it within Kshaudra Meha and Madhu Me-*, Chip. VI.] KIDANA STIIANAM. 47 non-relish for food, indigestion, expectoration of mucous, vomiting, excessive sleep, cough and laboured breathing (Svasa) arc the supervening traits (Upadrava) of the Kaphajl Prameha. A piercing pain in the testes, a pricking (veda) pain in the bladder, a shooting pain (Tuda) in the penis, a griping pain at the heart, acid eructations, fever, dysentery, a non-relish for food, vomiting, a sensation as if the entire body is emitting fumes, a burning sensation in the skin, thirst, epileptic fits, insomnia, jaundice (Pandu) and a yellow colour of the stool and urine are the supervening symptoms which mark the Pittaja types of Prameha. An oppressive feeling at the heart (Hridgraha), eager longings for foods of all tastes, insomnia, numbness of the body, fits of shivering, colic pain and constipation (jf the bowels arc the supervening symptoms, which specifically mark the Vataja types. Thus we have described the nature of the twenty different types of Mcha with their supervening evils as well. 1 3-16. The ten different types of J'jdaka (abujess, carbun- cles, pimples, pustules etc.) are found to crop up on the bodies of patients, suffering from Prameha, and abounding in fat and Vasa, and whose fundamental principles have been affected by the simultaneous derangement of the VAyu, Pittam and Kapham. They arc named as Siravika, Sarshapika, Kachchapika', Ja'lini, Viuaia, Putrini, Masurika, Alaji, Vida'rika and Vidradhika. 17. Metrical Texts :— An abscess which is raised at the margin and dipped in its centre, so as to resemble an Indian saucer in its shape is called Saraviktt Pimp- les or pustules of the shape and size of white mustard seeds are called Sarsha'piki An abscess, resembling (the back of) a tortoise in shape and attended with a burning sensation, is called Kachchapika' by the wise. 48 THE SUSHRUTA SAMIIITA. tChap. Vl. • An abscess studded with slender vegetations of flesh and attended with an intolerable burning sensation is called jyiilli. A large blue-coloured abscess (carbuncle) appearing on the back or the abdomen, and exuding a slimy secretion and attended with a deep-seated pain is called Vinati A thin and extensive abscess (studded withslcndcrpustulcs— D.R.) is called Putriui. Pimples to the size of lentil seeds arc called Masurika'. A dreadful abscess which is of a red and white colour, studded over with blisters or exuding vesicles is called Alaji. A hard and round abscess as large as a (full-grown) gourd is called Vidririka'. An abscess of the Vidradhi type is called Vidradhika' (carbuncle) by the wise. An incidental abscess in a case of Pramcha should be regarded as having its origin in the same morbific principle (Dosha) as that which has produced the disease (Pramcha) 18-28. Prognosis !-~A Pidaka.oran abscess, appearing about the region of the heart, anus, head, shoulder, back or at any of the vital joints (Marma) of the body, and attended wj\i\ other .supervening symptoms producing extrem; p;oUratio:i [impaired digestion— D. R.] in the patient should bj abandoned as incurable. In a case of Vataja mclia, the deranged Yayu presses all the fundamental principles out of the body through the urethra and rages rampant in the lower part of the body, united with the deranged fat, marrow and Vasi. Hence a case of Vataja mcha, (or its accompanying abscess), is held as incurable. 29-30. A person in whom the premonitory symptoms (Pur- varupam of Pramcha) have appeared and who passes a little larger quantity of urine than usual, should be considered as already afflicted with it. A person afflicted with all or half of the premonitory symptoms of the disease and passing a copious quantity of urine '•P' VI> NIDANA STHANAM. 49 ould be considered as one suffering from an attack Pramcha. 31 — 32. A Pramcha patient afflicted with deep-seated absces- i and other distressing .symptoms, which are usually md to supervene in the disease, should be pronounc- as suffering from Madhumeha and adjudged incurable Madhumcha patient seeks a halting place while walk- ;, wants a place to sit on while halting, lies down if he ds a sitting place, and sleeps if he lies down. 33 — 34. As five mixed colours such as grey, brown, Kapila uish yellow), Kapota (blackish grey), Mcchaka ,'ht-grccn) may be produced by combination of the : primary colours in definite proportions (such as itc, green, black, yellow and red), so a diversity of iscs, through the relative preponderance of the pafti- ar kinds of food, and of the deranged Doshas, root nciplcs (Dhatu) and excretions of the body (Mala), ,• be attributed to the origin of Pramcha. 35. Memorial verses : -All types of Pramcha, properly treated and attended to at the outset, y ultimately develop into those of A&dhumeha cs, which arc incurable. 36 or English equivalents of the different types of Pramcha compare :— 'vstitis (Acute Infective)— Frequent, painful micturition, small quantity ine voided with pain and urgency. Urine— slightly acid or alkaline in ion, cloudy, containing blood corpuscles. Cystitis (Chronic Infective) eat and frequent pain, in the lumbar region, rigor. Urine— thick, sive and alkaline, containing ropy mucous and blood. Cystitis (Non- tive)— Symptoms like those of acute inflammatory type. Urine— and cloudy with mucous. Iilood is generally present in derable quantity. Neuralgia of the bladder, compare Albuminuria, moauria, Hcemoglobinuria, Hoematuria, Peptonuria, Pyurfa natorrhoia and Diabetes, Proteuria and Polyuria. hui ends the sixth Chapter of the Nidana Slhariam in the Suihrula litl, which treats of the Nidanam of Prameha. CHAPTER VII. Now wc shall discourse on the Nidrfnam of Udara (dropsy with an abnormal condition of the abdomen), i. Metrical Text :-The royal sage Dhanv'an- tari, the foremost of all pious men who equalled in splondour and glory the lord of the celestials, thus blissfully discoursed on the Nidanam of Udara to Sus'ruta, the son of the holy Visvamitra, who devoutly approached him for that purpose. 2. Classification :-This disease may be divided into eight different types, of which four are produced by the several actions of the three deranged Doshas of the body and their concerted action as well. Of the re- maining types, two being known as Plihodara (including Yakritodara), and Vaddha-Gudodara (tympanites due tb the constriction of the anus), the seventh Agantuka (traumatic, or of extraneous origin), and the eighth Dakodara (Ascites proper). 3. Predisposing Causes :-The deranged Doshas of a person of extremely impaired digestion, addicted to the habit of taking unwholesome food, or of eating dry, putrid food, or of violating the rules of conduct to be observed in connection with oleaginous measures etc. « arc aggravated and find lodgment in the abdomen. Thus appearing in the shape of an abdomi- nal tumour (Gulma), they give rtseto thisdreadful disease, attended with all its characteristic symptoms. The lymph chyle formed out of the assimilated food getJ vitiated, and, impelled by the aggravated Vayu, it percolates' •Th«e include purg.iivc, emitlc, AWpuuo, .nd Anuv»' M n,m Chtp. VII.] NIDAtfA STHANaM. sf ' through the peritoneum in the'same manner as a quantity of oil or clarified butter kept in a new earthen pot will transude through the pores of its sides. It thus gradually distends the skin (Tvak) of the abdomen. The process becomes general all through the abdominal region and the disease (Udara) is produced in consequence. 4 — 5, Premonitory sypmtoms :— The precursory symptoms of the disease are loss of strength, complexion and appetite, emaciation of the muscles of the abdomen, appearance of veins on its surface, acid reaction of food closely following upon its digestion (VidAhai, pain in the bladder, and swelling of the lower extremities. The patient cannot ascertain whether his meal has been digested or not. 6. The Va'taja, Plttaja, and Kaphaja Types:— A case of Udara in which the abdomen en- larges on its sides and posterior part, and is over- spread with nets of black veins should be ascribed to the action of the deranged Vayu. A pain(Sula), suppression of the stool and urine (Aniha) and a ctitting and" piercing pain and flatulent rumbling in the intestines are the symp- toms which likewise characterise this Va'taja form of Udara. A sucking pain in the abdomen, thirst, fever with a burning sensation, yellow colour of the swollen skin of the abdomen, on the surface of which yellow veins appear, yellow colour of the eyes, nails, face, stool and urine and the rapid increase of the dropsical swelling, are the characteristics of the Pittaja Udara. In a case of Kaphaja type the dropsical swelling is cold to the touch and becomes overspread with white-coloured veins. The abdomen seems heavy, hard, glossy and is extreme- ly distended. The swelling slowly increases, and the finger- nails and face of the patient become white, and he complains of a general lassitude. 7—9 52 , THK SUSHRl^A SAMHITA. tQh?p. Vll" The Tridoshaja Type :— Evil-natmed wo-- men .(with a view to win the affections of their husbands or lovers sometimes) mix with their food and drink such refuse matters of their bodies as nails, hair, feces, urine, catamcnial blood clc. (which arc supposed to be possessed of ta/fsmanic virtues). The three Doshas of the body, vitia- ted by such food or drink, or through imbibing any sort of chemical poison (Gara)administcrcd by one's enemy, or by taking poisonous waters, or Dushi-Visha (slow poison whose active properties have been destroyed by fire or any antipoisonous medicine), will vitiate the blood and give rise to a kind of dreadful dropsical swelling of the abdomen, marked by the .specific symptoms of each of them The disease is aggravated in cold and cloudy days and a burning sensation is felt (,in the inside of the abdomcn\ The patient becomes pale, yellow, and emaciated, and is afflicted with thirst and dryness in the mouth, and loses consciousness at short intervals. This disease is also known as the dreadful Dushyodaram. 10. . Plihodaram.— (Spleen with dropsy of the abdo- men) :— Now hear me describe the symptoms of Pliho- daram. The blood and the Kapham of a person, derang- ed and aggravated through the ingestion of phlcgma- gogic food, or of those which is followed by an acid digestionary reaction (Vidiha), often enlarge the spleen, (which gives rise to a swelling of the abdomen). This disease is called Plihodara by the experts. i'lihodaram protrudeson the left side of the abdomen, its characteristic symptoms being lassitude, low fever, impaired digestion, loss of strength, jaundice, weakness, and other distress- ing symptoms peculiar to the deranged Pittam and Kapham. A similar enlargement of the liver through similar causes on the right side of the abdomen . is called Jakridddlyudaram. n— 12. Chap. VII.]" NIDANA STHAfrAM. ' jj '. Vaddha-gudodaram* :— The fecal matter, mixed with the deranged Vayu, Pittam etc . of the body, lies stuffed in the rectum of a person whtisc in- testines have been stuffed with slimy food (as pot herbs) or with stones and hair (enteiitis). They give rise to ' a sort of abdominal dropsy by swelling the part between the heart and the umbilicus which is called Vaddha Gudodaram. Scanty stools are evacuated with the great- est pain and difficult}' and the patient vomits a pe- culiar kind of matter with a distinctly fecal smell (scyabalous ?). 13. PariSravi-Udaram : -Now hear me describe the causes and symptoms of the type of Udaiam which is called Parisralviudaram. Thorny or sharp-pointed substances (such as fish-bones etc.), carried down "with the food in a slanting way from the stomach into the abdomen, sometimes scratch or burrow into the intes- tines. Causes other than the preceding ones, (such as a long yawn or over-eating etc.) may contribute to the perforation of the intestines, giving rise «to a copious flow of a watery exudation which constantly oozes out of the anus and to a distension of the lower part of the abdomen situated below the umbilicus. This is called Parisravyudaram which is marked by a cutting pain and a burning sensation. 14 DakOdaram : — Now hear me describe the causes and symptoms of the type known as Dakodaram (ascites 1 . The drinking of cold water immediately after the application of an Aunvasanam or Asthapanam enema, or closely following upon the exhibition of any purgative or emetic medicine, or just after the taking of a medicated oil or clarified butter, etc. tends to derange * Dropiical swelling of the abdomen wilh tympanites due to the coni- tiiclion of the tectum known ai inteatinal obitiuction. 54 THfe JSlJSHRUTA SAMHiTA. " [CMpVVII. . 4 Ihe water-carrying channels of the body. The same result may be produced by the drinking of oil, etc. in inordi- nate quantities The water, by percolating or transud- ing through the walls of these channels, as before des- cribed, inordinately enlarges the abdomen, which be- comes glossy on the surface and is full of water, being rounded about the umbilicus and raised like a full- bloated water-drum. The simile is complete as it fluctuates under pressure, oscillates, and makes a pecu- liar sound like a wafer-drum under percussion. 15. Dimension of the stomach, incapacity of locomotion, weakness, impaired digestion, a-dematous swelling of the limbs, a general sense of lassitude and looseness in the limbs, suppression of flatus and stool, and a burning sensation and thirst arc among the general characteris- tics of the disease in its various forms. 16. Prognosis :— All cases of Udaram after the lapse of considerable time develop into those of ascites and a case arriving at such a stage should be given up as incurable. 16-^-17. Thus ends Ihe seventh Chapter of Ihe Nidlna Sthanam in the Sui'ruta Stmhitd which treats of the Nidinam of Udaram, CHAPTER VIII. Now we shall discourse on the Nidanam of Mudhagarbham (, false presentations and difficult labour). I. Causes of Mudha-garbham : -Sexual intercourse during pregnancy, riding on horseback, etc., or in any sort of conveyance, a long walk, a false step, a fall, pressure on the womb, running, a blow, sitting or lying down on an uneven ground, or in an uneven posture, fasting, voluntary repression of any natural urging of the body, partaking of extremely bitter, pungent, parchifying articles, eating in inordinate quan- tities of Sakas and alkaline substances, dysentery (Atisira), use of emetics or purgatives, swinging in a swing or hammock, indigestion, and use of medicines which induce the labour pain or bring about abortions, and such like causes tend to expel the faetus from its fixture. These causes tend to sever the chijd from the uterine wall with its placental attachment owing to a kind of Abhighatam (uterine contraction) just as a blow tends to sever a fruit from its pedicel. 2. Definition: — The fetus, thus severed and dislodged from its scat, excites peristalsis not only in the uterus, but induces a sort of constant, spasmodic contraction of the intestinal cavities (Koshthas), pro- ducing pain in the liver, spleen, etc. The Apana Vayu, thus obstructed through the spasmodic contraction of her abdomen, produces any of the following symp- toms, viz. a sort of spasmodic pain in the sides, or in the neck of the bladder, or in the pelvic cavity, or in the abdomen, or in the vagina, or .Anaha (tymp- anies with obstruction, etc.) or retention of urine, 56 THE SUSHRUTA SAMHITA. f Ch "P- VIIL r and destroys the fetus, if immature, attended with bleeding. In case the fetus continues to develop and is brought in an inverted posture at the entrance to the vaginal canal, and is impacted at that place, or if the Ap.ina Vayu gets disordered and conse- quently cannot help the expulsion of the same, such an obstructed fetus is called Mudha garbhah. 3. Classification and Symptoms: -Cases of Mudha-garbha may be roughly divided into four different classes such as, the Kilak, the Pratikhurah, the Vijakah and the Paritfiah. The sort of false presentation in which the child comes with its hands, legs and head turned upward and with its back firmly obstructed at the entrance to the vagina, like a stake or a kila, is called Kilah. The sort of presentation, in which the hands, feet and head of the child come out, with its body impacted at the entrance to the vagina, is called Prathikhurah. The type in which only a single hand and the head of the child conic out (with the rest of its body obstructed at the same place), is called the Vijakah. The type in which the child remains obstructing the head of the passage in a horizontal position, like a bolt, is called the Parighah. Certain authorities aver that, these arc the only four kinds of Mudhagarbha. But we can not subscribe to the opinion (which recognises only four kinds of false presentations), inasmuch as the deranged Vayu (Apana) can present the fetus in various different postures at the head of the vaginal canal. Sometimes, the two thighs of the child are first presented, and sometimes it comes with a single leg flexed up. Sometimes the child comes with its body, bent double, and thighs .drawn up, so that only breech is obliquely presented. Sometimes the child is presented, impacted at the head Ch»p. VIII.] NIDANA STHANAM. 57 of the passage with its chest, or sides, or back. Some- times the child is presented with its arm around its head, resting on the side, and the hand coming out first, Sometimes only the two hands arc first presented, the head leaning on one side; sometimes the two hands, legs and the head of the child, the rest of the body being impacted at the exit in a doubled up posture. Some- times one leg is presented, the other thigh b:ing impacted at the passage (l'.'tyu). I have briefly described these eight sorts of presentation of which the last two arc irremediable. The rest should be given up as hopeless if these arc attended with the following compli- cations viz., deranged sense-perception of the mother, convulsions, displacement or contraction of the repro- ductive organ (yoni) a peculiar pain like the after-pain of child birth, cough, difficult respiration, or vertigo. 4, Memorial Verses:— As a fruit, fully matured, i* naturally severed from its pedicel and falls to the ground and not otherwise, so the cord, which binds the fietus to its maternal part, is severed in course of lime, and the child comes out of the uterus ( into this world of action ). On (he other hand, as a fruit, worm-eaten or shaken by the wind or a blow, untimely falls to the ground, so will a fcelus be expelled out of its mother's womb, before its time. For four months after the date of fecundation, the fietus remains in a liquid state, and hence its destruction or coming out of the womb goes by the name of abortion. In the course of the fifth and sixth months the limbs of the fcetus gain in firmness and density, and hence, its coming out at such a time is called miscarriage. 5-7. Prognosis :— The enceinte who violently tosses her head in agony (at the time of parturition) and the surface of whose body becomes cold, compelling 58 THE SUSHRUTA SAMHITA. [ Ch »P' vnI - • her to forego all natural modesty, and whose sides and abdomen arc covered with nets of large blue- coloured veins, invariably dies with the dead child locked in her womb. The death of the fretus in the womb may be ascertained by the absence of movements of the fectus (in the womb) or of any pain of child-birth, by a brown or yellow complexion of the enceinta, cadc- vcrous smell in her breath, and colic pain in the abdomen and its distension owing to the continuance of the swollen and decomposed child in the womb, 8-9. The death of a child in the womb may result from some emotional disturbance of its mother, (such as caused by bereavement or by loss of fortune during pregnancy) ; while an external blow or injury (to the womb) or any serious disease of the mother may also produce the like result, A child, moving in the womb of a dead mother, who had just expired (.from convulsions etc.) during parturition at term, like a goat (Vastamara) should be removed immediately by the Surgeon from the womb (by Cesarean Section);* as a delay in extract- ing the child may Idads to its death 10- ; 1. * Cxcsarean Section means incision of the uterus through the abdomi* nal walls and extrication nf the (fetus therefrom. Operation like this upon a dead subject requires no skill of a surgeon. Any one can do it wilhout the help of any anatomical knowledge. In modern times, when the mother's life is in peril, and the expulsion of the ftulus becomes nearly impossible, by the natural passage, owing to an cxistenee of deformity either in the parturient canal or in the forms and structures of the fcetu^ to save both mother and child this operation is principally undertaken. The evilencc of similar attempts, in ancient India, is found recorded in passages like what we have just translated and thit the operation was practised on living subjects, there is not the least doubt about it. This custom is still preserved in Central Africa, and it is possible that the Egyp- tians like Hindu philosophy and religion learnt this also from the Hindus, "Felkin," says "Baas in his History ofMedicine p. 70 "saw a case of the Cesarean operation in Central Africa performed by a man. At one stroke Chap. VIII.] NlDANA gTHANAM. 5^ Additional Text*.— The bladder is ruptured, the dead child lies like a weight upon the placenta and is pressed upward on the spleen, liver and gall bladder. The mother shivers and is oppressed with tremor, dryness of the tongue, dyspnoea and perspiration. She complains of a cadaverous smell in her breath and stands in danger of imminent death. By these symptoms a physician shall know the death of the child in the womb. This portion is partly recognised by Brahmadeva and is totally rejected by JejjadKcharya «3 spurious. an incision was made through both the abdominal walls and the uterus. The opening in the latter orgm was then enlarged, the hemorrhage checked by the actual cautery, and the child removed. While an assis- tant compressed the abdomen, the operator then removed the placenta. The bleeding from the abdominal walls was then checked. No sutures were placed on the walls of the uterus but the abdominal parietes were fastened together by seven figure-of-eight sutures, formed with polished iron needles and threads of bark. The wound was then dressed with a paste prepared from various roots, the woman placed quietly upon h/r abdomen, in order to favour perfect drainage, and the task of the African Spencer Wells was finished. It appears that the patient was first rendered half unconscious with banana wine. One hour after the operation the patient was doing well. And her temperature never rose above 101 F. nor her pulse above 108. On the eleventh day the wound was completely healed, and the woman apparently as well as usual," When we read this evidence of Felkin, we are reminded gf the opera- tive steps as described in our own ancient book of Surgery from which modern surgeons have been able to borrow the operation of rhinoplasty. It is a great pity that while in Africa the same practice is still retained intact, we in India by spurious attempts and disgraceful contortions, Subs- titutions of false readings and dismal knowledge of grammar and rhetoric try to prove in the face of strong evidence that in ancient India Ca-sarean Section wa3 attempted only on cases where one "might not perspire." If we take fifqwuj: in the sense of "a woman whose Jife is in great danger" and not exactly in the sense of "a woman who is dead" as recom- mended by Dalian and Arundutta (and which might have been the meaning if instead of fjqfl a word like «riqf had been used in the text), we 6nd at once that Weber's remark in his History of Indian Literature p. 270 "that in Surgery they {the Hindu*) attained to high proficiency" is not based on the solitary evidence of rhinoplasty alone. In performing obstetric operations with success examples like thii are not rare. If the two different readings ifftA and *faft{ be taken con- jointly into consideration we are impressed with the idea that in ancient 6o THE SUSIIRUTA SAMHITA. [Chap. VlJl. * India Cesarean operations were very frequently undertaken in cases of puerperal eclampsia, where ihe molher had been in (he deplorable condi- thn of & goat suffering from cramps and convulsions as well as in cases of an accidental death notuni'tks that which felt to the lot of the poor molher of him in whose name the operation is called. *r$T=goat i\\K = destroyer {See Momcr William's Dictionary) hence a goaUlestroyer^a tiger or wolf) or in cases where the presence of deformity in the parturient canal or of malformation of the fcetus prevented [he natural delivery of a living child. The incision is not to be made anywhere else but exactly in the place where Felkin saw the illiterate Negro successfully apply his knife, the selection of ^f^' %\\q as suggested by some commentators being a tempest on a tea pot especially when the subject is beyond the grave. In a living subject the selection of a proper site for the 0[ eration is of course very commendable, ller.ee we venture to suggest that extraction of the living foilus from the womb by making incision through this part of the pelvis was also attempted later on. We extract here the two different readings and leave our readers to judge whether we are Correct to draw the above Inferences.— Eil. ^fa?rt faw*m $fa : r«i^ qfa 51*11*1% w?t: uV qizfasl^- fanja I Urigabhala S'.-iiira Slhanam. ch. II. slo. 53. Tims ends the eighth Chapter of the NidAna SlhAnam in the Sus'ruta Samhita*, which treats of Nid.inain of difficult labour and false presenta- tions. CHATTER IX. Now we shall discourse on the Nidanam of Vidradhi (abscess etc.). i. The blessed Dhanvnntari, the lionoured of the gods, who for the promulgation of the knowledge of the Ayurveda and for administering proper medicines (to the sick), took his birth at Kasi, (Henarcs) as a king, thus fully discoursed on the symptoms of Vidradhi (abscess etc.) to his disciple, Sus'ruta. J, Definition and classification :— The extremely deranged and aggravated Vayu, 1'ittam and Kapham, resorting to the bone and vitiating the Tvaka ( skin ), blood, flesh, and fat of a person (with their own specific properties), gradually give rise 'to a deep-seated, painful, round or extetided swelling which is called Vidradhi by the wise. The disease admits of being divided into six types such as the Vatajn type, the PMaja type, the J\apluxja type, the Sannipatika type, the Ksliataja type (traumatic), and the Asrija .which has its seat in the vitiated blood). Now we shall describe their specific symptoms. 3-4. The Vataja Type:— This abscess assumes a black Or vermilion colour, is felt rough to the touch and is characterised by a sort of excruciating pain. The growth and suppuration of the abscess arc brought about in a variety of forms (owing to the variable and irregular action of the deranged Vriyu inolved in these cases). 5- The Pittaja Type :— This abscess assumes a blackish yellow colour or one like that of a ripe Audum- vara fruit. It is attended with fever and a burning sensation, and is of rapid growth and suppuration. 6. 62 NIDANA STHANAM. Cha P' **-J t The Kaphaja Type:— This abscess is shaped like an Indian saucer (s'ar/iva) and seems cold to the touch. It assumes a light yellow colour and is character- ised by numbness, itching and little pain. The growth and suppuration of this abscess is very slow. The secretions from a VAtaja abscess arc thin, those from a Pittaja type are yellow, while the exudations from a Kaphaja abscess arc white. 7. The SaVinipatika Type: -An abscess of the Sanntpatika type is of varied colour, and is attended with a varied sort of pain (sucking, drawing, turning etc.) and exudes secretions of various colours (white, yellow, etc.). It is little raised or elevated at its top, large and irregular in its shape and does not uniformly suppurate in all its parts. 8. Agantujaor Kshataja Type: -The local or inherent heat of an ulcer, (caused by a blow or a dirt) in a person, addicted to unwholesome regimen, is augmented and conducted by the deranged Vayu and vitiates the blood and l'ittam, thus giving rise to a kind of abscess which is known as the Agantuja Vidradhi (traumatic abscess). Symptoms of the Pittaja type like- wise mark this type of abscess and fever, thirst and a burning sensation attend it from the very beginning. 9. The Raktaja Type : -This abscess assumes a black or tawny colour, covered with a large number of black vesicles, and fever and an intolerable burning and pain attended with all the symptoms peculiar to the Pittaja type, mark the present form of the disease. It is called Raktaja Vidradhi. Of external Vidradhis or abscesses, those of the Sdnnipatika type should be regarded as incurable, 10 — 11. Antara-Vidradhi :— Now we shall describe the characteristic features of internal abscesses (Antara- [Chap. IX. THE SUSHRUTA SAMHITA. 6$ » Vidradhi). The Vayu, Pittam and Kaphah of the bod}-, deranged through eating heavy, incompatible and in- congenial (to the physical temperament of the cater) articles of food or of dry, putrid and decomposed sub- stances, or by excessive coition and fatiguing physical exercise, or by voluntary repression of any natural urging of the body or through the eating of food which is followed by an acid reaction, cither severally or collectively give rise to a tumour-like (Gulma), raised, or elevated abd» tht ninth Chipln of the NidsnBJthsntm in the Su>'iut» SunbM which tints of the etiology of tbscnt. CHAPTER X. Now we shall discourse on the Nidanam of Vlsat"- pa (erysipelas), Nrfdi (sinus) and Stana-roga (diseases affecting the mamma: of a woman). [. Definition Of Visarpa : -The deranged and aggravated Doshas, (VAyu, l'ittam and Kapham) having recourse to, and affecting the Tvaka (Skin), flesh and blood, speedily give rise to a sort of shifting, elevated swelling (Sotha) marked by the characteristic symptoms of any of them involved in the case. This swelling tends to extend all over the body. The disease is called Visarpa from the fact of its extending or swiftly shifting character (Skr. srip -to go, to extend). 2. The VAaJa Type :— The swelling (S'otha) is soft and rough and assumes a black colour attended with an aching pain in the limbs and a cutting or piercing pain (in the affected locality). It is further marked by (all the usual) symptoms of the Vatika fever. A case of this type in which uneven flame coloured vesicles or bulbs appear on the affected part through the extreme vitiation (of the Vayu and l'ittam) should be given up as incurable. 3. The Pittaja and Kaphaja Types : - The Pittaja Visarpa (erysipelas) rapidly extends (over the body, attended with severe fever, a burning sensation, suppuration and cracking (of the skin'. A large number of vesicles appears on the spot which as- sume a blood-red colour. A case of this type, characteiised by the destruction of the local flesh and veins owing to the excessively aggravated condition of the deranged Doshas (Kaphha and Pittam) and a 68 THE SUSIIRUTA SAMHITA. [Chap. X. • collyrium-likc black colour (of the swelling), should be regarded as incurable. The Kaphaja Visarpa extends slowly and the process of suppuration is tardy. The affected part becomes white, glossy and swollen, and is marked by a slight pain and excessive itching. 4-5. The Sannipatika Type : -The Visarpa of the Tridoshaja type is deep-seated and the affected part assumes all colours and is attended with all sorts of p.iin which are peculiar to the three aforesaid types The local flesh and veins are destroyed in the suppurating stage of this disease and hence, it shouldbc looked upon as incurable. 6. The Kshataja Type (Erysipelas due to a wound or an ulcer): —The l'ittam of a person with a temperament marked by the extreme aggravation of all the three Doshas, in conjunction with the blood, resorts to a wound* in his body and immediately gives rise to Erysipelas (Sopha— lit rash) which assumes a reddish- brown colour, with high fever with a burning sensation, and suppuration jn its train, and it is found to be covered with black vesicles to the size of Kulattha pulse. 7. Prognosis : --The Vataja, Fittaja and Kaphaja Visarpas are curable ; the Sannipatika and Khataja ones being incurable. The symptoms, which indicate an unfavourable prognosis in a case of Vataja or Pittaja Erysipelas, have been described before. Those, which attack the vital parts (Mannas) of the body, can be cured only with the greatest difficulty.f 8. , •' Or through the extreme augmentation of all the three doshas in ' t,he urcer'(Sadyah-kshata.Vfana) according to others. - + Uolden coloured (yellow) Erysipelas due to the action qf the (deranged) Pittam is incurable {Pitlfami Kfonhana-vaftutha tahi na >