The Sushruta Samhita — trans. Bhishagratna

The patient experiences a sort of breaking pain at the chest, waist and thighs, (which are ultimately broken). The disease Is called Vahiratyatma, and should be looked upon as beyond the pale of all medicinal treatment. 47 — 50.

Four types of Akshepaka are usually- recognised in practice such as, the (i) 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 injuiy or blow (Abhighataja).* An attack of Apatdnkah 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, Samsrishta Akshepakah, simple Akshepakah and the Abhighataja (traumatic).

il;2 THE SUSHRUTA SAMHITA. [Chap. I.

The disease, in which the extremely agitated Vayu 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 Pakshfiighstta (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.

ProgTIOSis:— -A case of Pakshaghata (Hemiplegia), 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 Vayu in conjunction with the deranged Pittam or Kapham, proves amenable to medicine (Sadhya). It becomes incurable when caused through the waste of the root principles (Dhatu) of the body. 55.

Apatantrakah (Convulsions) :— The Vayu, aggravated (by its specifically exciting factors and principles) and dislodged from its natural seat or receptacle 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.

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 asphyxiaChap. I.] 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-e^aturated Vayu. This disease is called Apatantrakah and is ascribed to the action of the enraged Vayu surcharged with the deranged Kapham. 56.

IVIanyastambha:— The local Vayu, agitated through such causes as sleep in the day time, 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 Manyastambha (wry neck or torticollis). 57.

Arditam (Facial Paralysis) :~*P regnant 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 haemorrhage 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 th^.

* The portion of the text included within asterisks has been reject by Jejjadacharyya as spurious.

p. 14

eyes are 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

p. 14

eyes are 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, cloudiness of vision, upcoursing 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 case of Arditam, appearing in an extremely 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.

ViS'vachi (Erbe's paralysis or Bracial neuralgia):— The disease in which the enraged Vayu affecting the nerve-trunks (Kandara) which run to the tips of fingers behind the roots of the upper arms, making them [capable of movement and depriving them of their )wer of flexion or expansion is called Vis'vachi* 60.

KrOShtukaS'irsha (Synovitis of the knee- Ints) : — An extrimely painful swelling in the knee- When the aforesaid nerve of a sirgle arm is afTecld the disease is :ted to it alone, while it attacks the both when both their nerves areChap. I.] NIDANA STHANAM. 1$ 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 (Kroshtuka) in shape. 6i,

Khan ja (Lameness): — The disease proceeds from the drawing up of the nerve trunks (Kandara) of a leg by the deranged Vayu lying about the region of the waist. When both the legs are 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 Kalaya Khanja one in whom the bone-joints become loose. 62 — 6^.