The Sushruta Samhita — trans. Bhishagratna

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^.

Vata Kantaka : -The local Vdyu, enraged by making a false step on an uneven ground, finds lodgment in the region of the ankle (Khudaka, instep 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 Pada-daha, which is generally 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 Padaharsha, 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 shoulderjoints is called Ansa-s'hoshaka. The form in which the aggravated local Viiyu contracts the nerves of the arms is called Avavahuka*. 64—67.

Vad hiry ay am (deafness) :— The disease occurs only when the deranged Vayu, either singly or surp. 1charged with the Kapham, stuffs the sound-carrymg channels (Srota) of the ears. 68.

* The Ansa-shosha is due to the single action of the enraged Vayu, while Ava-vahuka is due to the concerted action of the deranged Vayu and Kapharo,

Kama S'ulam:— 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 Karnas'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

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 (Vayu) and an intense pain and rumbling in its inside, is called Adhmsinam (Tympanites). When it first affects the stomach fAmasaya) and is unattended with an oppressive feeling about the heart and pain at the sides' it is called Praty^dhmaiinam. The Vayu saturated with the deranged Kapham causes the preceding type of distemper. 71—74.

A knotty stone-like tumour (Granthi) of considerable 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 VatabSthilSb, (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 faeces. A tumour of similar shape,

Chap. I.] NIDANA STilANAM. I^

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 — ^6.

Thus ends the first Chapter of the Nidana Sthanam in the Subhruta Samhita, which treats of the Nidanam of the diseases of the nervous system.

\

p. 11

Now we shall discourse on the Nidanam of
Ars'aS (Haemorrhoids}, i.

Haemorrhoids may be divided into six classes viz : —

• (i) Vdtaja (due to the action of the deranged Vayu\
• (ii) Pittaja (due to the action of deranged Pittam), (iii) Kaphaja (due to the action of deranged Kapham), (iv) Raktaja (due to the action of the vitiated blood), (v) Samiipdtaja (due to the concerted action of the deranged Vayu, Pittam and Kapham i and (vi) Sahaja (congenital).

PathoIOg^y : —The deranged Vayu, Pittam, etc. enraged by their specific aggravating causes, or by such acts or conduct as partaking of food composed of incompatible substances, eating before the previous meal has been digested, inordinate sexual intercourse, sitting on the haunches, excessive riding, and the voluntary suppression of any natural urging of the body, 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 Prasaranam (expansion and change of place by a deranged organic principle)] and are carried down through the large intestine (Pradhana Dhamani) into the descending colon and getting lodged therein, give rise to growths of polypi or fleshy condylomata, which are 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 passes into the flexure of the rectum and measures four and

Chap. II J NIDANA STHANAM. I9

a half fingers in length, is called the Gudam (lit — the channel of fecal 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 are respectively known as Pravdhini, Visarjani and Samvarani, or the grooves of out-flow, defecation and closure of the anus (sphincter ani), covering a space of four fingers and having laterally 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 (Gudoushtha). 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 non-relish