The Sushruta Samhita — trans. Bhishagratna

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

Cbap. II.] MDANA STHANAM. ^3

upward course, and finding a lodgment In the ears, nose, mouth and eyes may produce similar warts in those localities. Warts, which crop up inside the cavities of the ears, may bring on earache, dumbness, and afoul discharge from those organs, while those (cysts) cropping up in the eyes will obstruct the movement of the eye-lids, 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 Futinasya. 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, they impair the faculty of taste, and diseases which affect the cavity of the n^outh follow. The excited Vyana Vayu, united with the aggravated Kapham, produces a kind of hard papillomatous growths on the skin (about the anus) which are called the Charmakilas (papillomata).* 15.

Authoritative verses on the subject :

— These Charmakilas may be attended with a kind of pricking pain through an excess of the deranged Vdyu, whereas those which have their origin in the deranged Kapham (lymphatics) assume a knotty shape and become 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 Fittam. 16.

The symptoms of polypi, appearing in the neighbourhood of the anus, have been described in full, while the general characteristics of those, which are 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.

^4 THE SUSMRUTA SAMHITA. [Chap. II.

upon. An intelligent physician should ponder over the two groups of symptoms while engaged in treating a case of piles. A case of piles exhibiting symptoms peculiar to the two deranged Doshas is called the Samsargajam. Six distinct types of bio-Doshaja piles arc known in practice.* 17.

A case of piles exhibiting symptoms peculiar to the two deranged Doshas is called the Samsargajam. Six distinct types of bio-Doshaja piles arc known in practice.* 17.

Prognosis :— A case of piles due to the concerted action of the three deranged Doshas of the body, (with its characteristic symptoms) but partially developed, may be temporarily checked (Yapya). Cases, which are of more than a year's standing, as well as those in which the hciemorrhoids 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 the 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 in its passage by the vegetations, and then mixes with his Vyana Vayu, thus imparing (the fivefunctioned) fire (Pittam) in his body. 18-19.

* Such as (i) the one due to the concerted action of the deranged Pittam and Kapham, (2) the one incidental to the simultaneous derangement of the Vayu and the Kapham, (3) the one brought about through the disordered condition of the Vayu and blood, (4) the one due to the combination of the deranged Pittam and Kapham, (5) the 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 Nidanasth^nam in the Sus'ruta
Samhita which deals with the Nidanam of piles.

I

CHAPTER III.

Now we shall discourse on the Nidanam of As'« mari (urinary calculi). I.

The disease admits of being divided into four several types, such as the Vdtaja, the Pittaja, the Kaphaja and the Sukraja (Seminal) concretions. An exuberance or preponderance of the deranged Kapham should be understood as the underlying cause of all invasions of this disease. 2.

General aBtioIOgy :— The Kaphah of a man, who neglects to cleanse (Samsodhana) the internal channels of his organism, or is in the habit of taking unwholesome food, enraged and aggravated by its own exciting causes, is carried into the urinary bladder. Here it becomes saturated with the urine, and gives rise to the formation of concretions or gravels in its cavity. 3,

Premonitory Symptoms:— An aching

Here it becomes saturated with the urine, and gives rise to the formation of concretions or gravels in its cavity. 3,

Premonitory Symptoms:— An aching

pain in the bladder, with a non-relish for food, difficulty in urination, an excruciating pain in the scrotum, penis, and the neck of the bladder, febrile symptoms, physical lassitude, and a goat-like smell in the urine are the symptoms, which indicate the formation of gravel in the bladder. 4.

Metrical Text ;— The deranged Doshas involved in a particular case respectively impart their specific colour to the urine, and determine the character of the accompanying pain. The urine becomes thick, turbid, and vitiated with the action of the aggravated Doshas, and micturition becomes extremely painful. 5.

Leading Indications :— A sort of excruciating pain is experienced either about the umbilicus, or in the bladder, or at the median rape of thep. 4p. 26 perineum, or about the penis, during micturition when gravel is forming in the bladder. The urine is stopped at intervals in its out-flow, or becomes charged with blood, or flows out twisted and scattered like spray, leaving a sediment of clear, sandy, red or yellow particles of stone, which resembles a Gomedha gem in colour. Moreover a pain is experienced in the bladder at the time of running or jumping or in swimming, or while riding on horseback, or after a long journey. 6.

The ^leshmas'mari:— Stone or gravel, originated through the action of the deranged Kapham, saturated with an excessive quantity of that Dosha by the constant ingestion of phlegm-generating (Sleshmala) substances, increases in size at the lower orifice of the bladder and ultimately obstructs the passage of the urine. The pressure and recoil of that incarcerated fluid on the walls of the urinary badder gives rise to a kind of crushing, bursting, pricking pain in that organ, which becomes cold and heavy. A Kapha-origined stone or gravel is white and glossy, attains to a large size, to that of a hen's egg, and has the colour of the Madhuka flower. This type is called S'leshmas'mari. 7.

The Pitta ja As'mari :— The Kapham