The Sushruta Samhita — trans. Bhishagratna

Text):— The type known as Sthula'rushka appears about the joints. It is extremely thick at its base, is cured with the greatest difficulty, and is strewn over with hard pustules (Arungshi). In the type known3^ THE SUSHRUTA SAMHITA. [Chap. V. as of Mahatkushtham the skin contracts, and with the bursting of the skin (a piercing pain is felt in the affected part), which loses all sensibility to the touch, accompanied 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 characterised 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 fVidaha), 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 does not create any disturbance (in the patient), is called Sidhma (Maculae atrophicae). This form is generally found to restrict itself to the upper part of the body. Vicharchika (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 Vipatdikat. The type in which the eruptions exude (a kind of slimy secretion) and which are 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 Fakma (Eczema). The preceding kinds of pimples attendedp. 39 with burning vesicles, are 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 Rakasai (dry Erythema). 9-10.

A sort of dry and non-exuding pimples characterised by excessive itching and appearing all over the body, is called Rakasai (dry Erythema). 9-10.

The forms known as Sthularushka, Sidhma, Rakasa, Mah^kushtham and Ekakushtham should be considered as offspring of the deranged Kapham. Parisarpa-kushtham 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. ii.

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 Kilisam and Kushtham is that the former confines itself only to theTvaka (the skin)and is marked by the absence of any secretion.* A case of Kilasam caused by the action of the deranged Vdyu 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 are 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,p. 40 the palms of the hands and the region of the anus, and in which the local hairs assume a red colour should be regarded as incurable. A case of Kilasham, which is the outcome of a burn (cicatrix) should be likewise considered as incurable. 12.

* A case of Kushtham has its primary seat ir\ 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*

V.

the palms of the hands and the region of the anus, and in which the local hairs assume a red colour should be regarded as incurable. A case of Kilasham, which is the outcome of a burn (cicatrix) should be likewise considered as incurable. 12.

A preponderance of the deranged Vayu 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 Kushtham, 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 the nose and ears, from the redness of the eyes and from the germination of parasites in the incidental ulcer. An excessive action of the deranged Kapham, in a case of Kushtham, gives rise to itching, discolouring and swelling of the affected part which becomes heavy and exudes the characteristic secretion. The types, Pundarika and Kakanam, which are due to the germinal defect of the patient, are incurable, inasmuch as they involve (according to Dallana) the concerted action of the three simultaneously deranged Doshas from the very outset. 1 3 .

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 almost all the fundamental principles or elements Dhdtus are attacked by its virus in the course of time. 14.

Chap, v.] NibANA STHANAM. 4t