The Sushruta Samhita — trans. Bhishagratna

An abscess, resembling
(the back of) a tortoise in shape and attended with a
burning sensation, is called Kachchapika by the wise.

p. 48

An abscess studded with slender vegetations of flesh and attended with an intolerable burning sensation is called Jg^lini. 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 Vinatat A thin and extensive abscess (studded withslender pustules —D.R.) is called Putrini. Pimples to the size of lentil seeds are 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 Vidai'ikat. An abscess of the Vidradhi type is called Vidradhika (carbuncle) by the wise. An incidental abscess in a case of Prameha should be regarded as having its origin in the same morbific principle (Dosha) as that which has produced the disease (Prameha) 18-28.

Prognosis : — A Pidaka,or an 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 with other supervening symptoms producing extreme prostration [impaired digestion — D." R.] in the patient should be abandoned as incurable. In a case of Vataja meha, the deranged Vayu 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 Vasa. Hence a case of Vataja meha, (or its accompanying abscess), is held as incurable. 29-30.

A person in whom the premonitory symptoms (Purvarupam of Prameha) 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

Chap. VI. NIDANA STHANAM.

p. 49

should be considered as one suffering from an attack ofPrameha. 31 — 32.

A Prameha patient afflicted with deep-seated abscesses and other distressing symptoms, which are usually found to supervene in the disease, should be pronounced as suffering from Madhumeha and adjudged incurable. A Madhumeha patient seeks a halting place while walking, wants a place to sit on while halting, lies down if he finds a sitting place, and sleeps if he lies down. 33 — 34.

A Madhumeha patient seeks a halting place while walking, wants a place to sit on while halting, lies down if he finds a sitting place, and sleeps if he lies down. 33 — 34.

As five mixed colours such as grey, brown, Kapila (bluish yellow), Kapota (blackish grey), Mechaka (light-green) may be produced by combination of the five primary colours in definite proportions (such as white, green, black, yellow and red), so a diversity of causes, through the relative preponderance of the particular kinds of food, and of the deranged Doshas, root principles (Dhatu) and excretions of the body (Mala), may be attributed to the origin of Prameha. 35.

IVIemorial verses :— All types of Prameha, not properly treated and attended to at the outset, may ultimately develop into those of Madhumeha types, which are incurable. 36

For English equivalents of the different types of Prameha compare : — Cystitis (Acute Infective) — Frequent, painful micturition, small quantity of urine voided with pain and urgency. Urine — slightly acid or alkaline in reaction, cloudy, containing blood corpuscles. Cystitis (Chronic Infective) — Great and frequent pain, in the lumbar region, rigor. Urine — thick, offensive and alkaline, containing ropy mucous and blood. Cystitis (Non- Infective) — Symptoms like those of acute inflammatory type. Urineacid and cloudy with mucous. Blood is generally present in considerable quantity. Neuralgia of the bladder, compare Albuminuria, Albumosuria, Hoemoglobinuria, Hoematuria, Peptonuria, Pyuria, Spermatorrhoea and Diabetes, Proteuria and Polyuria.

Thus ends the sixth Chapter of the Nidana Sthanam in the Sushruta
Samhit^, which treats of the Nidanam of Prameha.

QS

CHAPTER YII.

Now we shall discourse on the Nidainam of Udara

(dropsy with an abnormal condition of the abdomen), i.

Metrical Text :— The royal sage Dhanvantari, the foremost of all pious men who equalled in splendour and glory the lord of the celestials, thus blissfully discoursed on the Niddnam of Udara to Susruta, the son of the holy Vis'vamitra, 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 remaining types, two being known as Plihodara (including Yakritodara), and Vaddha-Gudodara (tympanites due to the constriction of the anus), the seventh Agantuka (traumatic or of extraneous origin), and the eighth Dakodara (Ascites proper). 3.

Of the remaining types, two being known as Plihodara (including Yakritodara), and Vaddha-Gudodara (tympanites due to 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.,* are aggravated and find lodgment in the abdomen. Thus appearing in the shape of an abdominal tumour (Gulma), they give rise to this dreadful disease, attended with all its characteristic symptoms. The lymph chyle formed out of the assimilated food getj vitiated, and, impelled by the aggravated Vdyu, it percolates k th«p. VII.] NIDANA STHANAM. Jt 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.

* These include purgative, erpitic, A'stha'panam and Anuva'sapann p(iej^su|re§,

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 (Viddha\ pain in the bladder, and swelling of the lower extremities. The patient cannot ascertain whether his meal has been digested or not. 6.

The Vataja, Pittaja, and Kaphaja