The Sushruta Samhita — trans. Bhishagratna

ch. II. slo. 53.

Thus ends the eighth Chapter of the Nidana Sthanam in the Sus'ruta Samhita, which treats of Nidanam of difficult labour and false presentations.

CHAPTER IX.

Now we shall discourse on the Niddnam of
Vidradhi (abscess etc.)- I.

The blessed Dhanvantari, the honoured of the gods, who for the promulgation of the knowledge of the Ayurveda and for administering proper medicines (to the sick), took his birth at Kdsi, (Benares) as a king, thus fully discoursed on the symptoms of Vidradhi (abscess etc.) to his disciple, Sus'ruta. 2.

Definition and classification :— The

extremely deranged and aggravated Vayu, Pittam and Kapham, resorting to the bone and vitiating the Tvaka ( skin ), blood, flesh, and fat of a person (with their own specific properties), gradually give rise to a deep-seated, painful, round or extended swelling which is called Vidradhi by the wise. The disease admits of being divided into six types such as the Vataja type, the Pittaja type, the Kaphaja type, the Sdnnipatika type, the Kshataja type (traumatic), and the Asrija (which has its seat in the vitiated blood). Now we shall describe their specific symptoms. 3-4.

The Vataja Type : — This abscess assumes a black or vermilion colour, is felt rough to the touch and is characterised by a sort of excruciating pain. The growth and suppuration of the abscess are brought about in a variety of forms (owing to the variable and irregular action of the deranged Vayu inolved in these cases). 5.

The Pittaja Type :— This abscess assumes a blackish yellow colour or one like that of a ripe Audumvara fruit. It is attended with fever and a burning sensation, and is of rapid growth and suppuration. 6.

62 NIDANA STHANAM. Chap. IX. ]

The Kaphaja Type:— This abscess is shaped like an Indian saucer (s'arava) and seems cold to the touch. It assumes a light yellow colour and is characterised by numbness, itching and little pain. The growth and suppuration of this abscess is very slow. The secretions from a Vataja abscess are thin, those from a Pittaja type are yellow, while the exudations from a Kaphaja abscess are white. J.

The Sannipatika Type:— An abscess of

the Sannipatika type is of varied colour, and is attended with a varied sort of pain (sucking, drawing, turning etc.) and exudes secretions of various colours (white, yellow, etc.). It is little raised or elevated at its top, large and irregular in its shape and does not uniformly suppurate in all its parts. 8.

Agantuja or Kshataja Type :-~The local

It is little raised or elevated at its top, large and irregular in its shape and does not uniformly suppurate in all its parts. 8.

Agantuja or Kshataja Type :-~The local

or inherent heat of an ulcer, (caused by a blow or a dirt) in a person, addicted to unwholesome regimen, is augmented and conducted by the deranged V^yu and vitiates the blood and Pittam, thus giving rise to a kind of abscess which is known as the Agantuja Vidradhi (traumatic abscess). Symptoms of the Pittaja type likewise mark this type of abscess and fever, thirst and a burning sensation attend it from the very beginning. 9.

The Raktaja Type:— This abscess assumes a black or tawny colour, covered with a large number of black vesicles, and fever and an intolerable burning and pain attended with all the symptoms peculiar tOj the Pittaja type, mark the present form of the disease. It is called Raktaja Vidradhi. Of external Vidradhis or abscesses, those of the Sannipatika type should be regarded as incurable. 10 — 11.

Antara-Vidradhi :— Now we shall describe the characteristic features of internal abscesses (Antara-

[Chap. IX. THE SUSHRUTA SAMHITA . 6$

VidradhI). The Vdyu, Pittam and Kaphah of the body, deranged through eating heavy, incompatible and incongenial (to the physical temperament of the eater) articles of food or of dry, putrid and decomposed substances, or by excessive coition and fatiguing physical exercise, or by voluntary repression of any natural urging of the body or through the eating of food which is followed by an acid reaction, either severally or collectively give rise to a tumour-like (Gulma), raised, or elevated abscess in the interior of the organism, which is often felt to be shaped like an ant-hill. 12-13.

Localities : — They are generally found to be seated at the mouth (neck) of the bladder, or about the umbilicus, or in the sides, or in the Kukshi (inguinal regions), or on the Vrikkas, or on the liver, or in the heart, or on the Kloma, or on the spleen, or in the rectum. Their general characteristics are identical with those of the several types of external abscess. The symptoms of their suppurated or unsuppurated stages should be determined in the light of the chapter on Amapakvaishanyiam (Ch XVII Sutra.). 14-15.

Their specific symptoms : -Now hear

The symptoms of their suppurated or unsuppurated stages should be determined in the light of the chapter on Amapakvaishanyiam (Ch XVII Sutra.). 14-15.

Their specific symptoms : -Now hear

me describe the symptoms which specifically mark these internal abscesses according to their seats in the differj ent regions of the organism. An abscess appearing in the rectum (Guda) is marked by the suppression of the flatus ( Vata). Seated in the bladder, it gives rise to difficulty of urination and scantiness of urine. Appearing about the umbilicus it produces a distressing hic-cough and a rumbling sound (Atopa) in the intestines. Seated in either of the sides (Kukshi) it tends to aggravate inordinately the vayu of the body. Appearing in the inguinal region it gives rise to an extreme catching pain at the back and waiyt. Sea^ted in either

64 NIDANA STHANAM [Chap. IX.

of the Vrikkas it brings about a contraction of the sides. Appearing on the spleen, it produces symptoms of difficult and obstructed respiration. Seated on the heart it gives rise to an excruciating and piercing pain within its cavity and a drawing pain (Graha) extending all over the body (D. R. — cough). Seated in the Liver its characteristic indications are thirst and difficult breathing (D. R. — hic-cough) whereas a sort of unquenchable thirst is the symptom which marks its seat on the Kloma. 16-17.

Prognosis : — An abscess appearing on any vital part (Marma) of the organism, whether large or small in size, suppurated or unsuppurated, should be deemed as extremely hard to cure. Discharge from an abscess formed in the region of the organism above the umbilicus and (spontaneously bursting), will flow out through the mouth whereas similar secretions from down the umbilical region of (the abdomen), naturally find an outlet through the fissure of the anus. The case in which the secretions (pus etc.) find a downward channel and outlet may end in recovery of the patient; whereas the one in which the secretions take an upward course invariably proves fatal. An incision made by surgeon from the outside into an internal abscess, other than the one situated on the heart, or on the bladder or on the umbilicus may occasionally, prove successful, but the one, seated on any of the preceding vulnerable visceras (heart, bladder etc.) of the body and surgically opened invariably ends in death. 18-19.