The Sushruta Samhita — trans. Bhishagratna

The local flesh and veins are destroyed in the suppurating stage of this disease and hence, it shouldbe looked upon as incurable. 6.

The Kshataja Type (Erysipelas due to a wound or an ulcer):— The Pittam of a person with a temperament marked by the extreme aggravation of all the three Doshas, in conjunction with the blood, resorts to a wound* in his body and immediately gives rise to Eiysipelas (Sopha— lit rash) which assumes a reddi.shbrown colour, with high fever with a burning sensation, and suppuration in its train, and it is found to be covered with black vesicles to the size of Kulattha pulse. 7.

Prognosis : — The Vataja, Pittaja and Kaphaja Visarpas are curable ; the Sannipdtika and Khataja ones being incurable. The symptoms, which indicate an unfavourable prognosis in a case of Vdtaja or Pittaja Erysipelas, have been described before. Those, which attack the vital parts (Marmas) of the body, can be cured only with the greatest difficulty.i* 8.

* Or through the extreme augmentafion of all the three doshas in the ulcer (Sadyah-kshata-Vj ana) according to others.

t Golden coloured (yellow) Erysipelas due to the action of the (deranged) Pittam is incurable (AV/a/wa /^h-tichana-vapuicha ta^hi na sydhyet.).''V>. R.

p. 69

The N^ldi-Vrana :~The pus of an abscess or swelling burrows into the affected part if a person neglects it in its fully suppurated stage, dubious of its being so conditioned, or not, or even neglects to open a fully suppurated abscess. An abscess or swelling is called a Gati Vrana owing to an excessive infiltration of pus, and it is also called a N^di-vrana owing to the presence of a large number of recesses or cavil ies in its inside. There are five different types of Nddi-vrana (sinuses) such as the Vdtaja, Fittaja, Kaphaja, Tridoshaja and Salyaja. 9— 10.

The Vataja, Kaphaja and Pittaja

There are five different types of Nddi-vrana (sinuses) such as the Vdtaja, Fittaja, Kaphaja, Tridoshaja and Salyaja. 9— 10.

The Vataja, Kaphaja and Pittaja

Types :~The V^fcaja SiEUS is rough and shortmouthed, characterised by an aching pain (in its inside). It exudes a sort of frothy secretion which becomes greater at night and is attended with an aching pain. Thirst, lassitude, heat and a piercing pain jn the affected locality) are the usual accompaniments of the Pittaja types. Fever is present from the beginning and the Sinus exudes a large quantity of hot and yellow coloured secretion which is more by day than by night. The Kaphaja Sinus becomes hard and is characterised by 'itching and a slight pain (numbed ?). It is found to secrete a copious quantity of thick, shiny, white-coloured pus which becomes greater at night. 11-13.

Dvandaja and Tridoshaja Types :—

A case of Nddi-Vrana involving the concerted action •of any two of the deranged Doshas (Vayu, Pittam and Kapham) and exhibiting symptoms peculiar to • both, is called a Dvandaja* one. There are threep. 70 types of this class of disease, (such as the Vata-pittaja, Vhta-kaphaja and Pitta-kaphaja) A case of Na'divrana, exhibiting symptoms of the three aforesaid types, and attended with fever and a burning sensation, difficult breathing, dryness of the mouth and syncope, is called Tridoshaja. An attack of this type should be regarded as dreadful and fatal, casting around the gloom of death. I4-I5-

* Gayadasa does not read the symptoms of Dvi-doshaja (?.<;., due to two morbific principles) types of sinus a g ven in the text which he has rejected as spurious

The ^alyaja Nadi-Vrana :— A foreign

matter (such as dirt, bone, splinter etc.), lodged within the body and invisible to the eye, tends to burst open the skin, etc. of the locality along its channel of insertion and gives rise to a type of Sinus. It is characterised by a constant pain, and suddenly and rapidly exudes a sort of hot, blood-tinged, agitated, frothy secretion. This type is called Salyaja. i6.

of the locality along its channel of insertion and gives rise to a type of Sinus. It is characterised by a constant pain, and suddenly and rapidly exudes a sort of hot, blood-tinged, agitated, frothy secretion. This type is called Salyaja. i6.

ThcStana-Roga: — These may be divided into as many types as the aforesaid Nadi-Vrana and are caused by the same exciting factors as the last named malady. The milk-carrying ducts remain closed in the breast of a nullipera thus barring the possibility of the descent of the Doshas through them and of an attack of any disease at that part of the body. On the contrary, such ducts in the breast of a piimipara open and expand of their own accord, thus making the advent of diseases possible that are peculiar to the mamma. I7-I9-

The breast-milk : -The sweet essence of the Rasa (lymph chyle) drawn from the digested food courses through the whole body and is ultimately concentrated in the breast of a mother or a woman (big with child) which is called milk. 2o.

Its character :— The breast-milk, like semen, lies hidden and invisible in the organism, though

Chap. X ] NIDANA STHANAM. /r

permeating it in a subtle or essential form. The characteristic features of the breast-milk bear analogy to those of semen The breast milk is secreted, and flows out at the touch, sight or thought of the child in the same manner as the semen is dislodged and emitted at the sight, touch or recollection etc. of a beloved woman. As the strong and unclouded affections of a man are the cause of the emission of semen, so the fondest love of a mother for her children brings about the secretion of her breast-milk Both semen and breast-milk are the product of the essence of digested food, this essence being converted into milk in women. 21 — 22.

Its abnormal and normal Traits: —

The milk of a mother vitiated by the deranged Vayu of her system has an astringent taste and floats on water The milk of a mother vitiated by the deranged Pittam has an acid and pungent taste and becomes marked with a yellow hue,* if left to float on water. The milk of a mother vitiated by the deranged Kapham is thick and slimy and sinks in water. The milk of a mother vitiated by the concerted and simultaneous derangement of the three Doshas of the body is marked by the combination of all the preceding symptoms. An external blow or hurt too (Abhighata) sometimes produces vitiation of the mother's milk. 23.