The Sushruta Samhita — trans. Bhishagratna

An external blow or hurt too (Abhighata) sometimes produces vitiation of the mother's milk. 23.

The milk (of a mother), which instantly mixes with water, tastes sweet and retains its natural greyish tint, should be regarded as pure. 24.

The bodily Do.shas having recourse to the breasts of a woman whether filled with milk or not and vitiatinsf o the local flesh and blood give rise to mammary diseases,

* The particle 'Cha" in the text indicates that the colour may turn blue or pink in some cases.

p. 72

(Stana-roga). All the types of abscess (Vidradhi) excepting the one called the Raktaja out of the six types desciibed before are found to attack the mammae^ and their symptoms should be understood as identical with those of external abscesses. 25.

Thus ends the tenth Chapter of the Nidaram Sthdnam in the Su&'ruta Samhit^ w ich treats of the oetiolcgy and symptoms of Erysipelas, vSinus and mammary abscesses.

CHAPTER XL

Now we shall discourse on the Nid^nam of Granthi
(Glands etc.), Apachi (Scrofula etc.), Arvudi (Tumours)
and Gralagand a (Goitre), i.

The deranged and unusually aggravated Vayu etc. (Pittam and Kapham), by vitiating the flesh, blood and fat mixed with the Kapham (of any part of the organism), give rise to the formation of round, knotty, elevated swellings which are called Granthi (Glandular inflammation). 2.

The Dosha-Origined Types :— The swelling (Sopha) of the Vaitatja type seems as if it were drawn into and elevated or as if severed or pricked with a needle, cleft in two or drawn asunder or as if cut in two or pierced. The knotty growth assumes a black colour, and is rough and elongated like a bladder. On bursting a granthi of this type exudes clear bright red blood. The Fittaja Granthi is characterised by heat and an excessive burning sensation (in its inside). A pain, like that of being boiled by an alkali or by fire, is felt in the inside. The knotty formation assumes a red or yellowish colour and exudes a flow of extremely hot blood on bursting. The Kaphaja Granthi is slightly discoloured and cold to the touch. It is characterised by a slight pain and excessive itching, and feels hard and compact as a stone. It is slow or tardy in its growth and exudes a secretion of thick white-coloured pus when it bursts. 3-5.

The Medaja Type :— The fat origined Granthi is large and glossy and gains or loses in size with the gain or loss of flesh by the patient. It is marked

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p. 74

3-5.

The Medaja Type :— The fat origined Granthi is large and glossy and gains or loses in size with the gain or loss of flesh by the patient. It is markedp. 10p. 74 by a little pain and an excessive itching sensation and exudes a secretion of fat resembling clarified butter or a gruel, in colour and consistency, made of the levigated paste of sesamum on bursting. 6.

Si ra-Granthi— (aneurism or varicose veins) : — The bodily Vayu in weak and enfeebled persons, deranged by over-fatiguing physical exercises, straining or exertion or by pressure, presses on, contracts, dries or draws up the ramifications of veins (Sira) or arteries (of the affected locality), and speedily gives rise to a raised knotty formation which is called a Sira-Granthi, In the event of its being shifting and slightly painful, it can be cured only with the greatest difficulty. Whereas a case in which the knotty formation is painless, fixed, large and situated at any of the vital parts of the body (Marmas), should be deemed incurable.* 7.

Apachi — (Scrofula etc.) : — The augmented and accumulated fat and Kapham give rise to string of hard glossy, painless, nodular, or elongated granthi (swellings) about the joints of the jawbones, at the waist, joint, about the tendons of the neck, about the throat or about the region of the arm-pits. These glands (Granthis) resembling the stones of the Amalaka fruit or the spawn of fish in shape or like some other shape, are of the same colour as the surrounding skin ; and a string or a large crop of such glandular knots, gradually growing is called Apachi-f- on account of the extensive nature of their growth. 8-9.

* In several editions an additional line is to be found running as men well conversant with symptoms (of Gtanthis) recognise a type of Granthi due to the action of the deranged flesh and blood, which exhibits symptoms identical with those of a tumour {Mansjtasrayam chdrvuda laskhanena tulyam hi drish/awaih lakshanajunih). But Jejjata has rejected it as of questionable authority.

t These glandular formations appear about the root of the penis, about the sides, in the arm-pits and about the throat and the tendons of the neck.

Chap. XI.] NIDANA STHANAM. 75

But Jejjata has rejected it as of questionable authority.

t These glandular formations appear about the root of the penis, about the sides, in the arm-pits and about the throat and the tendons of the neck.

Chap. XI.] NIDANA STHANAM. 75

These knotty formations are characterised by itching and a slight pain. Some of them spontaneously burst exuding secretions while others are observed to vanish and re-appear (in succession). Such vanishings, reappearances, or fresh formations continue for a considerable time. The disease undoubtedly owes its origin to the deranged fat and Kapham, and may only be made amenable (to medicine) with the greatest difficulty lasting for years at a time. lO.

ArVUda— (tumour etc.) : — The large vegetation of flesh which appears at any part of the body, becomes slightly painful, rounded, immovable and deep-seated, and has its root sunk considerably deep in the affected part, and which is due to the vitiation of the flesh and blood by the deranged and aggravated Doshas (Vayu, Pittam and Kapham) is called an Arvuda (tumour) by the learned physicians*. The growth of an Arvuda is often found to be slow, and it seldom suppurates. The characteristic symptoms of an Arvuda which owes its origin to the deranged condition of the Vayu, Pittam, Kapham, flesh or fat, are respectively identical with those, which mark the cases of Granthis, brought about by the same deranged principles of the body. II.

Raktaja— Arvuda :— The deranged Doshas
(Vayu, Pittam and Kaphami) contracting, compressing

They resemble spawns of fish in shape and size and are due (o the action of the deranged Vayu, Pitiam and Kapham. The appearance ol such glands in the upper part of the body should be attributed to the aciicn of the deranged and aggravated Vayu. They are ixtremdy hard to cure inasmuch as their growth (formation) involves the concerted action of the morbific principles (Doshas) of the body. — Bhoja.

Charaka, who designates this disease as Gandatncild, describes its location in regions about the jawbones alone.

* That they having recourse lo the flesh, produce deep-seated vegetations (of flesh) is the reading adopted by Gayadasa and ot>iers.

76 THE SUSHRUTA SAM HIT A. [Chap. XI.