The Sushruta Samhita — trans. Bhishagratna

* 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.

and drawing the vessels (Sira) and blood (of the affected partj, raise a slightly suppurated and exuding tumour which is covered with small warts and fleshy tubercles and is called a Raiktatrvuda. This tumour is rapid in its growth and exudes a constant flow of (vitiated) blood. The complexion of the patient owing to depletive actions and other concomitant evils of haemorrhage becomes pale and yellow. The type should be considered incurable on account of its having its origin in the blood.* 12 — 13.

IVIansarvuda :— The flesh of any part of the body hurt by an external blow etc. (hurting it with a log of wood — D.R.) and vitiated in consequence, gives rise to a sort of swelling (tumour) which is called Mdnsarvuda, which originates through the action of the deranged Vdyu. It is glossy, painless, non-suppurating, hard as a stone, immobile, and of the same colour as the surrounding skin. Such a tumour appearing in a person addicted to meat diet becomes deep seated owing to the consequent vitiation of the bodily flesh and soon lapses into one of an incurable type. 14.

ProgTIOSIS :— Even of the aforesaid curable types (such as the Vataja, etc.^, the following types of Arvudam (tumours) should be likewise regarded as incurable, those which appear in the cavity of a Srota channel or an artery , or any vulnerable joint of the body and arc characterised by any sort of secretion and also immovable, should be deemed incurable. An Arvudam (tumour) cropping up on one existing from before is

* Although all types of Arvuda have their origin in the deranged flesh and blood, i)reponderant action of the deranged blood is found in Raktdarvuda^ while a dominant action of the deranged flesh marks the MAmArvuda type.

Chap. XI. NIDANA STIIANAM. TJ

called Adhyarvudam, which should be likewise deemed as incurable. A couple of contiguous Arvudam (tumours) cropping up simultaneously or one after another is called Dviarvudam, which should be held as equally incurable (with one of the foregoing types). An Arvuda (tumour) of whatsoever type, never suppurates owing to the exuberance of the deranged Kapham and fat as well as in consequence of the immobility, condensation and compactness of the deranged Doshas (Vayu, Pittam and Kapham involved in the case, or out of a specific trait of its own nature. 15-16.

Definition of Galaganda (Goitre;:— The

15-16.

Definition of Galaganda (Goitre;:— The

deranged and aggravated Vayu in combination with the deranged and augmented Kapham and fat of the locality affects the two tendons of tne neck (Manyds) and gradually gives rise to a swelling about that part of the neck characterised by the specific symptoms of the deranged Doshas (Vayu or Kapham) and principles involved in the case. The swelling is called Galganda (Goitre). 17.

Symptoms of the Dosha-orig-ined

Types : — The swelling or tumour in the Va^tajai goitre is characterised by a pricking pain (in its inside) marked by the appearance of blue or dark coloured veins Sira) on its surface. It assumes a vermilion or tawny brown hue. The goitre becomes united with the local fat in course of time, and gains in size, giving rise to a sense of burning in the throat, or is characterised by the absence of any pain at all. A Vataja goitre is rough to the touch, slow in its growth, and never or but rarely suppurates. A sense of dryness in the throat and the palate as well as a bad taste in the mouth likewise marks this type. The swelling in the Kaphaja Type assumes a large shape and becomes hard, firm, cold

78 THE SUSHRUTA SAMHITA. [Chap. XI.

and of the same colour (white). There is but slight pain and the patient feels an irresistible inclination to scratch the part. It is slow in its progress and suppuration is rare and tardy. A sweet taste is felt in the mouth and the throat and the palate seem as if smeared with a sort of sticky mucous. 18-20.

Symptoms of the IVledaja Type:—

The swelling is glossy, soft (heavy — D.R) and palecoloured. It emits a fetid smell and is characterised by excessive itching and an absence of pain. It is short at its root and hangs down from the neck in the shape of a pumpkin (Aldvu), gradually gaining its full rotundity at the top. The size of the goitre is proportionate to the growth or loss of flesh of the body. The face of the patient looks as if it has been anointed with oil and a peculiar rumbling sound is constantly heard in the throat. 21.

Prognosis : - A case of goitre attended with difficult respiration, a softening of the whole body, weakness, a nonrelish for food, loss of voice as well as the one which is more than of a year's standing should be abandoned by the physician as incurable. 22.

Metrical Text: — A pendent swelling whether large or small and occurring about the region of the throat and resembling the scrotum in shape is called a Gala-Ganda. 23.

22.

Metrical Text: — A pendent swelling whether large or small and occurring about the region of the throat and resembling the scrotum in shape is called a Gala-Ganda. 23.

Thus ends the eleventh Chapter of the Niddna Sthanam in the
Susruta Samhita which treats of the Nidanam of Granlhi, Scrofula, «lc.

CHAPTER XII

Now we shall discourse on the Nidanamof Vriddhi (hydrocele, hernia, scrotal tumours etc), Upaclansa (disease of the genital organ*, and Slipada (elephantiasis), I .

Classes : -There are seven different types of Vriddhi such as the Vataja, Pittaja, Kaphaja, Raktaja, Medaja, Mutraja and the Antra-vriddhi. Of these both the Mutraja-vriddhi (hydrocele or extravagation of the urine), and Antra-vriddhi types, though owing their origin to the deranged condition of the bodily Vayu, have been so named after the organic matters or anatomical parts (urine, iliac colon etc.) involved in them. 2.

Definition and Premonitory symptoms : — Any of the deranged Doshas (Vayu, Pittam, etc ) lying in the nether regions of the body may resort to the spermatic cords (Dhamani) and give rise to a swelling and inflammation of Phalacosha (scrotal sac) which is called Vriddhi (scrotal tumour etc.). A pain in the bladder, scrotum, penis and the waist (Kati) incarceration of the Vayu and the swelling of the scrotum, are the premonitory symptoms of the disease. 3 — 4.

The Dosha-origined Types :— The type

in which the scrotum becomes distended with Vayu like an inflated air-drum, marked by roughness of (its surface) and the presence of a varied sort of Vataja pain (in its interior) without any apparent cause is called Vataja Vriddhi. The swollen scrotum, of the Pittaja Vriddhi, assumes the colour of a ripe

8o THE SUSHRUTA SAMHITA. [Chap. XII.