The Sushruta Samhita — trans. Bhishagratna

The disease is due to the deranged condition of the blood and Pittam. 26—33.

IVIasaka (Lichen) : —The hard, painless, black and elevated eruptions on the body (skin) resembling the Mdsha pulse in shape, caused by the aggravated condition of the bodily Vayu are called Mas'aka Tilakalaka: — The black painless spots on the skin about the size of a sesamum seed and level with the skin are called Tilakalaka. This disease is caused through the aggravated condition of the Vayu, Pittam and Kapham .f Nyachcham: — The congenital, painless, circular, white or brown (Sydva) patches on the skin, which are found to be restricted to a small or comparatively diffused area of the skin, are called Nyachcham. Charmakila (hypertrophy of the skin) : — The causes and symptoms of the disease known as Charmakila have been already described (under the head of the Ars'a-Nidanam). Vyanga : — The Vayu being aggravated through wrath and overfatiguing physical exercise, and surcharged with Pittam, and suddenly appearing on the face of a person, causes thin, circular, painless and brown-coloured patches or stains. They are known by the name of Vyanga * 34-38.

* According to certain authorities it is due to the absorption of blood by Vayu and Pittam.

+ According to others the spot goes by the name of Nilikam^ if it is black-coloured and appears anywhere other than on the face*

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The Parivartika :— The vital Vayu (Vydna) aggravated by such causes as excessive massage (masturbation), pressure, or local trauma, attacks the integuments of the penis (prepuce) which being thus affected by the deranged Vayu forms into a knot-like structure and hangs down from the glans penis. The disease known as Parivartika or Phymosis is due to the action of the deranged Vayu aggravated by any extraneous factor. It is marked by pain and burning sensation; and sometimes suppurates. When the knotty growth becomes hard and is accompanied by itching, then it is caused by the aggravated Kapham. 39.

It is marked by pain and burning sensation; and sometimes suppurates. When the knotty growth becomes hard and is accompanied by itching, then it is caused by the aggravated Kapham. 39.

Avapatika :~When the integuments of the prepuce is abnormally and forcibly turned back by such causes as coition under excitement, with a girl ^before menstruation and before the rupture of the hymen and consequently with a narrow external orifice of the vagina) or masturbation or pressure or a blow on the penis, or a voluntary retention o{ a flow of semen or forcible opening of the prepuce, the disease is called Avapdtikd or paraphymosis. Niruddha-prakatsa :— -The prepuce affected by the deranged Vayu entirely covers up the glans penis and thus obstructs and covers up the orifice of the urethra. In cases of partial obstruction a thin jet of urine is emitted with a slight pain. In cases of complete closing the emission of urine is stopped without causing any crack or fissure in the glans penis in consequence. The disease is called Niruddha-prakds a which is due to the deranged Vayu and is marked by pain (in the glans penis\ 39-41.

Niruddhaguda :-The Vayu (Apana) obstructed by the repression of a natural urging towards defecation stuffs the rectum, thus producing constriction of its passage and consequent difficulty of defeca-

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Niruddhaguda :-The Vayu (Apana) obstructed by the repression of a natural urging towards defecation stuffs the rectum, thus producing constriction of its passage and consequent difficulty of defecap. 93tion. This dreadful disease is known as Niruddhagudam (stricture of the rectum) which is extremely difficult to cure. Ahiputana : — A sort of itch-like eruptions appearing about the anus of a child owing to a deposit of urine, perspiration, feces etc consequent on the neglect in cleansing that part. The eruptions which are the effects of the deranged blood and Kapham soon assume an Eczematous character and exude a purulent discharge on account of constant scratching. The Eczema (Vrana; soon spreads, and coalesces and proves very obstinate in the end. The disease is called Ahiputana. Vrishana-kachchu : — When the filthy matter, deposited in the scrotal integuments of a person who is negligent in washing the parts or in the habit of taking daily ablutions, is moistend by the local perspiration, it gives rise to an itching sensation in the skin of the scrotum, which is speedily turned into running Eczema by constant scratching of the parts. The disease is called Vrishana-kachchu and is due to the aggravated condition of the Kapham and blood. Guda-Bhransa : — A prolapse or falling out of the anus (due to the Vayu) in a weak and lean patient through straining, urging or flow of stool as in dysentery is called Guda-Bhransa or prolapsus ani. 42 — 45.

Thus ends the thirteenth Chapter of the Nidana Sthanam in the
Sus'ruta Samhita which treats of the Nidanam of minor ailments.

CHAPTER XIV.

Now we shall discourse on the Nidanam of the disease known as SukadOSha. i.

Any of the eighteen different types of the disease may affect the genital (penis) of a man who foolishly resorts to the practice of getting it abnormally elongated and swollen by plastering it with Suka (a kind of irritating water insect) and not in the usual officinal way.

Classification : — Diseases, which result from such malpractices, are knonwn as, — Sarshapika, Ashthilika, Grathitam, Kumbhika, Alaji, Mriditam, Sammudhapidaka, Avamantha, Pushkarika, Spars'ahani, Uttama, Satoponaka, Tvakapaka, Sonitarvudam, Mansarvudam, Mansapaka, Vidradhi and Tilakalak. 2.