Charaka-Samhita — trans. Kaviraj Avinash Chandra Kaviratna

The varieties of Piles that have been laid down (above)' are due only to the predominance of a particular fault over the two others, or of two faults over the remaining one.f 52

The vital airs, five in number (via., Prfina, Apana, Samana, Udâna and Vyana), the five varieties of bile, {viz., Alochaka, Ranjaka, Ssdhaka, Pâchaka, and Bhrajaka), the five varieties of phlegm {viz., Avalamvaka, Kledaka, Bodhaka, TSrpaka, and £leshmaka), and the three rings in the anal canal {viz, Pravahani, Visarjjani, and Samvarani), are all excited together in the production of Piles in the anal canal, S3

For this reason, Piles are very painful, and productive of various other diseases, and cause the whole body to burn with pain, and are very generally exceedingly difficult to cure. 54

The Piles of that person are regarded as incurable who has swell¬ ings in his hands, feet, mouth, anus, and the testicles, and who has pains in his chest and the flanks. 55

The following symptoms, viz., pains in the chest and the flanks, swoons or loss of consciousness, vomiting, pains in the limbs, fever, thirst, and inflammation (ending in suppuration) of the anus, kill one who is afflicted with Piles. 56

* That is, the person looks as if he has got lienteric dysentery, or chlorosis, or abdominal dropsy. — T.

f What is meant is this : all the three faults must be excited together in order to pro¬ duce piles. When, however, it is said that the piles from which a particular person suffers are characterised by wind, or by bile, or by phlegm, what is really said is that the wind, or the bile, or the phlegm has been more excited than the others. Similarly, in the ease of Piles that are said to be characterised by two faults, what is said is that the piles are characterised by two faults more excited than the remaining one. — T.

15/8

CHARAKA-SAMHITA .

Those Piles that are congenital, those that are characterised by the excitement of all the faults, and those that grow affecting the inner rings (in the anal canal), should be regarded as incurable. 57 Of a person whose digestive fire has not been extinguished, if the period of his life has not run out, Files become suppressible if treatment with its four principal incidents be had recourse to. Otherwise, the physician should not take them up for treatment.* 58 Those piles are said to be curable with difficulty which are charac¬ terised by a predominance of two faults, which grow affecting the second (or middle) ring in the interior of the anus, and which are more than a year old. 59

Those Piles which grow affecting the external ring, those which are characterised by the predominance of only one fault, and those which are of recent growth, are easily curable. 60

One that is possessed of intelligence should, therefore, direct his endeavours to alleviate them without loss of time, for, if not attended to, they close up the anal canal and cause the diseases called ‘Vaddhaguda’ and ‘Vaddhodara.’f 6*

Some say that to cut them off by instruments is beneficial for Piles ; some say that it is good to cauterize them by alkaline ashes -r some say that it is good to cauterize them by fire. ^

It is true, physicians possessed of intelligence and experience and knowledge of diverse medical scriptures treat Piles in all these three ways, but the removal of Piles by these means is productive of very great pain. 63

Through unskilfulness of operation or of the application of alkaline ashes, or of cautery, such consequences may arise as the loss of virile power, swelling (with sores) in the anal canal, the suppression of the urgings of urine and stools, flatulence of the stomach, severe ■£ula’ pains, pains in the body, hemorrhage, the re-appearance of

* This verse seems to be an interpolation. Charaka did not believe in the fact of a per¬ son’s coming into the world with a definite period of existence or ‘ayus’ as it is generally understood. The four principal incidents of treatment are I. an obedient patient, 2. an attentive or careful nurse, 3. a skilful physician, and 4. good drugs. Vide Lesson X of Sutrasthana. — T.

•j- ‘Vaddhaguda’ is that disease in which' the anal canal becomes closed ; ‘Vaddhodara’ is severe constipation of the intestines. — T.

CHARAKA-SAMHITA.

p. 1379

the Piles removed by the three surgical processes adverted to, the discharge of foetid matter from the roots of the Piles removed, prolapsus ani, or even speedy death. 64-65

I shall now speak of that treatment which consists of the use of easy means, which is productive of little pain, which involves no dangerous consequences, and which is capable of extermining the the disease by its roots. 66